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LCQ12: Default of payment of Hospital Authority medical fees
     Following is a question by the Dr Hon Cheng Chung-tai and a written reply by the Secretary for Food and Health, Professor Sophia Chan, in the Legislative Council today (February 7):


     It has been reported that the problem of Non-eligible Persons (NEPs) defaulting on payment of public hospital charges has been serious in recent years.  The amounts of unpaid medical fees owed by non-local pregnant women after giving birth in public hospitals and written off by the Hospital Authority (HA) in 2015-2016 and 2016-2017 were $6.1 million and $4.7 million respectively. Besides, in 2015-2016, an NEP did not pay any fees despite having been hospitalised for more than 100 days. On preventing NEPs from defaulting on payment of public hospital charges, will the Government inform this Council if it knows:

(1) the number of cases in each of the past five financial years in which NEPs defaulted on payment of public hospital charges and the total amount involved, with a breakdown by specialty;

(2) whether HA has considered adopting new measures to recover arrears from NEPs; and

(3) given that HA recorded an operating deficit of $1.5 billion in 2016-2017, whether HA will consider implementing a measure that NEPs "must make payment before receiving treatment", in order to avoid deterioration of the problem of operating deficit caused by bad debts?



     My reply to various parts of the question raised by Dr the Hon Cheng Chung-tai is as follows:

(1) Public healthcare services in Hong Kong are heavily subsidised by the Government, targeting at local Eligible Persons (mainly holders of Hong Kong Identity Card). Apart from emergency services, medical institutions of the Hospital Authority (HA) will consider providing non-emergency services for Non-Eligible Persons (NEPs) on a case by case basis only when there is spare service capacity and the services provided for local residents will not be affected. The rates of charges applicable to NEPs will apply.

     The number of write-off cases of public hospitals involving NEPs in each of the past five years and the amount of fees so written off are set out as follows:
Obstetrics and gynaecology (O&G) services provided Non-O&G services provided
No. of cases Amount of fees
written off
($ million)
No. of cases Amount of fees
written off
($ million)
2012-13 379 10.2 6 232 20.0
2013-14 188 8.6 5 226 23.0
2014-15 127 7.6 5 961 52.2
2015-16 97 6.1 7 232 35.5
2016-17 88 4.7 7 854 45.8

(2) and (3)

     The HA has put in place an established mechanism to minimise default on payment of medical fees. Relevant measures include:

(i) requiring NEPs to pay a specified amount of deposit upon admission to hospital (except for emergency cases);

(ii) issuing interim bills to patients once every three days during their hospitalisation and reminding patients or their family members to settle the bills;

(iii) issuing final bills to patients upon their discharge or mailing the bills to the Hong Kong or overseas addresses provided at registration. If the bills remain outstanding after the patients' discharge, patients or their family members will be reminded through telephone calls for settlement of bills and monthly statements be mailed to the Hong Kong or overseas addresses provided at registration; and

(iv) imposing administrative charges on patients who have failed to settle the bills within a specified period.

     If the bills remain outstanding after the above actions have been taken, the HA will institute legal actions including submission of cases to the Small Claims Tribunal and commissioning of lawyers to issue letters where appropriate.

     As for those NEPs who do not have to be hospitalised after treatment but need assistance with discharge arrangements, under suitable situation, the HA will contact the Social Welfare Department, or the relevant consulates or the Mainland authorities via the Immigration Department, to make suitable discharge arrangements for them.

     The HA reviews the mechanism for recovery of medical fees from time to time and keeps in view the modes of payment commonly used in the market to facilitate payment by patients and reduce arrears. For example, the functions of the existing self-payment kiosks have been upgraded in phases and efforts have been made to explore the feasibility of adopting various modes of payment with a view to providing greater convenience for patients to make their payment.

     To enable the HA to address the staffing issue and service demands arising from a growing and ageing population in a more effective and sustained manner, the Government will introduce a new arrangement to increase the recurrent funding for the HA progressively on a triennium basis, having regard to population growth rates and demographic changes.
Ends/Wednesday, February 7, 2018
Issued at HKT 15:55
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