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Medical staff outside Princess Margaret Hospital in Hong Kong on February 4, 2020. The city is struggling with a shortage of health care workers. Photo: AFP
Opinion
Opinion
by Ken Chu
Opinion
by Ken Chu

Relaxing the rules on doctors trained overseas will ease Hong Kong’s shortages, but only in the short term

  • The government’s proposal to allow more foreign-trained doctors is expedient but, ultimately, Hong Kong has to train more doctors of its own and explore technology to complement the city’s health care

Hong Kong’s lack of doctors is once again at the forefront of public debate. After a private member’s bill to relax the rules admitting foreign-trained doctors was introduced by Executive Council member and Liberal Party lawmaker Tommy Cheung Yu-yan, Chief Executive Carrie Lam Cheng Yuet-ngor weighed in on the issue.

At a Legislative Council question and answer session, Lam said the government would soon table a bill to amend the law to allow more foreign-trained Hongkongers to return to the city to practise.
Doctors are indeed in short supply, especially in Hong Kong’s public sector. The city has a much lower doctor-to-population ratio than other mature economies, with about 1.9 per 1,000 residents.

This is not only lower than Singapore’s ratio of 2.4, but also the lowest among the world’s mature economies. A minimum ratio of 3.4 doctors per 1,000 residents is recommended by the Organisation for Economic Cooperation and Development (OECD). In other words, we should double the number of doctors we have.

Hong Kong’s public hospitals are short of about 660 doctors but our annual number of medical graduates barely totals 500. If the exodus of public hospital doctors to the private sector witnessed in past years continues, the cumulative shortfall may result in a major crisis.

A continuing shortage of doctors – and for that matter, nurses and auxiliary health care workers – can deal a big blow to the city, with our ageing population heavily reliant on the public health care system.

The unpredictability of when another deadly pandemic could occur also weighs on our already stretched health care system. If we can attract graduates from foreign medical schools and doctors in practice abroad, the manpower crunch can be alleviated.

According to the initial idea disclosed by the chief executive, the government will target overseas-trained doctors and medical students who are permanent residents of Hong Kong. They must meet stipulated professional requirements, and have graduated from recognised medical schools. There are merits to this idea.

First, it would widen the pool of trained doctors we can tap. Second, these overseas-trained medical school graduates and doctors can bring valuable experience and knowledge.

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Further, foreign-educated and trained doctors whose families are originally from Hong Kong should find it easy to communicate with patients and adapt to the local working environment because they share the same culture and language with most Hong Kong people.

At first glance, Hong Kong should not face much difficulty in attracting doctors and medical graduates from overseas, given the huge income disparity between those practising in Hong Kong and most Western countries. Physicians in private practice in Hong Kong can often earn comfortably more than their counterparts in Britain, for example.

But there may be other factors at play. For example, some eligible experienced foreign doctors may not welcome the idea of working in public hospitals and clinics or university medical colleges first, before being able to freely practise medicine in Hong Kong.

We might also need to offer compelling reasons and incentives for the move, because they will be uprooting their lives and potentially their families.

Now as before, Hong Kong doctors are wrong to shut out foreign competition

Research by leading international accounting firms and headhunters reveals that, when evaluating whether to relocate to start a new career, professionals with families are concerned about the quality of living environment, work-life balance and entertainment opportunities, as well as education opportunities and outdoor activities for their children. Can Hong Kong satisfy their requirements?

The move to attract foreign-trained doctors and medical graduates with Hong Kong permanent residency is the right way to go but this is, after, all an expedient arrangement rather than a long-term solution to the shortage of doctors.

To raise its doctor-to-citizen ratio to the recommended OECD level, Hong Kong has to train more doctors, and boost research and development efforts in the medical field. In this way, technology can complement human health care, perhaps through advanced artificial intelligence and robotics.

Ken Chu is group chairman and CEO of Mission Hills Group and a national committee member of the Chinese People’s Political Consultative Conference

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