I read with interest the letter by Thomas Yiu written on behalf of the Secretary for Health and Welfare, Yeoh Eng-kiong, ('Health reforms based on decisive timetable,' South China Morning Post, May 31). Regrettably this opinion is based on the culture of hospital-based, hi-tech medicine. It is a view that seems increasingly to want to quash private practice, instead of regarding private practitioners as a valuable and under-utilised public resource. After all, we too were educated at public expense, though we now cost the Government nothing, and provide 85 per cent of the primary health care in Hong Kong.
As people age and retire, their health costs rise as their income falls. This particularly applies to the cost of medicines and tests needed to manage their chronic health problems such as diabetes, hypertension, and cardiovascular disease. What they do now have is time, so they opt to spend hours on end in government hospital clinics, where they are seen by over-busy and often poorly supervised junior doctors, a different one on every visit, and pay next to nothing. These clinics are now so busy with these primary care problems that they cannot deal with those cases that really need specialist hospital management. Meanwhile, private practitioners have more and more time on their hands.
No health-care reform in Hong Kong will work unless it regards all trained doctors as a single valuable resource, and includes the private practitioners in its plans. A simple system should be introduced for individuals with chronic illnesses needing long-term treatment to register with one doctor of their choice. These patients can get their medicines and essential tests prescribed by this doctor, at the same subsidised rate as they would get them from the hospital. The patients would surely get much better care than they do from the hospitals at present.
This would then remove the cost of medication and essential tests from the equation. In return, the Department of Health can insist on the standards of care and training of these doctors. The patients would of course negotiate their fee with their doctor as they do at present. Pressure would be taken off the hospitals, which could then concentrate on what they are supposed to be doing.
Public Health-Care in China