Replies to LegCo questions
LCQ4: Obstetric services
Following is a question by the Hon Cheung Man-kwong and a reply by the Acting
Secretary for Food and Health, Professor Gabriel Leung, in the Legislative
Council today (May 11):
Question:
The Court of Final Appeal ruled in 2001 that children born in Hong Kong to
Chinese nationals had the right of abode in Hong Kong. Since then, the number of
babies born in Hong Kong to mainland women whose spouses are not Hong Kong
permanent residents has soared by more than 50 times, from 620 in 2001 to 32,653
in 2010. The authorities announced on April 28 this year that seven measures
would be introduced to alleviate the pressure on the healthcare system caused by
mainland women giving birth in Hong Kong. Such measures include refusing the
admission of non-local high-risk pregnant women, setting up a working group to
determine the number of non-local pregnant women to be admitted next year and,
starting from next year, determine at the beginning of each year the number of
non-local pregnant women allowed to give birth in Hong Kong in the following
year. In this connection, will the Executive Authorities inform this Council:
(a) how they will, in implementing the aforesaid measures, stop agencies from
arranging for mainland pregnant women to illegally come to Hong Kong to give
birth;
(b) of the justifications for treating in the same manner mainland pregnant
women whose spouses are and those women whose spouses are not Hong Kong
permanent residents; in connection with these two types of pregnant women,
whether the authorities will request public and private hospitals in providing
obstetrics services to give priority to mainland pregnant women whose spouses
are Hong Kong permanent residents; and
(c) of the expected number of mainland pregnant women giving birth in Hong Kong
this year, and how it ensures that this number will not exceed the capacity of
the healthcare system in Hong Kong?
Reply:
President,
It is the Government's policy to ensure that Hong Kong residents are given
proper and adequate obstetric services. The Administration is very concerned
about the surge of demand for obstetric services in Hong Kong by non-local women
(including Mainland women) in recent years, which has caused tremendous pressure
on the overall obstetric and neonatal care services. We held a meeting with the
Hospital Authority (HA), Department of Health (DH), the representatives of 10
private hospitals that provide obstetric services, the concern groups on Hong
Kong's obstetric and neonatal services, the Hong Kong College of Obstetricians
and Gynaecologists and the Hong Kong College of Paediatricians to discuss the
arrangements for provision of obstetric services to non-local pregnant women
next year, with a view to alleviating the pressure on the overall obstetric and
neonatal services in Hong Kong.
We have proposed a number of measures to ensure local pregnant women are given
priority for obstetric services and all mothers delivering in Hong Kong and
their babies are safe and given the best of care, as well as to maintain the
high professional standard of our services and the sustainable development of
obstetric and paediatric services in Hong Kong. Non-local pregnant women who
intend to have deliveries in Hong Kong will be required to undergo antenatal
checkups by obstetricians in Hong Kong at an appropriate stage for assessment on
whether they are suitable to give birth in Hong Kong, and if so the issuance of
a "Certificate on confirmed antenatal and delivery booking" which will be
standardised by DH. In addition, we will endeavour to combat the improper and
unprofessional co-operation between individual local obstetricians and agencies.
We will also set up a working group to determine in the first quarter of each
year the number of non-local pregnant women allowed to give birth in Hong Kong
in the following year.
Our replies to various parts of the question are as follows:
(a) It is not illegal for non-local pregnant women to receive obstetric services
in Hong Kong through arrangements by an agency. However, if any local
obstetrician cooperates with an agency in an improper and unprofessional manner
with reckless disregard for the safety of pregnant women and their babies for
the sake of profit, such as providing admission certificate to any non-local
pregnant woman who has yet to undertake any antenatal checkup in Hong Kong,
changing the expected date of delivery, unnecessarily arranging early caesareans
for the sake of bed availability, etc., the doctors involved may be subject to
disciplinary action for breach of the Code of Professional Conduct for the
Guidance of Registered Medical Practitioners as stipulated by the Medical
Council of Hong Kong. Private hospitals are also obliged to terminate their
co-operation with the doctors concerned and refuse to allow them to provide
obstetric services at their hospitals. To our understanding, there is no
collaborative relationship between local private hospitals and any agencies
providing services to mainland women delivering in Hong Kong. DH, as the
regulatory authority over private hospitals, will continue to monitor the
situation closely.
(b) At present, the public healthcare services in Hong Kong are heavily
subsidised by the Government. It is necessary for the Administration to ensure
our public healthcare services can meet public demand and at the same time can
sustain in the long-term within limited financial resources. It has been our
policy that public healthcare services are provided primarily for Hong Kong
residents. Only "Eligible Persons" (EPs) (i.e. holders of Hong Kong Identity
Card and children who are Hong Kong residents and under 11 years of age) are
eligible for the highly subsidised public healthcare services. Non-Hong Kong
residents (i.e. Non-eligible Persons (NEPs)) are provided with public healthcare
services in emergency situations and they may seek non-emergency public
healthcare services when there is spare service capacity. However, the rates of
charges applicable to NEPs will apply. Fees for public healthcare services are
currently charged in accordance with the status of the patients directly using
the services and no consideration is given to family relationship. As in the
case of obstetric services, fees are charged in accordance with the status of
the pregnant women.
In 2003, we clarified the definition of EPs to the effect that non-Hong Kong
residents who are the spouses or children of Hong Kong residents would be
treated as NEPs and charged the NEP rates when using public healthcare services,
including obstetric services.
We propose that non-local pregnant women should be checked and assessed by
doctors in Hong Kong to see if they are suitable to give birth in Hong Kong, so
as to ensure the safety of pregnant women and their foetus as well as to
maintain the standard of our high quality services. To require non-local
pregnant women to receive antenatal checkups by obstetricians in Hong Kong at an
appropriate stage would help identify high-risk pregnancies, so that the
pregnant women in questions, who in fact require additional attention and
checkups, and their fetuses are not subject to risks associated with travels or
other factors. We have invited the Hong Kong College of Obstetricians and
Gynaecologists and the Hong Kong College of Paediatricians to give professional
advice and guidelines for the checkups, so that obstetricians in the public and
private sectors can make decisions and professional judgement consistently based
on the guidelines. Obstetricians may exercise flexibility if they are convinced
that individual non-local pregnant women can be followed up by obstetricians in
Hong Kong.
(c) Based on the number of bookings for deliveries already made with local
hospitals, we anticipate that there will be a slight increase in the number of
deliveries in Hong Kong this year in comparison with that of last year. HA has
already allocated additional resources and manpower to obstetric departments and
neonatal intensive care units of public hospitals. It is anticipated that we are
able to cope with the service demand this year.
In the long run, we endeavour to maintain the sustainability of our obstetric
and paediatric services while continuing to provide high quality and
professional services. We have reached consensus with the public and private
hospitals providing obstetric services that measures have to be taken together
to cap the number of deliveries in Hong Kong with regard to the overall capacity
of our obstetric and neonatal care services. Based on such consensus, the
working group to be set up will determine in the first quarter of each year the
number of non-local pregnant women allowed to give birth in Hong Kong in the
following year.
Ends/Wednesday, May 11, 2011
Issued at HKT 13:44
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