Why did a public hospital ask the family of a woman seriously injured in an accident to pay almost HK$22,000 before doctors could treat her? To stop internal bleeding, the patient needed an expensive drug that was not on the list of those available for general use. The hospital was right to point out the availability of the drug, normally used to treat haemophilia, that could help stem the bleeding. But staff obviously felt they could not authorise its use even in a life-or-death situation. The Hospital Authority described it as a 'grey area'. Thankfully, the hospital will refund the money to the family.
Hopefully, this case will help highlight the more general issue of how funding cuts have resulted in patients being denied optimal treatment. The problem is serious but has not received sufficient public attention.
It was not that long ago when public health-care patients had to wait a long time to see a doctor. Indeed, Hong Kong's health care provision was unimpressive throughout the 1980s and not in step with the growing wealth of the city.
When the Hospital Authority was set up in 1990, although substantial funding was provided, it had the daunting task of dealing with decades of policy neglect. Solid improvements were nevertheless made in public health care. Yet, a decade later, the authority was a prime target for major funding cutbacks. There seemed to be two reasons for this - low-cost public medicine was seen as 'welfarism', and the private sector was concerned that the public sector was taking away business.
The consequences were dire, but not well known to the public. For example, in 2000, the government announced that financial restrictions would be placed on a range of drugs and treatments, including for hepatitis, breast cancer, multiple sclerosis and leukaemia. The supply of pacemakers was also restricted. Poor patients could apply to charitable funds to help them pay. But it is not easy for a disadvantaged patient and his or her family to deal with such a set-up. Anecdotal evidence suggests that the poor get further impoverished to finance treatment.
With the city's continuing financial woes, health care funding has had to be cut further. By 2003, funding and staff levels had been severely cut, leading to longer waiting times and worsening services for patients.