25 October 1997

Private Hospitals being maltreated as ¡§Concubine¡¦s Sons¡¨

(Keywords:- private hospitals, ambulance transfer, clinical waste)

          Hong Kong has always boasted a dual health care system:  private practitioners and private hospitals providing services side by side with public clinics and hospitals. Though not completely complementary, they each take their market share and share the load of work if not the strain on public coffer. Recently, witnessing the mounted workload in public hospitals, there is a call to channel some affordable patients back to the private sector. Regrettably, experiences by private hospitals have shown that they are looked upon by Government as the ¡§concubine¡¦s sons¡¨ and private patients are deprived of taxpayers¡¦ rights!

          Take non-emergency ambulance services. Hitherto most of all types of ambulance services are provided by the Fire Services Department (FSD) supplemented by the Government funded Auxiliary Medical Service (AMS).  Adopting a cosultancy¡¦s advice for FSD to concentrate on emergency cases, non-emergency services within public hospitals were hived off to the Hospital Authority, in steps, through special transfer of budget.

          Extending the consultant¡¦s advice, yet without prior official warning, supply of non-emergency ambulance service to private hospitals by the FSD was abruptly stopped by July this year. The onus of this essential service is left to the AMS which rightly so feels that the ¡§hot potato¡¨ on its lap was too hot to handle -- it has six ambulances which need to handle an estimated 9,000 cases for Government clinics, aged homes and private hospitals. Yet, in the past six months, its actual case load was already some 60% over its estimation. Furthermore, they have stated in no unclear terms that while they observe the principle of first come first serve, Government clinics are given priorities.

          The result -- private hospitals¡¦ patients requiring such service could have to wait up to 10 days. In short, if your doctor in a private hospital says you can go home today, do not be overjoyed. Your illness may be cured, but your have to pay out some 10 days¡¦ hospital charges whilst waiting to go home. There are suggestions that bookings could be made a week in advance. Yet it take more than a prophet to predict when a sickness is going to get better and fit for discharge.

          There are further suggestions that since they are private patients, they should pay for the transportation. Yes, they should pay the taxi fare. Yet, not all can go home in an ordinary public or private transport means. For patients with plaster cast, patients on oxygen inhalation, patients on stretcher, they need special vehicles that are not available even at a charge. Let us not forget that most of them are also Hong Kong taxpayers.

          How can the private sector help to alleviate the increasing workload of our public hospitals, in face of such ridiculous maltreatment by the Government?

          Government¡¦s attitude in handling clinical waste in the private sector is even worse. Medical institutions do produce, besides the normal household wastes, clinical wastes. These are sharps (needles and blades), infected materials which might be biological hazardous, and tissues, organs and body parts which must be aesthetically annoying.

          Few would disagree that they should be disposed properly. They all must be placed and treated in special containers before transportation, which the health care profession has dutifully complied. Sharps and infected materials so collected are now disposed in landfills for which each institution has to apply for a licence at a three-monthly interval. How bureaucratic! For human parts and tissues, the situation is ridiculous. In the past these were incinerated in the crematories of the two municipal departments. Such services have now been discontinued. Nor can the Hospital Authority help owing to  the limited capacity of its incinerators. Ironically, the Environment Protection Department advised private institutions to find their own means of incineration!

          For the smooth running of Hong Kong, Government and the public must cooperate. In the issue of clinical waste, the health care profession are more than eager to cooperate but Government has failed to create an environment for them to do so!

(Hongkong Standard)

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