THE Government must first define its health policy and targets before it decides how it is going to pay for Hong Kong's future health care system. That is the view of the Legislative Council's medical constituency representative Dr Leong Che-hung, who has put together a sixth option to add to the five proposals on health financing in a new government consultation document. ''The Government has got it the wrong way round,'' he said. ''It must first define its health policy before looking at financing.'' Dr Leong said his option would draw a line between essential services - to be provided free - and non-essential services, for which the user would pay the whole or partial costs. He said his proposal could fit quite comfortably alongside the Government's favoured options of lower bed cost subsidies, waivers for targeted groups, itemised charging and voluntary insurance. However, it would be much more comprehensive than any of the consultation paper's proposals, because it would include defined health targets and a government pledge to provide health care to a stated standard. The five consultation proposals also include introducing compulsory medical insurance for all and treating high priority conditions, neither of which is favoured by the Government. ''This is supposed to be 'Towards Better Health','' he said, pointing to the consultation paper's title. ''But the only thing it talks about is how to increase fees. ''It's supposed to be about choice. Can you find any choice in this document except how to pay?'' Dr Leong said the 1974 White Paper on health pinpointed the shortage of doctors, hospital services and beds as targets for change, for instance. The result had been several hospital building projects and the establishment of the Chinese University's Faculty of Medicine. ''That was nearly 20 years ago, so what do we see for Hong Kong's health system over the next few years?'' he asked. Possible future health targets could include heart disease or cigarette smoking. The Government should also decide what standard of health care it was willing to provide for Hong Kong. ''Does it want Hong Kong to move into the sharp forefront of medicine or does it just want a reasonable level of health?'' he said. ''The Government must decide how far it is prepared to go. For example, one heart transplant costs $3 million - and that is enough to immunise everybody for Hepatitis B.'' Dr Leong said the health targets and standards should be used to draw a line to indicate the Government's health commitment. Below this line, the Government would pay, above it, the user would pay. Dr Leong said this would mean that urgent cases, such as accident victims, would be treated free. Those requiring a non-essential service, such as cosmetic surgery, would pay in one of four ways. They could pay out of their own pockets, by voluntary insurance, by a comprehensive, compulsory medical insurance scheme or, in the case of public assistance recipients, the elderly, disabled and long-stay patients, by government waiver. Dr Leong said he believed those who could afford to pay should do so, provided there was help for society's poorer members. The consultation period on the Government's proposals will end next month.