LCQ11: Monitoring of services of private hospitals
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Question:
It has been reported that during the period when the fifth wave of the Coronavirus Disease 2019 epidemic in Hong Kong was extremely severe, a number of private hospitals were alleged to have refused to admit patients with fever symptoms, which has aroused great controversy in society. Regarding the monitoring of services of private hospitals, will the Government inform this Council:
(1) given that it was specified in the land grant conditions of private hospitals in the past that private hospitals were required to reserve no less than 20 per cent of their total beds as low-charge beds, and the Executive Council decided in January 2011 that such requirement would no longer be retained upon renewal of the land leases with various private hospitals in future, but the Direct Investigation Report published by the Office of the Ombudsman in July 2020 revealed that the utilisation rates of low-charge beds in two private hospitals had reached a maximum of about 60 per cent to 80 per cent, reflecting that there was still a demand for low-charge beds, whether the authorities will consider reintroducing and enhancing such requirement when renewing the land leases and licences of all private hospitals in future, so as to alleviate the pressure on the public healthcare system; if so, of the details; if not, the reasons for that;
(2) as it has been reported that at present, most private hospitals in Hong Kong operate as non-profit-making charitable bodies and, apart from enjoying tax exemption, are granted land by the Government at nil or nominal premium for their operation, whether the authorities will consider, by way of amendment to the Private Healthcare Facilities Ordinance (Cap. 633), clarifying the responsibilities and obligations of all private hospitals in facing major public health incidents and regularly assessing the response of all private hospitals in facing such incidents, and using the assessment results as a factor for consideration in the renewal of licences and land leases or provision of tax exemption in future; if so, of the details; if not, the reasons for that; and
(3) as it has been reported that at least four private hospitals have recorded sizeable surpluses in recent years and some private hospitals have not made public their accounts for a long time, whether the authorities know the annual expenditure of such hospitals on healthcare development, and what measures are in place to ensure that relevant resources will not be misallocated for non-healthcare development purposes; whether it will require all private hospitals to make public their accounts, so as to facilitate public monitoring; if so, of the details; if not, the reasons for that?
Reply:
President,
Upon consultation with the Department of Health (DH), the consolidated reply to the questions raised by Dr the Hon Chow Man-kong is as follows:
The healthcare system of Hong Kong runs on a dual-track basis encompassing both the public and private sectors. The public healthcare sector serves as the safety net for all in Hong Kong's healthcare system, while the private healthcare sector provides personalised choices for citizens who can afford the fees. All along, the Government has been adopting the policy direction of continuously strengthening the public healthcare system while promoting the development of the private healthcare sector in parallel.
In the early years, the government sites were granted by the Government to non-profit-making private hospitals at nil or nominal premium subject to land grant conditions including (1) the provision of free or low-charge beds; and/or (2) profits/surplus derived from the operation of hospitals to be ploughed back for improving and expanding hospital facilities.
To further ensure the provision of quality service by private hospitals and better cater for the needs of the public, the Government has, after a review on the policy on private hospital development, adopted a set of minimum requirements for new private hospitals to be developed on the government sites since 2011, covering requirements such as land use, bed capacity, service scope, packaged charge and price transparency, service target, service standard and reporting. As for the expansion or redevelopment of the existing private hospitals, if the relevant development project requires land leases modification or approval from relevant departments, the Government will take the opportunity to invite the relevant hospitals to consider whether to accept the minimum requirements; and if so, relevant requirements will be included in the modified land leases and suitably reflected in the land premium.
In accordance with the above policies, two private hospitals are currently required to provide free or low-charge beds under the land grant conditions. However, it does not mean that other private hospitals are spared from the responsibilities for combating the epidemic. Since the fifth wave of the COVID-19 epidemic, the Health Bureau and the Hospital Authority (HA) have maintained close communication with private hospitals. All 13 private hospitals have continuously provided beds with the number adjusted from time to time based on the need of the HA. As of January 9, 2023, private hospitals provide 390 beds. Throughout the epidemic, they have received 4 392 patients from public hospitals, including COVID-19 patients received by CUHK Medical Centre, thereby freeing up 50 300 bed days in public hospitals and allowing the HA to focus its resources on combating the epidemic.
Besides, various private hospitals have actively responded to the Government's appeal by deploying medical teams to participate in the operation of holding centres for the elderly (including CUHK Medical Centre, Gleneagles Hospital Hong Kong, Hong Kong Adventist Hospital – Tsuen Wan, St. Paul's Hospital and Union Hospital), as well as providing outpatient or teleconsultation services for COVID-19 patients in the community etc., alleviating the pressure on the public healthcare system. Since August 2022, the HA has engaged private healthcare institutions (including private hospitals) to provide teleconsultation service for COVID-19 patients and served 88 495 patients so far.
On the other hand, six private hospitals are currently subject to the land grant condition of no distribution of profits/surplus. Accordingly, the DH will examine the relevant financial accounts to monitor grantees/lessees' compliance with the concerned condition. At present, the Government does not require private hospitals to publish their financial accounts for public inspection.
As for the Private Healthcare Facilities Ordinance (Cap. 633) (the Ordinance) enacted in 2018, it aims to introduce a premises-based regulatory regime for different types of private healthcare facilities (PHFs) (including private hospitals) to further protect patients' safety and rights. Amongst others, it stipulates that the Director of Health may issue codes of practice on (1) the equipment, fittings and furnishings in PHFs; (2) the management and staffing arrangement of PHFs; (3) the quality of care for patients and patients' safety in PHFs; and (4) establishment of regulatory standards for any other matters relating to the protection of health and interests of individuals receiving healthcare services in PHFs. The Ordinance does not empower the Government to mandate licensed PHFs to provide specified services under specific circumstances, nor does it concern land grant conditions.
The COVID-19 epidemic has posed unprecedented challenges to the public health of Hong Kong. The Government will summarise the experience on the cooperation with private hospitals in combating the epidemic, the latest development of the overall healthcare system and implementation of minimum requirements to review the policy on private hospital development at a suitable juncture.
Ends/Wednesday, January 11, 2023
Issued at HKT 12:35
Issued at HKT 12:35
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