10 October 1998

Policy Address poses disappointing picture in social issues

(keywords:- Policy Address, elderly, health financing, productivity gain)

          The long awaited second Policy Address from the Chief Executive was finally delivered. It is foolhardy to expect Mr Tung and his administration to pull a hat trick and produce an "Elixir of Life" to reverse our economic nose-dive.

          Yet in this difficult time, it is just fair to realise that our public needs more than just a "pat on the back" or the message that "the unemployed should not become discouraged". It is also fair to realise that our public will not regain their confidence unless they see an administration which is fully accountable to the public, willing to admit mistakes and mishaps and set concrete plans for improvement instead of one which self glorifies by giving high marks to minor achievements, ignoring the flaws for major issues. How ironic when the saga of avian flu, an international scandal, has now been rated as an "achievement" because we finally got rid of the infection!

          As expected, major criticisms of the Address has been placed on areas of economy, housing and unemployment, and rightly so too! Yet, it is social issues which affect our daily life also that disappointments abound.

          Let us look at care of the elderly, an area the Chief Executive has pledged and vowed to improve even in his campaigning days. Yet, 15 months down the line of establishment of high-powered Elderly Commission, what is being proposed in the Address is that we need more residential care places -- a fact obvious to all for at least a decade.

          The disappointment in area of health and medical is even more abound. With respect, the ancient tune of "Hong Kong people enjoy health status that is amongst the best", "our infant mortality rate is a low 4 per 1000 live births", "life expectancey is long at 76 years for men and 82 years for women" have been sung too much and too often to ad nausea.

          Worse, the "yearly delay" of promises of health care policy and health financing review seems to be a rule rather than an exception. Conveniently, Government has hide behind the shield of "the consultant's review is still in progress". Yet if Government is sincere in its determination to reform, if Government is genuinely posed to effect a charge which is for the better, the least any responsible body could do is to spell out the general principle and the direction forward, leaving the "consultant's review" to fill in the details.

          Instead the Address ponders over ad hoc increase in hospital beds, labours over the need for the Hospital Authority (HA) to improve its clinical audit and risk management, whilst refusing to address the "Achilles heel" of public health care which is "using a finite resource to supply infinite and unsatiable needs". Is this an act of willful procrastination or is Government genuinely oblivious to the basic flaw?

          One wonders whether the Government will have the political determination to push for a reform should the "consultant's review" strongly indicate that "those who can pay, pay" is the best way forward!

          Without a revised health financing policy, workload of public health institutions would inevitably surge especially when additional revenue is unlikely to be forthcoming. Worse, frontline workers are now sting by the "productivity gain" demand stated in the Address that public departments have to save up to 5% of budget in two years.

          Such austere demand is no doubt timely for civil service, but should never be forced onto the HA. No, the HA should never have privilege over others, yet it has already implemented "productivity gain" for some six years. It was only in this year's budget that HA decided to focus on "consolidation" of existing services, acknowledging that hospitals have no more "fat" to be trimmed.

          HA is now left with only "lean meat", any further squeeze will affect service quality and staff morale. It also emerges too obvious that the root solution in face of ever surging health expenditure lies in rational overhaul of our health financing mechanism.

(Hongkong Standard)