The public-private health alternative

The development of private medical care to complement overburdened public services should be the new health-care model for the city, according to a senior Hospital Authority executive.

Fung Hong, chief executive of the authority's New Territories East Cluster, said it would be a good idea if Chinese University set up its own private hospital to work with Prince of Wales Hospital, its teaching centre.

Prince of Wales is the major acute case hospital in the cluster. Earlier this year it opened a private medical centre where the university's doctors provide 40 to 50 consultations a day to patients at market rates.

Dr Fung said Chinese University was a 'famous brand' and many patients sought consultations from its experts.

'Some of our patients come from other districts and there are also overseas visitors. But at this stage, private medical care is not our core service under the existing government policy. We only provide very limited private services to patients who want the service and can afford it, such as those who have medical insurance coverage.'

He said in the long run, it would be a good idea for the university to set up a self-financed private hospital as its own teaching hospital.

'Such a partnership model in Australia, for example, has proved a success. This model is definitely an advantage to the whole health-care system - the two hospitals can complement each other.'

He said while a public hospital could provide more comprehensive services, including those that did not make large profits, a private hospital could provide profitable hi-tech medicine and health assessment services, and become an international medical centre that could attract overseas patients. 'Whether we are going for this direction will depend on the government policies and what the public wants. The Prince of Wales Hospital is ready for it.'

Chinese University's dean of medicine, Fok Tai-fai, said the collaboration model was worth studying further.

'But building a private hospital is not an easy task at all. We need the blessing of the government.'

In the face of financial difficulties, the cluster is also making efforts to control its drugs budget. The Hospital Authority last year standardised the drugs lists for all public hospitals. It also identified drugs that patients could buy themselves.

The cluster spent $300 million on drugs last year, with antibiotics alone costing $42 million.

Dr Fung said since the introduction of the drug formulary and an audit programme on the use of antibiotics, the cluster's drugs budget, which had been growing by 10 to 12 per cent a year, was frozen for the first time this year.

Meanwhile, the 22-year-old Prince of Wales Hospital, which has suffered from flooding, fallen concrete and water leakage, will be redeveloped with better infection-control facilities under a 15-year plan. The Hospital Authority board will discuss the plan at a meeting today. The authority said the hospital had been burdened by a sharp increase in the population of New Territories East, from 203,000 in the mid-1970s to 1.3 million today.

The authority said heavy use had led to rapid deterioration in services. The shortage of clinical space and lack of infection-control facilities struck the hospital most during the Sars epidemic.

New Territories East Cluster

Prince of Wales Hospital, North District Hospital, Alice Ho Miu Ling Nethersole Hospital, Tai Po Hospital, Shatin Hospital, Cheshire Hospital (Shatin), Bradbury Hospital

Population: 1.3 million

Number of beds: 3,866

Number of staff: 8,800 (including 200 or so university medical staff)

Bed ratio: 3 per 1,000 people