A controversial plan to introduce a two-tier ranking system for public doctors is too aggressive and is a backdoor cost-cutting measure, a concern group says. The Medical and Health Care Forum says the change is 'harmful and demoralising'. Hospital Authority chiefs have proposed dropping a tier of the present three-tier system - comprising consultants, senior medical officers and medical officers - to make two-tiers, specialists and residents. The move would follow an overhaul of doctors' salary packages, which would include pay cuts for some. The authority says the reform will improve professionalism because specialists will be responsible for service quality and supervision of residents. But forum spokesman Professor Dennis Lam Shun-chiu said the shake-up would create unrealistic public expectations. 'Patients may walk in and demand a specialist treat them and once they find the doctor is only a resident, they will complain. It will pose tremendous pressure on the specialists,' he said. It also would demoralise non-specialists, who would be downgraded to 'trainees', he added. In its submission to the authority, the forum said a professional-led system was the right direction, but premature. The group estimates that for adequate supervision of residents, the authority will need to hire at least 2,000 more junior specialists in the next three to five years. However, it said the plan was unlikely to materialise because of the financial crisis. 'While the Government is still mapping out the health care reform, and while resources for the health care system are shrinking, it would be better to wait and see,' Professor Lam said. He claimed the proposal was a cost-cutting measure rather than a bid to uphold quality of service. The Medical and Health Care Forum was set up recently by more than 40 doctors from the private and public sectors. The group aims to provide comment and direction on medical and health development. Academic experts in economics and management have been invited to act as advisers.