**************

Following is a speech (English only) by Secretary for Health and Welfare, Mrs Katherine Fok, at the Seventh Annual Scientific Congress of the Hong Kong College of Cardiology today (Saturday):

Dr Cheng, Dr Tai, Ladies and Gentlemen,

Good afternoon to you all. It is my honour to be here today to officiate at this Opening Ceremony of the 7th Annual Scientific Congress of the Hong Kong College of Cardiology.

Heart diseases have been the second leading cause of death in Hong Kong for decades. In 1998, 5,000 people died from heart problems, and the total number of hospital cardiac patients came close to 53,000. I was advised that on average, every citizen faces a 10% lifetime risk of dying from a coronary heart disease. Statistics have also shown that patients are now getting heart problems at a younger age. The disease has put an immense burden on the society and requires priority attention from the medical profession and the community.

The Hong Kong College of Cardiology, since its formation in 1992, has devoted itself in earnest to the promotion of expertise in treating heart diseases. It has organised numerous education programmes, seminars, workshops, international conferences and research activities to enable our medical specialists and practitioners to keep abreast of the latest technologies and development in the management of this very serious disease.

Over these few days, you will be engaged in meaningful exchanges and vigorous discussions on various topics related to the illness and you will meet old acquaintances and make new friends. I wish all of you a most stimulating and successful Congress.

Anybody who has read this week's newspapers, I believe, must have noticed the intense public interest in the Consultancy Report on Hong Kong's health care system, prepared by the Harvard team for the Hong Kong Special Administrative Region Government. The Report has confirmed our worries that there are problems in our healthcare system, and that unless we push for some early reforms, the quality of our health care service may deteriorate significantly in future years.

The Consultants point out that the sustainability of our current financing arrangement for the health care system is highly questionable. It is forecast that because of our ageing population, adoption of new technologies and the rising public expectation, health care cost will continue to escalate, and as a result, total health care expenditure as a percentage of our GDP will rise from 4.6% in 1996/97 to 6.4% in 2016. This forecast is made on the optimistic assumption that our real GDP will continue to grow by 5% per annum. The Consultants also forecast that the main burden of this expenditure increase will fall on the public sector, and hence, public health care expenditure as a percentage of the total public annual budget will increase from 14% in 1996/97 to 20%-23% in 2016, at the expense of competing demands from other equally important public programmes, such as education, welfare and infra-structural developments.

The Consultants also question the sustainability of the organisational structure of our present delivery system, which is described as highly compartmentalised. They point out that the current lack of co-ordination and cohesion between the public and the private sectors and among primary, inpatient and community medicine has often resulted in duplication of services, waste of resources and discontinuity of health care. It is also pointed out that such a compartmentalised system is not best suited to deal with the increasing burden of chronic illnesses such as hypertension and diabetic. The Consultants are of the view that this lack of integrated service provision threatens the quality of service and efficiency of our system.

These are serious problems, which we must tackle. The Consultants have recommended different options to address these problems, and each option has its own pros and cons, entails a different degree of change and has different impacts on different sectors. I appreciate that there will be no easy solutions, but there is no place for complacency. I am glad to see that the community at large has already started an intensive discussion on this subject, and I look forward to more in-depth and constructive debates on this important issue in the months to come. Your views and suggestions will assist us in developing a better health care system which can adequately meet the needs of the next century.

Thank you.

End/Saturday, 17 April 1999

NNNN