Private Hong Kong doctors stay away from public subsidy scheme for hypertension patients

They say Hospital Authority subvention for hypertension patients fails to cover costs

PUBLISHED : Monday, 01 September, 2014, 5:55am
UPDATED : Monday, 01 September, 2014, 7:57am

Private doctors are unhappy with a scheme that subsidises some public-hospital patients for treatment at private clinics in an effort to ease demand in the understaffed public sector.

The public-private partnership project, now running in Wong Tai Sin, Kwun Tong and Tuen Mun, provides hypertension patients with a subsidy of HK$2,708 for 10 treatments a year at a private clinic.

But only 80 of more than 400 private practitioners in these areas have joined the scheme since it began in April as many are in dispute with the Hospital Authority over the size of the subsidy.

The Medical Association, the main doctors' union, said the authority should not be the party that sets the market price.

"There is a conflict of interest when the authority is the one which distributes the public resources between themselves and the private doctors," association president Dr Louis Shih Tai-cho said. "The subsidy amount is too low to cover the consultation fee and cost of drugs."

The authority's chief manager for service transformation, Dr Choy Khai-meng, said they had attracted sufficient doctors to the scheme. But he defended the funding as fair and just.

The project is aimed at taking 30,000 hypertension patients out of public hospitals in the three districts to provide more capacity for patients needing urgent treatment. It costs the authority an average of HK$385 a visit to treat patients with the chronic condition at public hospitals.

But the subsidy for selected patients works out at HK$270.80 a visit at private clinics. The fee includes the same medicine as that prescribed in public hospitals.

Shih said the scheme was unpopular among private practitioners as the authority had refused to increase the subsidy and half of those who joined worked for medical chains.

He said the association had withdrawn from a deal to promote the scheme for the authority after several "fruitless" meetings.

The clinic of former association president Gabriel Choi Kin in Wong Tai Sin did not sign up for the scheme. The specialist in nephrology said he charged a hypertension patient HK$350 per consultation excluding the cost of medicine.

It included measuring blood pressure, checking kidney and heart function, a urine test and advice on dieting and exercise.

"I offer a much more comprehensive and high standard of medical check-up than that in public hospitals, and this is the price I have to charge," Choi said. "I would not allow myself to offer a service of lower standard just to fit in with the fixed charge set by public hospitals."

But the Hospital Authority's Choy explained that the cost for private doctors to treat these patients should be less than the cost at public hospitals as only patients in stable condition would be selected to join the scheme.

The programme will be reviewed in a year when a decision will be made on whether to expand it to other districts and cover other chronic illnesses such as diabetes.