In the morning of 22nd August 2006, I have the opportunity to have a meeting with our Chief Executive (CE), Mr. Donald Tsang, on Medical and Health Issues before his drafting of the Policy Address of the HKSAR Government for the period till June 2007 when his term expires. This is the fourth time that I, as President of the Hong Kong Doctors Union, have the honor to meet our Chief Executive to express our concerns on the Medical and Health Development in Hong Kong.
The CE said from the start that he would like to present to the public the Policy Address in October 2006 that would have solutions and actions that could be accomplished before his term is expired. He uttered that even we have heated discussions on Health Care Financing, yet the Government cannot sort out any solution to such a historical problem, especially when the Goods and Services Tax was rejected by the public opinion fiercely. As such, Health Care Financing would not be an item in the Policy Address. He said that the percentage of public health care expenditure within the total Government・s public expenditure could not be increased. The only way to increase the absolute amount of money spent in Public Health care is to increase the total public expenditure which is very much dependent on the Government・s annual revenue. However, he understands that as the life span of average Hong Kong citizen is being prolonged, the increased old age population would be a big headache and a critical problem for the Government. I would say the problem is world wide and Hong Kong is no exception and I would suggest extend the retirement age if we doctors can maintain the health status of those getting old.
In the round table discussion, there are representatives from more than 12 organisations including medical, dental, Chinese medical, nurse, chiropractors etc. I was the fourth one to speak on our concerns. I remembered I spoke over half an hour each time in the previous meetings with the CE in the one hour meetings. So I squeezed my talk this time to less than 10 minutes so as to allow other representatives more time for their presentations.
However, in contrast to the previous meetings, I made no submission to the CE this time. The reason was, as I told Mr. Tsang in the meeting, there was no response to nor any improvement to the problems we have repeatedly submitted to the CE previously. The problems which we have highlighted are: Health Care Reform and Financing that Mr. Tsang dared not to contemplate in his term of service, Severe Public Private Imbalance which may be more perpetuated with the recent news of Hospital Authority・s (HA) expanding her public and even private services; the problems of regulation of : (1) Health Maintenance Organisations (HMOs) and contract medicine, (2) Health Food Industry particularly in her advertisements and (3) Illegal drug sales by dispensaries. I hope Mr. Tsang would take a few minutes to peep into our past submissions.
I repeatedly remind Mr. Tsang that the morale in doctors is historically low in both the private and the public sectors. The private doctors are starved to death due to the monopoly by the HA and the stringent conditions or fierce competitions from the HMOs in the medical market. The public colleagues are not satisfied with their contracts with HA and the Government, not to say the salary scale of doctors is now much below that of other professionals in Hong Kong.
I said that ever since the invasion of HMOs in Hong Kong Medical Market in the 90s・ and the abortion of ballot system in the allocation of public housing estates in 2000, there is a strong force in the market driving our private colleagues turning into real businessmen in order to survive in the small portion of pie left in the market by HA. This is inevitable since most private colleagues are struggling for their living. The situation has worsened due to the Government・s lassie faire attitude on the regulation of HMOs, illegal drug sales and health food industry. I said that the ultimate cause for such situation is the Government・s underlying policy. If the Government is craving for a financial centre disregarding the ethical and service elements of medical and health practitioners, and even the standard of medical care, we have no choice but to turn ourselves into real businessmen. I am certain some of the undergraduates in the Medical Faculty are now planning of how to secure a place in this profession and to make money as much as possible after graduation. If not, the Government should spearhead to control the aforesaid irregular practices in the medical arena without further delay.
Our Chief Executive is really a capable man. He said to me, ：Henry, you are bringing problems to this meeting each time but never bring me any solution. I shall be obliged if you can propose good solutions to me.； I replied, ： Mr. Tsang, we shall bring you good solutions soon if you so wish.； (Please refer to P. x of this bulletin for our follow up submission.)
Dr. Yeung Chiu Fat Henry