Hong Kong's medical lobby must put public good ahead of private interest

Albert Cheng says the shortage of public-sector doctors cannot be resolved until there's a level playing field for those trained overseas

PUBLISHED : Thursday, 13 February, 2014, 6:00pm
UPDATED : Friday, 14 February, 2014, 1:54am

It's a well-known fact that local public hospitals have a serious shortage of doctors. We currently have about 5,100 doctors serving at public hospitals, but they have to handle 20 million consultations per year.

With this unimaginable workload, a lack of resources, and poor working conditions, coupled with a rising demand in private hospitals due to a continuing influx of mainlanders, it's understandable that more and more public hospital doctors are migrating to the much better paid private sector.

The authority is reportedly now short of about 300 doctors, some 6 per cent of its total workforce. And just over a week ago, it was reported that the city's 15 major accident and emergency departments are struggling to meet their targets for urgent care because of a shortage of doctors.

To tackle this severe shortage, some academics and doctors have suggested that the government should require newly qualified doctors to first serve in the public health system for a designated period before being allowed to work in the private sector.

On the surface, this is a reasonable proposal to help resolve the manpower shortage in public hospitals. But, really, it's a veiled attempt by private doctors to protect their vested interests.

In reality, they are reluctant to have more doctors joining the private sector and taking a share of their interests. They want to continue with their monopoly by minimising competition from newcomers.

In fact, the Hospital Authority has taken a range of emergency measures to address the manpower issue, such as hiring retired private doctors and recruiting overseas doctors with limited registration.

Foreign doctors hired under this condition are required to pass local professional exams to qualify for local practice and can only work in public hospitals. This proposal has been vehemently attacked by private doctors.

The Medical Council of Hong Kong sets qualifying exams for local practice that make it difficult for foreign doctors to work here. The whole idea is to limit the number of overseas-trained doctors joining the local medical sector.

Obviously, with this kind of mentality, there is no way we can resolve the perennial shortage. On the other hand, the shortage serves to increase the demand for private doctors.

From 1997 to 2011, the Medical Council only issued some 150 licences to allow overseas-trained doctors to practise here. It's unbelievable and totally illogical that the number should be so low.

Our local medical landscape is operated by a monopoly and our medical professionals are all treated as kings and queens, highly regarded in society. This is, of course, a fact of life.

But we shouldn't forget that the public foots the bill for our locally trained doctors. The government has to invest millions to nurture our medical students, which is a costly public investment.

Doctors can, of course, protect their professional interests, but while doing so they can also give back to society and strike a balance between self and public interests.

During the colonial era, all doctors from the Commonwealth and those trained in those regions were automatically allowed to work here.

After the handover, the rule was changed in order to unify the system requiring all overseas doctors to pass local exams before allowing them to practise here.

The qualifying entrance exam for overseas doctors is a sound practice only if its level of assessment is the same as that used to qualify local doctors. But what we see is an utterly unfair system designed to exclude foreign talent, which in the end will hurt the general public.

Our standard of medical services is quite high, but the overall standards in other Western countries, such as the US and Britain, are definitely not inferior, which explains why our medical professionals customarily choose to further their studies overseas.

What about those Hongkongers who are forced to study medicine overseas because of a shortage of university places here? Would they be considered outsiders and forced to go through the same prejudicial exam treatment before being allowed to come home and work here?

We shouldn't turn a blind eye and allow a small group of people to manipulate the situation in the medical sector for personal gain.

We shouldn't tolerate a professional monopoly that hurts public interests and endangers public health and safety.

We must salute all public doctors who insist on staying on to serve the public despite the harsh working conditions. Their commitment and sacrifice should be recognised and their pay and working conditions should be improved accordingly.

Albert Cheng King-hon is a political commentator. taipan@albertcheng.hk