Fee adjustments loom in bid to discourage mild cases at A&E wards

Wallis Wang

The SAR administration plans to adjust fees at public hospitals in order to avoid wasting medical resources.

The resources saved can then be used to help those who need to pay for their own medications, said Secretary for Health Lo Chung-mau.

In an interview with Sing Tao Daily, sister paper of The Standard, Lo said the administration should use its limited resources to care for patients with complex illnesses and financial difficulties.

Improving the training and innovation at the Hospital Authority is also a priority.

The fee adjustments at public hospitals do not mean the administration will reduce overall medical funding. Instead, the goal is to prevent the waste of resources that can then be directed at more serious cases.

Lo said that around 60 percent of emergency-room cases are for mild conditions, costing over HK$2 billion per year.

He believes it would be more meaningful to help seriously ill patients with financial struggles than to treat minor issues in accident and emergency rooms.

The average cost per patient in emergency rooms is HK$2,400, but patients only pay HK$180.

Simply making people wait longer is not an effective deterrent for mild cases.

"The large number of such patients also strains waiting areas, facilities and puts pressure on medical staff," he said.

The fee adjustments will involve both increases and decreases.

The administration, Lo stressed, is not aiming to raise revenue with the move.

It is also considering setting cost caps for treatment of major diseases.

"Over 30,000 hospital patients are taking self-financed drugs, including 1,300 cancer patients spending HK$170,000 to HK$400,000 per year, and 300 spending over HK$400,000 annually," Lo said.

In light of frequent medical blunders, Lo said it is necessary to comprehensively and systematically review the management issue of public hospitals, including whether there is room for improvement in assessments, the reward and punishment mechanism and hardware facilities.

Asked if the review will affect morale, Lo said unclear rules of reward and punishment will be the biggest blow to morale.

But an accountability system does not mean those executives in the Hospital Authority who are involved will be forced to step down, he said. Instead, it aims to find out the departments responsible for medical incidents and make improvements.

"Simply requiring management to step down cannot solve the problem, it would only make the manpower shortage worse," he said.

Lo also said in the Legislative Council yesterday that there is no proof that many Hongkongers who have migrated are returning to seek consultations.

Currently, all residents can enjoy public health care and there is no requirement for them to ordinarily reside here, he said.

"The authority does not collect information on whether patients ordinarily reside in Hong Kong, nor does it compile statistics on the utilization of public health-care services by eligible persons who do not ordinarily reside in Hong Kong," Lo said.

"When reviewing relevant policy according to related mechanisms, the government and the Hospital Authority will keep in view changes to the patterns of residents moving to the mainland or overseas, as well as make reference to the subsidization policies of other public services and social welfare."