Private health care must play a bigger role in Hong Kong
A Hospital Authority official called on more patients with chronic illnesses to switch from overstretched public hospitals to visiting private doctors.
Learning on the job has its place. But it must have come as a surprise to many to read of concerns among leaders of the city's medical profession that some graduates fresh out of medical school are launching their own private general practice clinics, without any experience let alone specialist training in family medicine. At the same time, a Hospital Authority official called on more patients with chronic illnesses to switch from overstretched public hospitals to visiting private doctors.
The two news items are not unrelated. A bigger role for private doctors in primary medical care has long been a goal of health services reform. It is hoped the voluntary health insurance scheme expected to start soon will promote it.
This makes sense, since the public sector employs 40 per cent of the city's doctors but serves 90 per cent of the patients. However, it is doubtful that fresh graduates without experience would inspire confidence. Medical leaders agree, and say they should be put through another two to four years' training before they can set up their own private clinics. Dr Louis Shih Tai-cho, president of the Medical Association, says a good primary health care system can help promote self-care, enhance control of chronic diseases and lower hospital admission rates. Dr Donald Li Kwok-tung, president of the Academy of Medicine, which trains specialists, says lack of experience and training poses a significant obstacle to quality and efficiency. Dr Angus Chan, president of the College of Family Physicians, believes the government should impose a minimum standard of at least four years' training. They are all sound arguments.
Meanwhile, the Hospital Authority has been subsidising hypertension patients to visit private clinics in a trial involving 88 doctors in Wong Tai Sin, Kwun Tong and Tuen Mun. This is intelligent use of taxpayers' money to tap a valuable community resource. The government should consider attracting more doctors to join the scheme by lifting the HK$2,708 ceiling on reimbursements for up to 10 visits a year.
