Elderly people will be restricted in the way they use their annual health care vouchers after a review found the controversial pilot scheme was not meeting the objective of promoting preventive medical care. This comes as the government considers increasing the amount of the vouchers, HK$250 a year at present, and extending them to people some years under the threshold age of 70 - and as users complain that some health care providers charge more when they use the vouchers. A person familiar with the review said that in future recipients would be required to use the vouchers for designated health-prevention consultations or programmes. The three-year pilot scheme for people aged over 70 was launched in January 2009 in the hope that it would encourage patients to use private services and have a family doctor for regular consultation and advice. Yet after 21 months, both doctors and patients have complained that the vouchers have not promoted primary care in the way the government wanted. 'The main direction of the review is to make the scheme more focused on preventive health. In the future, some or all of the vouchers will be used only on health assessments or vaccinations and many options are being considered,' the person said. 'Now the use of the vouchers is too general - many patients just use them for consultations for a common cold.' Service providers will also be asked to be more transparent in their charging after it was found some raised fees after accepting vouchers. Lai Ngor, 73, of Tsz Wan Shan, complained that her private doctor had raised the fee from HK$140 to HK$180 per consultation after she used the vouchers. 'The doctor raised his fee after accepting the vouchers,' Lai said. 'It is not fair because the government subsidises it.' She also said that she wanted the government to increase the value of the vouchers. The scheme provides five HK$50 electronic vouchers a year. Participating providers include doctors, Chinese medicine practitioners, dentists, nurses and allied health professionals, such as physiotherapists and occupational therapists. Chief executive Donald Tsang Yam-kuen pledged in his policy address last week that the government would earmark HK$1 billion for the scheme pending the review. The person familiar with the plan said the government was considering increasing the amount of the vouchers and expanding the scheme to people aged some years below 70. By the end of September only 357,628, or 53 per cent of the 670,000 eligible elderly people, had joined the scheme, and only 277,855, or 41 per cent, had used vouchers; the vouchers used totalled HK$93 million. More than 102,000 people have used up all 10 vouchers over the two years. The person said the response to the scheme was not bad. 'The pick-up rate of the government free flu vaccination programme for the elderly is only about one-third ... this is a good scheme to let money follow patients.' Dr Choi Kin, president of the Hong Kong Medical Association, said the poor design of the vouchers had led them to be snubbed by both services providers and patients. Only 24 per cent of 6,000 private doctors have joined the scheme. 'Doctors need to do a lot of paper work and computer entries for accepting only HK$250 a year from each patient; they are not happy. Patients also have to pay extra for consultations, so they are not happy, too. This is a waste of time for everyone,' Choi said. The association has called on the government to raise the total voucher amount to at least HK$1,000 a year. Tim Pang Hung-cheong, spokesman for the Patients' Rights Association, said many elderly people quickly used up all the five vouchers before going back to the public clinics. 'It defeats the original purpose of the scheme, which is to encourage elderly people to have a stable family doctor, someone they will get advice from whenever they need it.' He said the government should consider working with non-governmental organisations to promote the scheme in a more organised manner. 'There should be some ongoing programmes such as regular checks of hypertension or blood sugar, so the elderly participants learn how to manage their own health,' he said. Pilot fails to take off Both doctors and patients have complained the new scheme has not worked By the end of September the total value, in HK dollars, of the vouchers used since the January 2009 launch: $93m