Do we have enough doctors in Hong Kong? Is protectionism to blame for this perceived manpower crisis in hospitals? As soon as the people of Hong Kong decide how much to spend on public health care, it is easy to calculate the number of doctors to train (or import). We have about 1.8 doctors per thousand people in Hong Kong. If we want 2.2 doctors per thousand, like Singapore, we need to either train or import 2,800 more doctors.
It is all relative. Compared to the mainland (with fewer than one doctor per thousand people), we have too many doctors. A more pertinent question to ask is whether we have utilised our manpower effectively.
The government sees importing foreign graduates as a quick fix. Morphine does ease pain, but what next? Increasing the supply of doctors by whatever means may reduce doctors' salaries for the Hospital Authority and further widen the income gap between public and private doctors. In fact, the salary of new public-sector recruits has been cut twice since 1997. This strategy will work until the day the already poor morale of public doctors hits rock bottom. Parents may even begin to discourage their children from studying medicine.
No supply will ever satisfy demand for cheap but good-quality services. Take a look at the phenomenal surge in demand for obstetric services in Hong Kong recently. The reason is glaringly simple: HK$39,000 for a Hong Kong identity card is cheap for mainland Chinese.
What about hiring doctors in private practice to work part-time in the public sector? Junior specialists who are willing are being paid 70 per cent of the base salary of full-time staff, which equates to an average of HK$400 per hour. They are obviously not 'greedy protectionist doctors'. According to the Hospital Authority, the HK$1,200 per hour requested by some private specialists is ludicrously excessive. In my opinion, it is cheap compared to the hourly charge of my lawyer and my accountant.
Specialist medical care is expensive and needs to be rationed. For example, relatively straightforward hypertension and diabetes cases could have easily been referred to private-sector GPs in order to shorten the waiting time for complex medical cases in the specialist clinics. Hiring more overseas-trained doctors to be GPs in our specialist outpatient clinics is not a long-term solution.
To spend the public health dollar wisely, it is important to dissect every waiting list to weed out optional or non-essential tests and procedures. 'Medical need' should be given more weight than 'medical want'.
