Charges for emergency medical treatment and a health-care savings fund are likely to be proposed by the Government, a senior official indicated yesterday. But the administration plans to ensure medical expenses do not exceed a 'certain percentage' of household income. Households currently spend around two to three per cent of their income on health. According to the Harvard Report on health-care reform, released in April, total domestic health expenditure in the SAR amounted to $56.2 billion in 1996/97, with per capita spending of $8,911. In order to recover part of the cost and stamp out abuse of expensive medical services, the official said, charges should apply to over-stretched accident and emergency departments and also to certain medicines. Abuse of the free emergency services at public hospitals has been a serious problem. More than 70 per cent of all patients are classified as either 'semi-urgent' or 'non-urgent' cases which clog up services for genuine emergency cases. The official said a health-care fund, under which workers set aside part of their wages for medical care, would be 'more suitable' to Hong Kong than the two insurance schemes proposed by Harvard team leader, Professor William Hsiao. The official warned that insurance would induce unnecessary use of medical services. A savings scheme would be much closer to Chinese culture as people were used to having to save for rainy days, he said. 'Professor Hsiao does not really understand the culture in Hong Kong . . . it seems that the report is prepared without thorough thinking,' he said. The official said health-care financing would only be a 'very small part' of the reform, which would include an overhaul of the services provided and a new equilibrium between the public and private sector. He rejected a proposal for an independent ombudsman to deal with medical complaints. 'We have to be clear about how much such an ombudsman can do. We still need the profession to deal with the complaints.' The health security plan proposed in the Harvard Report would cover inpatient services and specialist outpatient services for certain chronic diseases. All employees and employers would have to jointly contribute two per cent of wages to this plan. For longer-term care, the proposed Medisage programme would require both parties to jointly contribute one per cent of wages. Hong Kong health officials have visited Singapore, where a Medisave programme has been implemented for the past 15 years.