Why haven’t Hong Kong’s private hospitals stepped up in Covid fight? Lack of facilities, manpower to blame, sector chief says as pressure mounts
- Private health sector has come under renewed scrutiny after mainland Chinese Vice-Premier Han Zheng criticised them for not admitting Covid-19 cases
- Sector representative says that private hospitals have never been engaged by government to take care of coronavirus patients due to a lack of isolation facilities
Insufficient isolation facilities, manpower and the absence of government engagement were the reasons behind Hong Kong private hospitals’ refusal to take in Covid-19 patients, the sector’s leader has said, as pressure mounted for them to step up efforts against the pandemic.
The city’s private health sector has come under renewed scrutiny after mainland Chinese Vice-Premier Han Zheng criticised them for not admitting Covid-19 cases during a meeting on Sunday with Hong Kong delegates to the Chinese People’s Political Consultative Conference (CPPCC), the nation’s top advisory body.
Top government pandemic adviser Professor Yuen Kwok-yung last week also said it would be “morally wrong” for private hospitals to turn away coronavirus patients when public facilities were like “battlefields”.
But Dr William Ho Shiu-wei, chairman of the Hong Kong Private Hospitals Association, told a radio programme on Monday that “some individuals in society” had passed “misconstrued messages” to Han, the mainland state leader who oversees Hong Kong and Macau affairs.
“I totally agree with Vice-Premier Han that once ‘the angels in white’ put on their white robe, they are duty bound to save lives,” he said, referring to a phrase used by the state leader to describe doctors.
Ho also said that private hospitals had never been asked by the government to take care of coronavirus patients due to a lack of isolation facilities, adding there had been a consensus that only non-Covid-19 patients would be transferred to ease pressure on the public health care system.
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“Rather, over the past two years we have been doing a lot to relieve the strain on public hospitals,” he said. “We have accepted many non-coronavirus patients from the Hospital Authority so public hospitals can free up the space for Covid-19 patients.”
But with the city having experienced a recent surge in coronavirus cases, public hospital chiefs have called on their private counterparts for more support.
Current measures include the public-private partnership scheme, in which public hospitals can refer patients to the private sector for subsidised treatment.
Launched in 2008, the scheme covers eight areas, mainly involving chronic illnesses ranging from cataract surgery, colon assessment and glaucoma.
Before the coronavirus pandemic, the programme was used to alleviate overcrowding at public hospitals during busy winter flu seasons.
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During the city’s second wave of Covid-19 cases in early 2020, the Hospital Authority expanded the scheme to include services such as neonatal jaundice treatment, caesarean delivery, radiotherapy for cancer patients, orthopaedic surgery, cystoscopy, gastroscopy and breast cancer surgery.
But as infections surged in the fifth wave, the authority appealed for more support on February 22, as it announced St Paul’s Hospital had become the first private operator to provide 20 beds to take in non-Covid-19 patients.
Dr Lau Ka-hin, a chief manager of the authority, had said the 20 beds were vital, as patient turnover would allow for more people to be transferred there.
On Monday, the authority said Baptist Hospital had agreed to provide 12 beds for public rehab patients, while CUHK Medical Centre became the first private hospital to dedicate 24 spots to treat coronavirus cases.
It added that Li Ka Shing Foundation had donated HK$60 million to support the admission of non-Covid-19 patients from public hospitals to private facilities.
Despite the number of beds provided by private hospitals, health authorities said more than 450 patients were waiting to be transferred, for services including childbirth, coronary heart disease and gastric cancer treatments.
Association chairman Ho said private hospitals had already conducted several hundred surgeries, computerised tomography (CT) scans, and magnetic resonance imaging scans on patients referred from the authority.
“At present, one-fourth of the patients receiving dialysis in our centres are actually referred from the Hospital Authority,” he said.
However, private hospitals have also been criticised for their handling of non-Covid-19 patients transferred from public facilities.
Dr Tony Ling Siu-chi, president of the Hong Kong Public Doctors’ Association, said the process was too slow, with each case taking about one or two weeks to be admitted.
“It is severely lagging behind the spread of the virus,” he said, adding that private hospitals had sent back patients who tested positive for Covid-19 on arrival.
“Private hospitals need to think about this: with the virus spreading quickly in the community, are they not going to do any business soon if they refuse all patients who test positive for Covid-19?” Ling said.
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He said the private operators could expand to treating mild coronavirus patients by installing ventilators in their general wards, as public hospitals have already done.
Lawmaker Elizabeth Quat, who chaired the Legislative Council’s panel on health services last session, said the government should have seen this situation coming and made plans well in advance.
“Extraordinary times require big innovative thinking, and this is a policy level decision by the top and the Food and Health Bureau, not the Hospital Authority, which is just executing an old plan,” Quat said. “If the government can lease hotels as isolation facilities, why can’t they do the same to private hospitals?”
Quat said she hoped there would be voluntary concessions on the part of the private sector after the intervention of the Chinese state leader, but added that she and other legislators would support the government in using the Emergency Regulations Ordinance to requisition private hospital spaces if needed.
But Ho said private hospitals’ shortage of personnel had made it difficult for facilities to admit infected patients.
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“We also have a manpower issue as we have staff getting infected or being close contacts of the infected,” he said. “There have also been some constraints as we need to ensure that the Covid-19 patients won’t mix together with other patients.”
Dr Gabriel Choi Kin, President of the Medical Association, said family doctors at private clinics could help by administering Covid-19 vaccines at care homes for the elderly or volunteering at community isolation facilities.
But Choi said about 10 to 20 per cent of his fellow colleagues, including himself, had shut down their clinics for 14 days after contracting Covid-19 or when staff had been infected by their patients.
“The private system could also collapse and our patients could be forced to go back to the public sector,” he said.
