The government has unveiled details of proposed legislation to lure foreign-trained doctors back to the city to work in the undermanned public health system – without having to pass the local licensing exam. When considering the changes next month, lawmakers will have to make important decisions. Ultimately it is about ensuring enough doctors to avoid even longer queues and waiting times for treatment, without compromising standards. To build support for the government’s plan, health minister Professor Sophia Chan Siu-chee says that without it Hong Kong will have 1,610 fewer doctors than needed by 2030, rising to 1,949 by 2040, a gap that she says cannot be closed by increasing the number of medical students. These are worrying figures in terms of maintaining the quality and supply of medical services. Under the proposal, eligible doctors must be permanent residents, graduates from approved medical schools, and already registered to practise elsewhere. The controversial aspect is the exemption from having to sit the local licensing exam. Local doctors remain largely opposed to this concession, arguing that it risks diluting professional standards. The bill faces resistance from doctors and some, but not all, patients’ rights groups. In an interview with the Post this week, Chan denied that the government was “standing against” the medical sector and said it was willing to communicate and listen to its opinions. The government needs to explain why the scheme is limited to permanent residents, as well as to graduates of schools assessed as comparable to the two local schools at the University of Hong Kong and Chinese University. Chan estimates thousands of Hong Kong doctors are practising elsewhere, but concedes it is difficult to say how many would return. The question is why many would, amid the uncertainties of the pandemic and a post-Covid-19 world, when they are professionally and personally settled elsewhere. If the limitation is meant to be a sop to local doctors it looks problematical in practice. Doctor shortage hurting special needs children in Hong Kong: welfare chief The issue of professional standards is likely to loom large in the debate about ensuring an adequate supply of doctors. Both sides have to explain how their position strikes an acceptable balance. Patients rights advocate Tim Pang Hung-cheong supports the proposal and even loosening criteria. Public Doctors’ Association president Dr Arisina Ma Chung-yee says it is hard to assess overseas doctors’ abilities without an exam. The local profession and its supporters will have to combat the perception of an element of protectionism. Patient safety is paramount. Neither an undermanned, overworked public medical sector, nor dilution of standards, does anything for it.