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Following is the speech by the Secretary for Food and Health, Dr York Chow, at the opening ceremony of the Hospital Authority Convention 2012 "enHAncing Health" at the Hong Kong Convention and Exhibition Centre this morning (May 7) (English only):
Mr Anthony Wu, Dr P Y Leung, distinguished guests, ladies and gentlemen,
It is indeed my great pleasure to join you all at this major annual Convention of the Hospital Authority (HA). The event this year is a timely occasion for us to take stock of the development in public health care in Hong Kong over the past five years, as the term of this Government is drawing to a close and as we prepare ourselves for the challenges ahead.
Hong Kong takes pride in its highly efficient health-care system underpinned by very dedicated health-care professionals. Our health indicators, such as life expectancy and infant mortality, rank among the best in the world. The infant mortality rate reached 1.7 deaths per 1,000 live births in 2010. Over the past five years, life expectancies for males and females increased from 79.4 and 85.4 in 2007 to 80.4 and 86.6 respectively this year.
On the other hand, longevity brings with it the challenges of an ageing population, a rising demand for health-care services, and escalating medical costs. Against this background, we set forth clear public health-care policy directions in 2005. Let me take you back a decade or two ago, when the HA was established in 1990 and started to operate in 1992. The Government put a large amount of resources into strengthening the public health system, building new hospitals, improving the employment benefits for staff of public and particularly subvented hospitals, and developed a strong "patient-centred" culture, with reforms in all areas of hospital administration. The HA became the dominant service provider, and at one time looked after over 95 per cent of all inpatients in Hong Kong. Despite an increase in resources, even on a yearly basis, there were still long waiting times and waiting lists, also related to the ease of access to services and high government subsidies for all services.
I fully believe that health-care reform cannot be restricted to public hospital services, nor limited to the hospital level. We need to address the majority of patients looked after by private sector primary care, and 60 per cent of private medical practitioners. Health-care reform needs to address the total market and total service capacity, and at the same time address the issues of access, service interface, quality, efficiency and sustainability. From 2005 onwards, the Government started to place the HA firmly as the universal health-care safety net for Hong Kong and as the major health-care provider. The HA prioritised four essential services, namely the provision of acute and emergency care; care for low-income and underprivileged groups; tackling illnesses that entail high costs, advanced technology and multi-disciplinary professional teamwork; and training of health-care professionals. We also made a clear commitment to devote additional resources to enable the further development and improvement of other aspects of our health-care system. We introduced pilot projects to stimulate, enhance and test the private market through public subsidies and public-private partnership schemes. We facilitated private sector development, whilst at the same time introducing infrastructure to bring the service quality and transparency of the public and private hospitals on the same level. We also initiated many measures in preventive medicine and primary care, aimed at improving the quality and sustainability of our health-care system. I shall summarise our major initiatives as follows:
(1) Commitment of Financial Resources
In the past five years, the annual recurrent government expenditure on health has increased by more than 40 per cent, i.e. $13 billion in real terms. In 2012-13, we will spend $44.7 billion on health, amounting to about 17 per cent of the Government's total recurrent expenditure, compared to 15.9 per cent in 2007-08. The subvention to the HA also increased from $30.1 billion in 2007-08 to $41.8 billion in 2012-13. In the past five years, the number of HA doctors and nurses increased by 9 per cent and 8 per cent respectively.
It has been our policy that no one should be denied adequate health care through a lack of means. Apart from the standard drug formulary in the HA, there is the Samaritan Fund to provide financial assistance to needy patients to meet expenses for drugs and medical items required in the course of treatment. We will shortly seek our legislature's approval for further enhancing the Samaritan Fund with a proposed government grant of $10 billion.
(2) New Hospital and Capital Projects
On the hardware front, we have launched a number of public hospital development and redevelopment projects to improve quality and overall service capacity. The more recently completed ones include the Pok Oi Hospital and Prince of Wales Hospital. Phase I of the new North Lantau Hospital will be completed by the end of this year. Three other hospital projects, namely Yan Chai Hospital, Caritas Medical Centre Phase 2 and Tseung Kwan O Hospital, are under way and targeted for completion between 2013 and 2016. We are also actively planning the construction of a Tin Shui Wai Hospital and the redevelopment of three hospitals (the United Christian, Queen Mary and Kwong Wah Hospitals), involving an estimated cost of $26 billion.
Medical technology advances by leaps and bounds. To upgrade the medical care for children in Hong Kong, we will establish a medical Centre of Excellence in Paediatrics, or CEP in short. The CEP is the first of its kind in Hong Kong, which seeks to establish a multi-partite medical centre with advanced technological facilities to enhance the quality of clinical services, research and training in the specialty of paediatrics. We have just tendered the design and construction work of the CEP at the former airport site at Kai Tak and plan to commence services by phases in mid-2018.
Apart from the CEP, we have also been planning the establishment of a medical Centre of Excellence in Neuroscience, i.e. the CEN, alongside the CEP at the Kai Tak site. Similar to the CEP, the CEN will serve as a tertiary referral centre, pooling professionals and expertise in the fields of neurological and neurosurgical diagnosis and treatment for achieving clinical excellence and advanced professional research and training.
(3) Enhancement of Medical Research
Scientific knowledge, expertise and innovations are the real assets of health care. Recognising the importance of medical research in the development of high-quality medical services, we consolidated the former Research Funds for Health Services, Control of Infectious Diseases, and established a new Health and Medical Research Fund in December last year with an additional injection of $10 billion to further promote research and development in health and medical services. The research projects to be supported by the Fund will continue to help support health policy formulation and health-care services delivery, generate a critical mass of health-related knowledge, increase health and research capacity and create a strategic reserve of talent.
(4) Health-care Reform and Health-care Insurance
At present, the HA is providing over 90 per cent of the inpatient services in Hong Kong. While the Government will continue to strengthen public health care as the cornerstone of the health-care system, to maintain long-term sustainability, we have to reform in order to redress the imbalance between public and private sectors in meeting the community's demand for hospital services. There is also an increasing trend of health-care insurance subscribers in Hong Kong. After two rounds of thorough public consultation, we have achieved a general consensus for introducing a voluntary, government-regulated Health Protection Scheme (HPS), which aims to provide better protection and value-for-money services to those who may be able to afford and are willing to use private health-care services.
To take the HPS forward and to cater for a future expected increase in service demand, we are adopting a three-pronged approach: firstly, to formulate detailed proposals for the implementation of the HPS; secondly, to ensure an adequate supply of quality health-care professionals; thirdly, to facilitate the development of health-care services, including the disposal of land for private hospital development and the promotion of packaged pricing for common procedures in the private sector. We aim to complete these three tasks by mid-2013, and will then proceed with the necessary legislative procedures.
(5) Infrastructure Reform and Quality Management
Mindful of the importance of creating a facilitative environment in which the medical sector can operate and develop, we introduced a new approach to private hospital development and launched projects to establish a Hong Kong-wide Electronic Health Record Sharing System and a hospital accreditation system for public and private hospitals.
The territory-wide patient-oriented Electronic Health Record Sharing System (eHR) will be established by 2014 with the aim of making records follow patients, even with mobility of patients between the public and private health-care sectors. We completed a two-month public consultation on the legal framework to ensure patient privacy in February 2012 and are glad that the majority of the responses were supportive of eHR development and the principles set out in the Framework.
In order to further improve hospital service quality and uphold patient safety, a Pilot Scheme on Hospital Accreditation was launched in partnership with the Australian Council on Healthcare Standards in 2009, and was concluded with fruitful results in early 2011. The five public and three private hospitals which participated in the Pilot Scheme were all awarded full accreditation status for a period of four years. A set of locally applicable standards was developed for measuring the performance of both public and private hospitals in Hong Kong. In addition, more than 40 health-care professionals from different disciplines of both the private and public sectors were trained to become the first batch of local surveyors. With these encouraging results and the full support of the Government, the hospital accreditation scheme has been extended to another 15 public hospitals, with the aim to cover all hospitals in the medium term.
(6) Primary Care Reform
While disease fighting is at the core of health-care services, we should not lose sight of the fundamentals. As part of our health-care reform, last year we introduced the primary care strategy to strengthen the development of primary care, especially in preventive care and wellness promotion, improving the health of the general population and reducing the need for more expensive medical services such as specialists and hospital services.
We work with the HA to develop evidence-based conceptual models and reference frameworks for specific diseases or population groups, to introduce the Primary Care Directory to promote the family doctor concept, and to explore appropriate service models for delivery of enhanced primary care services in the community, especially through the concept of community health centres (CHCs) or networks. The Tin Shui Wai Community Health Centre, the first purpose-built CHC in Hong Kong, will officially open next month.
As part of our efforts to promote primary care and public-private partnership, we introduced the Elderly Health Care Voucher Pilot Scheme in 2009 to subsidise the elderly aged 70 years or above using primary health-care services in the private sector. Starting from January this year, the annual voucher amount per eligible elderly person has been increased to $500. Up till now, more than 420 000 or 61 per cent of eligible elderly people have joined the Scheme, involving $265 million of subsidies being reimbursed by the Government. We will conduct a review to evaluate whether the Scheme has been effective in achieving our stated policy objectives of enhancing primary, especially preventive, care for the elderly. We will also consider whether and how the details of the Scheme should be adjusted to further enhance primary care services for the elderly and for the betterment of their health and well-being.
Alongside the Elderly Health Care Voucher Scheme, we have also been planning the introduction of a Health Assessment Pilot Programme for the elderly in partnership with NGOs. Our objective is to promote preventive care for the elderly by encouraging provision of preventive care through introducing a voluntary, protocol-based health assessment programme for elderly people. We are working out the programme details in consultation with potential partners, and will launch the Pilot Programme in early 2013.
(7) Disease Prevention and Health Promotion
Hong Kong is well respected for its vigilance in disease surveillance and control measures. We have devised contingency plans for pandemics and conduct drills from time to time, ensuring preparedness against public health emergencies. In 2008, we enacted the Prevention and Control of Disease Ordinance, which brought our legislative provisions in line with the latest International Health Regulations of the World Health Organization (WHO). Hong Kong's measures were put to test over the course of 2009 and 2010 as we faced the threat of human swine influenza - our measures proved effective with the hard work of our health-care professionals and the Administration's close partnership with the HA. We have established very close working relationships under the WHO framework in disease surveillance and response with neighbouring economies, including Mainland China and Macau in particular. The tripartite framework with the Mainland and Macau has been effective in enhancing our vigilance in disease surveillance and control. I would like to take this opportunity to thank colleagues in the Ministry of Health and Macau for their support and co-operation over the years.
Prevention is always better than cure. We spare no efforts in disease prevention and health promotion. To promote public health, the Government has been taking a multi-pronged and progressive approach in tobacco control. I am glad to share with you that smoking in Hong Kong is decreasing, and the prevalence of smoking has been reduced significantly from 23 per cent in the 1980s to the all-time low level of 11 per cent now. We are considering measures to further our efforts.
(8) Non-communicable Diseases
In addition, the Government has also been working on mitigating the burden brought by non-communicable diseases (NCDs), as the local population is perhaps prone to more risk factors due to a high population density, ageing population and fast pace of life. The Department of Health has launched the Strategic Framework for Prevention and Control of Non-communicable Diseases in October 2008, setting out targets for fostering a healthy environment, promoting community health, and reducing the progression of NCDs as well as avoidable hospital admissions. The Government has continued to forge multi-sectoral partnership in implementing the Framework and has implemented a wide variety of recommendations, such as organising health promotion publicity events and expert forums, as well as stepping up surveillance on alcohol consumption among the population in order to strengthen the evidence base of relevant policies.
(9) Chinese Medicine
We have all along attached great importance to the promotion and development of Chinese medicine. The Chinese Medicine Ordinance, enacted in 1999, provides a solid statutory framework to regulate the practice, use, trading and manufacture of Chinese medicine. Implementation of mandatory requirements for registration and labelling of proprietary Chinese medicine enhances public confidence in using Chinese medicine and contributes positively to the long-term development of Chinese medicine. The Department of Health also conducted research to establish the pharmaceutical criteria of the most popular 200 traditional Chinese medical herbs, which will be completed by early next year. In view of the increasing demand for Chinese medicine services from the public, we have been actively incorporating Chinese medicine services into the public health-care system, including the setting up of 16 Chinese Medicine Clinics in the territory and the provision of Chinese and Western medicines shared care services in some 20 HA hospitals. We will continue to promote the development of Chinese medicine through the evidence-based approach, in order to meet the needs of the general public, and support pilot projects of Chinese medicine hospitals initiated by NGOs and relevant university institutions.
Ladies and gentlemen, we have indeed come a long way in health-care reform since the Discussion Paper "Building a Healthy Tomorrow" was published in 2005. This can only be made possible through the joint efforts of everyone here today, and particularly our dedicated health-care professionals. The good economy and solid financial position of the Government in the past few years provided an unprecedented opportunity for us to increase health-care expenditure both on the hardware and software sides, to expand the breadth and depth of services, and to experiment with different service delivery models. We are now steadily on the way to further reform. More needs to be done in the next term of Government to continue the momentum, and the various infrastructural projects that I have mentioned earlier will have to be continued. The ongoing reviews on health-care manpower planning, the required amendments of some outdated laws and regulations also need to be addressed. Irrespective of how health-care reform will take place, we must respect our societal core values and preserve the most valued professional integrity and ethical practices, and the spirit of putting patients' and public interests first. These are the essential qualities that guide our city's health-care development and differentiate us from others.
The Government and the HA have been unswervingly working in partnership for the continual improvement and striving for excellence of the public health-care sector. In a dynamic and changing environment, the HA has adapted itself and successfully transformed its services over the past few years to meet the growing demands of Hong Kong. I am confident that the HA will continue to review and better its operations in the face of the new missions and tasks ahead. With the continued support and co-operation of our health-care professionals, medical service providers, academics and all relevant sectors and stakeholders, I am sure that we will go from strength to strength in striving for even better health-care provision to meet rising public expectations and to cater for increased demands in the years to come.
On this note, may I wish the HA and this Convention much success. I would also like to thank the speakers and guests from all over the world for joining this meaningful event today. I am sure all will benefit from your experience and wisdom. Thank you.
Ends/Monday, May 7, 2012
Issued at HKT 13:05
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