14th January, 2005
Dear Mr. Tung,
Re : Meeting on 13th December 2004 with Medical and Nursing Professions
On behalf of Hong Kong Doctors Union, I must thank you for listening to our views and for reading our printed presentation on health issues in the captioned meeting.
To maintain the standard of healthcare in Hong Kong, I must say that it is imperative for the Government to have a balanced control of all the factors affecting the Health of the Community as stated in our printed presentation and to achieve this with urgency before it is too late.
The importance of the Government to define the scope of Public Health Services by the Government as advocated by the Secretary for Health, Food and Welfare need no further elaboration in view of the potential huge public health budget deficit.
As mentioned by your good self, the high standard of medical care in Hong Kong is reflected in her excellent health indices. As such, there is no pressing concern about the studiousness and integrity of Hong Kong doctors to justify linking CME with the license to practice. Medical practitioners are already continuously updating their medical knowledge in order to serve the community better. Surveys among doctors repeatedly show consistent strong resentment to such unnecessary linkage, which the Medical Council and the Secretary for Health, Welfare and Food are trying to press upon doctors. Hong Kong Doctors Union does not want your Government doing things against the majority of doctors. Before any drastic actions by the Government on this issue there should be a thorough consultation with the medical profession. There is nothing more important in Hong Kong now to prevent polarization and division and to foster harmony and unity, and such can only be reached by patiently building up trust and arriving at a consensus before far reaching policies such as this linkage mentioned.
Hong Kong Doctors Union is heartened to see in your new policy address that the Government will uphold the vision of “people-based” governance, gauging the mood of the people more accurately and listen more closely to their opinions. All the above suggestions by Hong Kong Doctors Union reflect too well the sentiment of Hong Kong doctors and with the upgrading of healthcare of Hong Kong people in mind. We sincerely hope that you would heed our opinion and realize our hopes in accordance with your spirit enshrined in your policy address.
Hong Kong Doctors Union is adamant that the illegal practice of dispensing drugs by drug stores by whatever person in these shops without doctors’ prescriptions is detrimental to the health of the community. Any suggestion that by so called separation of consultation and dispensing but in fact removing the supervision of doctors will only encourage more such direct selling of drugs to the public. In seeking separation of medical consultation and drug dispensing, some members of the public have completely missed the point that drugs ought to be dispensed responsibly and only with appropriate indication and therefore only when advised by doctors. This is exactly the same rationale behind controlling irresponsible and undesirable medical advertisements. Medicine should be taken only after proper medical consultation and recommendation.
One very important problem facing doctors and directly affecting the health of the community is the phenomenon of powerful merchants exploiting the ignorance of purchasers of private insurance and the lack of resources by the medical profession to organize themselves. Patients either as insurance purchasers or employees enjoying medical benefits of employment will be directed to a panel of doctors of which they have a limited choice and there are a lot of limitation to the services provided in accordance of the rules spelt out by these merchants. The service provided are quoted as worth a lot while the doctors are paid poorly and late. We are talking of the so-called HMOs. Already being rich and influential they stand to compete with the single-handed family physicians so that the morale of doctors are low especially fresh medical graduates. Unless the Government is willing to regulate these HMOs, patients and doctors will become subdued and controlled by these commercial middlemen, which do not need to exist at all. To make these HMOs accountable for their activities we suggest that the Government introduce legislation along the same line as Medical Practice Act of Australia (Please refer to P. 4 of the HKDU December 2004 Bulletin) to make it compulsory for them to nominate one registered doctor to be held responsible for their activities. In this case the Medical Council will be able to supervise the person responsible and indirectly influence the HMOs’ behaviour to ensure medical ethics is not infringed and the quality of health care service is not jeopardized.
One serious problem facing the medical profession is the recent astronomically high premium of the professional medical indemnity, which has led to a reduction in certain specific services provided by doctors, especially those in private practice. Our Union is seriously asking the Government to work on the introduction of capping of medical mishap compensation as a first step to solve the problem.
Further, Hong Kong Doctors Union sincerely urge the Government to introduce tax exemption for citizens who purchase medical insurance out of their own pockets and to consider allowing medical expenses be included in the tax exemption. This will speed up the recovery of citizens from illnesses and will positively contribute substantially towards the economy by cutting loss in manpower. The encouragement of paying for private medical treatment will definitely reduce the load on public health care financing which is after all the most pressing issue facing Hong Kong today. Easing the need to increase budget for the Hospital Authority by cutting demand for services will further boost the morale of medical staff.
Wishing you a prosperous and healthy New Year of the Rooster!
Yours sincerely,
Dr. Yeung Chiu Fat Henry, President, Hong Kong Doctors Union