The key source of strain in our healthcare system

March 22, 2019 11:28
Elderly people account for 40 to 50 percent of the city's total public healthcare services in terms of inpatient bed-days, A&E attendances and specialist outpatient (clinical) attendances. Photo: Reuters

The last winter flu surge has again highlighted the shortage of hospital beds and staff in our public healthcare system, with every accident and emergency department overwhelmed by the influx of patients.

Some brought up the idea of introducing overseas medical practitioners or relaxing licensing requirements for medical graduates who were not locally trained to address the crisis.

Meanwhile, some blame new immigrants from the mainland for burdening the healthcare system and demand that the government review the one-way permit system, lower the number of daily quotas or even scrap the entire scheme.

Previously, I noted in my column that the one-way permit scheme was designed for the purpose of family reunions, and as such was not attracting either professionals or investors to Hong Kong.

However, I was not trying to imply that the new immigrants were welfare-dependent. On the contrary, the findings of some studies suggest that they are contributing to society by filling the labor gap created by the city's ageing population and low fertility rate.

The community should therefore not simply blame our housing or social welfare problems on the one-way permit scheme.

From my point of view, population ageing is the culprit.

The current number of elderly people aged 65 or above in Hong Kong is around 1.2 million. They account for 40 to 50 percent of the city's total public healthcare services in terms of inpatient bed-days, A&E attendances and specialist outpatient (clinical) attendances.

On the other hand, the median age of one-way permit holders is 33.9, with less than 2.5 percent of them aged 65 or above. This means new immigrants are mostly young and strong.

Cutting the daily quota is not going to instantly help alleviate the pressure on our public healthcare system.

If you take a look at a typical public hospital or outpatient clinic, on top of the elderly, you might be surprised to find that quite a number of non-ethnic Chinese individuals are waiting for consultations.

It is unfair if we just limit the number of immigrants from mainland China without cutting the number of foreign domestic workers or non-ethnic Chinese immigrants at the same time.

Since it takes time to produce local medical graduates, introducing overseas medical practitioners and relaxing licensing requirements for non-locally-trained medical graduates would help in easing the situation.

There are a number of ways to do this. Suggestions include reducing the number of licensing examinations and required internship training tours, or permitting graduates from renowned overseas medical schools or Hong Kong-born graduates to be exempted from licensing examinations and internship training, or requiring foreign medical practitioners to serve in public hospitals for a period of time before switching to private practice.

I think these suggestions should address much of the concerns about hiring foreign medical practitioners such as the possibility that we might accept substandard overseas doctors or that their presence here might have an impact on local health professionals.

This article appeared in the Hong Kong Economic Journal on March 13

Translation by John Chui

[Chinese version 中文版]

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Legislative Council member