Shall we teach the Government and HMOs a lesson?

ˇ§We would not enforce regulations on HMOs. If we have to, we would enforce more regulations on private medical practice too.ˇ¨ This is how the Authority cautioned the profession before the meeting of the LegCo Panel on Health Services on 13th Feb 2006.

The long awaited rally on regulation of HMOs kicked off on 13th Feb 2006 when the LegCo Panel on Health Services under the Chair of Dr. Kwok Ka Ki conveyed its first meeting to discuss on the issue. It attracted so much attention from the Legislative Councilors that a special follow up meeting of the LegCo Panel on Health Services dedicated to the discussion of a single item of regulating the HMOs is to be scheduled on 30th March 2006.

A telephone survey done and reported by the news media on 15th Feb 2006 showed that overwhelming 87% of respondents agreed that the Authority should enact new laws as soon as possible to regulate the operations of HMOs to protect the health of the citizens. Over 30% complained of receiving disturbing telephone cold calls for recruitment by the HMOs. Only 12% agreed that patients benefit from the low medical cost attained by the HMOs. And only 5.5% of respondents agreed further regulations on HMOs were not necessary.

In the beginning of my presentation to the LegCo Panel on Health Services on 13th Feb 2006, I pointed out that in order to protect the health of the community at large, our Union has been negotiating with the Authority repeatedly since early 1990s on the issue of incorporation of medical practice and regulations of HMOs but in vain. Similar to the tone of the Chief Executives of some HMOs, the Authority even voiced out her disapproval of regulating the HMOs in the media day before the meeting. However, our Union would not regret in fighting this war against Commercial Profiteering HMOs even though we may fail at the end of the day.

I pointed out that the media report of illegal import of Flu Vaccines by certain HMOs is only the tip of an iceberg. There are of course numerous malpractices and unethical measures by the HMOs which are jeopardous to health of the community and which may escape attention of the public, especially the Government.

Our Union is totally for regulating the HMOs, even though we have been cautioned that there would be more control on our practice. And such control should not delineate too much from the Government control on other professionals in Hong Kong. As before, our submitted proposals on new legislations are:

1. It is legal for the medical practitioners to incorporate their private practice no matter it is a profit making or non-profit making concern;
2. The percentage of shares in such incorporated private medical practice owned by doctors should be equal to or more than 90% of the entire issued share capital of the company.

From the British reign up till our return to our mother Mainland, the local Government would not lay her hands free on the regulation of Medical and Health personnel. Unlike other professions whom have their own registration and disciplinary councils, the medical and health professional councils have been unnecessarily and strongly intervened by the Government under the disguise that Health problems of the community should be under stringent control by the Government. However, this double standard does apply to HMOs and Health food industry too and they do not require regulation even though they are playing a more and more significant role in the Health Care Industry in Hong Kong as in other developed countries like the United States. We have voiced out the danger of double standard and the unbalanced control of health care personnel to the two secretaries for Health, Welfare and Food and even to our two Chief Executives previously and it seems that all our concerns end up in deaf ears. Even the repeated requests, at least twice recently, from the Medical Council of Hong Kong to the Authority to tighten control of HMOs end up in rubbish cabins.

No matter what the ill effects are of the HMOs, the Government seems to turn her blind eye on the matter. We guess that the Authority would like to make use of the HMOs to control and regulate private medical service fee so as to facilitate smooth transfer of patients from the public to the private sector. After all, the Authority has said that she cannot afford to see staffs from the HMOs marching in the streets one day. She cannot afford to infuriate the tycoons.

However, the public and the LegCo members are wiser this time. They are convinced of the following malpractices of HMOs elaborated during the meeting:

1. Capitation leading to substandard medical practice such as prescribing drugs not in current use;
2. Standard length of hospital stay for contracted surgical patients which is both unethical and unsafe to the patients;
3. Unregistered doctors in HMO practices;
4. Delay payment or even refuse payment to panel doctors not belonging to certain categories but who have provided satisfactory medical service;
5. Dangerous drugs not under control by registered health personnel at times of change of personnel.

The Legislative Councilors are convinced to regulate the HMOs because they themselves are victims of HMOs in Hong Kong or elsewhere already. They are convinced because there is an alarmingly increase in the number of complaints to the Consumer Council on HMOs. They are convinced because there are already laws governing HMOs in US and Australia. The Legislative Councilors challenged the lassie faire attitude of the Authority in the meeting and demanded another Special Meeting for further in-depth discussion on HMOs.

At this critical moment before the special meeting of the LegCo Panel on Health Services, your Council wish to appeal to you all to collect evidence against HMOs which will serve as ˇ§bulletsˇ¨ for the Legislative Councilors in their deliberation next time. Would those members who have complained to us on the above-mentioned malpractices of HMOs and those who have evidence of other ill effects of HMOs, which are detrimental to the health of the public, fill in and return the enclosed questionnaire to our secretariat before 28th March 2006. With the strong support from all of you and the public, we would now teach the Government and the HMOs a lesson. Many thanks!

Dr. Yeung Chiu Fat Henry