Following is a question by the Hon Cheung Man-kwong and a reply by the Acting Secretary for Food and Health, Professor Gabriel Leung, in the Legislative Council today (May 11):
The Court of Final Appeal ruled in 2001 that children born in Hong Kong to Chinese nationals had the right of abode in Hong Kong. Since then, the number of babies born in Hong Kong to mainland women whose spouses are not Hong Kong permanent residents has soared by more than 50 times, from 620 in 2001 to 32,653 in 2010. The authorities announced on April 28 this year that seven measures would be introduced to alleviate the pressure on the healthcare system caused by mainland women giving birth in Hong Kong. Such measures include refusing the admission of non-local high-risk pregnant women, setting up a working group to determine the number of non-local pregnant women to be admitted next year and, starting from next year, determine at the beginning of each year the number of non-local pregnant women allowed to give birth in Hong Kong in the following year. In this connection, will the Executive Authorities inform this Council:
(a) how they will, in implementing the aforesaid measures, stop agencies from arranging for mainland pregnant women to illegally come to Hong Kong to give birth;
(b) of the justifications for treating in the same manner mainland pregnant women whose spouses are and those women whose spouses are not Hong Kong permanent residents; in connection with these two types of pregnant women, whether the authorities will request public and private hospitals in providing obstetrics services to give priority to mainland pregnant women whose spouses are Hong Kong permanent residents; and
(c) of the expected number of mainland pregnant women giving birth in Hong Kong this year, and how it ensures that this number will not exceed the capacity of the healthcare system in Hong Kong?
It is the Government's policy to ensure that Hong Kong residents are given proper and adequate obstetric services. The Administration is very concerned about the surge of demand for obstetric services in Hong Kong by non-local women (including Mainland women) in recent years, which has caused tremendous pressure on the overall obstetric and neonatal care services. We held a meeting with the Hospital Authority (HA), Department of Health (DH), the representatives of 10 private hospitals that provide obstetric services, the concern groups on Hong Kong's obstetric and neonatal services, the Hong Kong College of Obstetricians and Gynaecologists and the Hong Kong College of Paediatricians to discuss the arrangements for provision of obstetric services to non-local pregnant women next year, with a view to alleviating the pressure on the overall obstetric and neonatal services in Hong Kong.
We have proposed a number of measures to ensure local pregnant women are given priority for obstetric services and all mothers delivering in Hong Kong and their babies are safe and given the best of care, as well as to maintain the high professional standard of our services and the sustainable development of obstetric and paediatric services in Hong Kong. Non-local pregnant women who intend to have deliveries in Hong Kong will be required to undergo antenatal checkups by obstetricians in Hong Kong at an appropriate stage for assessment on whether they are suitable to give birth in Hong Kong, and if so the issuance of a "Certificate on confirmed antenatal and delivery booking" which will be standardised by DH. In addition, we will endeavour to combat the improper and unprofessional co-operation between individual local obstetricians and agencies. We will also set up a working group to determine in the first quarter of each year the number of non-local pregnant women allowed to give birth in Hong Kong in the following year.
Our replies to various parts of the question are as follows:
(a) It is not illegal for non-local pregnant women to receive obstetric services in Hong Kong through arrangements by an agency. However, if any local obstetrician cooperates with an agency in an improper and unprofessional manner with reckless disregard for the safety of pregnant women and their babies for the sake of profit, such as providing admission certificate to any non-local pregnant woman who has yet to undertake any antenatal checkup in Hong Kong, changing the expected date of delivery, unnecessarily arranging early caesareans for the sake of bed availability, etc., the doctors involved may be subject to disciplinary action for breach of the Code of Professional Conduct for the Guidance of Registered Medical Practitioners as stipulated by the Medical Council of Hong Kong. Private hospitals are also obliged to terminate their co-operation with the doctors concerned and refuse to allow them to provide obstetric services at their hospitals. To our understanding, there is no collaborative relationship between local private hospitals and any agencies providing services to mainland women delivering in Hong Kong. DH, as the regulatory authority over private hospitals, will continue to monitor the situation closely.
(b) At present, the public healthcare services in Hong Kong are heavily subsidised by the Government. It is necessary for the Administration to ensure our public healthcare services can meet public demand and at the same time can sustain in the long-term within limited financial resources. It has been our policy that public healthcare services are provided primarily for Hong Kong residents. Only "Eligible Persons" (EPs) (i.e. holders of Hong Kong Identity Card and children who are Hong Kong residents and under 11 years of age) are eligible for the highly subsidised public healthcare services. Non-Hong Kong residents (i.e. Non-eligible Persons (NEPs)) are provided with public healthcare services in emergency situations and they may seek non-emergency public healthcare services when there is spare service capacity. However, the rates of charges applicable to NEPs will apply. Fees for public healthcare services are currently charged in accordance with the status of the patients directly using the services and no consideration is given to family relationship. As in the case of obstetric services, fees are charged in accordance with the status of the pregnant women.
In 2003, we clarified the definition of EPs to the effect that non-Hong Kong residents who are the spouses or children of Hong Kong residents would be treated as NEPs and charged the NEP rates when using public healthcare services, including obstetric services.
We propose that non-local pregnant women should be checked and assessed by doctors in Hong Kong to see if they are suitable to give birth in Hong Kong, so as to ensure the safety of pregnant women and their foetus as well as to maintain the standard of our high quality services. To require non-local pregnant women to receive antenatal checkups by obstetricians in Hong Kong at an appropriate stage would help identify high-risk pregnancies, so that the pregnant women in questions, who in fact require additional attention and checkups, and their fetuses are not subject to risks associated with travels or other factors. We have invited the Hong Kong College of Obstetricians and Gynaecologists and the Hong Kong College of Paediatricians to give professional advice and guidelines for the checkups, so that obstetricians in the public and private sectors can make decisions and professional judgement consistently based on the guidelines. Obstetricians may exercise flexibility if they are convinced that individual non-local pregnant women can be followed up by obstetricians in Hong Kong.
(c) Based on the number of bookings for deliveries already made with local hospitals, we anticipate that there will be a slight increase in the number of deliveries in Hong Kong this year in comparison with that of last year. HA has already allocated additional resources and manpower to obstetric departments and neonatal intensive care units of public hospitals. It is anticipated that we are able to cope with the service demand this year.
In the long run, we endeavour to maintain the sustainability of our obstetric and paediatric services while continuing to provide high quality and professional services. We have reached consensus with the public and private hospitals providing obstetric services that measures have to be taken together to cap the number of deliveries in Hong Kong with regard to the overall capacity of our obstetric and neonatal care services. Based on such consensus, the working group to be set up will determine in the first quarter of each year the number of non-local pregnant women allowed to give birth in Hong Kong in the following year.
Ends/Wednesday, May 11, 2011
Issued at HKT 13:44