When chief executive-designate Leung Chun-ying promised to exclude mainland mothers without Hong Kong husbands from private hospital maternity wards, he touched a sensitive public nerve. The outgoing administration has proved numb to it, pressing ahead with negotiations for 20,000-25,000 mainland babies to be born in private hospitals in 2013 regardless. As a result, Leung has felt compelled to go back on a promise not to comment on policy matters before he is sworn in, and reiterate that there will be a birth quota of zero next year for these mainland women to ensure access for local women.
The current administration remains in charge and private hospitals need to know where they stand next year. But Leung has made the issue a top priority after a very positive community reaction. Many Hong Kong mothers cannot compete financially with mainland mothers, who are prepared to pay whatever it takes to secure a maternity bed. Public anger and resentment is, therefore, very strong and Leung had no real alternative but to respond to that.
Nonetheless the sudden policy announcement has surprised private hospitals, which had expected a gradual reduction in quotas for mainland mothers. At the end of the day, Leung's proposal is a populist measure that treats a symptom of a wider problem - the lack of a strategy for improving health care.
The system is a voracious drain on public funds that increasingly struggles to meet the expectations of an ageing population. Blueprints for reform of health-care financing and delivery have been on and off the agenda for 20 years. They have been shelved for want of community consensus and political will. As a result, we are a wealthy and advanced society that not only lacks a vision for medical services, but also for a fair and competitive education system and a sustainable supply of affordable housing.
Hopefully, the mainland-mothers saga will lead to a comprehensive debate among all stakeholders on how to improve medical care, for a start. Leung should use the political momentum the issue has given him.
Hong Kong has a public health system that is the envy of many countries. To allow the influx of mainland pregnant mothers without imposing some limits could place intolerable strains on it.
But Leung's plan will be controversial with a private medical sector that has invested heavily in expanding obstetrics services. He should commit to embarking on a major programme to increase the number of hospital beds and expand nursing care, so that in the future the zero- quota policy can be reviewed and probably relaxed.