Collaboration key to reviving ailing health system
I refer to Bernard Chan’s article (“Unfinished business for Hong Kong’s legislators: medical reform”, September 29) and the report (“Fee estimates under new scheme: charge patients less if difference is small, leader of Hong Kong’s private hospitals says”, September 30).
As an active follower of these programmes, I am deeply concerned about the cheap band-aid measures being undertaken to remedy a haemorrhaging health system, when the remedies are simple and effective . Before referencing them, I make three points:
Firstly, archaic, disparate systems and practices should be replaced with a single, collaborative system that meets the needs of government, health-care providers, practitioners and most importantly, the public.
Secondly, the comment by Dr Anthony Lee Kai-yu, chairman of the Hong Kong Private Hospitals Association, that hospital expenses cannot be fixed before surgery due to too many variables sadly reflects the hospitals’ inability to calculate their costs using an effective method.
Thirdly, Bernard Chan’s referenced government plan to increase the Medical Council’s membership is a positive step but the council needs representatives from the insurance industry, external advisers and the public.
Without input from these groups, the only interests being served are either doctors or hospitals, to the detriment of patients.
As an executive strategy adviser to major health-care providers across Australia, the US and Europe, I am acutely aware of the implications of reformative programmes that seek transparency, accountability and service effectiveness.
Successful health reforms require the development of a standardised procedural costing and classification system; that is, a time-driven, activity-based management system. Collaborative frameworks are also needed between hospitals, insurance agencies and government authorities, to define and categorise cost and information requirements.
If the Legislative Council and health-care providers implement these elements, some benefits would include:
● Public and private hospitals (including doctors) could provide fixed fee estimates with no surprises for their patients or private health insurers;
● The government would be able to fund public hospitals based on activities/procedures performed, as opposed to bulk funding, therefore making hospitals more accountable and transparent for their resources; and,
● Hospitals could access the information to grow services, become less dependent on government subvention and benchmark services against leading health-care providers globally.
Ultimately, it is not appropriate to waste resources on ineffective measures and excuses when better solutions are available.
Benjamin Kelly, director, Serabus Consulting, Brisbane, Australia
