Cataract surgery waiting time should be addressed

PUBLISHED : Monday, 01 December, 2008, 12:00am
UPDATED : Monday, 01 December, 2008, 12:00am

Ten years must seem like a lifetime to wait for surgery that will make a real difference to one's quality of life, particularly for older people who need operations for cataracts. Years of impaired vision that can be easily corrected is not a price anyone should have to pay for growing old. Sadly this is the case in Hong Kong, where more than 50,000 patients are on waiting lists for cataract operations at public hospitals. The average waiting time is two to five years, evidence enough that resources such as the number of eye doctors do not meet the demands of a growing and ageing population.

The extent of the problem has been highlighted by the extreme plight of new cataract patients at United Christian Hospital. After they have waited nearly 21/2 years for a first appointment at the hospital's eye clinic, patients are being told that they will have to wait nine or 10 years for their operation. An alternative is to accept a HK$5,000 government subsidy towards the cost of surgery by a private doctor, which leaves patients to find up to HK$8,000 from their own pockets.

Thankfully, as we report today, the Hospital Authority has directed the Kowloon East cluster, to which the hospital belongs, to take action from next year to shorten the wait and has promised funds to hire more doctors. However, this is at best a band-aid for a problem set to worsen with population growth and ageing. A more effective approach is to be found in plans by the authority for funding reform for its 40 hospitals from next year.

The new model, called case-mix funding, will replace allocation of resources among clusters and hospitals according to population. The present system is inefficient because it does not take account of differences in the demand for treatment between hospitals. Districts with older populations, for example, have different disease profiles and resources needs than those with younger residents. The backlog for cataract surgery at United Christian Hospital is a case in point. Funding targeted at disease patterns promises to improve delivery of health care and give better value for the HK$30 billion distributed to hospitals each year.