LCQ1: Latest implementation progress of public healthcare fees and charges reform
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Question:
Regarding the latest implementation progress of the public healthcare fees and charges reform implemented by the Hospital Authority (HA) early this year, will the Government inform this Council:
(1) given that patients currently can submit medical fee waiver applications at designated service units only during office hours, and that the arrangement for self-service waiver applications via the electronic platform will not be introduced until the second quarter of this year at the earliest, whether the Government knows if HA has any measures in place to facilitate the public's submission of waiver applications and enhance the processing efficiency before the introduction of the arrangement;
(2) since the commencement of accepting medical fee waiver applications, of the total number of briefing sessions or publicity activities organised by the Government in various districts to inform the public about the relevant waiver arrangements; whether it has plans to regularly publish data on the effectiveness of the public healthcare fees and charges reform, such as changes in public healthcare utilisation rates and the success rate of fee waiver applications; if so, of the details; if not, the reasons for that; and
(3) to dovetail with the implementation of the fees and charges reform and to reduce the service demand for accident and emergency departments at night, whether the Government has completed planning for strengthening evening consultation services, including their geographical distribution, service scope, consultation hours, and fees and charges; if so, of the details; if not, the reasons for that?
Reply:
President,
In consultation with the Hospital Authority (HA), our reply to the question raised by the Hon Joephy Chan is as follows:
(1) The fees and charges reform for public healthcare aims to enhance healthcare protection for "poor, acute, serious, critical" patients. The various measures under the reform have been smoothly implemented since January 1 this year, among which the HA has expanded the medical fee waiver mechanism for poor patients. The number of eligible low‑income individuals who could potentially benefit is estimated to increase significantly from about 900 000 before the reform to about 2 million after the reform, meaning more than one out of four citizens are entitled to fee waivers, with over 95 per cent of approved cases being full waivers.
While enhancing protection for "poor" patients, the HA is obliged to conduct financial assessment for fee waiver applications to prevent abuse. Up till now, the HA has approved over 210 000 fee waiver applications, which is 15 times the annual number of around 14 000 persons before the reform. To this end, the HA has deployed designated teams across the various hospital clusters to process applications and established the conditional waiver mechanism, under which applications are approved and subsequently reviewed. Even during the peak period when over 5 900 applications were received daily, with the New Territories East Cluster receiving as many as 1 800 applications in a single day, the majority of these applications were still approved on the same day. Currently, on average around 82 per cent of applications can be approved on the same day, with some hospital clusters reaching over 90 per cent, exemplifying the very high efficiency of the handling process.
To further facilitate patients and expedite assessment, the HA is progressively enhancing its electronic system. Currently, patients can already upload documents for financial assessment and check the progress and status of their applications, as well as applying for extension of waiver period, through the "Medical Fee Assistance Domain" in "HA Go". Starting from the end of the second quarter, patients can submit applications and make appointments for applications through the platform. Furthermore, members of the public may also make use of the drop-in boxes set up by various service units to submit supplementary documents for financial assessment outside office hours.
(2) Since the announcement of the fees and charges reform in March last year, in addition to briefing the Legislative Council Panel on Health Services, the Health Bureau (HHB) and the HA held District Council (DC) briefing sessions, and proactively met with different stakeholders to provide explanations. Since accepting fee waiver applications on November 3 last year, up till March this year, the HA has organised over 100 sessions of various activities, such as briefings and workshops, for DC members, patient groups, volunteers, and more, to disseminate relevant information to the community. The HA will continue to collaborate with members of the local community to organise activities in order to enhance public understanding of the various reform measures, including the fee waiver.
The HHB and the HA have also been consistently providing the latest updates and data on effectiveness of the reform through channels such as press releases, media interviews and replies to the Legislative Council, and will further report on the implementation progress and effectiveness of the reform at the Legislative Council Panel on Health Services in May this year. The reform has so far achieved remarkable results in terms of the usage of Accident and Emergency (A&E) departments and the strengthening of patient protection. The A&E departments have been able to better concentrate resources to serve critical and emergency patients, with the number of non-urgent and semi-urgent patients dropping by nearly 20 per cent compared with the same period last year. The efficiency of patient care has also improved, with the proportion of urgent patients receiving treatment within 30 minutes rising from 79.9 per cent in the same period last year to 88.3 per cent. The number of patients approved for fee waiver has significantly increased by 15 times to over 210 000. The $10,000 annual spending cap and subsidies for innovative drugs and devices are also gradually showing effectiveness.
(3) A&E services are open 24 hours a day and no appointments are required. They are positioned to provide care for patients with urgent illnesses or injuries, as well as casualties arising from major incidents. Non-urgent and semi-urgent patients are encouraged to consider public and private primary healthcare services.
At present, public Family Medicine Clinics mainly provides primary healthcare services to grassroots citizens, particularly those from the underprivileged groups. The primary healthcare needs of most other citizens are mainly met by the private community clinics.
Regarding public primary healthcare services, 23 out of the 75 Family Medicine Clinics under the HA currently operate with extended service hours (i.e. evening outpatient services). Taking into account the demand for evening outpatient services, and having considered factors such as population size in different districts, waiting times of A&E departments, and the availability of private doctor services, the HA will, starting from the second quarter of this year, progressively increase a total of 25 000 evening consultation slots in Tuen Mun, North District, Tai Po, Sha Tin, Sham Shui Po, Kwai Tsing and Kwun Tong. In addition, the North Kwai Chung Family Medicine Clinic also plans to regularise its current evening clinic arrangements on Wednesdays and Thursdays to Mondays through Fridays in 2026-27. The HA and the Primary Healthcare Commission will continue review the service needs in various districts, and consider to adjust the evening outpatient service capacity through deploying manpower and resources.
As for private services, currently 13 private hospitals in Hong Kong already provide evening outpatient services. Besides, about 1 000 clinic service points of doctors and about 1 000 clinic service points of Chinese medicine practitioner also provide evening or holiday out-patient services. To facilitate public access to and selection of suitable primary healthcare service providers, the Government has established the Primary Care Directory as a web-based database, containing the information and service hours of the service providers in the community. Citizens can also use the "Doctor Search" function of the eHealth mobile application and the eHealth website to check the list of doctors and details of clinics providing evening outpatient services.
Thank you, President.
Ends/Wednesday, March 25, 2026
Issued at HKT 16:08
Issued at HKT 16:08
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