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8 February 2000
Health Care Reform in dire need
for addressing long working hour problem
(Keywords: workload, long working hours, health financing)
The
recent controversy over long working hours for frontline public
doctors have raised concerns both amongst the profession and the
public.
The
reason for doctors to work long hours are more then obvious. The
medical profession functions on dedication. The responsibilities of
a doctor towards a patient only ends when the patient is either
cured or unfortunately succumb. Any doctor will have to finish an
operation irrespective of the time it takes. Any committed doctor
will stay by the patient until his condition is stabilized or
otherwise. In no way can a doctor waive his responsibility basing on
the hands of a clock.
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)
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