Reform the Hospital Authority

Speech of the Hon KP Chan on Member’s Motion on Reforming the Hospital Authority (Synopsis)

•    Public medicine has been problematic.  The recent “exodus” of doctors has led to manpower shortage in some public hospitals, provoking grievances at the frontline and in turn plans of industrial actions.  Senior management of the Hospital Authority rushed to meet frontline doctors and pacify their anxieties with follow-up measures for staff retention.

•    Although senior management of HA is responsive with interim fixes, they have treated only symptoms, not the cause.  The situation would only aggravate.  The Motion of Dr the Hon Leung Ka-lau that calls for comprehensive review and reform of HA is the right prescription for the root cause.  Dr Leung is a seasoned practitioner, having served HA for 24 years, and his diagnosis would not miss the mark.  It deserves attention of both the Government and HA.

•    HA has been established for [more than] 20 years.  Its annual budget has risen from $7.7 billion to record high of $33 billion this year.  It is not easy to manage such a large organization, in particular one having inherited problems in public medicine.  For the last 10 years, the increase in manpower supply in HA has far exceeded the increase in patient demand (visits) at outlets.  Since resources have increased, why are doctors still working overtime?  Why are queues at specialist clinics also getting longer?  I am convinced that HA is not managing manpower and operations good enough to meet mounting workload despite increased manpower.   In fact, HA had recruited an overseas expert, Solomon to lead changes but improvement was still not forthcoming on his recent departure.  In this light, it is a matter of determination of the Government to advocate comprehensive institutional reform of HA with a strong dose.

•    As HA is not a government department, the public could not monitor it in the same way as the civil service.  However, a public body that spends over $30 billion of taxpayers’ money a year should be more open to allow better public scrutiny.   This should be the first step of the reform.  I urge the Government to seriously consider the original motion and proposed amendments.

•    Closely related to healthcare reform is the Health Protection Scheme.  Frontline doctors are complaining against workload, but local medical service is still far behind its peak demand.  Currently, one out of eight people in the population is aged 65 and above, and the ratio would rise to one out of four in 22 years’ time.  The aging population is a big challenge.  In this light, the Government is launching a voluntary Health Protection Scheme with the view to attracting middle-class participation and diverting demand for public medicine to private practice.  It is hoped that the pressure on public medicine would be eased then.  The Government has set aside $50 billion in support for 20 years or $2.5 billion annually.  Although the reserved sum is amounted to just a few percentage points of annual spending in public medicine, it would still be attractive enough to relieve future stress on the public sector.  Of course, development of private practice should not be ignored as well.

•    Finally, I would like to bring up the issue of dispensary at HA institutions.  Under the current practice, outpatients are given far more supply of medications than private clinics, no matter at accident and emergency or specialist and generalist consultations.  Is there any wastage?  I believe there is room for saving and ask HA to review.

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