*************************
Following is a question by the Dr Hon Yeung Sum and a written reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (February 20):
Question:
Regarding health care expenditure, will the Government inform this Council:
(a) of the respective public, private and overall health care expenditure as a percentage of the Gross Domestic Product in each of the past five years;
(b) of the number of attendances and the total bed-days in each of the past five years in respect of non-eligible persons (NEPs) receiving in-patient health care service provided by the Hospital Authority (HA); the total expenditure and income in this respect; and after deducting the expenditure on the provision of health care service to NEPs, the ratio of HA's annual expenditure to the Hong Kong population;
(c) of the per capita public health care expenditure in each of the past five years;
(d) whether the public health care expenditure had increased correspondingly with population growth in the past five years; and
(e) given that the Government will increase its recurrent expenditure on public health care from the present 15% to 17% in 2011-2012, of the estimated increase in per capita public health care expenditure in 2011-2012 after discounting population growth and increase in unit cost of health care service?
Reply:
Madam President,
(a) Statistics on the public and private health expenditure of Hong Kong are compiled in accordance with the International Classification of Health Accounts Framework developed by the Organisation for Economic Co-operation and Development (OECD) in 2000. Detailed statistics are collated under the Hong Kong Domestic Health Accounts (DHA) and are published on the webpage of the Food and Health Bureau (FHB) (http://www.fhb.gov.hk/statistics/cn/index.html). The DHA provide comprehensive and detailed information on the public and private health expenditure, facilitating comparison with other advanced economies that have also compiled their own Health Accounts using the same framework. We regularly update the DHA and the latest update to be released soon will include statistics up to 2004-2005. The compilation of statistics for 2005-2006 and 2006-2007 will also commence shortly and is expected to be completed in 2009.
In general, the public health expenditure under the DHA covers a wider scope than the government expenditure under the health policy area in the General Revenue Account (GRA), and is therefore often higher than the latter. Under the GRA of the government budget, only direct expenditure by FHB and the Department of Health (DH) (including FHB's allocation to the Hospital Authority (HA)), and those expenditure directly related to health by departments such as the Government Laboratory are counted as government expenditure under the health policy area. Whereas under the DHA framework, apart from those already classified as health expenditure under the GRA, public health expenditures also cover other health-related functions performed by other government departments. For example, the DHA include health expenditure on nursing homes, rehabilitation and medical social services under the Social Welfare Department, and ambulance service under the Fire Services Department and Auxiliary Medical Service, etc. These are not included in the government expenditure under the health policy area in the GRA.
The public, private and total health expenditure as a percentage of the Gross Domestic Product (GDP) from 2000-2001 to 2004-2005 according to the DHA are set out in Table 1. The decline in public health expenditure in 2004-2005 was mainly due to the downward adjustment of the civil service pay in 2004 and 2005, and the subsidy provided by the Government for the HA was adjusted accordingly. As mentioned above, the statistics for 2005-2006 and 2006-2007 have yet to be complied.
(b) The total number of discharges and deaths of NEP in-patients and day patients, numbers of bed-days utilised by NEPs, and the total in-patient fees collectable from NEPs, as well as the ratio of the HA's total costs to the Hong Kong population in each of the past four years are set out in Table 2. The HA's services provided to eligible persons and NEPs are basically the same in terms of content and quality and so the costs of service for both categories of patients are more or less the same. Hence, the HA does not maintain statistical data specifically on the costs of services provided to NEPs.
(c) The per capita public health expenditure and its growth rate for the five years from 2000-2001 to 2004-2005 (at 2000 price level), according to public health expenditure under the DHA and population data from the Census and Statistics Department (C&SD) are set out in Table 3.
(d) According to Table 3, after discounting the effects of inflation and population growth, there had been a real increase in the per capita public health expenditure between 2000-2001 and 2004-2005 except for 2004-2005. As mentioned above, the decrease in public health expenditure in 2004-2005 was mainly attributed to a downward adjustment of the civil service pay in 2004 and 2005, and the subsidy provided by the Government for the HA was adjusted accordingly.
(e) The Government is committed to increasing its recurrent government expenditure on health from the present 15% to 17% by 2011-2012.
Since we are unable to make an accurate estimation of the amount of recurrent government expenditure in 2011-2012 at this juncture, we cannot provide an estimate of the increase in recurrent government expenditure on health by that financial year. If we estimate on the basis of the recurrent government expenditure in 2007-2008, the recurrent government expenditure on health after increasing to 17% will amount to 35 billion, representing 14.5% increase over the present estimate of 30.5 billion. According to the population projection of C&SD, the present population will increase by 3.3% by 2011. Discounting the effect of population growth, there will still be 11.2% increase in per capita public health expenditure (based on C&SD's Hong Kong Population Estimates for 2007 and Projections for 2007-2036).
Ends/Wednesday, February 20, 2008
Issued at HKT 15:52
NNNN
