Health care scheme does not resolve manpower shortage in medical sector

Albert Cheng says the voluntary health protection scheme should be shelved and the money injected into the public health-care sector

PUBLISHED : Friday, 01 November, 2013, 12:08am
UPDATED : Friday, 01 November, 2013, 1:01am

Hong Kong's medical services and public health expenditure are among the most hotly debated social issues by people from all walks of life. With a rapidly ageing population, government spending to address relevant issues has understandably been on the rise.

In a bid to rid itself of a colossal financial burden, our government, which has been obsessed by the principle of "big market, small government", has decided to introduce a voluntary health protection scheme and encourage Hongkongers to purchase their own medical health insurance.

Eventually, it is hoped that the majority will switch to the private health sector in order to lessen the load on the public health system.

I have always opposed the idea of privatising health care services and the so-called voluntary health protection scheme. The reason is simple. All Hongkongers are entitled to public health care, as they are to public housing.

Furthermore, our public health care expenditure is not expensive as it amounts to less than 5 per cent of our gross domestic product, which is far less than the average 8 per cent of developed countries. Even though we have to tackle an ageing population and an increased expenditure as a result, public health care spending shouldn't pose any significant problem.

Besides, Hong Kong's public health care standard is remarkably high and is ranked as one of the best in the world. If a system is well-run, and has been proven to be extremely successful, there is absolutely no reason why we should change or replace it.

Recently, Secretary for Food and Health Dr Ko Wing-man endorsed the idea of a voluntary health protection scheme.

His support came at a time when deep-rooted problems arising from both public and private health care remain unresolved.

One major problem is private hospitals poaching staff from the public sector, depriving public hospitals of manpower and raising the risk of more medical mishaps and blunders. The problem seems to have worsened as our medical system has been stretched by the influx of mainlanders using our medical services in both the private and public sectors.

As a result, the middle class has been pushed out by wealthy mainlanders and is unable to use private medical services. In other words, even if the government pumped in HK$50 billion to subsidise the middle-class to buy health insurance, middle-class people may still be unable to enjoy the services.

Mainlanders snapping up medical services is not something new. It first happened a few years ago when mainland pregnant women came to local public hospitals to give birth and exhausted the quotas, leaving local mothers with no hospital beds.

Before the ban on non-local mothers giving birth in Hong Kong became effective, private gynaecologists were in great demand. Today the door may have been closed on pregnant mainland mothers, but mainlanders' demand for other medical services continue to rise.

So if we did go ahead with the voluntary health protection scheme, it would do more harm than good.

Instead of wasting his time on mapping out business strategies for his friends in the private medical sector, it would be more constructive for Ko to fix the public health care system. The HK$50 billion medical fund proposed by the government should be injected into the Hospital Authority to boost manpower and improve existing facilities and services.

To resolve the perennial manpower problem in the public health care sector, besides improving pay and working conditions, we must break the monopoly and allow the recruitment of qualified overseas doctors. Qualified foreign doctors should be allowed to work in public hospitals without having to be vetted by local exams. First and foremost, we should accept locals who have qualified overseas.

This bold step forward would immediately resolve our long-standing manpower shortage problem. Unfortunately, there has been a strong counter force created by local private doctors who have been monopolising the market.

We would do well to follow in the footsteps of Singapore. Its medical council has drafted a list of medical schools recognised by the government and graduates from any of these schools are allowed to practise in the island state. Hong Kong should do the same and allow graduates from recognised medical schools to practise freely in Hong Kong after serving in the public sector for an agreed period of time.

If Ko really has our best interests in mind, he should open the door for overseas doctors to join the public sector.

As for the voluntary health protection scheme, we can just shelve it indefinitely.

Albert Cheng King-hon is a political commentator.