LCQ12: Appointment system for non-urgent radiology services in public hospitals
*******************************************************************************
Question:
Under the public healthcare fees and charges reform implemented since January 1 this year, if a patient does not settle the payment at least 14 calendar days before the appointment date of a non-urgent radiology service, the system will automatically cancel the appointment and the radiology department will allocate the appointment slot to another patient. If the patient would like to reschedule the appointment, the relevant clinician will assess the clinical condition of the patient to determine whether a new radiology service referral is required before the radiology department will arrange a new appointment schedule. The Hospital Authority (HA) has previously made special transitional arrangements for patients, but such arrangements ended on April 14 this year. In this connection, will the Government inform this Council:
(1) whether it knows the number of patients with their non-urgent radiology service schedules automatically cancelled due to failure to settle payments on time (with a breakdown by each public hospital); and among these patients, of the number of those being referred for radiology services again by the relevant clinicians;
(2) as the "HA Go" mobile application currently issues a maximum of three payment reminders to patients before their payment deadlines, and for non-"HA Go" users, HA's Finance Division sends a payment reminder via a paper bill by post, and also at the meeting of the Panel on Health Services on May 8 this year, HA stated that hospital staff would review on a daily basis cases of scheduled imaging services due in 14 days and make telephone reminders to patients yet to settle payments, whether the authorities have evaluated the effectiveness of the above measure; and whether they have looked into the reasons for patients failing to settle payments on time despite reminders have been made;
(3) whether it knows if priority will be given to patients' new appointments following their reassessments and new referrals are made; and of the average waiting time before they can receive the relevant services after automatic cancellation of their appointment schedules;
(4) given that the new policy requires clinical reassessments to be made by the relevant clinicians for rescheduling an appointment, whether the authorities have assessed if this requirement will increase the workload of the relevant clinicians; and
(5) whether the authorities will consider setting up an appointment rescheduling function in the "HA Go" mobile application to streamline administrative procedures and make it more convenient for patients?
Reply:
President,
In consultation with the Hospital Authority (HA), the reply to the question raised by the Hon Christine Fong 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, with a view to ensure that limited healthcare resources can be directed in a targeted manner to help those patients most in need, thereby enhancing the sustainability of the healthcare system and strengthening its role as a safety net for all. The various measures under the reform have been successfully implemented since January 1, 2026. Following 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.
Under the fees and charges reform for pubic healthcare, the HA has introduced a co-payment model for non-urgent radiological diagnostic services to reduce the number of appointment slots left unused due to patients not attending scheduled examinations, thereby enhancing service efficiency. The HA has adopted a three-tier charging arrangement. X-ray examinations, which account for the largest share of service volume, are classified as basic items and remain free of charge. Intermediate items, including fluoroscopy, ultrasonography, and mammography, are charged at $250 per item. Advanced items, including computed tomography (CT), magnetic resonance imaging (MRI), angiography and vascular interventional radiology, non-vascular interventional radiology, nuclear medicine, and positron emission tomography-computed tomography (PET-CT), are charged at $500 per item. These charging arrangements apply to non-urgent radiology services arranged for follow-up from outpatient clinics or accident and emergency (A&E) departments, as well as for day patients or discharged inpatients. Emergency radiology services, including those required during A&E attendance and inpatient episodes, are entirely unaffected by the fees and charges reform and remain free of charge, with a view to ensuring patients' timely access to necessary investigations in urgent situations.
To facilitate the new charging arrangements for non‑urgent radiology services, the HA has introduced a special transitional arrangement following the implementation of the fees and charges reform for public healthcare. For patients who made appointments before January 1, 2026, and were scheduled to receive services on or before April 14, 2026, patients can fully settle the payment before or on the day of service through HA Go, at the hospital Shroff/Accounts Office, or at a one-stop electronic kiosk. Following the end of the special transitional arrangement, for appointments scheduled for April 15, 2026, or later (i.e. with payment deadlines on or after April 1, 2026), patients must settle the payment at least 14 calendar days before the appointment date; otherwise, the appointment will be automatically cancelled by the system. Patients who no longer require the service may cancel their appointment via the HA Go mobile application at least 14 days before the appointment date and will receive a refund of the relevant fees paid upon cancellation.
The special transitional arrangement aims to familiarise patients with the new charging and appointment system. At the same time, the 14‑day payment deadline effectively provides patients with sufficient time to consider whether they wish to receive non‑urgent radiology services from the HA. Patients may no longer require their original appointment for various reasons (e.g. changes in their clinical condition or having completed examinations at other healthcare institutions). Through appropriate fee structures and appointment management arrangements, the HA allows patients who no longer require the service to cancel their appointment at least 14 days in advance and receive a refund. This helps to encourage the release of appointment slots for other patients in need, ensuring more effective use of public healthcare resources and achieving the objective of reducing wastage.
The reform for non‑urgent radiology services has shown initial positive outcomes since its implementation. In April 2026, the number of default appointments for CT decreased by 18 per cent compared with the same period last year, with a drop in default rate by 1.6 percentage points to 6.6 per cent. For MRI, the number of default appointments decreased by 24 per cent, with a drop in default rate by 1.6 percentage points to 5.0 per cent. For ultrasonography, the number of default appointments decreased by 24 per cent, with a drop in default rate by 1.8 percentage points to 6.7 per cent. These results reflect the positive impact of the fees and charges reform in guiding patients to use healthcare services appropriately, reducing default appointments and resource wastage, and improving the utilisation efficiency of public healthcare resources.
The table below sets out the comparison of the number of default appointments as well as the default rates for non‑urgent radiology services in April 2025 and April 2026:
(a) Comparison of the number of default appointments
| Default Appointment Items (Note) | April 2025 | April 2026 | Percentage Change |
| CT | 1 705 | 1 390 | -18% |
| MRI | 497 | 379 | -24% |
| Ultrasonography | 2 036 | 1 557 | -24% |
(b) Comparison of default rates
| Default Appointment Items (Note) | April 2025 | April 2026 | Change (percentage points) |
| CT | 8.2% | 6.6% | -1.6 |
| MRI | 6.6% | 5.0% | -1.6 |
| Ultrasonography | 8.5% | 6.7% | -1.8 |
(1) From January 1 to April 30, 2026, a total of 361 597 non-urgent radiology appointments were recorded across all hospitals. Among these, 6 796 appointments were given up due to failure to settle payment by the deadline, of which 2 997 were subsequently rescheduled. These figures represent 2 per cent and 1 per cent of the total number of non-urgent radiology appointments respectively. Some patients may have obtained radiological investigations from other places and thus no longer required the scheduled public service. The breakdown by hospital cluster is set out below:
| Hospital Cluster | Number of appointments automatically cancelled due to failure to settle payment by the deadline | Number of rescheduled appointments |
| Hong Kong Island Cluster | 1 333 | 625 |
| Kowloon Central Cluster | 1 619 | 773 |
| Kowloon East Cluster | 723 | 272 |
| Kowloon West Cluster | 953 | 375 |
| New Territories East Cluster | 1 445 | 638 |
| New Territories West Cluster | 723 | 314 |
| HA Overall | 6 796 | 2 997 |
(2) The HA has been promoting the charging arrangements for radiology services and the related payment arrangements through various channels, including holding briefing sessions and producing promotional videos and leaflets, to help patients, their family members and carers understand the payment requirements, deadlines and reminder arrangements, and to settle payment on time. The HA will continue to strengthen publicity to ensure that patients understand the charging policy and to ensure proper use of healthcare resources.
If a patient does not settle the payment for radiology services before the payment deadline, the HA Go mobile application will issue up to three payment reminders before the deadline. These reminders are sent on the 44th, 35th and 15th day prior to the appointment date. In addition to reminders issued via HA Go, the HA will mail a paper billing notice to non-HA Go users around the 35th day before the appointment as a payment reminder. The arrangement for hospital staff to make reminder calls was a transitional measure introduced during the initial phase of the new charging arrangements. The HA understands that some patients may need time to become familiar with the new payment arrangements. Therefore, during the early stage of implementation of the charging policy, the HA strengthened reminders through multiple channels and provided transitional phone reminders to help patients keep track of payment deadlines.
The HA is closely monitoring the effectiveness of the reminder mechanism in helping patients to complete payment on time and will review the arrangements in a timely manner. Patients may fail to meet the payment deadline for various reasons, including insufficient understanding of the payment arrangements, difficulties encountered when using electronic payment channels, or personal financial or other practical circumstances. The HA will continue to monitor the situation and provide appropriate assistance and guidance to patients where necessary.
(3) to (5) The HA encourages patients to set aside sufficient time to attend their scheduled examinations or consultations punctually, so as to avoid the need for reassessment and re-scheduling due to unattended appointments. This not only wastes valuable healthcare resources, but may also result in delay in patients' own diagnosis and treatment.
If a patient is unable to keep the original appointment for any reason, they should cancel it as early as possible via HA Go mobile application, so that the slot can be released to other patients in need. If a patient gives up an appointment slot (for example, due to failure to complete payment before the deadline or for other reasons) and subsequently requires a new appointment for radiology services, the attending doctor will first assess the patient's clinical condition to determine whether a new referral to radiology is required. The radiology department will then arrange an appointment according to clinical urgency to ensure that the patient receives appropriate care. To ensure that service arrangements align with clinical needs, re-booking of radiology services must be made through clinical assessment and referral by the attending doctor, and should not be made directly by patients through HA Go mobile application.
The HA will continue to review the implementation of the radiology charging arrangements and make appropriate arrangements in accordance with the principles of optimal utilisation of healthcare resources and smooth service operation.
Ends/Wednesday, May 27, 2026
Issued at HKT 15:30
Issued at HKT 15:30
NNNN