Flu season a reminder of Hong Kong’s pressing need for more foreign-trained doctors in public hospitals
Michelle J. Tao says it is in the public interest for the government to loosen restrictions on foreign-trained doctors practising in the city, to cut waiting times and ease the pressure on overworked staff
As the flu season rages on, patients are waiting for hours for treatment at public hospitals and doctors are working overtime. Meanwhile a record-high percentage of doctors have left public hospitals for private practice.
While overwork is one reason behind the high turnover rate of doctors in public hospitals, another is the lucrative opportunities in the private sector due to rising demand from the mainland. More importantly, there was a major policy change in 1997 limiting foreign-trained doctors from practising in Hong Kong.
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The Medical Council of Hong Kong used to recognise medical qualifications of select Commonwealth countries. After 1997, however, it required all non-locally-trained doctors to pass its licensing examination and to complete an internship. As a result, the proportion of foreign-trained doctors – which had first increased from 40 per cent between 1990 and 1994 to 66 per cent in 1996 in anticipation of the policy change in 1997 – fell to 20 per cent between 1997 and 2003, and finally to a negligible 3 per cent in the 2004-2010 period.Concurrently, the number of newly registered doctors annually has declined from 523 over the 1990-1996 period, to 409 over the 1997-2003 period, and 316 over the 2004-2010 period.
The sudden decrease in new doctors after 1997, coupled with rising demand from the mainland, has caused an increase in costs for medical services and better compensation for doctors in the private sector. However, public hospitals have encountered restrictions on raising service prices and offering doctors better pay, leading to the exodus from public hospitals to the private sector.
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The government has a few options. One is to increase the budget for public hospitals. But these establishments will still be short of doctors as long as their pay lags behind the private sector.
Another option is to refer patients to private doctors, which would require government subsidies. But subsidies for seeing private doctors would lead to even higher pay in the private sector.
The most logical approach is to increase the supply of doctors. While the government has allocated more student places to the two medical schools, it will take time for this to have an effect. We can learn from Singapore, which has continued to accept doctors from Commonwealth countries after independence and has expanded the list of recognised institutions and countries.
So, in the interests of the public, the government should facilitate the removal of the red tape for foreign-trained doctors to practise here, and better prepare ourselves for the next flu season.
Michelle J. Tao is a Hongkonger currently studying economics at New York University