2 January 1999

Making Health Wish for New Year realise through vision and determination

(keywords:- health policy, infectious diseases, Hospital Authority, medical mishaps, public-private demarcation)

          The dawn of a new year invariably brings new hope -- hope for peace instead of military aggression; hope for sufficiency instead of famine and poverty; hope for work instead of relying on the "dole". For any individuals, perhaps the single undeniable new hope is hope for health.

          It would be ideal if all forms of diseases could be wiped out from the surface of this earth. Unfortunately, such miracles have yet to come by and elixirs of life have yet to be discovered. The next best, yet prudent, solution to health is the provision of a good health service -- high standards, efficient, available to all.

          Hong Kong has boasted unique health indices ranging from long life expectancy to low infant mortality rate. Disappointingly and regrettably, the last 18 months has seen an unprecedented nose-dive -- the saga of the avian flu, home grown cholera, increasing incidents of food poisoning, the successions of medical mishaps -- all have but marred the good name of our health care system and landed us in a scandalous list.

          Yet, these are no coincidental events, nor should we put the blame on a stroke of bad luck! For years, our policy makers have never placed the consideration of health care in their priority lists. Blinded by the laurels created by our health care forefathers, the Government refuses to develop a proactive sensitivity to health care risk. Worse, many still maintain an air of superiority boasting unashamedly at our superficial seemingly unparalleled health care statistics.

          One word says it all -- there has been no health care policy review, let alone policy revamp, since the last "White Paper" published in 1974!

          Yes, the Government has established the Hospital Authority (HA). Yet, at best the HA is a knee jerk response of the Government to the then unsatisfactory public hospital service. Looking at it from a cynical angle, the HA is a Government creation to hive off hospital care from its shoulders. Regrettably, Government has never nurtured the development of this body. Instead, the HA is left to fend for itself against the ever increasing patients' demand while Government is to cunningly slice its budget.

          Nor is HA itself completely absolved from blame. Some seven years since its establishment, its governing board is still unwilling to confront the Government on the extent HA should provide in Hong Kong's health care service given the constraint of budget allocation. Instead, the Board repeatedly gave in to the Government's insatiable demand for increased or better services. Part of this burden, at least, has been put to bear on the frontline staff. Little wonder that morale has been dwindling, which must be responsible for some of the medical mishaps.

          The way ahead for a better health care service is a long and arduous one.

          The role of the public and private sectors in the provision of health care services must be properly redefined. How should future public health care services be funded must be solved. The policy of highly subsidised public health care service even for the wealthy must be revisited.

          No proper health care is complete without consideration given to oral health. Regrettably, our Government has willfully neglected for decades the provision of public dental service. Lastly, with the proper registration of Traditional Chinese Medicine (TCM) practitioners just round the corner, it is high time to consider the future positioning of TCM in the whole health care spectrum.

          On disease prevention, it is an area that the Department of Health must take full charge and review any shortfalls. The proposed centralisation of food and environmental hygiene at governmental level must be a step in the right direction, only if the responsibility falls into the remit of the Department of Health.

          But this is only the beginning. There is a dire need to set up a "Centre for Diseases Control" type unit to collate better disease statistics and dwell deeper into disease surveillance for better infectious diseases understanding and prevention. There is also an urgent need for a "Food and Drug Administration" type unit to monitor drug, food and medical appliances importation and distribution. These are, regrettably, still lacking in this Special Administrative Region.

          Let our Government show the determination to come out with solutions and the political will to carry them out in the new year!

(Hongkong Standard)