LCQ10: Manpower of medical practitioners needed by beauty industry
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Question:
One of the provisions proposed in the Private Healthcare Facilities Bill, which is now under scrutiny by this Council, is that a person must not serve at the same time as the chief medical executive of more than two day procedure centres or clinics. Although it is learnt that the Government intends to raise that upper limit to three, some members of the beauty industry have pointed out that, as the existing manpower of medical practitioners in Hong Kong has already been stretched to the limit, the implementation of the proposed provision may aggravate the manpower shortage of medical practitioners and push up the salaries of medical practitioners. They worry that quite a number of beauty service providers may close down because they are unable to recruit medical practitioners to station on-site or afford the high expenses for engaging medical practitioners. Furthermore, the wastage of medical practitioners in the public healthcare sector may be aggravated. In this connection, will the Government inform this Council:
(1) of (i) the current total number of registered medical practitioners in Hong Kong and (ii) the current ratio of the number of medical practitioners per 1 000 population of Hong Kong, and (iii) how that ratio compares with the relevant figures in South Korea, Singapore, Japan, the United Kingdom and the United States; the projected medical practitioners to population ratio in Hong Kong in each of the coming five years, and whether there will be improvement to such ratio;
(2) whether it knows the current (i) number of medical practitioners who provide medical cosmetic services and (ii) number of beauty service providers which employ medical practitioners for provision of such services;
(3) whether it has assessed the shortfall in medical practitioners in Hong Kong in each of the past five years and the coming five years;
(4) whether it has assessed the feasibility and possible impacts of the aforesaid proposed provision, including whether there are sufficient medical practitioners in Hong Kong to dovetail with the implementation of such provision; if it has assessed, of the outcome; if not, the reasons for that;
(5) how the Government determines the maximum number of beauty service providers that a medical practitioner may serve; and
(6) as it is learnt that some cosmetic procedures are required to be performed by medical practitioners under the current law, but there is a view that those beauty practitioners who have received professional training and possess the relevant qualifications should in fact be able to perform some of such procedures, whether the Government has conducted an in-depth study on the feasibility of taking on board this view for alleviating the manpower shortage of medical practitioners; if so, of the details; if not, the reasons for that and whether it will conduct such a study expeditiously?
Reply:
President,
My reply to various parts of the question is as follows:
(1) In view of the ageing population and the manpower shortage of doctors, the Government has substantially increased University Grants Committee (UGC)-funded medical training places over the past decade, from 250 in the 2005/06 academic year to 470 in the 2016/17 academic year, representing an increase of 90%. The Government is discussing with UGC to further increase the number of medical training places. It is expected that increasing the number of medical training places will alleviate the manpower shortage of doctors.
According to the figures of the Department of Health (DH), there are a total of 14 290 registered doctors in Hong Kong as at end 2017. The number of registered doctors per 1 000 population in each of the past five years is as follows:
| 2013 | 2014 | 2015 | 2016 | 2017 |
| 1.8 | 1.8 | 1.9 | 1.9 | 1.9 |
According to the statistics of the Organisation for Economic Co-operation and Development (OECD) (the latest figures as at 2015), and the Ministry of Health Singapore and DH, the number of doctors per 1 000 population in South Korea, Singapore, Japan, the United Kingdom and the United States in each of the years between 2013 and 2015 is as follows:
| 2013 | 2014 | 2015 | |
| South Korea | 2.2 | 2.2 | 2.2 |
| Singapore | 2.0 | 2.1 | 2.3 |
| Japan | － | 2.4 | － |
| United Kingdom | 2.8 | 2.8 | 2.8 |
| United States | 2.6 | 2.6 | － |
(2) The Food and Health Bureau and DH do not keep information on the number of doctors who provide medical cosmetic services and the number of beauty service providers which employ medical practitioners for provision of such services.
(3) The Government published the report of the Strategic Review on Healthcare Manpower Planning and Professional Development (Strategic Review) in June 2017. According to the projection results of the Strategic Review, with the ageing population and increasing demand for healthcare services, it is projected that there will be manpower shortage of doctors in the medium to long term. The manpower shortage of doctors in 2020, 2025 and 2030 are as follows:
| 2020 | 2025 | 2030 | |
| 5th percentile | 320 | 596 | 829 |
| (2.6%) | (4.4%) | (5.7%) | |
| Best guestimate | 500 | 755 | 1 007 |
| (3.9%) | (5.5%) | (6.8%) | |
| 95th percentile | 989 | 1 296 | 1 575 |
| (7.5%) | (9.0%) | (10.3%) |
We are conducting a new round of manpower projection exercise to update the demand and supply projection of healthcare manpower (including doctors).
(4) and (5) Under clause 53(4) of the Private Healthcare Facilities Bill (the Bill), a person must not serve at the same time as the chief medical executive of more than two day procedure centres or clinics (note).
Such a requirement was proposed to ensure that the chief medical executive will be able to take charge of the day-to-day administration of the facilities under his/her responsibilities effectively. With each chief medical executive being allowed to take charge of more private healthcare facilities (PHFs), there may be doubt on the internal governance of the PHFs concerned, which is one of the important regulatory aspects to be enhanced under the new regime. Whether or not the services are provided for cosmetic purposes, all PHFs must comply with the requirements stipulated in the Private Healthcare Facilities Ordinance when the Bill comes into effect after enactment.
Some Legislative Council Members and stakeholders have proposed that the Government should consider relaxing the requirement under clause 53(4) of the Bill. We are now comprehensively assessing the implications of this proposal in consultation with stakeholders, before considering whether it is appropriate to relax this requirement via a Committee Stage Amendment.
(6) Beauty industry in Hong Kong, like most other industries and businesses, runs and evolves in a free-market environment subject to laws and regulations of a general nature. Instead of regulating the beauty industry indiscriminately, the Government has adopted a risk-based approach to focus on high-risk procedures, which may cause unnecessary harm or complications to members of the public if performed by a person without proper training or qualification. Certain procedures, irrespective of whether they are for cosmetic purposes, should only be performed by registered medical practitioners or registered dentists. These procedures include those involving injections, mechanical/chemical exfoliation of the skin below the epidermis, hyperbaric oxygen therapy and dental bleaching. Traditional body tattooing and piercing should nevertheless be exempted from being considered as a "medical procedure". However, special care should be taken for those performed on body parts which are of higher risk of complications (e.g. near the eyes or tongue).
Note: Except in the situation referred to in clause 53(5).
Ends/Wednesday, March 21, 2018
Issued at HKT 19:25
Issued at HKT 19:25
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