Self-interest is standing in the way of a vital cure

PUBLISHED : Wednesday, 09 November, 2011, 12:00am
UPDATED : Wednesday, 09 November, 2011, 12:00am


The exodus of public hospital doctors is not only threatening the well-being of patients, it is also causing a firestorm of controversy in the medical community. It's not hard to fathom why. It boils down to private-sector doctors protecting their own interests under the guise of preserving medical standards. They are fighting tooth and nail against the Hospital Authority's stop-gap measure of recruiting doctors from overseas and exempting them from the local licensing examinations.

In RTHK's City Forum programme on Sunday, Dr Tse Hung-hing, a member of the Medical Council and a spokesman for the interests of local private-sector doctors, vociferously opposed such a move.

Legislator Dr Leung Ka-lau, who represents the medical sector, went further: he denied there is even a shortage of doctors in public hospitals. According to him, any problems have been caused by the authority's mismanagement of resources. He said the number of public doctors has increased by 40 per cent in recent years, while hospital stays have fallen due to advances in medical technology. The shortage of doctors is thus a mismanagement problem, he said, and importing doctors will not solve the problem. He pointed out, for example, that hospitals in western Hong Kong Island received more in public resources than hospitals in some other territories, and this led to lengthy waiting periods in certain areas.

On the surface, such views appear reasonable and logical. In fact, they are anything but.

First, the quality of health care in Hong Kong ranks among the best in the world, but this is not because only Hong Kong-trained doctors are capable of treating patients. In fact, many Hong Kong doctors were trained overseas. If we follow the opponents' logic, even professor-level doctors or Nobel-winning doctors would need to pass local licensing exams.

Also, they forget that overseas-trained doctors would only be working in public hospitals, not in private practice. In no way would they impinge on the basic interests of local private-sector doctors. Imposing licensing exams on them is nothing more than members of the medical lobby guarding their own fiefdom against any foreign encroachment.

Tse was right when he said that back in the 1960s, when faced with a huge influx of mainland refugees, the colonial authorities permitted mainland doctors to practise a limited form of medicine, subject to them passing an exam. But he omitted to mention that the same colonial government exempted all Commonwealth-trained doctors from licensing exams. Is he saying that standards in Commonwealth countries have declined sharply, and we need to be protected against substandard practitioners?

On the other side of the issue, the University of Hong Kong's dean of surgery, Dr Lo Chung-mau, pointed out that, in recent years, there has been a substantial reduction in doctors' hours. That means more have to be hired. It is only by hiring more doctors and making medical duties less onerous that public doctors will be dissuaded from joining the more lucrative private sector.

Leung's misallocation argument doesn't hold water, for the simple reason that hospitals in Hong Kong Island west take on both teaching and patient-care responsibilities, and therefore deserve a greater share of the resources.

It's true that importing overseas-trained doctors is only a band-aid solution. For a long-term solution, more resources must be pumped into the public system. But the dire situation is crying out for stop-gap measures. Only self-serving doctors would stand in the way.

Cheung Tak-hei, a patients' rights advocate, said it best: 'What patients care for most is to enjoy medical care without delay.'

The medical lobby's squabbling is putting patients' lives and health at risk. Private-sector doctors would be well-advised to put the public interest ahead of their own. Public interest should always trump personal interest.

Albert Cheng King-hon is a political commentator.