Press Releases
Government launches public consultation on Review of Regulation of Private Healthcare Facilities
The Government today (December 15) launched a public consultation on the
Review of Regulation of Private Healthcare Facilities to solicit views from
the public on revamping the regulatory regime for private healthcare
facilities (PHFs). The consultation period will last for three months until
March 16, 2015.
Speaking at a press conference to launch the public consultation exercise
today, the Secretary for Food and Health, Dr Ko Wing-man, said that as Hong
Kong's healthcare system runs on a dual-track basis comprising both the
public and private sectors, private healthcare is an essential component of
our healthcare system. With the advancement of medical technology and rapid
changes in medical practice, the mode of service provision of PHFs has also
been evolving. For example, high-risk medical procedures/practices once
confined to hospitals are increasingly performed in an ambulatory setting,
and community outpatient clinics that used to be run by individual medical
practitioners have increasingly given way to incorporated clinics, where
ownership is not confined to the medical practitioners delivering the
medical services.
Dr Ko said, "In light of the above, there is a genuine need to conduct a
detailed review of PHFs regulation and introduce a robust and comprehensive
regulatory regime for PHFs so that other facets essential to their
regulation such as corporate governance, clinical governance and price
transparency can be adequately provided for, thereby protecting the rights
of the consumer and contributing to the sustainable development of Hong
Kong's healthcare system."
In 2012, the Government established the Steering Committee on Review of the
Regulation of Private Healthcare Facilities to conduct a root-and-branch
review of the regulation of PHFs. Taking into account the recommendations of
the Steering Committee, the Food and Health Bureau today released a
consultation document setting out the proposed regulatory regime for PHFs,
which will help to address the main concerns raised by the public in recent
years including price transparency, quality of healthcare service, consumer
protection, standard of facilities and sanctions.
Regarding the legislative framework, the Government proposes to introduce
new legislation to broaden the types of PHFs to be regulated, and to replace
the existing Hospitals, Nursing Homes and Maternity Homes Registration
Ordinance (Cap. 165) and the Medical Clinics Ordinance (Cap. 343), which
were enacted in the 1960s. The new regulatory regime will cover three
classes of PHFs, enhance regulatory powers over PHFs and confer authority on
the Director of Health to impose licensing requirements.
The three classes of PHFs are hospitals, facilities providing high-risk
medical procedures in an ambulatory setting and facilities providing medical
services under the management of incorporated bodies.
The Government proposes to define "hospital" as "any healthcare facility
primarily for the provision of medical care and/or Chinese medicine practice
with continuous medical support and lodging", so that community-based
centres such as nursing homes providing care without or with minimal medical
involvement will no longer be caught under regulations targeting medical
facilities.
A PHF providing high-risk medical procedures in an ambulatory setting should
be regulated under the new regulatory regime. A medical procedure is
classified as high-risk if the procedural risk is high, if the risk of
anaesthesia involved is high, or if the patient's condition is classified as
unstable severe systemic disease (acute exacerbation) or worse.
Concerning PHFs run as incorporated bodies in which non-medical investors or
managers may be involved in day-to-day operation, the consultation document
proposes that it is necessary to introduce facilities-based regulation in
addition to professional self-regulation for these PHFs, with a view to
ensuring effective governance and maintaining service quality meeting
professional standards.
To better protect patients' safety and consumers' rights, the consultation
document proposes to constitute 19 regulatory aspects under five broad
categories of control including corporate governance, standard of
facilities, clinical quality, price transparency and sanctions. These
regulatory aspects serve as essential requirements of the regulatory regime
for private hospitals, with suitable adaptation commensurate with the lower
degree of complexity and risks of medical services provided in other PHFs.
As regards corporate governance, the Government proposes mandatorily
requiring the appointment of a person-in-charge for each regulated PHF and
the establishment of a Medical Advisory Committee for each private hospital;
a complaint management system for each private hospital and regulated PHF;
the development of an information system connectable with the Electronic
Health Record Sharing System (eHRSS), and maintenance of Hospital
Accreditation Status.
Regarding standard of facilities, the scope of regulation includes premises
management, physical conditions and infection control. It is recommended
that PHFs should develop their policy and guidance on the control and
prevention of infectious diseases for diagnosis, treatment, operation and
other medical procedures (such as proper record keeping to ensure compliance
with the guidance).
The Government considers it essential to monitor the quality of clinical
works in order to enhance the quality of healthcare services, minimise
clinical risk and improve efficiency of service provision. The revamped
regulatory regime seeks to enhance clinical quality in six key areas, namely
service delivery and care process, resuscitation and contingency, standards
specific to procedures performed, credentialling of visiting doctors,
establishment of a clinical audit system and sentinel events management.
Recommendations on enhancing price transparency include requiring all PHFs
to prepare a fee schedule setting out all charges that may be levied; that
patients should be informed of the estimated total charges on or before
admission to private hospitals; requiring hospitals to publish key
historical statistics on their actual bill sizes for common
treatments/procedures; and encouraging all PHFs to provide Recognised
Service Packages.
At present, the maximum penalty for operating a hospital without being duly
registered is $2,000, while penalties for other non-compliance and the daily
fine for continuous contravention are set at $2,000 and $50 respectively.
This is clearly unlikely to have any deterrent effect at today's prices. We
consider that regulated PHFs that fail to comply with regulatory
requirements should be subject to sanctions commensurate with the
seriousness of the offence. For example, it is proposed that the maximum
penalty for unlawful operation of a hospital should be a fine of $5,000,000
and imprisonment for two years, and for other regulated PHFs a fine of
$100,000 and imprisonment for three months.
Dr Ko said that certain short to medium-term administrative measures would
be introduced to supplement the existing regulatory regime before the new
regime is put in place.
These measures include:
(a) review the existing administrative Codes of Practices for the Hospitals,
Nursing Homes and Maternity Homes Registration Ordinance and the Medical
Clinics Ordinance to strengthen existing requirements in the regulation of
PHFs;
(b) conduct a survey to assess the number, types and range of services of
PHFs that might be affected by the new regulatory regime; and
(c) introduce an administrative listing system for ambulatory facilities
providing high-risk medical procedures in an ambulatory setting to monitor
such facilities before the introduction of statutory registration.
The regulatory authority will also work with the Hong Kong Academy of
Medicine to establish a mechanism for setting the standards required of
ambulatory facilities providing specific classes of high-risk procedures.
These procedure-specific standards will be promulgated to the profession as
guidance before being incorporating into the future legislation as part of
the statutory requirements.
Dr Ko added, "The proposals being put forward in the consultation document
will help to enhance the sustainable development of our private healthcare
system. We appreciate that some of them may have implications for existing
private hospitals, facilities providing high-risk medical procedures in an
ambulatory setting, clinics and relevant stakeholders. Members of the
public, in particular healthcare professionals, are invited to offer
comments and suggestions on the above and other issues during the public
consultation period. If the community supports the proposals on regulation
of PHFs, we will proceed with legislative procedures in order to implement
those proposals."
Copies of the Review of Regulation of PHFs consultation document are
available for collection at district offices or can be downloaded from the
Food and Health Bureau website (www.fhb.gov.hk).
The public can send their views on the consultation document on or before
March 16, 2015, by email (hpdo@fhb.gov.hk),
by post (Healthcare Planning and Development Office, Food and Health Bureau,
19/F, East Wing, Central Government Offices, 2 Tim Mei Avenue, Tamar, Hong
Kong), or by facsimile (2102 2493).
Ends/Monday, December 15, 2014
Issued at HKT 16:32
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