LCQ2: Review of measures to combat pregnant Mainland women giving birth in Hong Kong

     Following is a question by the Hon Chan Hak-kan and a reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (February 8):


     The Food and Health Bureau announced seven measures in April last year to tackle the problem of continuing influx of pregnant mainland women giving birth in Hong Kong. Yet the authorities announced earlier that the total number of pregnant mainland women rushing directly to the accident and emergency (A&E) departments for delivery without appointment was 1,656 in the whole year last year, which surged by more than twice the number in the previous year, and quite a number of pregnant women were accompanied to A&E departments by the staff of agents. The Chief Executive (CE) indicated at the Question and Answer Session of this Council last month that four new measures to rigorously combat pregnant mainland women crossing the border to enter Hong Kong will be introduced, including working with the mainland government to combat agents and vehicles bringing such women to Hong Kong, stepping up efforts to intercept non-local pregnant women at immigration control points, enhancing enforcement against unlicensed guesthouses, and reviewing the fee for non-local pregnant women giving birth at A&E departments.  In this connection, will the Government inform this Council:

(a) of the respective implementation details of the four new measures mentioned by CE, including the government department responsible for the implementation, implementation timetable, and additional manpower and resources involved; how it will assess the effectiveness of these new measures in combating pregnant mainland women giving birth in Hong Kong;

(b) of the enforcement actions taken by the Hong Kong Government to combat the illegal activities of the aforesaid agents in Hong Kong last year, and the number of cases in which prosecutions were instituted, as well as the penalties imposed; and

(c) when it will carry out a comprehensive review on the aforesaid seven measures announced in April last year, together with the relevant details; when it expects to announce the quotas for pregnant mainland women giving birth in Hong Kong in the coming year; and whether it will consider substantially reducing the quotas to demonstrate the Government's determination to combat pregnant mainland women giving birth 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 have caused tremendous pressure on the overall obstetric and neonatal care services. Since mid-2011, we have launched further measures to ensure that adequate obstetric and neonatal care services are available in Hong Kong, and local pregnant women are given priority for obstetric services. In 2012, the number of non-local pregnant women giving birth in Hong Kong will be limited to 35,000 (including 3,400 delivery places for non-local women in the Hospital Authority (HA) and around 31,000 planned number of deliveries in private hospitals).

     My reply to the various parts of the question is as follows:

(a) During the Question and Answer Session at the Legislative Council on January 19, the Chief Executive announced four measures to deter pregnant women from seeking emergency deliveries through the accident and emergency (A&E) departments shortly before labour, thereby posing a higher risk to mothers, babies and healthcare staff. Relevant government departments and HA are actively implementing these measures. A review is being conducted by HA on the charge for non-local pregnant women seeking hospital admission through A&E departments to deter the dangerous behaviour of Mainland pregnant women rushing to A&E departments for delivery.

     On immigration controls, the Immigration Department (ImmD) will strengthen surveillance of non-local pregnant women; the Department of Health (DH) is also taking measures to enhance assistance to the ImmD staff by providing additional healthcare manpower at the boundary control points. The ImmD also maintains close liaison with the Mainland authorities to deter non-local pregnant women from seeking entry shortly before labour. Besides, cross-boundary hire cars are not allowed to carry passengers for hire or reward unless the vehicles have been issued the cross-boundary hire car quota by both the Hong Kong and Guangdong authorities.  We believe that there are agencies which arrange for non-local pregnant women without booking to enter Hong Kong by means of cross-boundary vehicles with no hire car quota. Regarding these cases of non-compliant use of cross-boundary vehicles for carrying non-local pregnant women to Hong Kong, the Police are collaborating with the Mainland authorities to jointly combat non-compliant vehicles and drivers.  

     On the other hand, the Police have been closely monitoring the modus operandi and promotion tactics of agencies in Hong Kong. If any unlawful acts are detected, enforcement actions will be taken in accordance with the relevant legislation. For agencies operating in the Mainland, the Police have been conducting joint investigations with the Mainland authorities to combat cross-boundary illegal practices.

     To enhance enforcement against unlicensed guesthouses, the Office of the Licensing Authority (OLA) of the Home Affairs Department has stepped up inspection and enforcement efforts, including conducting more frequent inter-departmental joint operations with the Police, and collecting evidence proactively by posing as clients (commonly known as "snaking"). Meanwhile, the OLA has worked closely with the Estate Agents Authority and the Office of the Commissioner for Insurance to take enforcement actions against the illegal practices of estate agency practitioners and insurance agency practitioners.

     Besides, to encourage public rental housing (PRH) tenants to report suspected abusive use of PRH flats (including letting flats to Mainland pregnant women), the Housing Department has stepped up publicity and education, and will detect and follow-up any suspected tenancy abuses cases under the established mechanism, such as through routine and surprise flat inspections, to avoid abusive use of PRH resources.

(b) Under the laws of Hong Kong, 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 false records or proof of antenatal attendance to any non-local pregnant woman, making false statement of 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 should also put in place a mechanism to disqualify a doctor from working or practicing in the relevant hospitals when he/she is found to have violated the relevant code of practice. To our understanding, there is no collaborative relationship between local private hospitals and any agencies providing services to mainland women delivering in Hong Kong.

     Besides, HA has also discovered cases in which non-local pregnant women are suspected to have used false instruments or stand-ins to secure a delivery place in public hospitals. Such false instruments include forged referral letters from private medical practitioners and ultrasound pregnancy images which do not belong to the pregnant women themselves. HA will refer these cases to the Police for follow-up actions. Between July 2011 and end of January 2012, a total of 16 referral cases have been received by the Police.

     As mentioned in part (a) above, the Police will continue to monitor the situation closely and liaise with the Mainland authorities to combat cross-boundary illegal practices of agencies.

(c) The first and foremost priority should be given to the local patients and pregnant women for healthcare resources of both public and private hospitals. The number of deliveries by non-local pregnant women should be limited with regard to the capacity of our healthcare system and arranged in an orderly and planned manner.

     To ensure that adequate obstetric and neonatal care services are available in Hong Kong and local pregnant women are given priority for obstetric services, as well as taking into account the possible effects of the "Year of the Dragon", as mentioned above, since mid-2011, we have set a limit for the number of non-local pregnant women giving birth in Hong Kong in 2012, resulting in a nearly 20% decrease in the estimated number of deliveries by non-local women in Hong Kong in 2012 as compared with 2011. There is also a 9% increase in the number of deliveries by local pregnant women at HA hospitals in 2011.

     We have gradually implemented various measures put forward in the middle of last year. Non-local pregnant women who intend to have deliveries in private hospitals in Hong Kong are required to undergo antenatal checkups by obstetricians in Hong Kong at an appropriate stage to assess if they are suitable to give birth in the territory so that the pregnant women and their fetuses are not subject to risks associated with travels or other factors. In this connection, the Hong Kong College of Obstetricians and Gynaecologists has issued professional guidelines on the projection of high-risk pregnancy in September 2011. DH has also standardised the "Certificate on confirmed antenatal and delivery booking" for issuance by hospitals to pregnant women who are suitable to give birth in Hong Kong. The Certificate also enables the Administration to monitor the utilisation of delivery places.

     HA is reviewing the number of delivery places for non-local pregnant women in 2013. Subject to the demand for obstetric services in Hong Kong from local pregnant women, we will further reduce or cancel all the quotas if necessary. The Food and Health Bureau will discuss with private hospitals the number of deliveries by non-local pregnant women for next year. Private hospitals have also agreed to reserve sufficient places for local pregnant women and give them priority for such services. It is expected that the number of non-local pregnant women giving birth in Hong Kong in 2013 will be announced in April this year. We will review the effectiveness of various measures from time to time, having regard to the circumstances.

Ends/Wednesday, February 8, 2012
Issued at HKT 16:44