會長通訊：政府會聽取我們的意見嗎 ? | President's Message：Would the Government listen to our views?
政府會聽取我們的意見嗎 ? 行政長官在社會活動中，於2019年10月16日在她的辦公室而不是在立法會發表施政報告。這是香港歷史上首次發生這種情況。其後，包括行政長官在內的政府高級官員在媒體上發表了講話，向記者和香港市民進一步解釋施政報告的內容。 如果您希望查看《施政報告》中的醫療課題，其實不難理解其中數段。我現在翻印那幾段供大家細讀。 "保護民康 36.由於人口老化，慢性和複雜疾病日趨普遍，香港的公共醫療系統正承受着巨大的壓力；與此同時，市民普遍仍然偏重以治療為主的醫療服務。 37.為扭轉現時「重治療，輕預防」的醫療體制和觀念，我在上一份《施政報告》提出在全港18區成立地區康健中心（康健中心），透過醫社合作及公私營合作模式提供基層醫療健康服務，提升市民自我管理健康的能力及支援長期病患者。首間位於葵青區的康健中心已於上月底啟用。我們會加快把地區康健中心服務推展到全港18區，預期可於本屆政府任期內在另外六個地區成立康健中心，並會在其餘11區設立屬過渡性質的「地區康健站」，為區內居民提供健康推廣、諮詢及慢性病護理服務。” 第38和39段建議加強對罕見疾病患者的支持，並採取措施縮短受工傷工人的康復進度。 對我們而言最重要的是關於地區康健中心的問題，我們早在這裡已經討論過。從本質上講，我們並不感到驚訝。但是，如果您關註到地區康健中心在網絡醫生工作回報的模式，除了向醫生提供固定回報之外，它們還允許患者自付，以吸引更多的醫生加入該計劃。地區康健中心強調預防醫學，這是我們不能不同意的。因此，我加入了葵青區的地區康健中心，以獲得第一手的經驗。我希望你們亦可以參加，看看它是如何運作的。在這些地區康健中心中，我們似乎在爭取共付計劃方面取得了成果。這與普通科門診公私營協作計劃不同，在該計劃中，迄今為止並不允許任何共付金額。現在，政府似乎在聽取並回應我們的意見。 我最近遇到的下一個課題是“院舍防疫注射計劃”（RVP），該計劃是針對包括老年人中心在內的院舍的補貼疫苗計劃。不久之前，在2019年10月9日，衞生防護中心就新安排進行了簡報，其中包括為參與醫生（VMO）設計出大量文事及電腦程式的工作。我立即對新安排提出了質疑，這項新安排本應簡化VMO的工作，但適得其反，令到大部份與會者都對此表示反對。在問答環節中，我們還威脅要辭職。幾天後，我們突然收到來自衞生防護中心的通知，通知我們新的安排將與所有VMO都應該熟悉的舊方法或傳統方法並駕齊驅。我想說這是政府聽取我們合理要求的另一個課題。 我要向大家強調的第三個課題也是最重要的是當選立法會衞生事務委員會主席的最新結果。這是我們第一次有一位既不是醫生也不是護理專業人員的女性主席。對我和我們大多數醫生來說，這是對我們專業的危險信號。我們的專業自主會受到威脅嗎？這位女士最近提出的建議似乎最有可能是通過在不經過執照考試的情況下從海外招聘醫生來增加香港的醫生人數。我們會弄清楚政府是否同意這位女士的說法。食物及衞生局局長將於2019年11月17日在瑪嘉烈醫院舉行的週日下午座談會上與我們會談，這將是您参加並表達您意見的良機，看看政府是否願意聽取民意。如果我們仍然相信對香港所有醫生要求一個標準的評核專業考試，以維護我們對香港市民的醫療水平，那將是一場硬仗。 楊超發醫生 Would the Government listen to our views? Amidst society activities, the Chief Executive presented her policy address in her office instead of in the Legislative Council on 16 October 2019. This is the first time for such to happen in the history of Hong Kong. Afterwards, Government high officials including the Chief Executive presented in the media to explain further on the issues of the Policy address to reporters and the citizens of Hong Kong. If you care to look into the Policy address on the paragraphs of Health care, it is not difficult to digest the few paragraphs. I would like to reproduce the paragraphs below for your perusal. “Embracing Public Health 36 Hong Kong’s public healthcare system is under enormous pressure due to an ageing population and the increasing prevalence of chronic and complex diseases. Meanwhile, members of the public are mostly relying on treatment-oriented healthcare services. 37 In a bid to shift the emphasis of the present healthcare system and people’s mindset from treatment-oriented to prevention-focused, I proposed in my last Policy Address to set up District Health Centres (DHCs) in all 18 districts to provide primary healthcare services through medical-social collaboration and public-private partnership. The aim is to enhance the public’s capability in selfmanagement of health and provide support for the chronically ill. The first DHC in Kwai Tsing District has commenced operation at the end of last month. We will expedite the setting up of DHCs in all 18 districts. It is expected that within the term of the current government, DHCs in six more districts and interim “DHC Express” in the remaining 11districts will be established to provide health promotion, consultation and chronic disease are services.” Paragraphs 38 & 39 suggested Strengthen support for patients with uncommon disorders and Means to shorten the recovery progress for workers injured at work. What is most important for us is on the issue of DHCs, which we have discussed here long time ago. In essence, there is no surprise for us. However, if you care to look at how DHCs work now on the reimbursement for Network Doctors, apart from fixed reimbursement to doctors, they allow copayment from patients so as to attract more doctors to join the scheme. DHCs stress on preventive medicine which we could not disagree. As such, I have joined the DHC in Kwai Tsing district in order to have the first hand experience. I hope some of you can join to see how it works. It seems that we are successful in fighting for copayment scheme in these DHCs. This is not like the General Outpatient Clinic PPP programme where no copayment is allowed whatsoever up to now. Now the Government seems to listen and response to our opinion. Next topic which I have recently encountered is on the Residential Care Home Vaccination Programme (RVP) which is a subsidized vaccine scheme for the residential care centres, including elderly centres. Not too long ago on 9th October 2019, there was a briefing by the CHP on the new arrangement which included a lot of paper and computer work for the Visiting Medical Officer (VMO). I immediately challenged the new arrangement which is supposed to streamline the work and claim by the VMO and this was echoed by the majority of the attendees. We further threatened to resign from the voluntary work during the Q & A session. Few days later, out of a sudden, we received a notice from the CHP informing us that the new arrangement would go hand in hand with the old or traditional method which should be familiar to all VMOs. I would say this is another issue of Government listening to our reasonable request. The third and the most important issue I would like to highlight to your good selves is the latest result of election of Chairman for the Panel on Health Services of the Legislative Council. For the first time, we have a lady Chairman who is neither a Healthcare nor an Allied Healthcare Professional. To me and most of us, this is a dangerous sign to our profession. Would our professional autonomy be jeopardized? It seems most likely so by what this lady suggested recently to increase the number of doctors in Hong Kong by recruiting doctors from overseas without going through licensing examination. We would figure out if the Government is in agreement with this lady. Our Secretary for Food and Health would talk to us in our coming Sunday afternoon symposium in Princess Margaret Hospital on 17th November 2019, it would be good opportunity for you to join and to air your concerns to see if the Government would listen. It would be a tough war to fight if we still believe in one licensing examination for one common standard for all doctors in Hong Kong to safeguard our standard of medical care to our Hong Kong citizens. Dr. Yeung Chiu Fat Henry