Replies to LegCo questions
LCQ3: Non-local doctors recruitment scheme
Following is a question by the Hon Fred Li and a reply by the Secretary for Food
and Health, Dr York Chow, in the Legislative Council today (November 9):
Question:
In view of the serious wastage problem of doctors in public hospitals in recent
years, the Hospital Authority (HA), in addition to increasing promotion
opportunities and recruiting part-time local doctors, also plans to recruit
overseas doctors to practise with limited registration in Hong Kong, but the
Allied Concern Group on the Standard of Medical Services in Hong Kong, which
consists of doctors' associations such as the Hong Kong Medical Association, the
Association of Private Medical Specialists of Hong Kong and the Hong Kong Public
Doctors' Association, has jointly signed a submission to the Medical Council of
Hong Kong (MCHK) to voice opposition. In this connection, will the Government
inform this Council:
(a) whether it knows the impact of non-Hong Kong residents using medical
services in Hong Kong on the demand for doctors in private hospitals and
specialists, and on the recruitment and retention of specialists by public
hospitals; the current percentage of the number of attendances of non-Hong Kong
residents in the total number of attendances of private hospitals per annum;
whether the authorities will consider including a provision to prescribe the
percentage of the number of attendances of non-Hong Kong residents of private
hospitals when they apply for licence renewal; further, the number of doctors
who have returned to the Mainland to set up clinics and hospitals or practise
under the Mainland and Hong Kong Closer Economic Partnership Arrangement; the
impact on the supply of doctors in Hong Kong; how the doctor-to-population ratio
in Hong Kong compares to that in other advanced countries which provide medical
services for a large number of non-nationals;
(b) whether it knows the criteria adopted by HA for the initial screening of the
applicants for the overseas doctor posts; the number of doctors HA intends to
recruit in this way, as well as their specialties and ranks; the wastage rates
of such posts in the past two years and the number of current vacancies; whether
it will continue to recruit more overseas doctors to fill such posts; how the
authorities will address the dissenting views of local doctors' associations and
ensure that the overseas doctors recruited by HA and their local counterparts
can whole-heartedly work together in the future; whether, under the existing
legislation or the Professional Code and Conduct for the Guidance of Registered
Medical Practitioners in Hong Kong, doctors' associations are allowed to attempt
to influence the decision of MCHK regarding the vetting and approval of
applications for limited registration; and
(c) whether the authorities have reviewed the causes of the low passing rate of
overseas doctors attending MCHK's Licensing Examinations; whether it knows if
MCHK has a statutory obligation to make improvements to attract more quality
medical personnel, having regard to safeguarding the public's health and
interests?
Reply:
President,
With an ageing population and advances in medical technology, there is an
increasing demand for healthcare services in the community, and the manpower
requirement for healthcare personnel grows commensurately. In the past few
years, the Hospital Authority (HA) has implemented a series of measures to
address manpower issues. In 2011-2012, HA will continue to recruit additional
healthcare staff, including about 330 doctors and 1,720 nurses, to meet the
service demand. To increase doctor manpower in the short-term, HA has enhanced
the remuneration package and allowed greater flexibility for employments of
part-time doctors early this year. Without affecting the promotion of other
young doctors, HA has taken proactive efforts to retain some of the doctors who
have retired or left HA. By now, some 60 senior doctors remain serving in the
public hospitals on a part-time basis. In addition, HA has, in recent years,
created additional promotion posts, strengthened professional training and
relieved the workload of its frontline healthcare workers by re-engineering the
work processes and streamlining work procedures with a view to boosting staff
morale and improving staff retention. Since there will only be some 250 local
medical graduates each year up to 2014, it is anticipated that the problem of
shortage of doctors in public hospitals will persist in the next few years even
after the implementation of such measures. Under such circumstances, the
employment of non-local doctors with limited registration is necessary.
The Government supports HA's recruitment of non-local doctors to practise with
limited registration as one of the additional and immediate measures to address
the manpower problem. In tandem with recruiting non-local doctors to practise
with limited registration, the Government has also taken steps to tackle the
healthcare manpower shortage problem at source by a number of measures,
including allocation of an additional $200 million to increase the number of
training places for healthcare personnel. To ensure a sufficient supply of
healthcare manpower in the long run, the Government will, on the basis of the
outcomes of the Second Stage Public Consultation on Healthcare Reform, set up a
high-level steering committee to conduct a strategic review on healthcare
manpower planning and professional development. The steering committee will put
forward recommendations in the first half of 2013 with a view to ensuring the
healthy and sustainable development of our healthcare system.
My reply to the various parts of the question is as follows:
(a) With Hong Kong being an international city, there have always been non-local
residents using the healthcare services of Hong Kong. Based on the number of
hospital discharges and deaths, the percentage of non-local residents using
public healthcare services is about 1.2%. In general, the demand of non-local
residents for some specialist services, such as obstetric services, is higher.
Private hospitals are regulated by the Department of Health under the Hospitals,
Nursing Homes and Maternity Homes Registration Ordinance (the Ordinance). At
present, there are 12 private hospitals registered in accordance with the
Ordinance in Hong Kong. They are required to meet the conditions relating to
accommodation, staffing and equipment. No restriction on these hospitals'
service scope and target clients has been laid down in the Ordinance.
Under the liberalisation measures of Mainland and Hong Kong Closer Economic
Partnership Arrangement (CEPA) and its seven Supplements, the Department of
Health of Guangdong Province has approved 10 certificates to the Hong Kong
service suppliers for setting up clinics/outpatient clinics in Guangdong
Province and 10 specialist doctors have obtained the Mainland's certificate of
qualification as doctors through accreditation. Besides, according to
information available to the Department of Health, a total of 23 registered
western medical practitioners sat for the National qualification examinations
for doctors and obtained the certificate of qualification as doctors from the
Ministry of Health. With more than 12,000 registered doctors in Hong Kong, the
impact of CEPA on the supply of doctors in Hong Kong is minimal.
As for the doctor-to-population ratio, there were about 12,800 doctors
registered with the Medical Council of Hong Kong as at end October 2011,
equivalent to 1.8 doctors per thousand population. According to information from
the Organisation for Economic Cooperation and Development and the countries
concerned, the respective ratios of doctors per thousand population in other
advanced countries in 2008 were, for example, 2.6 in the United Kingdom, 3.1 in
the United States, 2.2 in Japan, 2.3 in South Korea, and 2.2 in Singapore.
(b) When taking forward the non-local doctors recruitment scheme on this
occasion, HA has attached great importance to the quality of doctors and set up
a Task Force of Limited Registration Scheme (the Task Force) specifically for
scrutinising the qualifications and eligibility of the applicants. To ensure
that the recruited doctors have attained the required medical standard, all
applicants have to be overseas medical graduates with at least three years'
working experiences in hospitals after completion of their internship, and
possess a specialist qualification comparable to the Intermediate Examinations
of the constituent Colleges of the Hong Kong Academy of Medicine.
As at September 2011, HA received a total of 160 applications, of which 29 were
assessed to be eligible for further processing. The Task Force will first
process applications from certain specialties which are with acute manpower
shortage, including the specialties of medicine, anaesthesia, and accident and
emergency. HA already set up a selection board in late October 2011 to conduct
interviews with the 15 shortlisted applicants who have met the requirements for
the above three specialties. Subject to Medical Council's approval of their
limited registration applications, the selected non-local doctors will be
employed as resident doctors (equivalent to entry rank doctors in HA) and only
be allowed to work in HA public hospitals. In 2009-10 and 2010-11, the turnover
rates of doctors were respectively 5.2% and 5% in the specialty of medicine, 6%
and 4% in the specialty of anaesthesia, and 3% and 5.7% in the specialty of
accident and emergency. Members of the professional team of the concerned
departments in HA will continue to work in a cooperative manner and will offer
appropriate support and guidance as and when necessary.
(c) The Medical Council, established under the Medical Registration Ordinance,
is empowered to handle registration and disciplinary regulation of medical
practitioners in Hong Kong. One of the main functions of the Medical Council is
to administer and conduct the Licensing Examination for medical graduates from
non-local medical schools. The Licensing Examination of the Medical Council aims
to ensure that those who wish to register as medical practitioners in Hong Kong
after having received medical training outside Hong Kong have attained a
professional standard comparable to that of local medical graduates. This is to
safeguard the quality of our medical services and public health. Hence, the
Medical Council will ensure that the standard of the Licensing Examination is
consistent with that adopted by the two faculties of medicine in Hong Kong for
assessing their medical graduates. Papers of the Licensing Examination are also
prepared by the teaching staff appointed by the two faculties of medicine and
vetted by the Examination Sub-Committee of the Licentiate Committee under the
Medical Council.
Under the principle of professional autonomy, the Government respects the
arrangements made by the Medical Council regarding the registration of medical
practitioners and its Licensing Examination. It is believed that the Medical
Council will, as before, handle the registration of medical practitioners in
Hong Kong on the premise of safeguarding public interest and protecting public
health.
Thank you, President.
Ends/Wednesday, November 9, 2011
Issued at HKT 16:25
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