After years of heated debate, the government is finally ready to consult the public over the structure and financing of public medical services.

The Secretary for Health, Welfare and Food, York Chow, said Monday the bureau will draft a plan next month and begin consulting the public in July.

``We plan to contemplate the model of long-term public health services and its financing method by the end of the year,'' he said. ``We will display different options of financing for the public to discuss.''

The options include a mandatory health savings plan, medical insurance scheme or taxation.

``Six months is not a long time, but at least we want to provide a detailed analysis to the public by the end of year,'' Chow said. ``We cannot afford to keep ignoring the issue as problems like the aging population and more expensive technologies are surging. We must let the public know why our costs and charges may go up.''

But he said the plan will exclude dental care, traditional Chinese medicine, and psychiatric services. And whichever financing plan is implemented, the decades-long practice of giving low-cost medical service to the public will come to an end.

The government has given a commitment that the poor will be covered by the social security safety net regardless of which model is adopted.

Dole recipients will continue to enjoy affordable or free medical services in public hospitals.

The budget for health services this fiscal year is HK$32.2 billion, down 2.2 percent from a year ago.

Chow believes the quality of medical services will be crucial when explaining medical financing to the public.

``If the services remain unchanged while we just increase the charges, the public will not accept it,'' he said.

He suggested private clinics could take on more responsibility as gate-keepers, while there is also room for improvement in public hospitals.

Chow said people with minor illnesses, such as a common cold, could choose to go to their family doctor instead of waiting at public clinics, so there will be a better balance between private and public health services.

``Family doctors understand their patients better, but [if we are] to encourage people to consult private doctors, the fees must be fair,'' he said.

Patients should also be allowed to retain their health records so they can follow up medical cases with private doctors of choice.

Chow pledged that more resources will be allocated to family doctors.

The health chief also said hospitals would require more resources to upgrade services. He said in some cases hospital beds are separated by as little as one meter, much more cramped than public hospitals in other developed countries.

Chow said accident and emergency service charges are ``way lower'' than private doctors' charges.

``If we are to raise the public service fees a little, not as much as to force someone into bankruptcy, but enough to change their behavior, we believe that will be good.''

There are concerns that people with assets may have to pay higher medical costs while only the poorest enjoy near-free benefits.

Chow said the Hospital Authority has set priorities in resources allocation, which will take care of the poor, continue subsidizing expensive treatments for rare and chronic diseases as well as emergency cases, and also training for medical professionals.

Chow chairs the newly reactivated health and medical development advisory committee, comprising about 20 members from the private and public-health sectors, academics, patient groups and experts. The committee has begun reviewing medical services at three levels - district family doctors, hospitals and high technology and rare diseases services.

Medical sector legislator Kwok Ka-ki praised the committee for acting quickly on a consultation. He said the timing and the format of dividing the consultation into two stages are appropriate as the model of services has to be decided before funding options can be discussed.

matthew.lee@singtaonewscorp.com