23 May 1998

Government should give priorities
in setting Health Policy and Health Targets

(keywords:- Health Targets, childhood injury, infectious diseases, food, drugs, medical appliances)

          The recent Public Health Report No.3 published by the Department of Health should be given its due applause, in particular its adaptation of "health targets" in relation to childhood injuries, hepatitis and liver cancer.

          For years, medical professionals have been pushing Government to take the lead in centralising health data collection, as well as to set "health targets" for our populace. Such targets, which are common in many advanced countries, actually set out the quantified level of improvement in mortality or morbidity of particular common diseases or injuries that the society aim to achieve within a certain period. Only with such clear-cut targets can different government departments and different sectors of a society coordinate well with solid thrust for solid goals. Only with such on-going targets can a society measure its achievements, or the lack of it, in improving health status and hold the parties concerned accountable.

          Take childhood injuries as an example. With injuries being the biggest killer of children, claiming some 50 lives a year from 1990-95, deed is more imminent than words. The Public Health Report No.3 appears to offer light from the end of the tunnel. It suggests aiming at reducing deaths caused by unintentional injuries from the present 4.1 per 100,000 children to 3 by the year 2005; by falls from 0.6 annual death per 100,000 children to 0.8; and by motor accidents from the current 15 to 10 per year during the same period.

          Needless to say, such practicable targets could only be achieved with coordination and changes amongst various fronts -- from Government policy bureaus to departments to non-governmental organisations; from legislative to environmental to behavioural approaches; from health care workers to engineers to city planners to manufacturers .... to name just a few.

          In this context, the Report rightly so recommends establishing a lead agency to lead and coordinate across disciplines involved in injury prevention, and to adopt and monitor targets. Such idea has been propelled for long by not only the medical and child care professionals, but also legislators as seen in the three motion debates on children protection in the past seven years.

          With the concrete recommendations and targets published in its official report, Government has no excuse to shred its responsibility. We need no further deaths nor disabilities from injuries of children before we act.

          In the same token, to cope with the onslaught of various infectious diseases -- old and new, a central coordinating body is in dire need. The current separative arrangements in monitoring and enforcing food safety amongst the departments of Health, Agriculture and Fisheries, as well as the two municipal departments, empowered by piece-meal legislations, are most unsatisfactory.

          Yes, the Public Health Report No.3 does list the "health targets" of reducing the morbidity and mortality rates of hepatitis and liver cancer within a specific timing in the next century. Yet, it takes more than immunisation programmes to achieve the targets.

          With the official prediction of rising threat from many other infectious diseases, like cholera, malaria, tuberculosis and Dengue fever, the Department of Health should pool its resources and expertise in the field under one roof. It is imminent that an "infectious disease control unit" for proper data collection, disease surveillance and epidemiological studies be established.

          With the on-going review of the roles and structure of district boards and municipal councils, it is high time for Government to consider setting up a centralised body with teeth under the Department of Health to oversee safety and standards of food, drugs, as well as medical appliances. More, it is also time for the Administration to have an overhaul of the many pieces of legislations related to pharmaceutical products, dangerous drugs, food hygiene, consumer products etc.

          Nevertheless, all these suggestions would only be piece-meal should the Administration lack the foresight in coming forth with a public health policy that could shape Hong Kong into a healthy society in the next century.

(Hongkong Standard)