1 January 2000

Health Wish List for Year 2000

(Keywords: health financing, food hygiene, doctor-patient relationship, defence medicine)

          As the clock strikes the final chime of midnight, Hong Kong and the rest of the world entire into the year 2000. Whether this is the beginning of a new millennium or the end of the existing one; whether we are already in the 21st century or the last year of the 20th is a matter of mathematical argument. The fact remains we are in a new year -- in a new era where changes are perhaps the only elements that remain constant.

          The quest for health is perpetual. Yet health services changes with needs. The year 1999 had been an eventful year for the Hong Kong health care scene. What lessons can be learnt from the changes in 1999 to assure that an ideal wish-list for the year 2000 comes true?

          Top of the list of changes is the appointment, for the first time in the history of this region, of a health care professional to take charge of the Health and Welfare Bureau. No less important is the "Harvard Report" on health care reform; the creation of a new food and environment bureau and department following dismantle of the two municipal councils; the administrative order for a 5% productivity gain on the public health services in three years, just name a few.

          The appointment of Dr Yeoh must be applauded not only for the sake of bringing, hopefully, significant health care reform into fruition. It is perhaps also a sign that our Chief Executive is opening up the Administration to expertise in the outside sector, at the same time taking a subtle move towards a quasi-ministerial system.

          The Harvard Report, irrespective of many flaws and shortcomings it contains, is an opportunity for Hong Kong to reform for a better system of tomorrow.

          The new bureau and department for food hygiene tends to blur its functions with the current Department of Health, in particular in control of infectious diseases. Its activities must be properly supervised. It would be a mockery to witness the principle of centralising food safety shattered by bureaucratic wrangle of two government departments.

          It takes more than a hat trick for the Hospital Authority to further save in face of rising demand, given that it has on its own already achieved some 11% savings in the past nine years. Irrespective of the dedication of the staff, an insatiable increase in workload would invariable lead to unwarranted deterioration of service standard.

          As we move towards the next century, it is high time for government to face the problems head on -- to properly define the role of heavily subsidised public health services, and to ascertain that health care cost must be shared between Government and the users for those who can afford. In short, the principle should be "those who can pay should pay, those who can pay more should pay more." Yet, the best treatment will still be available to the needy!

          For the new year, to the Administration, it is my sincere pledge that it should show determination and political clout and bring forth the long awaited health care policies reform that Hong Kong can be proud of.

          To the much divided and fragmented health care professions, I fervently pledge for their cooperation. The different health care sectors are very much divided and fragmented. Remember, power struggle, sectoral interest, protectionism are no means to face frustration. Instead, cooperation, open-mindedness, accepting different sectoral role and unity are the only means to push for a health care that we can all cherish.

          To the public, my pledge is simple. Patients and health care professions are members of the same team. They are not, nor should they ever be, in opposition. They have to learn that a proper confidence-orientated doctor-patient relationship is the only solution to good medicine. Anything less will force the health care providers to practise defensive medicine that none would like to fathom.

          Let us all grab hold of the opportunity of changes to establish a healthy and caring society! 

(Hongkong Standard)