Are Hong Kong’s doctors emigrating?

Mark O'Neill August 26, 2021 06:00

Young Kansas was born with a defective heart that has required five operations. A heart specialist in the Hong Kong Children’s Hospital performed all the operations. Kansas will need another procedure late this year or early 2022. But will the specialist be here to perform it?

Kansas’ father Jayco said he had heard that the doctor had emigrated. When he asked the hospital, it did not give an answer. “The doctor saved his life,” he said. “We could pay him to fly back for the procedure or fly Kansas to where the doctor is.”

Are the doctors emigrating? This is the nightmare of Hong Kong people who enjoy one of the world’s best medical systems. They can choose between well-equipped public hospitals which charge very little or private doctors who offer state-of-the-art advice and treatment.

Earlier this month, Henry Fan, chairman of the Hospital Authority, said that he was worried about the increasing loss of medical staff from the public sector due to emigration. From July 2020 to the end of June this year, the turnover rates of doctors and nurses were 4.6 per cent and 6.5 per cent respectively and that the rates were rising, he said.

“Some of our doctors moved to the private sector because some in private practice left the territory,” Fan said.

In May, Health Secretary Sophia Chan said that Hong Kong faced a serious shortage of doctors compared with international standards and that the crunch was expected to “deteriorate” in the medium term.

Hong Kong has two doctors per 1,000 people, compared to an average of 3.4 per 1,000 among countries in the Organisation for Economic Co-operation and Development (OECD). Of the 15,000 registered doctors in the city, 40 per cent work in the public sector, which handles inpatient services for 90 per cent of the population.

One specialist in a government hospital said that he had planned to spend his life in the public sector. “With the street protests and Covid, I continued to work on the front line and never thought of emigrating. But the National Security Law was the point of no return. This means politicising education of our children.” He has hired a recruitment firm to find him a job and plans to emigrate in 2022 with his family.

Doctors and nurses enjoy a great competitive advantage over other migrants – their skills are greatly in demand in immigrant countries.

In a report this year, the British Medical Association said the National Health Service -- the public sector -- needed almost 50,000 more doctors if the service was to keep up with demand. Britain has 2.8 doctors per 1,000 people, below the European Union average of 3.4. Main areas of shortage are psychiatry, general practice and emergency medicine.

Many Hong Kong doctors studied in Britain or have qualifications recognised there and in other Commonwealth countries, like Australia and New Zealand. They speak fluent English and are familiar with the medical practices and regulations of these countries.

On the negative side, work in public hospitals in these countries means long and exhausting hours and dealing with a racial and religious diversity they do not encounter here. Rates of taxation are significantly higher than in Hong Kong, so their net income will be lower.

Private practice is more lucrative. But building a network of contacts and doctors to provide a supply of patients takes a long time.

Britain is similarly short of nurses. Before Covid, it had a shortage of about 50,000 nurses. In January 2021,a survey by the British “Nursing Times” said that 80 per cent of nurses felt patient safety was compromised due to this severe staff shortage.

These shortages have been exacerbated by Brexit. Many EU doctors and nurses who did not have residence rights in Britain chose to return home or go to work in other EU countries.

David Wong, a dentist, said that he graduated from HKU in 2000. “Ours was the last group to be able to go to UK, Australia or New Zealand and practice, because they recognise our qualifications. Those who came after me have to re-qualify. So would I if I went to US or Canada.”

“Qualifications are not the only barrier. In the UK, the regulations on disposal of medical waste are more severe. Communications is another issue. Could I talk so well to British patients? And there is a new trend in our profession – you must explain everything to the patient and listen carefully to what he/she says. Our seniors did not have to do this.”

He said many of his high school classmates had emigrated because of their school-age children. “They sold their apartments and moved. They went in a rush and did not prepare a job in advance.”

Unmarried, Wong has made no decision on whether to emigrate.

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Mark O'Neill

A Hong Kong-based writer, teacher and speaker.