A brain drain of surgeons is affecting the quality of care of public medicine in Hong Kong, says the city's father of liver transplants. To keep more doctors from leaving, Professor Fan Sheung-tat proposes that public doctors be allowed to make extra money by treating private patients. At the University of Hong Kong, for which Fan is head of surgery for Queen Mary Hospital in Pok Fu Lam, at least 10 of about 100 surgeons have switched to private practice in the past two years. Among them were four consultants and senior doctors. The team consists of doctors from the university's medical school and the Hospital Authority. 'Although there's been no serious interruption to clinical services, the brain drain has to a certain degree affected the quality of care since we have lost some experienced doctors,' Fan said. The Hospital Authority predicts that the turnover of doctors will rise from 4.4 per cent in the last financial year to 6.8 per cent this financial year, a five-year high. Fan's recommendation comes as the government tries to reform health care to encourage more people to buy private medical insurance. The government wants to introduce a voluntary medical scheme to cover at least 500,000 people. The professor said the Hospital Authority should take the opportunity to change the system for public doctors so experienced staff would be more rewarded and stay. A similar system is used in Singapore. However, an authority official poured cold water on the idea, saying it would complicate the system. 'The whole thing needs a clear policy, we have to think about which doctors can do private practice,' the official said. 'If we expand private services, public services will be cut and the public may not accept this.' An authority spokesman said its hospitals currently provided private services 'on a very limited scale' as an alternative for patients. At present, university doctors can have a private practice and share the income with their departments and the medical schools. But doctors hired by the Hospital Authority are not allowed to do so, except in special cases. And they cannot pocket any income from the private services. Hong Kong's two medical schools - the other is at Chinese University - have been criticised for allowing academic staff to take private cases because of the harm it might do to public services. But Fan said this mindset must change. 'In future, more and more Hong Kong people will have insurance protection and some middle-class patients will want to be treated by a designated doctor,' he said. 'Public doctors can generate extra income by treating private patients. This will give them some incentive to stay. Also, the extra income generated from private cases can be used to subsidise public services.' Fan said the departure of public surgeons is an inevitable trend when the private sector is booming. 'But money is not the only factor,' he said. 'Many doctors who left were not satisfied with work conditions in the public sector. 'The good side of such a turnover is that it provides opportunities for young doctors to take up posts and bring in new ideas.' Medical sector lawmaker Dr Leung Ka-lau agreed that the Hospital Authority should allow public doctors to handle private cases.
