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The Government has invited members of the public to give their views on the future service delivery model for Hong Kong's health care system with a view to building a sustainable system that is accessible and affordable to all.
Launching the consultation exercise at a press conference today (July 19), the Secretary for Health, Welfare and Food, Dr York Chow, who is also the chairman of the Health and Medical Development Advisory Committee (HMDAC), said the sustainability of the public health care system, which depended heavily on public funding, had been a cause of growing concern for the Government and the community.
Dr Chow pointed out that Hong Kong had developed an enviable health care system, providing accessible and quality health care to all over the years. He also noted that over-reliance on the public health care system, an ageing population with one in five expected to be 65 or above by 2023, early occurrence of chronic illness in the population, advancement in medical technology leading to increasing costs, and over-stretched hospital services had posed immense challenges to the system.
"It is time for us to critically review and rethink what our future health care model should be so that our vision of ensuring a quality health care service that is sustainable, affordable and accessible to all can be attained," he said.
In 2004-05, the expenditure on public health care services totalled $30.2 billion and accounted for 14.4% of recurrent public expenditure.
"The community has to consider whether we should continue to put a larger and larger proportion of public expenditure on public health care services at the expense of other services and infrastructure development," he added.
The HMDAC proposed in its first report to re-align the roles of the public and private sectors and reposition the public sector to target its service at: acute and emergency care; low income and underprivileged groups; illnesses that entail high cost, advanced technology and multi-disciplinary professional team work; and training of health care professionals.
On primary health care services, the HMDAC recommended: to promote the family doctor concept; to place greater emphasis on preventive care; to purchase primary medical care service from the private sector; and to encourage private sector family doctors to consider working in group practice.
On hospital services, the HMDAC recommended: the Hospital Authority (HA) review the critical mass of demand by accident and emergency (A&E) departments to identify the need for merging or other forms of rationalisation; the public sector co-ordinate the planning and development of ambulatory services with private hospitals; the private sector establish more 24-hour clinics to deal with acute but non-emergency cases, and the A&E departments of public hospitals establish links and protocols with them to enable real emergency cases referred to A&E departments be attended to expeditiously; and public hospitals make it an explicit policy to refer chronic patients who are medically stable back to their family doctors or their referring doctors in public or private primary care services.
It recommended the Government commit to providing tertiary and specialised services for treatment of catastrophic illnesses and to ensure that these services are sustainable and affordable while the HA should continue the current approach of consolidating tertiary services in designated centres.
The HMDAC also recommended the Government consider: changing the licensing conditions of residential care homes for the elderly by requiring them to engage doctors to take care of their residents' medical needs on a regular basis; expanding the community nursing service; and encouraging the private and social welfare sectors to develop a new type of short-stay institution providing temporary convalescent and rehabilitation services.
As for infrastructural support, the HMDAC recommended a more aggressive prevention strategy by the public sector, a free flow of patient records, training for professionals in different roles, a fees and charges policy conducive to achieving the desired positioning of public health care services, the promotion of public education to bring about conceptual and attitude changes towards health and the use of our health care services, and to inculcate in patients a sense of responsibility for one's own health.
Dr Chow said the objectives of defining our future service delivery model were to rationalise and maximise the use of resources in both the private and public health sectors so that we could have a sustainable health care system.
"Should resources be identified in some service areas in the process, they will be ploughed back into the system for the purpose of enhancing services in other areas," he said.
Copies of the consultation document and leaflet "Building a Healthy Tomorrow" can be downloaded from the Health, Welfare and Food Bureau's website at http://www.hwfb.gov.hk/hmdac and are available for collection at the following places:
* Public Enquiry Service Centres of District Offices;
* Health InfoWorld in the Hospital Authority Building;
* Public hospitals and clinics of the Hospital Authority;
* Maternal and Child Health Centres, Elderly Health Centres and Women Health Centres of the Department of Health; and
* Major public libraries.
Members of the public can send their views to the Health Care Reform Section, Health, Welfare and Food Bureau by mail to 19/F, Murray Building, Garden Road, Central; by fax to 2840 0467; or by email to healthcare@hwfb.gov.hk. The deadline for submission is October 31, 2005.
The HMDAC will proceed to its second phase of work on financing issues later this year and recommendations on health care financing options will be put forth by the end of 2005 or early 2006.
The HMDAC will later embark on a review of mental health services, dental services and the development of Chinese medicine in Hong Kong.
Ends/Tuesday, July 19, 2005
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