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Wrong diagnosis in editorial's prescription for doctor shortage

Your editorial "Ease limit on overseas doctors (October 6)" is mostly typical of the health-care coverage of your newspaper: short, shallow and populist.

Health-care provision is complex, involving many compromises - most obviously between quality, quantity and cost - and is not generally cured with a single simple prescription such as in your editorial offers.

To paraphrase your editorial: private doctors are protectionist, therefore the Hospital Authority is short of doctors. It's true that private doctors are protectionist, but it's not true that simple protectionism is the reason for the Hospital Authority's shortage.

There is no absolute shortage of doctors in Hong Kong; Hospital Authority doctors have simply voted with their feet.

One possible solution is for the Hospital Authority to provide better conditions - a mix of professional satisfaction, career opportunity, pay and other factors - to attract and retain the staff they require.

Another possibility is for the government to fund primary care properly, so that patients go to the many primary-care physicians who are already available and allow the Hospital Authority to concentrate on the secondary and tertiary care for which it was designed.

There are many other options.

Overall manpower planning and the conditions for foreign-trained doctors to practise in Hong Kong are the subjects of much more extensive debate - it cannot be discussed in isolation from the overall structure of our health-care system.

Bringing in a few overseas doctors to replace the Hospital Authority shortfall will simply result in the new doctors leaving, like their predecessors, unless they are tied to their jobs by restrictive visa conditions, much like domestic helpers. This is different, of course, if you actually envisage flooding Hong Kong with so many foreign-trained doctors that both local and foreign-trained doctors will take any job regardless. This would be easily done - there are over two million doctors in China - and many are poorly paid and dissatisfied, and would love to come to Hong Kong.

Is this what you mean by the delightfully/quaintly/chillingly Orwellian "the government should exercise authority and leadership in the interests of patients"? Please explain further in sufficient detail to constitute an actual proposal. This would require a dedicated team of experienced journalists and a series of long articles but would certainly be in the interests of patients. I eagerly await your response.

This article appeared in the South China Morning Post print edition as: Wrong diagnosis ineditorial's prescription for doctor shortage
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