Full discussion of primary care is important
Your editorial ('Case for health scheme must be well argued', September 18) rightly highlighted the threat of a lowering of quality of care in our heavily hospital-based health system from the rapidly ageing population.
The Hong Kong College of Family Physicians agrees that there is an urgent need for all stakeholders, particularly the general public, to have a rational debate on how our health care should be financed.
Merely increasing the resources, be it by taxation or voluntary insurance, may actually create more demand for public hospital services unless there is proper gate-keeping through effective primary care.
Primary care can reduce the workload of secondary and tertiary care not only by preventive care but, most importantly, by more effective management of more than 95 per cent of the acute and chronic illnesses of our population. The more problems primary care can manage, the fewer need to be treated in secondary and tertiary care.
The current referral rate from primary to secondary or tertiary care is 2.8 per cent. A decrease of 1 per cent, that is, one less patient out of 100 primary care consultations, will decrease the new patient load in secondary care by 36 per cent.
The competence level of primary care doctors is the most critical determinant of how much and how well they can manage the various health problems of the population, which is in turn dependent on the knowledge and training that the doctors have.
