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LCQ12: Cases of default of payment involving non-local pregnant women

     Following is a question by the Hon Gary Fan and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (February 12):


     It has been reported that the total amount of unpaid medical fees owed by non-local pregnant women after giving birth in public hospitals exceeded $10 million last year.  That amount represented an increase of over 70% from the previous year and accounted for 20% of the provision made by the Hospital Authority (HA) for bad and doubtful debts of medical fees last year.  In this connection, will the Government inform this Council:

(1)  whether it knows the number of the aforesaid cases and the total arrears in each of the past five years, together with a breakdown by public hospital; among such cases, the number of those which involved mainland pregnant women whose spouses were not permanent residents of Hong Kong, and the total arrears concerned;

(2)  if it knows the existing procedure of HA for recovering arrears from non-local pregnant women; the number of cases in which HA took recovery actions in each of the past five years, as well as the number of cases in which the arrears were fully recovered and the total arrears collected; whether HA has reviewed the reasons why its recovery actions succeeded in some cases but failed in others;

(3)  if it knows whether HA has analysed the characteristics of non-local pregnant women who defaulted on payment (including their places of domicile and the number of days they stayed in Hong Kong before giving birth, etc.); if it has, of the conclusion, and whether it will make use of the relevant findings of such analysis to formulate a mechanism to closely monitor those non-local pregnant women who have a high risk of defaulting on payment; if not, the reasons for that;

(4)  whether it knows the measures adopted by HA at present to prevent non-local pregnant women from defaulting on payment, and whether HA will introduce any new measure; if HA will, of the details and implementation timetable; if HA will not, the reasons for that; and

(5)  as some members of the public have proposed that the Government should introduce legislation to require non-local pregnant women who defaulted on payment to immediately clear the debt (including interest) and pay a fine of the same amount when they re-enter Hong Kong, or face prosecution or refusal for entry, whether the authorities have assessed the feasibility of such proposal, and whether they will adopt it; if they will not, of the reasons for that ?



     Our healthcare system mainly serves Hong Kong residents. The Hospital Authority (HA) will provide healthcare services for non-local residents under specific circumstances, such as when the patients are in a "life or limb- threatening" situation, or when there is spare service capacity.  However, HA will charge these patients according to the cost-recovery principle.

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

(1) The number of cases and the amount of arrears where non-local pregnant women defaulted on payment after giving birth in public hospitals are set out in the Annex.

     Out of the above default cases concerning non-local pregnant women, HA does not have a breakdown on the number of those Mainland pregnant women whose spouses are not permanent residents of Hong Kong.

(2)-(5) HA handles all default cases in a serious manner.  It will, where appropriate, take legal actions and file claims with the court.  Since the implementation of the Non-eligible Person Obstetric Package Charge on September 1, 2005, the filing of claims and recovery of arrears by HA through the Small Claims Tribunal and District Courts are as follows:

Accumulated amount   Filing of Claims   Recovery of
as at March 31, 2013                     Arrears  
Amount ($ million)          97.1           14.1
Number of cases            3 290            556
     The reasons for being unable to recover the arrears in some of the cases include: incomplete addresses provided by the patients, financial difficulties claimed by patients or their departure from Hong Kong, etc.  HA notes that the non-local pregnant women who had defaulted on payments are mainly mainland pregnant women seeking treatments at the Accident and Emergency Departments (A&EDs) shortly before labour.

     HA reviews the default cases on a regular basis and takes appropriate measures to recover the arrears.  Apart from the above-mentioned legal actions, HA has put in place a series of measures to minimise default on payment of medical fees.  These measures include:

(i)  issuing interim bills to patients on a weekly basis during their hospitalisation and final bills regularly upon their discharge;

(ii)  requiring all in-patients to provide such contact details as addresses and telephone numbers (including contact details outside Hong Kong);

(iii)  reminding patients or their family members through telephone calls for early settlement of bills before and after the patients' discharge;

(iv)  requiring non-eligible persons to pay a deposit of $47,000 upon admission to public wards (except for emergency cases);

(v)  imposing administrative charges on patients who have received medical services but made late payments of medical fees and charges; and

(vi)  not providing non-emergency medical services for non-eligible persons with outstanding fees.

     Noting that some non-local pregnant women with outstanding fees will leave Hong Kong and return to the Mainland, HA will not only take legal actions in the courts of Hong Kong, but also attempt to recover the arrears through courts in the Mainland.

     HA will closely monitor the effectiveness of various measures and legal actions, keep close liaison with parties concerned, and take further measures as appropriate with a view to safeguarding the relevant public revenue.

Ends/Wednesday, February 12, 2014
Issued at HKT 15:16


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