There will be no funding cuts but the city's 40 public hospitals will be expected to improve patient care under funding reforms to be introduced soon, Hospital Authority chief executive Shane Solomon has said. The reforms, which involved a new pay-for-performance system, were about strategic purchasing of services that were most needed by the community, Mr Solomon said. A major component of the new system is case-mix funding, where the provider is paid for each case treated, adjusted for the complexity of the case, using a pre-set classification and price list. The Hospital Authority has been conducting a months-long internal hard sell of the reforms to its staff, many of whom are wary about the proposed changes. 'I see this as part of modernising, bringing it up to date in its management and financing systems with other parts of the world,' Mr Solomon said. The proposed reforms will be unveiled today. He said the changes would hopefully lead to improved efficiency and shorter waiting times, and reduce medical blunders. Hospitals in the New Territories West and Kowloon West would benefit the most, he said. There have been grumblings that the authority is now being run by 'finance men' rather than doctors. Mr Solomon is the first non-doctor to head the heavily subsidised authority, which has an annual budget of HK$30 billion. Authority chairman Anthony Wu Ting-yuk is an accountant by profession. It is proposed that the new funding system be adopted in the 2009-10 financial year, which starts in April. The exact budget will have to wait until the financial secretary presents his budget in March. It will apply only to acute inpatient services or about 53 per cent of the authority's expenditure. The case-mix classification system to be adopted by the authority has about 1,000 different case types and a price list of services, all of which have been tailored to Hong Kong by an Australian case-mix scientist. The cost per case is still being worked out. But preliminary figures showed that for heart attacks there would be four levels of cost, dependent on factors such as how complicated the infarction is. The system will also lead to more day surgeries and minimally invasive operations. 'Hong Kong doesn't do those nearly enough,' Mr Solomon said. 'If they did that, then we would reduce our waiting times. But there is no reward, no incentive.' Not since the population-based model of funding - which was never completely implemented after the government froze budget increases - has a shift in the funding allocation system such as this been proposed. Budget billions The Hospital Authority runs 40 public hospitals in the city Its annual budget, in HK dollars, is: $30b
