LCQ14: Medical fee waiver mechanism and medical consultation services
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Question:
The public healthcare fees and charges reform (Reform) took effect on January 1 this year, with the Hospital Authority simultaneously enhancing the medical fee waiver mechanism, resulting in an increase in the number of eligible beneficiaries from 300 000 to 1.4 million. In this connection, will the Government inform this Council:
(1) whether it knows the number of persons in each of the following categories who were exempted from medical fees in the past three years and the amounts involved: (i) recipients of Comprehensive Social Security Assistance; (ii) recipients of Old Age Living Allowance aged 75 or above; and (iii) holders of Level 0 Vouchers under the Residential Care Service Voucher Scheme for the Elderly;
(2) whether it knows the respective numbers of persons who were granted full and partial medical fee waivers for meeting the established financial assessment criteria in the past three years and the amounts involved;
(3) as the Government previously indicated that as at February 28, 2026, there were 752 approved cases under the annual cap mechanism of $10,000 on public medical fees and charges without requiring financial assessment, whether the Government has made any projections on the number of beneficiaries and the public expenditure involved for the whole year; and
(4) given that one of the objectives of the Reform is to reduce the demand for non-urgent consultations at Accident and Emergency departments (A&E), and that members of the public often attend A&E because they are unable to determine their own clinical conditions (especially at night or on holidays), whether the Government, apart from contemplating strengthening evening consultation services, has plans to set up a 24-hour medical consultation hotline service modelled on overseas practices such as the NHS111 hotline in the United Kingdom and healthdirect in Australia, so that members of the public can receive remote preliminary assessment and advice from healthcare professionals via telephone or electronic platforms, thereby helping them to assess their own clinical conditions more accurately and avoid seeking treatment at A&E for minor ailments; if so, of the details; if not, the reasons for that?
Reply:
President,
In consultation with the Hospital Authority (HA), the reply to the question raised by Hon Yiu Ming is as follows:
The fees and charges reform for public healthcare aims to, through reforming the subsidisation structure, guide the public to make optimal use of healthcare resources and reduce wastage and abuse. At the same time, the reform adopts the principle of "co-payment by those who can afford and co-payment by those with mild conditions" and enhances healthcare protection for the four categories of "poor, acute, serious, critical" patients on all fronts, thereby enhancing the sustainability of the healthcare system to cope with challenges posed by an ageing population, increasing prevalence of chronic diseases, etc, and strengthening its role as a safety net for all. The various measures under the reform have been smoothly implemented since January 1, 2026. After the implementation of the reform, the Government maintains a high level of subsidisation of up to 95 per cent for public healthcare services, with citizens co-paying a very low proportion of the cost.
As an essential part of the fees and charges reform for public healthcare, the HA has expanded the medical fee waiver mechanism. In addition to the some 600 000 people who have been benefiting from full medical fee waivers both before and after the reform, namely Comprehensive Social Security Assistance (CSSA) recipients, Old Age Living Allowance (OALA) recipients aged 75 or above and Level 0 Voucher Holders of the Residential Care Service Voucher (RCSV) Scheme for the Elderly, the number of other eligible low-income individuals is estimated to significantly increase from about 300 000 in the past to about 1.4 million. The total number of eligible low income individuals who could potentially benefit is estimated to increase from about 900 000 to about 2 million. This enables limited healthcare resources to be more precisely directed to help the "poor" patients among the "poor, acute, serious, critical" patients who are most in need, while ensuring that no patient is denied medical care due to lack of means.
(1) The table below sets out the numbers of CSSA recipients, OALA recipients aged 75 or above and Level 0 Voucher Holders of the RCSV Scheme for the Elderly who benefitted from medical fee waivers and the waiver amounts involved in the past three years and up to March 31 for the year 2026:
| Year | CSSA recipients | OALA recipients aged 75 or above | Level 0 Voucher Holders of the RCSV Scheme for the Elderly | |||
| Number of persons | Waiver amount involved ($ million) | Number of persons | Waiver amount involved ($ million) | Number of persons | Waiver amount involved ($ million) | |
| 2023 | 241 900 | 459 | 277 000 | 473 | 900 | 2 |
| 2024 | 236 600 | 467 | 300 400 | 514 | 1 200 | 2 |
| 2025 | 231 100 | 461 | 324 400 | 545 | 1 500 | 3 |
| 2026 (up to March 31) |
177 000 | 301 | 266 400 | 403 | 900 | 2 |
(2) Since the implementation of the fees and charges reform for public healthcare, the number of medical fee waiver applications approved by the HA has significantly increased by multiple times compared with the past, demonstrating that the reform has effectively strengthened support for low-income families and underprivileged groups. As at March 31, 2026, the HA has approved 224 039 medical fee waiver applications submitted by Eligible Persons (Note 1). Among the approved applications, 214 978 are full waivers and 9 061 are partial waivers.
The table below sets out the number of medical fee waiver applications approved by medical social workers/social workers for Eligible Persons (Note 1), as well as the number of persons who benefitted from medical fee waiver and the waiver amounts involved in the past three years and up to March 31 for the year 2026:
| Year | Full waiver (Note 2) | Partial waiver (Note 2) | ||||
| Number of approved cases | Number of persons benefitted from waiver | Waiver amount involved ($ million) | Number of approved cases | Number of persons benefitted from waiver | Waiver amount involved ($ million) | |
| 2023 | 15 918 | 13 800 | 47 | 382 | 500 | 0.8 |
| 2024 | 16 522 | 14 100 | 50 | 397 | 500 | 0.9 |
| 2025 | 18 832 | 16 400 | 54 | 515 | 700 | 0.8 |
| 2026 (up to March 31) |
214 978 | 183 400 | 235 | 9 061 | 6 800 | 3.9 |
(3) In addition to expanding the medical fee waiver mechanism, the HA has also introduced an annual cap on fees and charges of $10,000, which is not subject to financial assessment. All Hong Kong residents in need could apply for and benefit from this protection. The annual cap on fees and charges helps provide more comprehensive protection for patients with serious or chronic illnesses or heavy users of public healthcare services, thereby alleviating the financial pressure arising from their ongoing treatment.
As at March 31, the HA has approved 2 953 applications. Citizens approved are not required to pay any fees for eligible healthcare services within the relevant year, thereby further alleviating the financial burden on their families arising from long‑term medical expenses.
Given that the fees and charges reform is still at its initial stage of implementation, and that patients' utilisation pattern of healthcare services over the course of a year may vary, we are not able to make an accurate estimation of the annual number of beneficiaries and the relevant expenditure. The HA will continue to monitor the actual utilisation situation.
(4) To ensure that patients can be diagnosed and assessed as early as possible, the HA has established triage guidelines, under which an experienced and specially trained nurse will first assess patients' conditions, including reviewing their medical history, symptoms and vital signs at the time of attendance, and set priorities for treatment according to the severity. Patients are classified into five categories based on their clinical conditions, namely Triage I (critical), Triage II (emergency), Triage III (urgent), Triage IV (semi-urgent) and Triage V (non-urgent). The HA has set performance pledge to ensure that patients who need urgent medical attention are treated within a reasonable time. Patients triaged as critical will be treated immediately by healthcare staff without having to wait, while those with non-urgent conditions may have to wait longer.
The HA has been encouraging patients with relatively mild conditions to make good use of primary healthcare services. With the implementation of the fees and charges reform for public healthcare in 2026, the refund arrangement at the Accident and Emergency departments (A&E) has been regularised, providing patients with greater flexibility in seeking care. Patients who have been triaged but have not yet received consultation may apply for a refund within 24 hours after registration via HA Go mobile application or at the A&E registration counter, thereby enabling them to choose other healthcare services. This measure aims to focus A&E resources to serve critical and emergency patients, enabling A&Es to perform their emergency care function.
As regards public primary healthcare services, the Primary Healthcare Commission and the HA have been working to strengthen family medicine outpatient services and enhance service capacity, including the provision of evening and public holiday out-patient services. At present, the HA manages 75 Family Medicine Clinics (FMCs), 23 of which provide evening out-patient services across all districts in Hong Kong. The number of clinics offering Family Medicine Out‑patient Services on Sunday and public holidays has also increased to 15 in 2025. Given the demand for evening out-patient services, and having taken into account factors such as district population size, A&E waiting times and the availability of private doctors, the HA will progressively increase evening consultation slots by 25 000 from the second quarter of this year in districts including Tuen Mun, North District, Tai Po, Sha Tin, Sham Shui Po, Kwai Tsing and Kwun Tong. In addition, the North Kwai Chung FMC 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 continuously review the service needs of different districts and consider adjusting evening out-patient service capacity through deploying manpower and resources.
To facilitate public selection of suitable primary healthcare service providers, the Government has also established the Primary Care Directory (PCD), which contains the practice information and professional qualifications of primary healthcare service providers in the community, facilitating public access to such information and selection of suitable family doctor. At present, around 1 000 clinic service points of doctors and around 1 000 clinic service points of Chinese medicine practitioners in the PCD provide evening out-patient services. Meanwhile, to meet the demand for medical services during long holidays, the Government also collates information on private healthcare facilities, covering private clinics enlisted in the PCD, non-profit organisations and private Chinese medicine clinics, which will be in operation during public holidays across 18 districts in the territory. The list of doctors enlisted in the PCD and information (including addresses, phone numbers and operation hours) on healthcare facilities providing relevant services can be accessed via the "Doctor Search" function of the eHealth mobile app and the eHealth website. These measures aim to help the public easily find suitable private medical services in the community outside office hours or during holidays, thereby diverting non-urgent consultation needs from A&Es. The HA currently has no plans to adopt remote assessment via telephone or digital platforms considering the potential medical risks, quality and safety, as well as cost-effectiveness.
Note 1: According to the Gazette (G.N. 5708 issued on September 27, 2013), patients falling into the following categories are eligible for the rates of charges applicable to Eligible Persons:
(i) holders of Hong Kong Identity Card issued under the Registration of Persons Ordinance (Chapter 177), except those who obtained their Hong Kong Identity Card by virtue of a previous permission to land or remain in Hong Kong granted to them and such permission has expired or ceased to be valid;
(ii) children who are Hong Kong residents and under 11 years of age; or
(iii) other persons approved by the Chief Executive of the HA.
Note 2: Some patients may be approved for both full and partial medical fee waivers handled by medical social workers/social workers within the same year.
Ends/Wednesday, April 29, 2026
Issued at HKT 15:15
Issued at HKT 15:15
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