Letters | Easing the pressure on Hong Kong’s health sector starts with effective public-private partnership

Private doctors should be allowed to run clinics for profit for specific services, but must provide affordable care to patients with chronic conditions

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A member of staff puts up “off duty” and “daily visit limit reached” signs, as people queue up outside a clinic in Mong Kok for general check ups during the flu season, on January 17. Photo: Sam Tsang

Published: 8:05am, 29 Jan 2019Updated: 8:04am, 29 Jan 2019

The alarming rate of hospital bed utilisation in Hong Kong amid a seasonal flu surge is being widely covered and hotly discussed (“Hospital wards packed like Chinese restaurants, doctors complain”, January 25). However, primary health care in Hong Kong is not doing enough to alleviate the pressure on hospitals. The reasons for this minimal contribution lie deep in the structure of the health care system.

The current public-private market share for primary care (outpatient) services is about 3:7 and that for hospital services is 9:1 . This contrast is telling. First, because of the long-term financial burden, private GPs are seldom an appealing choice for patients with chronic illnesses (such as diabetes, chronic kidney disease, etc) who are known to be highly vulnerable to acute health problems, especially during peak flu seasons like the current one.

However, public clinics, with their limited scale, are not able to provide care to all these patients, thus increasing their risk of hospitalisation. In other words, without a comprehensive health care financing programme for citizens, the private sector is not adequate to provide primary care to those most at risk.

This problem has proven extremely difficult to address. Since the early days after the handover, there have been ongoing debates on health care financing but no consensus has been reached. The out-of-pocket payment remains high.

Another way to resolve the problem is an ambitious expansion of public primary care services, but this would increase the regular expenses of the government substantially and so is not very feasible either.