Following is a question by Dr the Hon Tik Chi-yuen and a written reply by the Secretary for Health, Professor Lo Chung-mau, in the Legislative Council today (September 25):

Question:

     The Government announced details of the fees and charges reform for public healthcare on March 25 this year, with the new structure of fees and charges to be implemented on January 1 next year. The fees and charges reform is based on the principles of "co-payment by those who can afford and co-payment by those with mild conditions", and the existing medical fee waiving mechanism (waiving mechanism) will be enhanced to enable resources to be precisely allocated to patients with urgent medical needs. However, there are views pointing out that the Government has yet to announce the specific administrative procedures for enhancing the waiving mechanism, as well as the transitional arrangements between the existing mechanism and the enhanced mechanism, arousing concerns about a "vacuum period" where fees are increased before waivers are implemented. In this connection, will the Government inform this Council:

(1) of the specific administrative procedures for enhancing the waiving mechanism (including but not limited to the allowance arrangements for itemised services for eligible persons, and the transitional arrangements between the existing mechanism and the enhanced mechanism, etc.);

(2) whether it knows the additional manpower required by the Hospital Authority (HA) after enhancing the waiving mechanism;

(3) given that the authorities anticipate a significant increase in the number of eligible beneficiaries under the enhanced waiving mechanism to 1.4 million, whether the Government knows the specific measures put in place by the HA to effectively streamline the vetting and approval procedures for applications, and whether it will set a commitment period for vetting and approval (e.g. undertaking to complete vetting and approval within one week after a patient's application is submitted and disburse subsidies to approved cases), so that patients can receive timely assistance; and

(4) given that according to the paper submitted by the Health Bureau to the Panel on Health Services of this Council in April this year, the Health Bureau expects that the fees and charges reform for public healthcare will take five years, of the specific timetable for the relevant work?

Reply:

President,

     In consultation with the Hospital Authority (HA), the consolidated reply to the question raised by Dr the Hon Tik Chi-yuen is as follows: 

     Hong Kong's healthcare system is renowned for its efficient and quality services. The public healthcare system is not only the cornerstone of the healthcare system, but also a safety net for all, and must be robust and sustainable. At present, public healthcare services are heavily subsidised by public funds, with a subsidy rate as high as 97.6 per cent. However, with an ageing population, increasing demand for services and rising healthcare costs, Hong Kong's healthcare system is facing unprecedented challenges.

     The Government is implementing healthcare system reform in a holistic manner, of which the fees and charges reform for public healthcare is an integral part. The reform is based on the following five principles:

(i) Commitment will not be lessened: The Government's commitment to public health will remain unchanged. All gains from the reform will be wholly utilised for public healthcare services; 
(ii) Co-payment for those who can afford it and for those with mild conditions: The Government will reasonably expand and enhance the co-payment mechanism; 
(iii) Enhancement and reduction: Protection for "poor, acute, serious, critical" patients will be enhanced and wastage will be reduced; 
(iv) High subsidisation: The high level of subsidy will be maintained after the reform, with the target of maintaining the 90 per cent overall public subsidisation rate; and 
(v) Gradual and orderly progress: The objective will be achieved in a progressive and orderly manner in five years.

     Reforming the subsidisation structure of public healthcare services aims to guide the public to make optimal use of healthcare resources, reduce wastage and abuse, and enhance healthcare protection for "poor, acute, serious, critical" patients on all fronts, thereby enhancing the sustainability of the healthcare system and strengthening the public healthcare system to cope with the challenges posed by an ageing population, inflation of healthcare costs, etc., and serve as a safety net for all.

     Relevant measures include enhancing the medical fee waiver mechanism by relaxing the income and asset limits under the eligibility criteria for application to protect more low-income grassroot citizens. Apart from the current full waiver beneficiaries under the three categories of social welfare schemes (including Comprehensive Social Security Assistance recipients, Old Age Living Allowance recipients aged 75 or above and Level 0 Voucher Holders of the Residential Care Service Voucher Scheme for the Elderly), the number of eligible beneficiaries is estimated to increase from 300 000 to 1.4 million. This means an additional 1.1 million low-income grassroot citizens who currently do not hold fee waivers will be eligible for partial or full fee waivers. Together with the existing 600 000 full waiver beneficiaries under the three aforementioned social welfare schemes, about two million citizens in Hong Kong, including those from the underprivileged and low income groups, will be eligible for full or partial medical fee waiver, covering all fees and charges incurred by patients for using in-patient, out-patient, as well as accident and emergency services etc., except for self-financed drugs and medical devices.

     Since the announcement of the fees and charges reform for public healthcare at the end of March, the Health Bureau (HHB) and the HA have been proactively explaining the reform to the Legislative Council, healthcare professionals and patient organisations, members of the public and other stakeholders, and have produced various information packs, short videos and promotional materials to help the public understand the new healthcare protection measures. The HHB and the HA have jointly organised briefings for the District Councils (DCs) to explain the reform to over 400 DC members and local community members, and leverage the role of DC as a bridge to assist members of the public to get a better grasp of the substance  and significance of the fees and charges reform, with a view to helping the public understand that the reform can provide them with more comprehensive healthcare protection. Meanwhile, the HA is also pressing ahead at full steam with the implementation of the various measures under the fees and charges reform for public healthcare to ensure its smooth implementation on January 1 next year.

     To dovetail with the implementation of the enhanced medical fee waiver mechanism, the HA will streamline the application process for medical fee waivers and expedite the progress of assessment to further facilitate the public. Under the enhanced medical fee waiver mechanism, the maximum validity period of fee waivers will be extended from 12 to 18 months, reducing the number of times patients need to re-apply. The scope of coverage for fee waivers will also be expanded to include episodic appointments for general out-patient clinic services. Patients using such services within the waiver validity period will no longer need to apply separately for one-off medical fee waivers. The HA will also relax the definition of "household" for the purpose of financial assessment during application. Family members who live with but not financially connected with the patient direct will no longer be included in the financial assessment, reducing the documents required for vetting thereby expediting the application process.

     Moreover, the HA will reduce the need for repeated verification of patients' income and asset information. For re-applications within a maximum period of 18 months, patients will only be required to sign a declaration confirming that there is no change to their household financial situation, without having to re-submit financial documents for assessment. Where the applicant's family member is a current medical fee waiver beneficiary, the HA will refer to the financial information submitted at the time of the family member's application and, based on actual circumstances, and only require the applicant to provide the necessary or missing information instead of starting a full re-assessment afresh for every case. Moreover, the HA will also refer to the verified financial assessment eligibility results of citizens under other social welfare and government subsidy schemes so as to minimise the need for repeated assessment when processing medical fee waiver applications.

     Furthermore, the application and assessment process will be conducted electronically as far as possible. The HA is progressively upgrading its electronic systems to facilitate citizens in submitting documents and applications via "HA Go" mobile application, thereby making it more convenient for the public and enhancing the efficiency of processing applications.

     To handle the additional applications under the enhanced medical fee waiver mechanism, the HA is also progressively recruiting additional staff to set up ten dedicated teams, with each team comprising approximately ten members, to be deployed across various hospitals to triage and process the relevant applications. The HA will continuously review the relevant manpower needs and make deployments as necessary to ensure timely processing of citizens' medical fee waiver applications so that citizens will not be denied adequate medical care due to lack of means, while also optimising the use of the relevant resources.

     Moreover, having regard to the inevitable increase in the volume of applications for medical fee waivers when the new fees and charges take effect next year, apart from setting up dedicated teams to triage and process applications, the HA will also begin to accept advance applications for medical fee waivers at the end of this year for patients with scheduled appointments for January to February next year. During the initial phase of fees and charges adjustments, the HA will also implement a series of temporary arrangements to manage the increased volume of applications. These include issuing conditional waivers for patients with urgent medical needs and whose financial assessment has not been completed, arranging refunds for patients who have already used the services and have subsequently been granted waivers. The relevant detailed arrangements will be announced to the public within October.

     The new fees and charges were gazetted on April 25 this year and will take effect on January 1, 2026. After the implementation of the first phase of the fees and charges reform in January 2026, the Government and the HA will follow the principle of progressive and orderly implementation and conduct a review every two years in accordance with the existing mechanism. The relevant reform is expected to be fully implemented in five years. Alongside the implementation of the fees and charges reform for healthcare, the Government will continue to take forward healthcare reform in other areas to build a "Healthy Hong Kong".

Ends/Thursday, September 25, 2025
Issued at HKT 14:10

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