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38pc of those eligible use health voucher in 18 months

A vicious circle of lukewarm reactions from doctors and patients might be to blame for the low participation rate of the health care voucher scheme for the elderly.

The latest Department of Health statistics show that in the 18 months since the launch in January last year, only 38 per cent of eligible people have used a voucher and only a third of doctors have signed up.

While some doctors said they did not want to pay for computers to process the electronic vouchers, patients said they could not use vouchers as their doctors were not taking part.

The government is to conduct an interim review of the scheme in the coming months.

As of May 30, half of the 670,000 eligible elderly had enrolled in the scheme, and only 38 per cent had used a voucher, the department said.

The scheme, being tested for three years, provides five HK$50 electronic vouchers a year for people aged 70 or over to be used in participating private clinics.

The government hoped it would encourage patients to switch to private health care, easing the heavy imbalance between the public and private sectors.

But only 2,645 health care service providers - such as doctors, Chinese herbalists and nurses - joined the scheme. Among them are about 1,800 doctors - less than a third of the city's 6,000. At least 148 service providers withdrew after enrolment and most have not said why.

An 82-year-old Tsz Wan Shan woman said she had not used a voucher as her doctor was not enrolled and nor were the two other clinics closest to her home. 'If I need to travel far to see a doctor, I may as well go to a public clinic,' she said.

Gerontologist Dr Paul Shea Tat-ming, who did not join the scheme, said some doctors were unwilling to sign up because the enrolment procedure was complicated.

'Private doctors would like to keep their administrative costs low,' he said.

'Participating in the voucher scheme might mean hiring more manpower to do the paperwork.'

Some clinics did not have computers, meaning that they would not be able to launch the electronic voucher system, he added. Another reason for the lukewarm response from doctors was that the annual subsidy of HK$250 per person was too low.

'A consultation at a private clinic costs at least HK$200,' Shea said. 'Even with a voucher of HK$50, a senior citizen still needs to foot three-quarters of the bill,' he said.

To make the scheme attractive, he said the government should at least increase the total subsidy to HK$800.

As of May 30, 1,527,340 vouchers have been used, involving a total amount of HK$76.4 million.

A total of 64,943 senior citizens have already used all the vouchers they are entitled to this year.

The government is carrying out a public consultation on how the scheme could be improved, and an interim review will be carried out later this year.

Patients and doctors have mainly called for an increase in the subsidy, and the lowering of the eligibility threshold to 65 or 60.

If the total annual subsidy were increased to HK$1,000 per person, it would cost the government an extra HK$683 million a year, according to a paper presented to the Legislative Council.

If the minimum eligible age were reduced to 60 and the size of the subsidy remained unchanged, HK$332 million more would be spent.

Adding up

As of May 30, 1,527,340 vouchers have been used, resulting in government spending of, in HK dollars: $76.4m

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