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Following is a question by the Dr Hon Joseph Lee and a written reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (March 12):
Question:
Regarding the application for medical fee waivers by the elderly not receiving Comprehensive Social Security Assistance, will the Government inform this Council:
(a) of the current application procedure for medical fee waivers, the medical care items for which the fees may be waived and the annual administration costs involved in processing such applications;
(b) of the number of elderly persons who were granted non-one-off medical fee waivers over the past three years, and its percentage among all successful applications in the period concerned;
(c) whether it has taken the initiative to promote the medical fee waiver system to the elderly; and
(d) whether it will consider streamlining the application procedure for medical fee waivers for the elderly and relaxing the relevant assessment criteria so as to benefit more elderly persons, as well as increasing the number of medical care items for which the fees are waived for the elderly and extending the valid period for each approved application; if not, of the reasons for that?
Reply:
Madam President,
The public health care services in Hong Kong are heavily subsidised by the Government and the fees are affordable by the general public. To ensure that no one will be denied adequate medical care due to lack of means, we have put in place a mechanism of medical fee waivers to provide assistance to needy patients.
(a) At present, patients receiving Comprehensive Social Security Assistance (CSSA) can be exempted from payment of fees for public health care services upon production of a valid medical fee waiver issued specially to CSSA recipients. Non-CSSA recipients who cannot afford medical fees because of financial difficulties can apply for a fee waiver at the Medical Social Service Unit of public hospitals and clinics, or approach the Integrated Family Service Centres (IFSCs) under the Social Welfare Department (SWD) to make a waiver application to the social workers. There are two main types of medical fee waivers. One is a one-off medical fee waiver and the other is a period medical fee waiver for multiple uses within a specified period. Medical social workers/social workers would issue patients with a one-off waiver or a period waiver, depending on the actual medical needs of the patients.
Under the existing guidelines, only one-off waivers will be issued to patients for hospitalisation or for unscheduled attendances at general out-patient clinics. Patients who have been confirmed by medical social workers/social workers to have the need for frequent follow-up medical treatment within a period of time can be issued with period waivers. Medical items for which fees may be waived cover accident and emergency service, specialist out-patient service, day hospital service, community care, general out-patient service (non-episodic cases), as well as injection and dressing.
In 2006-07, the total number of successful applications for medical fee waivers was around 87,200. Most of the medical fee waiver applications are handled by Assistant Social Work Officers, with the assistance from General Services Assistants. Since processing medical fee waiver applications is only one of the duties of Assistant Social Work Officers, and it is difficult to fully distinguish this duty from other medical social services work, it is not possible to calculate the annual administration costs involved in processing such applications alone.
(b) The number of elders who were granted period medical fee waivers in the past three years, and its percentage among all successful applications in the period concerned are set out at Annex I.
(c) Information on the eligibility and methods for application for medical fee waivers has been uploaded onto the website of the Hospital Authority (HA) and posted at the social worker offices, shroff offices, general out-patient clinics and specialist out-patient clinics in hospitals as well as SWD's IFSCs for easy reference by patients in need. HA has also published in newspapers the methods for application for medical fee waivers and a series of measures that make the existing medical fee waiver mechanism more accessible to the elders. In addition, HA holds meetings with mutual help groups for patients on a regular basis. In the course of discussion on medical services, HA often encourages patients with financial difficulties to approach medical social workers for assessment of their needs for medical fee waivers.
(d) Under the current medical fee waiver mechanism, all elders receiving CSSA are exempted from payment of medical fees in public hospitals and clinics without having to make any application. Elders who are not CSSA recipients can also apply for a fee waiver if they meet the criteria laid down by HA. HA and SWD have in the past implemented measures to make the medical fee waiver mechanism more accessible to elderly patients so as to alleviate the burden of medical expenses on them. For example, a higher asset limit of $150,000 per person is set for the elders (as compared to $30,000 per person for people below 65). Medical Social Workers may also exercise discretion to take into account specific needs of the elders when assessing their medical fee waiver applications. HA has extended the maximum validity period of period waivers granted to chronically ill or elderly patients who require frequent use of medical services from six months to 12 months. Since December 2005, the coverage of period waivers granted to chronically ill or elderly patients has been extended to include pre-scheduled appointments at general out-patient clinics.
To further enhance the accessibility of medical fee waivers to needy elderly patients, HA and SWD are planning to extend the coverage of period waivers to include general out-patient services without pre-scheduled appointment. The new arrangement is planned to be implemented at the end of March 2008.
Ends/Wednesday, March 12, 2008
Issued at HKT 16:07
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