Opinion | Hong Kong’s ailing health care system needs an injection of people-centred policymaking

Paul Yip says as the ageing population puts stress on the city’s health care system, apart from allowing in more overseas-trained doctors, greater use of technology, more after-hours clinics and a holistic approach would help

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Elderly patients wait in the Accident and Emergency Department of Queen Elizabeth Hospital in Yau Ma Tei in February. Photo: Dickson Lee

Published: 2:00pm, 15 Dec 2018Updated: 8:21pm, 15 Dec 2018

The report, “Fit for Purpose: A Health System for the 21st Century”, prepared by former health secretary Professor Yeoh Eng-kiong for Our Hong Kong Foundation is timely and relevant. It has shown that the present hospital-based medical system is unsustainable as we face a rapidly ageing society.

Although our life expectancy is increasing, our health is not getting better. At present, the hospitalisation rate of people aged 65 or above is four times higher than those below 65, with older adults taking up more than 50 per cent of all patient days. The public hospital system’s resources have come under tremendous pressure, with the bed occupancy rate frequently exceeding 100 per cent capacity.

Government expenditure on our health care system has been rising every year, for years, even exceeding gross domestic product growth, but it still falls behind the rate of increase in hospitalisation days. To maintain a quality and sustainable health care system, we need to think strategically and act decisively.

Hong Kong needs a two-pronged approach: increasing the supply of medical and health services while decreasing demand without compromising on quality.

A patient from Queen Elizabeth Hospital is transferred to privately run St Teresa’s Hospital in Kowloon City as part of a plan to ease overcrowding in public hospitals, in July 2017. Photo: Edward Wong

With regard to the supply side, we are not only short of doctors but have an imbalance between the private and public hospital systems: public hospitals employ 40 per cent of the doctors, while caring for 90 per cent of the patients.

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