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LCQ3: Use of medical facilities without payment by non-HK residents


Following is a question by the Hon Bernard Chan and a reply by the Secretary for Health and Welfare, Dr E K Yeoh, in the Legislative Council today (April 24):


It is learnt that quite a number of non-Hong Kong residents use the services of public hospitals during their stay in Hong Kong but they do not pay the required charges. In this regard, will the Government inform this Council whether it knows:

(a) the number of cases in which non-Hong Kong residents failed to pay hospital charges in each of the past three years; the default amount involved and its ratio to the overall revenue of public hospitals;

(b) the number of infants born in public hospitals to parents either of whom was not a Hong Kong resident, in each month from March last year to February this year and, among these cases, the number of those which involved non-payment of hospital charges; and

(c) how public hospitals can recover the outstanding payments, and if they will consider introducing a guarantor system or other means to reduce the number of default cases?


Madam President,

(a) At present, subsidised public medical services are provided to Entitled Persons (EP) who are either:

(i) holders of Hong Kong Identity (HKID) card or their children under 11 years of age; or

(ii) "other persons" approved by the Chief Executive of the Hospital Authority (HA) or the Director of Health.

In this connection, "other persons" include spouses of HKID card holders. Non-entitled Persons (NEP) who use public medical services will be charged the full cost of the services provided.

While HA's patient billing and revenue collection system captures payment statistics on NEP, it does not separately capture payment statistics on non-Hong Kong residents. The number of NEP cases with medical fees waived/written-off and the corresponding amounts involved, and ratio of the amounts waived/written off to the medical income of public hospitals for 1999/2000, 2000/01 and the first half of 2001/02 are listed in Table 1 of the Annex. Information on the NEP cases for the latter half of 2001-02 is not yet available.

(b) HA's clinical information system only captures statistics on the number of infants born in public hospitals whose mothers are non-Hong Kong residents from the Mainland. The corresponding monthly statistics for the period of March 2001 to February 2002 are set out in Table 2 of the Annex. It should be noted that the statistics in question include infants with non-Hong Kong resident mothers who are entitled to subsidised public medical services because their husbands are HKID card holders. The monthly statistics for those infants born in public hospitals whose mothers are NEP from the Mainland are set out in Table 3 of the Annex. HA's patient billing and revenue collection system does not separately capture information on non-payment cases involving non-Hong Kong residents who give birth in public hospitals.

(c) At present, HA requires an NEP or a person who could not be established as an EP to pay a deposit of $19,000, which is equivalent to six days of hospital charges, prior to or on admission into a public hospital. Thereafter, a demand note for payment of hospital fees will be issued to such a person every seven days of hospitalisation. That said, an NEP or a person who could not be established as an EP may not be required to settle payment of the requisite deposit prior to or on admission into hospital under the following exceptional circumstances:

(i) the patient requires medical treatment or service of an emergency nature; or

(ii) the Hospital Chief Executive is personally satisfied with a written guarantee of payment of hospital fees due by the patient's employer or the organisation responsible for the patient's hospital fees.

In respect of (i) above, HA hospitals will issue a demand note for payment of deposit and/or hospital fees as soon as practicable after the patient is admitted to the hospital.

If a patient fails to settle the medical bill, HA will contact his next of kin for payment. HA will also follow up with the defaulter by sending the final bill to the patient followed by subsequent reminders, and a final notice to be sent by registered mail, to urge the patient on early settlement of the medical bill. Follow-up telephone calls will also be made to the patient or his next of kin. Where appropriate, legal action may be instituted against defaulters.

HA's information system also generates on a weekly basis a defaulter report to keep track of those patients currently admitted into HA hospitals but have not yet settled previous medical bills so as to facilitate the collection of the outstanding amounts from such patients.

END/Wednesday, April 24, 2002


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