Market forces benefit doctors as well as malls

PUBLISHED : Saturday, 14 November, 2009, 12:00am
UPDATED : Saturday, 14 November, 2009, 12:00am

Benign militancy is a contradiction in terms. But it sums up the action of doctors who joined the protest by Link mall tenants on Thursday. The three-hour shutdown involved neither loss of income nor inconvenience to their patients, because it fell largely during their usual lunch break. It therefore lacked the elements that tend to grab people's attention - self-sacrifice and annoyance to others. It is good that patients were not affected, but the approach by the doctors does not suggest much conviction or belief in their cause.

Two hundred doctors joined the protest because they claim they will have to raise their fees if their landlord, The Link Management, raises rents again. That conjures up concerns about poor patients being unable to afford medical services. But a survey of clinic fees by the South China Morning Post shows that many public estate doctors already charge patients as much or more than those in nearby commercial buildings. The survey of four districts found they charged HK$150 to HK$250 for a consultation plus basic medication, compared with HK$180 to HK$250 charged by others in the same area. This, at least in part, reflects The Link's policy of progressively raising rents - previously subsidised by the taxpayers - towards commercial rates since the government privatised the malls. There is nothing wrong with doctors' fees also rising towards market rates. That was to be expected as The Link upgraded the malls.

But doctors still point out that before privatisation, estate clinics traditionally provided low-cost services on Housing Authority estates, and that further fee rises may drive patients away. This may be the case for a time, although it is far from clear they would have to pass rent rises on. Like their industrial action, this complaint carries a whiff of hypocrisy, given that private doctors strongly defend their own right to charge market rates for rendering public-service health measures such as flu inoculations.

That said, it is not surprising that the doctors, along with other long-standing tenants, have not found it easy to let go of subsidised rents. But they should not forget what they were being subsidised for in the past - tenancy in run-down, badly managed malls that were no competition for shiny new private retail developments. It is a reminder that the government has no business operating commercial services such as shopping malls, even on Housing Authority estates. The improvements wrought by a few years of commercial operations greatly benefit mall users who, after all, are the core market for the doctors' services. If doctors fear loss of business through raising their fees to cover another rent rise they can look for alternative, cheaper rooms nearby that are still convenient for their patients. That will test The Link's view of market forces.

Hundreds of Link mall doctors previously operated in a sheltered environment that did little to encourage them to market themselves as modern family practices, or to undertake further study so they could provide added value such as specialist family medicine skills. That is not in the long-term interests of patients, or in the spirit of the government's vision of a key role for family doctors under plans for reform of health services.

The dispute involves hundreds of housing estate doctors. The four medical groups concerned have reached agreement on rent and the principle that they should pay market rates. The 200-odd holdouts should recognise that ultimately everyone is better off for the privatisation of Link malls - including their patients - and leave pricing to the market.