Hong Kong should review A&E charges to prevent abuses, John Lee says, as authorities weigh upping service fees to combat budget deficit

City leader says fee review important to bring down waiting times, days after finance chief lists raising government service charges as an option to tackle deficit
‘In the past, we saw a lot of people using A&E services when they did not need them. We will focus on preventing abuse of A&E services,’ he adds

Hong Kong healthcare and hospitals

Emily Hung

Published: 2:21pm, 9 Jan 2024

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Hong Kong should review how much it charges for accident and emergency (A&E) services to prevent abuses, the city’s leader has said, after a top minister suggested raising public service fees to combat a substantial budget deficit.

“In the past, we saw a lot of people using the A&E services when they did not need them,” Chief Executive John Lee Ka-chiu said on Tuesday before a meeting with the Executive Council, the city’s top political advisory body.

“We will focus on preventing the abuse of A&E services … so the [waiting] times and service quality can be enhanced too.”

Financial Secretary Paul Chan Mo-po over the weekend said that authorities would review public service charges that had remained the same for several years and those based on a “user pays principle” in a bid to trim the budget deficit.

The minister earlier predicted a deficit of more than HK$100 billion for the 2023-24 financial year, which he attributed to slow economic growth and mass government spending amid the Covid-19 pandemic.

In the case of public hospital charges, the costs are reviewed every two years under an established mechanism. Accident and emergency attendance fees were last increased in 2017, going from HK$100 (US$12.8) to HK$180.

Hong Kong has 18 public hospitals that provide A&E services, with patients grouped into five categories under a triage system.

Those in the top category are typically treated immediately, while those in the next two receive care within 15 or 30 minutes. The three groups accounted for half of all patients visiting A&E units.

Those in the lower categories can expect to wait several hours.

The average waiting time for the lowest category of patients stood at 2 hours and 38 minutes as of March 31, 2023.

Those in the next group up wait 124 minutes on average before being treated.

Eight public hospitals recorded general waiting times of more than three hours as of Tuesday noon.

Some A&E patients heading to Pamela Youde Nethersole Eastern Hospital, Princess Margaret Hospital, Tin Shui Wai Hospital and Tuen Mun Hospital faced waits of more than eight hours.

Several lawmakers have also called for increases in public hospital service fees to prevent overcrowding at A&E rooms.

The budget for the 2023-24 financial year shows public services accounted for less than 4 per cent, or HK$21 billion, of the government’s estimated total revenue of HK$543 billion.

Economist earlier warned that raising services would do little to tackle the deficit, calling on authorities to focus on pursuing high-impact policies, such as improving the local business environment and increasing land premiums.