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Following is a question by the Hon Mrs Regina Ip Lau Suk-yee and an oral reply by the Secretary for the Civil Service, Miss Denise Yue, in the Legislative Council today (February 4):
Question:
The Civil Service Regulations stipulate that as the employer, the Government will make every endeavour to give civil servants, retired civil servants, and their eligible dependants "the best available medical attendance and treatment" (civil service medical benefits), including services of the Hospital Authority (HA). Yet, a number of civil servant organisations have relayed to me that there is a huge gap between the actual situation and the Government's pledge, and encountering difficulties in seeking medical consultation and obtaining drugs is a common phenomenon. For example, there is an acute shortage of the services provided by families clinics, rendering it very difficult to book consultation slots; the waiting time for specialist out-patient services is too long; potent but expensive drugs with little side effect have to be purchased at the patient's own expenses; and the procedure for claiming reimbursement of medical expenses are complicated. In this connection, will the Government inform this Council:
(a) of the expenditure on civil service medical benefits and the year-on-year percentage changes in each of the past five financial years;
(b) of the amount and percentage of the provision for HA in 2007-2008 allocated for providing civil service medical benefits, and the basis used by the authorities in determining the amount; and
(c) as the healthcare reform consultation document did not mention civil service medical benefits, when and how the Government plans to commence the relevant consultation, and what specific new measures are in place to improve civil service medical benefits?
Reply:
President,
Before giving a reply to the Hon Mrs Regina Ip's question, I would like to explain the medical and dental benefits enjoyed by civil service eligible persons.
Under the existing policy, save for the charges applicable to hospital maintenance, dentures and dental appliances as provided for in the Civil Service Regulations, civil service eligible persons (i.e. serving / retired civil servants, their eligible dependants and other eligible persons) are entitled to free medical treatment and medical services, X-ray examinations and medicines, but only when these benefits are provided by the Government's Department of Health (DH) or the medical facilities of the Hospital Authority (HA). Every endeavour will be made to give civil service eligible persons the best available medical attendance and treatment through these medical facilities, but the medical officer in charge of the case has sole discretion as to the nature and the amount of treatment provided.
Apart from medical treatment, if the attending HA doctor certifies that the prescribed drugs or equipment or other treatment are necessary for the patient on medical grounds, and such items are not available in HA or are chargeable by HA, civil service eligible persons may apply to the Government for reimbursement of the concerned expenses. This arrangement enables civil service eligible persons to have access to the necessary drugs for treatment, even though such drugs are classified as self-financed items in HA's Drug Formulary.
The provision of medical and dental benefits forms part of the employment contract between the Government (as employer) and civil servants (as employees). The Government is committed to honouring its contractual obligation through the facilities of DH and HA. Since 1979, the Civil Service Bureau (CSB) has established the Standing Committee on Medical and Dental Facilities for Civil Servants (SCMDF) which provides a useful forum to discuss with the staff sides matters regarding the provision of medical and dental benefits for civil servants. The SCMDF comprises membership from the official sides and the staff sides. Official members include representatives from CSB, Food and Health Bureau (FHB), HA and DH. Members from the staff sides include representatives from the staff sides of the four Central Consultative Councils. The SCMDF meets regularly. At Members' request, we have already arranged to increase the frequency of the SCMDF meetings from half-yearly to quarterly to facilitate Members to discuss important issues promptly.
We understand the concerns of civil service organisations over the provision of medical and dental services to civil service eligible persons. Given the size of the pool of civil service eligible persons and the ageing population, there will inevitably be a growing demand for medical and dental services. Medical and dental staff of HA and DH will accord priority to urgent cases having regard to the condition of individual patients. Service is also provided to patients through a booking arrangement.
Regarding Part I of the question, the annual cost of civil service medical and dental benefits provided by the Government through HA and DH and the year-on-year percentage changes in each of the past five financial years are provided at Annex.
Regarding Part II of the question, the annual subvention given by the Government to HA is a lump sum provision, in which the resources required for the provision of medical benefits to civil service eligible persons have been included. The Government does not have a separate annual provision for HA for civil service medical benefits. The total cost spent by HA on the civil service medical benefits each year can only be calculated on the basis of the unit cost and attendances by civil service eligible persons using HA services in that financial year. On this basis, in 2007-08, the cost of providing civil service medical benefits by HA accounted for 7.1% of the Government subvention to HA.
Regarding Part III of the question, FHB released the healthcare reform consultation document in mid-March last year and launched its first stage public consultation exercise, the purpose of which is to reach a consensus in the community on the reform of medical services and the financing arrangements of the existing healthcare system, so as to ensure the sustainability of the healthcare system in both the private and public sectors as a whole, cope with the challenges posed by the ageing population, improve the level of medical services, and continue to provide quality medical services to the public. The consultation period ended in mid-June last year. FHB released the report on the first stage public consultation on healthcare reform at the end of last year, and plans to proceed to the second stage of public consultation in the first half of this year.
At the same time, we note that the healthcare reform may bring possible changes to the provision of services by medical institutions in the public sector, including those provided by HA, which may have impact on the medical benefits provided by the Government as an employer to civil service eligible persons. Hence, when the first stage public consultation paper on healthcare reform was released, we had issued letters to the staff sides of the four Central Consultative Councils and retiree associations and invited them to examine the proposals in the document, in particular how we could leverage the possible changes to the public healthcare system to improve the provision of medical benefits to civil service eligible persons.
During the first stage of the public consultation exercise, we received views from individual retired civil servants, retiree associations, staff associations and the staff sides of the Central Consultative Councils. Views relating to the healthcare reform consultation document and the administration of HA have been forward to FHB for consideration. When FHB commences the second stage public consultation on healthcare reform, we will consult the staff sides and retiree associations as in the past.
As regards specific measures to improve civil service medical benefits, we have sought additional funding in this financial year to meet the rising expenses of reimbursing civil service eligible persons for medical expenses that are necessary for their medical treatment, to meet the additional costs arising from the participation of civil service eligible persons in the public-private partnership programmes launched by HA, and to improve the dental service provided by DH for civil service eligible persons. In the near future, we plan to improve the service capacity of the Families Clinics and dental clinics under the management of DH, and to extend the direct payment arrangement to cover cancer drugs supplied by HA. We will continue to discuss with the staff sides on matters relating to civil service medical and dental benefits through the SCMDF.
Thank you, President.
Ends/Wednesday, February 4, 2009
Issued at HKT 13:10
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