Press Release

 

 

Chief Secretary for Administration's speech at conference

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Following is the speech (English only) by the Chief Secretary for Administration, Mrs Anson Chan, at the Opening Ceremony of the 20th Eastern Region Conference of the International Union Against Tuberculosis & Lung Disease today (Friday):

Professor Lee, Dr Reuben, Professor Ip, Ladies and Gentlemen,

I am greatly honoured to be here this evening to officiate at the Opening Ceremony of the 20th Eastern Region Conference of the International Union Against Tuberculosis and Lung Disease. Hong Kong is privileged to be the host, for the first time I believe, of this very important biennial medical conference. I would like to join Professor Lee and Dr Reuben in extending a very warm welcome to you all, particularly to our overseas delegates.

I think most people will agree that "the first wealth is health". But accumulating this "wealth" is not easy particularly against the background of increasing population build-up, urbanisation, and industrialisation, all of which have an impact on our environment. This brings to mind what Julius Caesar said in Shakespear's play "I durst not laugh, for fear of opening my lips and receiving the bad air." If this was true in Shakespear's days, all the more true today.

Respiratory diseases continue to threaten mankind - tuberculosis is by no means a disease of the past. It remains a major cause of morbidity and mortality. The World Health Organisation has repeatedly warned us about the global re-emergence of this disease; lung cancer has been one of the top lethal malignancies for the past 15 years in Asia; asthma afflicts up to 12% of the population in heavily polluted cities; chronic obstructive airway disease is becoming more common due to the high prevalence of smoking in Asian countries; sleep apnoea, known to be highly common among Caucasians, is now increasingly recognised in Asia.

In Hong Kong, territory-wide studies commissioned by the Environmental Protection Department and two of our universities have pointed to the strong correlation between the measured levels of air pollutants and local daily hospital admissions as well as deaths due to respiratory and cardiovascular diseases. The resultant economic cost could also be significant.

Fortunately, as a result of Government efforts combined with those of our dedicated medical profession, I am happy to say that the general state of health of our community is good. In Hong Kong :

* the death rate of tuberculosis has dropped from over 2000 per million population in the 1950s to less than 40 as of 1998;

* the death rate of other respiratory diseases such as asthma and chronic obstructive airway disease has fallen steadily since 1990s; and

* life expectancy at birth has risen from 68 to 77 years for male and 75 to 82 years for female over the past 25 years.

As a result of sustained economy growth, we have been able to significantly improve both the quantity and quality of our health services. But like other countries, we are facing two serious challenges. Firstly, the financial sustainability of our system in the long run. Health care services in Hong Kong are presently heavily subsidized. The Government or taxpayers pay for over 97% of the costs. Our spending on health care services is growing at an average of 7% per annum in real term, much faster than the growth in total government expenditure. The public health bill this year is estimated to be $30 billion which represents one sixth of the Government's total recurrent expenditure. It is clear that we cannot sustain such spending in the long run without crowding out other essential social services for the community or seriously eroding their quality.

Secondly, our current service delivery mode is outdated with undue emphasis on hospital-dominated curative care. We need to effectively link primary health care with specialists, and hospital services so that patients can move easily through the entire health care system. In this way, we can keep costs down, improve patient's overall health and address more adequately the needs of an aging population increasingly suffering from chronic illnesses.

We have commissioned the School of Public Health of the Harvard University to take a critical and comprehensive look at both the funding and the delivery of health services in Hong Kong. The release of the Report in mid-April this year has sparked considerable public debate. Predictably, for a contentious issue like this, the views expressed are very diverse. There is a consensus on the need to reform our system. We hope with the tripartite effort of the Administration, the medical profession and members of the public, we will come up with the right prescription for our community which will ensure health for all at affordable prices.

The recent spate of public health incidents, ranging from the avian flu in Hong Kong to "madcow" disease in Europe has taught us that "prevention is better than cure". We need to do more to ensure food safety and environmental hygiene.

We are embarking on a series of institutional reforms to improve co-ordination and to minimise fragmentation of responsibilities. By the end of this year, we will have a new Department of Food and Environmental Hygiene to be responsible for surveillance and enforcement of all food safety and hygiene issues - "from plough to the plate" as it were and to ensure strong leadership in tackling environmental issues.

Health and the environment come closely together. But by themselves, the health specialists and the environmental specialists cannot deal with the problem. Air pollution isn't something you can wait to clean up after it has happened, or accept that you deal with the health effects as an inevitable consequence. Air pollution arises from the way in which our economy and city presently operate, with heavy reliance on oil powered road transport. We have to have mobility for goods and people, just as we have to have good health care and a good environment for this city to flourish. But the transport engineers, the city planners, the economists and the business community need to integrate the objectives of the health and environment experts into their own.

That integration of approach is what we are now trying to improve through the work we are doing on sustainable development. A key part of the work is to make the knowledge and goals of the health, welfare and environmental communities available directly to the engineers, planners and economists, and to make it available in ways that stimulate team work. Every group needs to be stimulated to achieve maximum gains for society, for the environment and for the economy together, rather than trading off one against another to the detriment of all.

Hong Kong has done much to counter air pollution. Emissions of sulphur dioxide and nitrogen oxides have been cut by 58% and 46% respectively since 1992. We have phased out leaded petrol. We have imposed the toughest standards on vehicle emissions and fuel quality in Asia, matching those of the US and Europe. We are planting half a million trees a year in country parks and urban areas. We are pressing ahead with a programme to replace our taxi fleet with ones using LPG. And we are strengthening co-operation with our neighbours. But the growth of population and economic activity in such a small space impose enormous additional pressures every year. Strengthening the efficiency with which we all work together is indispensable to sustaining a healthy living environment for ourselves and our children in the 21st Century.

"Health for all" is the common objective that unites all countries and all communities. This Conference provides a forum for experts from all over the world to come together to share their experience and knowledge. I wish you well in your deliberations and I wish all our overseas visitors a very enjoyable stay here.

Photo: The Chief Secretary for Administration, Mrs Anson Chan, officiated at the opening ceremony of the 20th Anniversary Eastern Region Conference of International Union Against Tuberculosis and Lung Disease organised by the Hong Kong Tuberculosis, Chest and Heart Diseases Association at the Hong Kong Convention and Exhibition Centre. Photo shows Mrs Chan dotting the eyes of a lion to mark the opening of the conference.

End/Friday, June 4, 1999

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