Stand up for our overseas doctors

If we have an illness or symptoms that call for further investigation, we expect to be referred to a specialist. Since most patients consult front-line hospital doctors, the public system needs adequate specialist resources to meet demand. Unfortunately, amid a chronic shortage of hospital doctors, getting a referral can be the easy part. Seeing a specialist can take much longer. It is disturbing therefore that a programme to recruit overseas-trained doctors has been unable to retain at least three of the 11 specialists currently working under the scheme because of local licensing rules.

Skilled expatriates come and go. As an international city Hong Kong does not usually have difficulty replacing them. But barriers to entry make medical practice an exception. The Hospital Authority has about 250 vacancies for doctors, partly because of defections to the lucrative private sector. The shortage is most critical for more experienced specialists.

The loss of these specialists highlights yet again the question of whether the licensing regime is serving the best interests of patients.

One of the three, an Australian who has worked in a public hospital on Hong Kong Island for two years on special licence valid for a year at a time, is returning home rather than seeking permanent registration by sitting a three-part examination and serving a 12-month, low-paid internship.

Given that specialists complete several years of training after becoming doctors, his objection to the Medical Council's rules does not seem unreasonable. To be fair, the council has tried to relax some of the barriers. The stance of the main doctors' union, the Hong Kong Medical Association, is less flexible and more consistent with maintaining a closed shop. The association has cited the need for local working experience and the lack of reciprocity with other countries as reasons for opposing liberalisation. It is hard to reconcile such concerns with patients' best overall interests. If the main stakeholders can't agree on them, the government should be prepared to stand up for them.