Public-private hospital for children

PUBLISHED : Friday, 22 October, 2010, 12:00am
UPDATED : Friday, 22 October, 2010, 12:00am

Hong Kong's first children's hospital will be a public-private venture in which private doctors will be allowed to treat patients under a regulated structure of fees and charges.

Medical academics will also have a role in the running of the 468-bed Centre of Excellence in Paediatrics, which is to offer a child-friendly environment with rest areas for families, Sandra Lee Suk-yee, permanent secretary for food and health, said.

The centre will be built on a site of 22,300 square metres in the Kai Tai development area and is expected to be operating by 2016.

The government says the new model, which was first proposed in the 2007 policy address, will put the advanced treatment of complicated diseases, professional exchanges, and research and teaching all under one roof.

Difficult areas the new hospital will target include cancer, neurosurgery and rare congenital or developmental diseases.

Lee said that while the centre would be a public hospital under the Hospital Authority, its operations would be overseen by a board of representatives from the authority, private doctors, the two medical schools, related non-governmental organisations and patients' groups. 'This centre is very new to Hong Kong,' Lee said. 'The governance model has yet to be worked out. We cannot use the traditional way of doing things.'

Patients referred by public hospitals to the new centre will continue to pay the public charge, HK$100 a day, while patients from private doctors will be charged at regulated private rates.

'We don't have a final plan for the private charges,' Lee said. 'The mechanism is similar to having a charging policy for existing private services at public hospitals.'

The government steering committee set up for the centre is working on criteria for patients and doctors who can use the services, and the fees and charges for private patients.

Doctors who practise at the new centre will have to agree on some clinical protocols.

Some of the 1,450 public paediatric beds across various hospitals will be moved to the new centre.

Dr Tse Hung-hing, a private paediatrician and former president of the Hong Kong Medical Association, said the hospital should not set any private charges.

'Market prices are always fair prices,' Tse said. 'Private doctors may not want to bring patients to the new centre if their prices are capped. They can admit patients to other private hospitals. If doctors charge too much, patients will go away, the market can regulate itself.'

Patients' Rights Association spokesman Tim Pang Hung-cheong is concerned about the possibility of conflict of interest among doctors at the centre. 'If a public doctor can do private services there, he may have the incentive to ask a public patient to become a private patient and pay the private rates; there must be a mechanism to avoid this,' Pang said. As the hospital involves members from various sectors, there is also concern within the medical profession that it will become a venue for keen resources competition, especially among the two medical schools.

Chinese University's dean of medicine, Fok Tai-fai, a professor of paediatrics and member of the steering committee, appealed for stakeholders not to adopt a 'territorial mentality'.

'The two medical schools have to work together. There should not be professional arrogance or a territorial mentality,' Fok said.

Parents at public paediatric wards often complain of a lack of places to rest or to accompany their sick children during admissions. Government focus groups have found parents and health care workers want a 'friendly and playful' environment for children, and better support for patients' families. Apart from the general wards, the new centre will have 12 operating theatres, 30 neonatal intensive care beds, 28 paediatric intensive care beds and 50 day beds. Children will have a learning space to continue their education during their stay.

Health officials have visited children's hospitals in Singapore, Britain, Germany and Australia during their planning for the hospital.

'We have learned from some overseas experience,' Lee said. 'For example, similar centres in Singapore have very flexible infection- control measures. There are single wards used for daily consultations, and these rooms are turned into infection-control wards if there is an infectious disease outbreak.'


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