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Following is a question by the Hon Cheung Man-kwong and a written reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (May 9):
Question:
The Secretary for Food and Health (SFH) earlier advised that he was in discussion with private hospitals on the delivery quota for pregnant mainland women whose spouses were not permanent residents of Hong Kong (doubly non-permanent resident pregnant women) giving birth in Hong Kong for the year 2013 and expected that there would be result before end of April this year. However, the Chief Executive-elect (CE-elect) put forth on April 16 this year that private hospitals should stop admitting doubly non-permanent resident pregnant women in 2013, and indicated that babies born to doubly non-permanent resident pregnant women in Hong Kong (doubly non-permanent resident babies) in 2013 would not be guaranteed Hong Kong permanent resident status. He also said that other legal means, apart from the interpretation of the Basic Law, might be used to revise the current arrangement for granting permanent resident status to doubly non-permanent resident babies. In this connection, will the Government inform this Council:
(a) whether the authorities have examined what legal means, other than the interpretation of the Basic Law, can be adopted to revise the current arrangement for granting permanent resident status to doubly non-permanent resident babies; if they have, what means they have examined and what the results are; if not, whether they have any idea about the legal means referred to by the CE-elect;
(b) given that after the CE-elect has made the aforesaid remarks, SFH advised that the Department of Health would not issue confirmation certificates to pregnant mainland women seeking to give birth in Hong Kong in 2013, and the Hong Kong Private Hospitals Association had also decided not to admit doubly non-permanent resident pregnant mainland women to give birth in Hong Kong starting from 2013, whether the authorities have examined adopting other concurrent measures to stop the entry of doubly non-permanent resident pregnant women; whether the authorities will strengthen manpower in public hospitals to deter doubly non-permanent resident pregnant women from seeking emergency deliveries through the Accident and Emergency Departments (A&EDs), so as to avoid affecting the other patients and pregnant women receiving services in public hospitals; and
(c) given that the Hospital Authority (HA) is planning to increase with effect from May 2012 the obstetric package charge to $90,000 for non-booked cases of non-local pregnant women seeking emergency deliveries through A&EDs, whether it knows if pregnant mainland women whose spouses are permanent residents of Hong Kong (singly non-permanent resident pregnant women) will be dealt with separately from doubly non-permanent resident pregnant women under HA's charging policy, and sufficient maternity beds will be made available for singly non-permanent resident pregnant women in public hospitals; if not, of the reasons for that?
Reply:
President,
(a) and (b) The Government of the Hong Kong Special Administrative Region has implemented a number of policy measures to ensure that Hong Kong pregnant women are given priority for proper obstetric services and neonatal services. The Government also limits the number of non-local pregnant women coming to Hong Kong to give birth to a level that can be supported by our healthcare system. These policy measures include strengthened complementary immigration measures to fully support the arrangements for implementing a delivery quota for local hospitals and the issue of "Confirmation Certificate on Delivery Booking" (Booking Certificate). Under the arrangement, non-local women who will soon give birth are required to have a Booking Certificate and produce it for checking by officers of the Immigration Department (Imm D) when they enter Hong Kong. Those who cannot produce a Booking Certificate may be refused entry.
Specific immigration control measures to prevent non-local women without a Booking Certificate from crossing the border to deliver in Hong Kong include stepping up inspection of non-local pregnant women at major control points through internal re-deployment; analysing the common tactics and trend of "gate-crashing" by non-local pregnant women through collection of intelligence and data, taking corresponding surveillance measures, and conducting joint raids with other departments; stepping up enforcement and removal actions against overstaying pregnant women; strengthening cooperation with the Police, conducting investigation and initiating prosecution under the law against individual or corporate intermediaries that are involved in illicit activities in arranging for non-local women to give birth in Hong Kong.
The Department of Health (DH) has deployed doctors and nurses to assist immigration officers in assessing the gestational age of incoming non-local pregnant women, and arranged Health Surveillance Assistants to identify non-local pregnant women. To prevent non-local pregnant women from entering Hong Kong early and going into hiding in order to evade the screening process, the Home Affairs Department has stepped up inspection and enforcement efforts against unlicensed guesthouses. The Housing Department will also detect and follow-up any suspected tenancy abuses cases under the established mechanism (including renting flats to non-local pregnant women), such as through routine and surprise flat inspections. Through the above measures, the average number of delivery cases through gate-crashing the A&EDs by Mainland pregnant women who do not have prior booking has declined substantially from about 150 recorded each month in the fourth quarter of 2011 to an average of around 90 per month for the first four months of this year.
As the Chief Executive-elect has not mentioned any specific legal arrangements on the permanent resident identity of babies of doubly non-permanent residents, we do not have any comment at this stage.
For public hospitals, although most of the cases of non-local pregnant women giving birth in A&EDs took place in hospitals with obstetrics and neonatal intensive care units, it is irresponsible for pregnant women to seek emergency delivery through A&EDs shortly before labour without any antenatal checkup as it is dangerous to both the pregnant women and their babies. In the absence of past medical records of these non-local pregnant women, healthcare staff face limitations in taking care of them. It may also be necessary to transfer those complex cases which cannot be handled by A&EDs to other hospitals with obstetrics and gynaecology services for further treatment and such cases will inevitably involve risks. In this connection, we strongly appeal to the public to stop such dangerous behaviour in order to protect the safety of pregnant women and their babies.
HA has enhanced the preparedness of A&EDs to deal with such cases, including strengthening emergency delivery training for healthcare staff of A&EDs, and providing additional equipment for maternal and neonatal care in A&EDs. HA will closely monitor the situation and review the service capacity of A&EDs from time to time.
(c) Hong Kong's healthcare system is provided primarily for Hong Kong residents. As our public healthcare services are heavily subsidised by the Government, it is necessary for the Administration to ensure that our public healthcare services can meet public demand and at the same time can sustain in the long term within the limited financial resources. Therefore, we need to draw up eligibility criteria for receiving the heavily subsidised public healthcare services and accord priority to taking care of the needs of Hong Kong residents. At present, only holders of Hong Kong Identity Card or children under 11 years of age who are Hong Kong residents are eligible persons entitled to use the healthcare services heavily subsidised by the Government. As for non-Hong Kong residents, including Hong Kong residents' spouses who are not Hong Kong residents, they may seek non-emergency public healthcare services when there is spare service capacity. However, they are required to pay a fee at the rates of charges applicable to non-eligible persons. At present, we have no plan to change HA's fee-charging policy to differentiate non-local women giving birth in Hong Kong into different categories for different treatment.
Taking into account the costs of services, the price being charged for comparable services by private hospitals and the affordability of service users, HA will increase the fees of emergency delivery to $90,000 to deter non-local pregnant women from seeking emergency admission through A&EDs for delivery to bypass the booking system. The new fees will take effect on May 12 this year. Since it is a dangerous behaviour for non-local pregnant women without prior booking to seek emergency hospital admissions through A&EDs for delivery, HA has set the fee at a level higher than that charged for booked cases regardless of whether the husbands of these non-local women are Hong Kong residents or not in order to achieve a deterrent effect.
In order to maintain adequate maternity services and neonatal intensive care services and accord service priority to local pregnant women, HA has since April 26, 2012 stopped accepting bookings from non-local women with expected dates of delivery in 2012 for delivery in public hospitals.
We understand that some Mainland pregnant women whose husbands are Hong Kong permanent residents hope to give birth in Hong Kong but are unable to make their bookings in hospitals this year. There is a consensus in the community that the Government should provide assistance to this group of expectant mothers as far as possible. At the beginning of this year, we began to study the mechanism and detailed arrangements for effective verification of the identity of Mainland pregnant women whose husbands are Hong Kong permanent residents. We have just reached a consensus with the private hospitals for at least four private hospitals (namely Hong Kong Baptist Hospital, Precious Blood Hospital (Caritas), Union Hospital and St. Teresa's Hospital) to provide obstetric services for Mainland pregnant women whose husbands are Hong Kong permanent residents and who hope to give birth in Hong Kong but are unable to make their bookings in hospitals this year. If necessary, DH will allocate additional delivery quota accordingly to private hospitals willing to provide obstetric services to this group of women.
Based on the documents submitted by Mainland pregnant women whose husbands are Hong Kong permanent residents, the private hospitals will issue them with a Confirmation Certificate on Delivery Booking. DH will closely monitor the process and conduct checks with authorisation from the couples concerned. Suspicious cases, if any, will be referred to law enforcement agencies for follow-up action.
In the past three years, we have in each year handled an average of 6 000 cases of delivery by Mainland pregnant women whose husbands are Hong Kong permanent residents. With private hospitals terminating the admission of Mainland pregnant women whose husbands are non-local residents for delivery in the coming year, there should be adequate manpower capacity and facilities for private hospitals, after giving service priority to local pregnant women, to take care of the Mainland wives of Hong Kong residents.
Ends/Wednesday, May 9, 2012
Issued at HKT 14:25
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