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Following is a question by Dr Hon Leung Ka-lau and an oral reply by the Secretary for the Civil Service, Miss Denise Yue, in the Legislative Council today (February 11):
Question:
At present, the Government provides medical benefits to civil servants, retired civil servants, and their eligible dependants (civil service medical benefits) and the Hospital Authority (HA) is the major service provider. In this connection, will the Government inform this Council:
(a) whether it knows the numbers of "in-patient days", "discharges and deaths", "accident and emergency services attendances", "specialist out-patient (clinical) attendances" and "general out-patient attendances" in respect of the above persons who used HA's services in each of the past three years, as well as the respective percentages of such numbers in the relevant totals; based on the "unit costs" referred to in HA's Annual Report, of the total costs for the provision of civil service medical benefits by HA in the past three years; and in order to provide services to the above persons, the resultant increase in the average number of days that new cases of the out-patient clinics of each specialty have to wait at present;
(b) given that HA's main service target is the public, of the reasons and justifications for the Government to shift to HA its responsibility, as the employer, to provide medical benefits to its employees; and
(c) whether it has any plan to purchase private medical services and medical insurance to substitute the services provided by HA, with a view to providing better civil service medical benefits and addressing the problem of imbalance between the public and private health sectors?
Reply:
President,
Regarding part (a) of the question, based on the information provided by the Hospital Authority (HA), a breakdown of the number of attendances and the percentage of civil service eligible persons using HA services against the total number of persons using such services in each of the past three financial years is at Annex 1. The cost of medical services provided for civil service eligible persons by HA in each of the past three financial years is set out at Annex 2.
Currently, according to the triage system under HA, specialist out-patient (SOP) clinics will determine the urgency of the clinical conditions of new SOP patients based on various factors including the patients' clinical history, the presenting symptoms, and the findings of physical examinations and investigations before arranging the dates of medical appointment. The status of a patient is not a factor of consideration. The dates of medical appointment for serving / retired civil servants and their eligible dependants, like that for all other members of the public, are arranged according to the triage system for new SOP cases. Therefore, the waiting time for SOP patients will not be prolonged or shortened due to HA's provision of medical services for civil service eligible persons.
Regarding part (b) of the question, before HA was established, the Government provided medical and dental benefits to civil service eligible persons through the facilities managed by the Department of Health (DH) and the then Hospital Services Department (HSD). When HA was established in late 1990 and took over the public hospitals and general out-patient clinics previously managed by HSD and DH in 1991 and 2003 respectively, the Government considered it most appropriate and effective for HA to provide the relevant medical services for the civil service eligible persons. The annual lump sum provision given by the Government to HA has included the resources required for the provision of medical benefits to civil service eligible persons.
Regarding part (c) of the question, the Government (as an employer) is committed to honouring its employment contractual obligation of providing medical and dental benefits to civil service eligible persons. Through the Standing Committee on Medical and Dental Facilities for Civil Servants (SCMDF), the Government discusses with the staff sides various feasible measures regarding civil service medical benefits. Besides, taking the opportunity of the release of the consultation document on healthcare reform by the Food and Health Bureau (FHB) in mid-March last year, we issued letters to invite civil service staff bodies to express their views, in particular on how we could leverage the possible reforms to the public healthcare system to improve the provision of medical benefits to civil service eligible persons.
At present, the Government does not have any plan to purchase private medical services and medical insurance for civil service eligible persons to substitute the services provided by HA. We will continue to discuss with the staff sides through the SCMDF all feasible proposals that can improve the medical benefits for civil service eligible persons. In considering any improvement proposals, we will weigh up the Government's financial capability, cost-effectiveness of the proposals and the views of the staff sides.
As regards addressing the problem of imbalance between the public and private health sectors, I understand this is one of the objectives of FHB in launching its consultation on healthcare reform, which is to optimise the use of public and private resources to ensure sustainability of the overall healthcare system and pave the way for improved quality and efficient healthcare services in both the public and private sectors.
Thank you, President.
Ends/Wednesday, February 11, 2009
Issued at HKT 12:48
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