Raising accident and emergency fee in Hong Kong public hospitals will hurt poor
Increases to fees in accident and emergency (A&E) departments in public hospitals will not deter those who can afford the higher charges.
The poor and elderly, the ones possibly most in need of hospital services, will be the greatest losers and the loss may result in a lack of medical care leading to more serious conditions arising or death. These will not appear in related statistics.
Most people attend A&E departments for a variety of reasons, one being because of their greater ability than community private doctors or clinics to treat them. Convenient hours, locations and the back-up facilities in hospitals, all may feature.
Private doctors prescribe at a high cost only what they can have in stock, without the investigative access of the A&E and many may advise their patients to go there for this reason.
The government will quote the discounts, the vouchers and public assistance as evidence that no poor or elderly person need go without medical help, but this is false. The government never undertakes surveys which might disprove its arguments.
What surveys have been undertaken to identify why people dropped out during the previous increase, their circumstances, or why the numbers have gone back up?
The emphasis is on benefiting the private medical sector and vouchers for the elderly are part of this ploy.
There are thousands of medical vacancies which new graduate numbers cannot dent or help to fill the “experience gaps” in the Hospital Authority.
The Hong Kong Medical Council introduced unnecessary restrictions which is partly responsible for a shortage of overseas-trained doctors.
These overseas doctors could provide what is needed as experienced Hospital Authority doctors leave to join the more lucrative and less stressful private sector. The restrictions help to keep up the incomes of doctors in a situation of short supply.
There needs to be a truly independent professional review of hospital and community health provision which can consider the cooperation between primary health care and hospitals.
This must include the shortcomings of the Department of Health in prevention and care in the community. This should include looking at the support for and training of care staff in homes, as well as the responsibility of a wealthy government in funding health care and supporting affordable and responsible insurance.
Piecemeal proposals do not address the health issues of the population.
Tom Mulvey, Wan Chai