Replies to LegCo questions

LCQ11: Private services in public hospitals

Following is a question by the Dr Hon Kwok Ka-ki and a written reply by the Secretary for Health, Welfare and Food, Dr York Chow, in the Legislative Council today (February 22):

Question:

Regarding the privatisation of public health care services, will the Government inform this Council:

(a) of the details of the current provision of "private services" by public hospitals, broken down by individual hospitals, in relation to general and specialist out-patient services, in-patient services and surgical services, including the specific operation of such services, standard fees and charges, as well as the establishment and strength of the medical practitioners involved;

(b) of the number of private patients who used the above services over the past year and the number of hospital beds and surgeries involved; the utilisation rate of such "private services", its estimated expenditure, the actual cost and its percentage in the resources for public health care services, as well as its income and expenditure; if surplus was recorded, of the income sharing arrangement and the amount allocated to public health care services;

(c) of the details of the specific operation of the "private services" provided by the medical centre jointly established by the Prince of Wales Hospital ("PWH") and the Faculty of Medicine of the Chinese University of Hong Kong, including whether such services operate independently and are not subordinate to the Hospital Authority ("HA"), as well as the establishment of the health care staff concerned; the impact of such services on the services provided by PWH; and whether other public hospitals plan to establish similar medical centres, or turn all their services into "private services";

(d) of the details of the plan of the Faculty of Medicine of the University of Hong Kong to establish a private hospital, and whether the Faculty will change its collaboration mode with Queen Mary Hospital; and

(e) whether it has assessed if the development direction of the privatisation of public health care services will change the focus of service and target customers of HA, resulting in a situation in which first class medical services will only be available to those who can afford high charges, thereby affecting the public hospital patients' waiting time for service and relegating to second class the medical services for the elderly, the poor and the severely ill; if it has, of the assessment results?

Reply:

Madam President,

(a) There are two main types of private services in public hospitals: private specialist out-patient (SOP) services and private in-patient (IP) services. In respect of SOP services, the majority of the relevant activities are concentrated at the two teaching hospitals, namely the Queen Mary Hospital (QMH) and Prince of Wales Hospital (PWH). One non-teaching hospital, Queen Elizabeth Hospital (QEH), also provides some private SOP services, but on a much smaller scale. The majority of private IP services are provided by the two teaching hospitals and QEH, although private beds are available in 14 other public hospitals. Public hospitals do not offer any private general out-patient services.

Private services in public hospitals are provided jointly by doctors of the two universities and specialists doctors of the Hospital Authority (HA). There is no specific establishment for the medical practitioners at the HA for private services.

The HA charges market rates for its private services, which are at least set at the cost recovery levels. Private patients are charged for each major medical service received. The full list of private charges are published in the Gazette.

(b) In 2004-05, there was a total of 23 206 private SOP attendances at public hospitals, which accounted for 0.38% of total SOP attendances. Total private bed-days was 41 858, which accounted for 0.57% of the total bed-days utilised in public hospitals. The HA generated a total income of $132 million from its private services in 2004-05. The full amount is retained by HA for the provision of services in public hospitals.

(c) PWH has been providing private SOP and IP services since its opening in 1984 in collaboration with the Faculty of Medicine of the Chinese University of Hong Kong (CUHK). There was then no designated location for the hospital's private SOP services. University professors and specialist doctors of the hospital had to attend to their private patients in their own offices, which were scattered in different buildings of the hospital.

The services offered by the CUHK-PWH Medical Centre, which was established in January this year, remain part of HA's private services. As the main aims of the Medical Centre are to provide a central location for all of the hospital private SOP services and better information technology support for such services, its establishment has no impact on the hospital's public medical services.

There are currently no plans for other public hospitals to establish similar centres.

(d) We are not aware of any concrete proposal by the Faculty of Medicine of the University of Hong Kong to establish a private hospital.

(e) It is a priority of all public hospitals to provide medical services to the low income group and the underprivileged. The main rationale for the provision of private services at public hospitals is that there are levels of expertise and facilities within the public medical sector, especially at the two teaching hospitals, which are not generally available in the private sector. It is therefore considered appropriate to offer the public, some of whom might want to procure private services, a means for accessing these specialised services. Private services accounted for less than 1% of the total service provision in public hospitals. Their effect on public services is minimal.


Ends/Wednesday, February 22, 2006
Issued at HKT 12:59

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