Replies to LegCo questions
LCQ6: Public hospital services and fees
Following is a question by the Dr Hon Yeung Sum and an oral reply by the
Secretary for Health, Welfare and Food, Dr York Chow, in the Legislative Council
today (February 23):
Question:
Regarding public hospital services and fees, will the Government inform this
Council:
(a) whether there has been a drop in the number of attendances at the accident
and emergency (A&E) departments which were classified as non-urgent cases since
the introduction of A&E charges in November 2002, and of the progress and
anticipated completion time of the review on A&E charges;
(b) of the fees of public hospital services which are being considered for
upward adjustments and the time when the relevant proposals will be announced;
and
(c) whether it plans to increase public hospital fees to alleviate the financial
pressures on the Hospital Authority (HA) before the implementation of long-term
health care financing schemes; if so, of the required level of fee increase in
order to enable the HA to attain a break-even?
Reply:
Madam President,
(a) & (b) Since November 29, 2002, the Hospital Authority (HA) has introduced a
charge for its A&E services. In the 12 months before introduction of this charge
(i.e. from December 2001 to November 2002), there were 1,714,651 attendances
that were classified as non-urgent cases. The corresponding figures for the 12
months immediately after fee introduction and the 12 months that follow are
1,294,206 and 1,385,281, representing a drop of 24.5 per cent and 19.2 per cent
respectively. Of course, apart from the level of charges, the utilisation of A&E
services is also affected by other factors such as seasonal fluctuations and
major epidemics (e.g. the SARS outbreak in the spring of 2003).
We are conducting a new round of review on public health care service charges
with a view to targeting government subsidies to patients and services most in
need, rectifying misconceptions and improper use of services, as well as
redressing the imbalance between public and private services.
The review on fee restructuring will cover a range of service areas including
A&E, in-patient, general out-patient, specialist out-patient and drug
prescriptions. Two different charges will apply to eligible and non-eligible
persons respectively for each service category. In drawing up specific fee
restructuring proposals, we will also examine the existing fee waiver mechanism
for public health care services to ensure that adequate services remain
accessible to persons in economic hardship who are non-CSSA recipients
(including low-income groups, chronically ill and poor elderly patients).
The Administration will first conduct in detail an affordability study on the
fee revision to ensure that the new charges to be introduced are affordable to
the public. At this juncture, we do not have an implementation timetable.
(c) Due to the ageing population, advancements in medical technology and growing
public expectations for health care services, medical costs in Hong Kong have
been on the rise. In face of these challenges, we must identify workable
long-term health care financing options (such as insurance and savings schemes)
to ensure that our health care system is financially sustainable over the long
run.
This pursuit of long-term financing options involves, among others, a
substantial amount of research, consultation, public deliberation and consensus
building. The actual implementation process may also entail complex
administrative and legislative procedures. To prevent the imbalance between
private and public health care systems from deteriorating, we consider it
necessary to restructure the fees for public health care services first.
As regards the financial strains experienced by the HA, we believe the problem
should be tackled by cost containment and identification of new revenues. In
view of the heavy subsidisation for public health care services, fee adjustment
alone cannot ease the HA's budget deficit. The Administration will consider
different funding mechanisms to help the HA make ends meet.
Ends/Wednesday, February 23, 2005
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