Dear Mr. Tsang,
Re : Meeting on 27th August 2005 with Medical and Nursing Professions
On behalf of Hong Kong Doctors Union, I wish you a happy and successful term of office as the Chief Executive of the Hong Kong SAR Government. I would also like to take this opportunity to thank you for inviting me to the captioned meeting in the Central Government Offices to express our concerns on the Health of the Community.
Undoubtedly, with the utilization of only 5% of GDP in Health Care, Hong Kong is efficient in building up superb medical standards as demonstrated by world top figures in life expectancy and world’s lowest infant mortality rate. However, the recent events of Fresh fish ban and public worries on cancer-causing chemical malachite green discovered on samples of imported fish should trigger your concern on Food Safety which is essential for the Health of the Community. Apart from strengthening of our Food Safety Notification System, we strongly agree to the proposal of setting up a new Food Safety Control Body to overlook the safety of ordinary food as well as the so called “Health Food” which is not under the scrutiny of any regulations. As you may be aware from everyday newspaper, there are frequent complaints from citizens and the Consumer Council on lack of control of such “Health Food” which are causing harm to the health of the community. Reports from the Department of Health have vividly documented controlled Western or Chinese medicine being incorporated into such “Health Food”.
Secondly, I would like to recapture on our printed presentation on health issues in the captioned meeting. To maintain the standard of healthcare in Hong Kong, 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. During the captioned meeting, you may recall that I have pointed out the insufficient or even lack of control of Illegal drug sale from drug stores, medical practice of Health Maintenance Organizations or Contract medicine companies and “Health Food” Industry. If the Government is still holding on to a laissez-faire attitude on such practice, it would not be long before the health of the community deteriorate tremendously.
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. From past experience, the regulatory role of the Department of Health is not sufficient in dampening down such illegal practice, the best solution of which is to set up a mechanism for professional control in the business so as to strengthen the quality of service from drug stores. We suggest setting up new legislation to control the ownership of drug stores to require at least over 50% share holding by registered pharmacists.
Another 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 with 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 be 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 upon and the quality of health care service is not jeopardized. An alternative control mechanism will be the reconsideration of introducing legislation to require at least 90% shares of all these companies to be owned by medical practitioners as in the case of law and accountancy firms in Hong Kong, where at least 90% shares of the companies are required by law to be owned by lawyers and accountants respectively.
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.
The importance of the Government to define the scope of Public Health Services by the Government in the reform document need no further elaboration in view of the potential huge public health budget deficit. However, in the course of doing so, please do not let the Government build a huge empire in health care services. The development of the private health sector should be subject to the market force while its quality should be subject to the control of the Medical Council of Hong Kong.
Thanking you in anticipation.
Yours sincerely,
Dr. Yeung Chiu Fat Henry
President
Hong Kong Doctors Union
cc: Dr. Chow Yat Ngok, Secretary for Health, Welfare and Food