Expand partnership in health care sector

Much has been said about the need to expand the limited public-private partnership to enhance delivery of health care services. The private sector has shouldered a little of the extra patient load in recent years such as during peak flu season, when the public hospital system has been creaking under the strain. The coronavirus pandemic, however, has prompted reflection on how little progress has been made. Hospital Authority chairman Henry Fan Hung-ling has lamented that Hong Kong still had not done a lot in public-private partnership, even before the outbreak.

He also revealed that colleagues had two concerns about possible adverse outcomes for public patients. One was whether quality control would be affected, and the other was that it would result in more HA staff being lured by the private sector. The latter is an understandable concern given chronic manpower shortages.

The public-private partnership concept originated in past proposals for reform of health care financing and service delivery. It envisaged the private sector taking a bigger part in integrated primary and preventive health care and freeing up the public system to focus more on major surgical and medical cases and services for the poor and disadvantaged. Though they are limited, instances of greater cooperation have made a difference. They include electronic health-record sharing between public and private sectors that enables more timely diagnosis and treatment, and reduces duplication of tests.

Fan says the pandemic has forced the authority to accelerate collaboration and transfer more surgeries and treatments to private hospitals, at public prices, on top of the eight already included in the partnership programme. More could have been done, but development of the partnership is a complex issue, given that it must preserve a high standard of care based on a public system accessible and affordable to all.

At the same time, as Medical Association past president Dr Gabriel Choi Kin points out, there are 6,000 to 7,000 private doctors, half of them specialists. There is clearly room for more collaboration that enhances overall health care. Given the resources absorbed by health services in an ageing society, expansion of the partnership is the way forward in providing preventive and primary care and making efficient use of resources.