Circular No. 2068, 6th November 2001

President’s message – Private Public Collaboration

On behalf of the Union, I attended a briefing by the Secretary for Health and Welfare on the Government’s Policy Address on Health and Welfare issues on 22nd October 2001 where the number of attendants was around 60. In his briefing to the audience, Dr. E.K. Yeoh stressed that the accusation of the Hon Dr. Lo Wing Lok about the Hospital Authority encroaching on the private medical market was groundless since the Government’s budget in public expenditure in the coming years would be cut due to economic downturn and this would lead to inevitable shrinkage of public health care expenses eventually. With the growing trend of the population craving for cheap service from the Government, it did not make sense that Hospital Authority would expand on an already stretched budget. The recent media report of an unexpected deficit of 100 million Hong Kong Dollars in one Public Hospital was a dangerous signal for the Hospital Authority to review its scope of services and it was not, according to Dr. Yeoh, the Government’s or his intention to ‘eat up’ the private medical market and indeed such ‘eating up’ plan did not and will not exist in the Government Health Plan. In a free market like Hong Kong, he supported the coexistence of both public and private medical services so as to give more choice to the patients.

Some attendants during the briefing challenged Dr. Yeoh to explain why then the Government in her policy address still expand on her health screening services through the executive arm of the Department of Health. What Dr. Yeoh replied sounded encouraging though it seems to be too good to be true. He said that such expansion of services would involve the participation and cooperation from the private sector where the patients could be charged for service by the private sector. It seems that Dr. Yeoh has an intention to give a chance to the private doctors, be it genuine or at his mercy.

Anyway, by the time when you read this article, the first meeting of the Working Group on Interface between Medical Practitioners in the Public/Private Sectors would have been held in which I was one of its members.

In the Medical market, there is immense tilting of balance with extremely heavy load to the Public Sector on one hand leaving the Private Sector in desperate situation on the other, some colleagues even went into bankruptcy. I share the wish of all our members that such imbalance should be rectified, the sooner the better. Some ways to rectify the imbalance are :-

  1. Introduce and enforce measures to decrease the incentives of Public Colleagues to hold on to patients, especially those who are previous patients of the Private Sector for a long time, who are able to finance their own health care in the private medical market;
  2. Introduce Health Tax Exemption for Private Health Care Insurance expenses to increase incentives for individuals to be responsible for one’s own health care and to buy one’s own health insurance. We may have to follow the example of the recent Government measures on Rates to cap such Health Tax Exemption;
  3. Implement and enforce measures to smoothen the exchange of Advances in Medical Knowledge and Patients’ Health Information between Public and Private medical sectors;
  4. Increase the charges for Public Medical Service as suggested when the economy of Hong Kong improves.

Discussions and exchange of ideas on collaboration between Public and Private Medical Practitioners would take months in the Working Group. I shall try to cover more in the next issue of the President’s message. In the mean time, members are most welcome to submit articles to the Union Forum or News to discuss on the ways of Public Private Collaboration. It would be nice to address all members’ concern before any viable implementation plans for future collaboration, if there is any.

Dr. Yeung Chiu Fat Henry

會長通訊－公私合作

二零零一年十月二十二日我代表聯會參與衞生福利局就施政報告對醫療服務的簡介，談話中楊永強局長強調勞永樂議員對醫管局侵佔私家醫療市場的指責是缺乏理據，他說因為政府就經濟衰退而將會把公帑的預算削減，必然最後會導致縮減公家醫療的支出。市民對政府廉宜的公共醫療服務日漸歡迎，然而醫管局照常理是不可能把她「巧婦難為無米坎」的處境再雪上加霜。最近傳媒報導一間公立醫院面對著1億港元赤字是向醫管局響起一個警號，提醒她急切需要重新審議她的服務範圍。而照楊局長所說，政府並沒有意圖「吞併」私家醫生的市場。實在政府的衞生健康政策並沒有這「吞併」私家醫療體制的計劃。他說香港是一個自由經濟體系，病人理應有選擇的權利，而公私營醫療體系亦應並存。

席上有人向楊局長責問為何政府施政報告仍提及衞生署將會增加健康普查服務的範圍。楊局長的答覆似乎對私家醫生是一個好消息，不過未必可行。他說這些增加的體檢服務，私家醫生應有機會參與和可以收費的。看來，楊局長是給與私家醫生一個良機，就請大家擦亮眼睛注意未來的發展去證明楊局長的心意是真還是假吧！

不論如何，當你們閱讀這份通訊時，衞生福利局公私營醫生合作工作小組第一個會議應已舉行，而我亦有份參與。

醫療市場現在偏重於公營服務，而大部份私家醫生生意淡薄，甚至有更多同業破產的例子。如大家意見一樣，我希望見到有可行的計劃儘快去糾正這個失衡。我想可行的辦法有如下幾點:-

  1. 推行政策鼓勵公家醫生將病人轉介回私家醫生，尤其是那些本來有經濟能力去接受私家醫生的服務者；
  2. 鼓勵市民對自己健康負責及替自己購買醫療保險，設立私家健康醫療保險費用的免稅額。而這個免稅額可仿效最近政府向大眾市民寬減差餉一樣設立上限；
  3. 推行特別措施，促進公營與私家醫生之間交換最新醫學知識和病人健康資料；
  4. 一如既往提出過，隨著將來香港經濟有所改善，公立醫療服務收費理應提高。

衞生福利局工作小組討論關於公私營兩個醫療體系的合作需要一段頗長時間。在下一期的通訊中我將嘗試提供多一些這方面的意見給大家。現在歡迎各位把你的高見，投稿到聯會論壇或聯會通訊。如果將來有新的可行合作計劃，我希望在推行時能夠照顧到各位的需要。

楊超發醫生

C2068c2001/Othercir(8)