Heed call for health care efficiency review

The budget sector safest from critical scrutiny of increased spending should be public health, since more than 90 per cent of patients depend on our overloaded public hospitals. Financial Secretary Paul Chan Mo-po’s budget announcement of an increase of nearly 11 per cent to HK$80.6 billion for public health, amounting to 18.3 per cent of total recurring expenditure, is therefore welcome, especially after publicity of the strain on undermanned medical and nursing staff through the peak winter flu season. An added highlight is a new HK$10 billion stabilisation fund to help the Hospital Authority (HA) weather the financial storm of a health crisis or an economic slump.

In the circumstances, it would seem perverse for the value of the extra money to be at risk of being tangled up in red tape and bureaucracy. But this can by no means be ruled out, prompting Secretary for Food and Health Professor Sophia Chan Siu-chee to ask the HA to review the efficiency and efficacy of its operation to save more of the time of doctors and nurses for clinical duties.

This followed criticism by HA board member Professor Gabriel Leung, dean of medicine at the University of Hong Kong, who questioned whether repeated meetings of management and staff on the same issues benefited patients. In remarks echoed by other HA insiders, he said this culture had resulted in a bloated structure that warranted reflection by management. The issue has been taken up by the Public Doctors’ Association and Frontline Doctors’ Union in a meeting with Chief Executive Carrie Lam Cheng Yuet-ngor, during which they asked her to give individual hospitals the power to decide how resources are best allocated. HA chief executive Dr Leung Pak-yin has agreed there is room for improvement in vetting proposals from frontline staff, though some meetings were needed to enable inclusive talks on clinical services.

To be sure, communication is important in ensuring the best use of resources. But the critical factor should be the common goal of safeguarding the best interests of patients. Public confidence would be best served by prompt and transparent attention to Professor Chan’s request for an efficiency review of the health care operation, and subsequent accounting for its effectiveness.