Top Hong Kong eye doctor sees public-private cooperation as key to fixing lopsided health system
Dr Chow Pak-chin, vice-president of the Medical Association, seeks to improve lopsided care structure via public-private partnership
As a vice-president of the city's largest doctors group, respected ophthalmologist Dr Chow Pak-chin believes one of his missions is to facilitate a partnership programme between private doctors and public hospitals aimed at easing burdens now facing the public sector.
Programmes rolled out by the government have failed to achieve their goals because of several factors, mostly technical problems in implementation, said the 61-year-old doctor, who had championed many campaigns to eradicate blindness, especially among the underprivileged in Hong Kong and on the mainland.
The Medical Association vice-president is known to be a supporter of Chief Executive Leung Chun-ying, and was once tipped to become health minister before Dr Ko Wing-man got the job.
"Senior government officials and hospital leaders have been very eager to set up the public-private programme," Chow said.
"Private doctors are also very supportive and hope it will be a win-win situation for both sides. Sadly, there are certain difficulties in implementation that have meant the programme has not been very successful."
The city's health care service relies heavily on public hospitals, which care for 90 per cent of patients while employing just 40 per cent of doctors.
The burden on the public sector is expected to increase amid a rapidly ageing population.
One of the remedies to correct the imbalance is the partnership project, under which the government subsidises eligible public patients who use private-sector doctors in an attempt to reduce the workload on the understaffed public sector.
The most successful example involves cataract surgery. Launched in 2008, this scheme subsidises eligible patients who undergo procedures offered by 111 private-sector ophthalmologists. The subsidy is worth HK$5,000 for each patient.
The private-public pilot project cut down waiting times for eye operations from more than five years to less than two at public hospitals.
But private doctors had given a cooler response to further schemes, Chow said.
He cited a scheme for patients suffering hypertension, under which those eligible receive a total subsidy of HK$2,872 for 10 visits a year to private clinics.
The association said the subsidy should be raised to between HK$3,400 and HK$3,800, but the Hospital Authority said its stipulated sum was based on market prices.
Chow, who owns a clinic in Mong Kok, said the low subsidy had damaged incentives for private doctors to join the scheme. Only about 90 private doctors have joined it, most of them working for medical chains.
"Private doctors cover all their costs in maintaining a clinic. It would not be cost-effective for them to take on public patients," he said. "Of course, private doctors are willing to help out at this difficult time, but the authority should not take their services for granted."
The subsidy is only one of many problems that make the scheme unpopular.
Chow said that although senior public-sector staff wanted the programme to be successful, some mid-level employees and frontline doctors might not be as supportive.
"Some of them may feel great responsibility towards their existing patients and feel that moves to shift some of them to the private sector may not be good for them."
Such feelings were misplaced, Chow said. "They should understand private doctors took the same training as them, and that many were even their seniors and trainers."
Some hospitals might feel reluctant to divert patients elsewhere as the resources allocated to them were based on the number of patients they served, Chow said. Fixing the problem would require a change in the way funds were allocated among hospitals.
In addition to increasing subsidies, the authority should offer appropriate recognition for doctors willing to help, so they would feel their contributions were valued, he said.
Chow has extensive experience in community service. He was honorable ophthalmologist ambassador of a campaign called "SightFirst China Action" from 1997 to 2007 - a blindness eradication campaign recognised by the World Health Organisation.
Under the campaign, some 4.5 million cataract operations were conducted on the mainland over 10 years and several regions, including Tibet , were made "cataract-free".
Chow also initiated a campaign named Project Vision in 2005, which sought to raise funds and established 100 eye centres on the mainland.
Asked whether he wanted to become the association's president after Dr Louis Shih Tai-cho left office next year, Chow said he was not interested.
Earlier, Shih had said he would not seek re-election and he wanted one of his deputies, Chow or Dr Alvin Chan Yee-shing, to replace him.
Chow said he supported former association president Dr Choi Kin as there was an agreement in the association that Choi would be the best candidate to take up the position again.
"Dr Shih has his merits and demerits," Chow said. "His merit is that he is very selfless. He has built up an extensive personal network and is always trying to please everyone. But in the end, he pleases no one."
Indeed, Shih was caught up in a split within the association over whether to poll the sector about its views on the government's reform proposal for the 2017 chief executive election. In the end, the body did conduct a survey, but it rankled some members of the association.
The sensitivity of having to deal with political issues was one of the reasons Chow cited for not wanting to run for the top post. He also said he did not have the ability or time for the job.
