Promote Physical Exercise and Medical Check-up for the Whole Community

Motion debate on “Promoting medical check-up for the whole community” to be held at the Legislative Council meeting of Wednesday, 11 March 2009

Hon CHAN Kin-por’s original motion

“That, as the population of Hong Kong is ageing, which will exert great pressure on the healthcare system, yet the general public often neglect the importance of undergoing regular medical check-up and do not seek medical consultation until their clinical conditions have worsened, which will not only affect their chance of being cured, but also substantially increase the public healthcare expenditure; this Council urges the Government to comprehensively plan afresh policies on prevention of non-communicable diseases and health promotion, including:

(a) expeditiously studying the provision of regular basic medical check-ups for Hong Kong residents gradually and systematically, so as to prevent diseases through early diagnosis and treatment;
(b) at the same time, formulating suitable medical check-up plans for different high-risk groups; and
(c) promoting healthy living and health education to encourage the public on all fronts to do more exercise, so as to enable Hong Kong to develop into a genuinely healthy city.”

Speech of the Hon K P Chan, JP At the Legislative Council On 11 March 2009 To Move Member’s Motion on “Promoting medical check-up for the whole community”(Synopsis)

President, I move that the motion, asprinted on the Agenda, be passed.

Today I move this motion for promoting medical check-up for the whole community and encouraging the public to have more physical exercise. There is indeed a common philosophy behind this proposal, that is, to build up a healthy society in which the public will be keen on doing physical exercises and concerned about their health.

Consequently, everybody would be fit and in fine fettle to strive for his or her own happiness. Perhaps some people would regard  this as too idealistic, but I firmly believe that if they are determined to head for that goal, there would be such a society.

I am very conscious of my health, it has been my belief that the greatest investment in life is health, and I live up to my belief. I jog regularly three times a week for over 30 minutes each time I take a lot of fruits and cereals, and try to go to bed before 11 pm each night. This healthy lifestyle makes me seldom take sick leave over the last 30 years or more. It has also reinforced my conviction that a healthy lifestyle would also suit other members of the Hong Kong public, including Mr WONG Yuk-man. Hence, after I joined the Council, I began to tidy up my thoughts for these recent years and make these as the topic of the first motion I propose as a Member of this Council.

I find it a pity that Hong Kong people have become less and less healthy over the recent years. Be it the grassroots or the middle class, the pressure in life coming from all sides have caused their health to deteriorate, and their health consciousness is reduced. In fact, many people nowadays would work hard to earn money at the expense of their health before they are 50 years of age; but they would use up all their hard-earned money to pay for their health when they reach 50 years of age. Would this not be a real pity?

At the same time, population ageing in Hong Kong is becoming more and more serious. It is estimated that ratio of the elderly (65 years of age or above) would increase gradually from one elderly in every eight people in 2007 to one elderly in every four people in 2033. Under these circumstances, there would certainly be huge increases in health care expenses. Leaving aside the inflation factor, expenditure on public health care services would increase from around $37.8 billion in 2004 to $186.6 billion in 2033. The extent of increase in health care expenses is so great that it is indeed worrying. We have to do something for our future generations.

Today four Members have proposed amendments, among which the amendment of Dr LEUNG Ka-lau certainly draws my greatest attention. Since Dr LEUNG is an elite of the medical profession, his amendment certainly carries much insight, and actually, we have a common goal. Later, I will explain certain proposals on the check-up for the whole community and on encouraging the public to do more exercise. However, I would like to emphasize that the major direction of my proposals is a macro one which focuses on the interest of society as a whole and which calls for simplicity and feasibility. I am even of the view that there is no need for rigidly adhering to what the Government would do. In all, it is better for the Government to take the first step for gradually implementing the proposal of medical check-up for the whole community rather than doing nothing at all.

Let me first talk about the merits of medical check-up for the whole community. I know some medical professionals have some reservations about the proposal for they reckon that a great deal of resources would have to be spent and the result may not be totally reliable. They regard it would be better not to have medical check-ups rather than having them. However, I do not agree with the view. In fact, they are merely contemplating the issue from a point of view of medical technology without considering the overall macro effect on society. This is a typical example of thinking in terms of the part but not the whole.

I reckon that apart from bringing to the public the latest information on health, medical check-up for the whole community can also remind them to be conscious of their health. A lot of people in Hong Kong have been paying no heed to their health all along. In fact, it might not be that they do not treasure their health; it might be that they take it that they are in good health, so there is no need to have a medical check-up. In some other cases, it might be that they do not want to face the reality and so they adopt an avoiding attitude and think that there would not be any problem if they just do not bother about anything. However, after they go for a body check and find out that there are medical problems, they should certainly receive treatment as soon as possible. Even if there are no problems, when they see that the result is not good enough, they would often be prompted to change their lifestyle for the sake of improving their health, and would be willing to receive body checks in the future. Indeed, nobody would be unconcerned about his or her own health; they just need somebody to inform them of their health problems.

Another merit of medical check-up for the whole community is to enable the public to have a closer understanding of the knowledge on health. Though Hong Kong is a city rich in information, a lot of people still do not quite know much about basic health information. A body check enables them to understand more about their health condition and to get a good grasp of health information. Health care personnel can also point out their undesirable habits they have through a medical check-up.

Meanwhile, once members of the public have gathered information about their own health condition, they can make use of the new and old data for drawing comparisons when they go for a body check in the future. They would then be able to know whether their health has deteriorated.

After consulting the views of various parties, I decide to propose a simple and feasible programme for medical check-up for the whole community, aiming at facilitating a final implementation by the Government. Currently, among the chronic diseases in Hong Kong, 80% of the patients suffer from hypertension, diabetes, and heart diseases. That being the case, in conducting medical check-ups in such a large-scale, I reckon that tests on blood pressure, blood sugar and cholesterol can first be performed, while other items can be studied in detail after the programme of medical check-up for the whole community has got started. Since public health care organizations may not have sufficient resources to cope with an exercise of such a large scale, I propose a practice similar to that of the elderly health care vouchers be adopted, whereby medical check-up vouchers would be distributed by the Government to the eligible persons to undergo medical check-ups in private clinics.

The Government would only be responsible for the funding and monitoring work. Due to limited resources, those who are 40 years of age or above can be singled out as target persons for the medical check-up. According to information from the Statistics and Census Department, about 3.5 million people in Hong Kong are 40 years of age or above, with about 1 million among them being patients of chronic diseases.

Many of them suffer from high blood pressure, diabetes, and heart diseases. As they are under treatment, they may not need to participate in the basic medical check-up programme, leaving the actual participants to be around 2.5 million. I have researched on the charges in the market for the relevant items, which are around $250 per person, rendering the total expenditure to be about $600 million. If this is to be implemented in three years, the annual expenditure would only be around $200 million. Certainly, discussions on the charges have to be conducted with the service providers if the scheme is actually to be implemented.

The annual expenditure on treatment of high blood pressure, diabetes, and heart diseases is estimated to be as high as $7 billion to $8 billion. Besides, results from a research carried out by The Chinese University of Hong Kong and the United Christian Hospital reveal that in the year 2006, there might be an economic loss of over $10 billion brought about by diabetes to the society, which includes hospitalization charges and medical expenses, direct and indirect expenditure relating to loss of productivity and early retirement. The medical check-up scheme can enable those with high risks to be aware of the problem as soon as possible, and to lower the incidence rate through having more sports and exercises as well as getting rid of their bad habits. Medical expenditure can be lowered greatly as a consequence.

The Administration may also take this as a trial scheme and conduct a systematic analysis on the data collected on completion of the scheme for assessing its effectiveness and to decide on the way forward, such as the timing for the second medical check-up, and whether the items for check-up are to be increased.

The second point I have to raise is about establishing an appropriate medical check-up programme for the high-risk groups. Suggestions like these have indeed aroused concern in the medical profession, including studies on resources and effectiveness.

However, the groups involved are those who have very serious diseases and if their illnesses could be detected at an early stage through medical check-ups, very often their lives could be saved. The Jockey Club Colorectal Cancer Education Centre of The Chinese University of Hong Kong conducted a colorectal cancer-screening programme last year. One thousand persons from 50 to 70 years of age who had been free of the symptoms all along were recruited. Results revealed that four persons were diagnosed with early stage colorectal cancer, 27 persons with advanced adenoma, and 151 persons with colorectal adenoma, which is “polyps” that may evolve into colorectal cancer. They were lucky to receive prompt treatments. Colorectal cancer is the second cancer killer in Hong Kong with new cases amount to 3 500 each year and a death toll of around 1 500. The Centre suggests it would be best for persons who reach 50 years of age to undergo regular medical check-up. Besides, breast cancer and cervical cancer could be detected at an early stage through medical check-ups, and the chances of curing are extremely high. In fact, the medical profession encourages persons of high risks to go for regular medical check-ups.

Even though we can detect these diseases in time through medical check-ups, there is no long-term corresponding policy established by the Government. While we understand that the expenditure concerned may be huge, the relevant check-ups could indeed save a lot of lives. Hence, effective examinations are worth the efforts. I reckon that the Government and the various charitable organizations should seriously consider establishing a comprehensive medical check-up scheme for diseases that can be detected early.

Finally, I have to speak on the issue of body strengthening through sports and exercises. I have proposed many suggestions for medical check-up for the whole community. However, when members of the public find that their health indicators are not so good after having a medical check-up, apart from seeking medical consultation, they may work on improving their health through sports and exercises.

A study named “The Health Benefits of Sport” conducted by the Hong Kong Sports Development Board and The Chinese University of Hong Kong points out that only 25% of the adults in Hong Kong have sufficient physical exercise, and that many do not have any sufficient understanding of the merits of physical exercises.

It is also suggested in the report that the Government should educate the public on the merits of physical exercise for health, and establish long-term strategy as to the means of encouraging the public to participate in sports and exercises.

A study announced by the U.S. Center for Disease Control and Prevention last year indicated that an effective programme on physical exercise for the whole community could lessen the incidence rate of various chronic diseases. For example, 476 cases of heart diseases and 207 cases of diabetes could be reduced at the most each year for every 100 000 people in the population.

In fact, large-scale public activities can indeed arouse the attention of the public, the most famous of which is certainly be the Standard Chartered Hong Kong Marathon which draws a lot of participants each year. Besides, the “Daily 8 000 step-by-step walk” campaign launched in 2003 by the Hong Kong Medical Association caused great enthusiasm for exercise at that time; however, nobody paid heed to it anymore soon after the enthusiasm subsided. Hence, I reckon that the Government should establish long-term policies for the public to join in and to share the joy of physical exercise. Naturally, we will become healthier and healthier.

The suggestions I propose above today are just made in the hope of attracting knowledgeable people from various fields to join in the discussion. The Government in the latest budget released has indicated clearly that it would reinforce primary health care work, and provide nursing support for chronic diseases such as diabetes, hypertension, and kidney diseases. Hence, it is believed that the views we raise today can assist the Government in doing the work well. I believe Hong Kong people can be made healthier through the two major directions of medical check-up and physical exercise. In this way, Hong Kong will also become a healthier society.

Deputy President, I move the motion above.

Social sharing