Replies to LegCo questions

LCQ6: Second stage public consultation on healthcare reform

Following is a question by the Hon Chan Hak-kan and an oral reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (June 17):

Question:

The Secretary for Food and Health has said earlier that as quite a number of the staff in his Bureau have been redeployed to undertake the work on fighting the Human Swine Influenza epidemic (anti-epidemic work), commencement of the second stage consultation on healthcare reform will be deferred. In this connection, will the Government inform this Council:

(a) whether it has assessed until when the aforesaid consultation will have to be deferred, the impact of the deferral on the future implementation of healthcare reform, as well as under what circumstances the consultation will commence;

(b) whether it has assessed if the implementation of healthcare service reform initiatives which have gained wider public support in the first stage public consultation on healthcare reform (including the development of a territory-wide electronic healthcare record sharing system and the promotion of public-private partnership in healthcare services) will need to be deferred as a result of undertaking the anti-epidemic work; and

(c) apart from the second stage consultation on healthcare reform, whether the anti-epidemic work has affected the formulation and implementation of other policies which are currently within the purview of Food and Health Bureau; if so, of the details; if not, the reasons for that as well as why only the consultation work on healthcare reform has been affected?

Reply:

President,

(a) First of all, I would like to stress that healthcare reform is an important, long-term and continuous policy which aims at ensuring the sustainability of our healthcare system to meet the challenges arising from ageing population and rising medical costs. To this end, we need to reform the existing structure of our current healthcare system, which put emphasis on hospital-based services, and strengthen primary care. At the same time, we have to address the imbalance between the public and private healthcare sectors so that our healthcare resources can be put into optimal use; and to ensure that adequate resources are available for the long-term development of the healthcare system. Our work on healthcare reform will not stop and the implementation of service reform proposals that have received broad public support is in progress. We will work with all sectors of the community to continue our deliberation on the issue of healthcare reform, which has far-reaching implications on the long-term healthcare development. It is also necessary for us to encourage further discussions and seek to forge a consensus on the introduction of supplementary financing arrangements.

Currently, the first and foremost task of the Government, in particular the Food and Health Bureau (FHB), is to launch an effective fight against human swine influenza (HSI). An adjustment to our manpower deployment is therefore inevitable. We are still studying and formulating detailed proposals on healthcare reform and the supplementary financing arrangements to prepare for the second stage public consultation. However, the timetable of the consultation has to be deferred. Our present target is to formulate detailed supplementary financing proposals for the second stage public consultation within this year. As I have mentioned earlier, the exact timing of the consultation has to be decided in light of our work progress and the prevailing socio-economic circumstances.

(b) As revealed in the first stage public consultation on healthcare reform, there is wide public support in the community for the service reform proposals, including the enhancement of primary care, promotion of public-private partnership in healthcare, development of electronic health record sharing and strengthening of the existing public healthcare safety net. We have also committed to making the best use of the increased healthcare expenditure in the next few years to actively take forward these service reform proposals on which consensus has been reached in the community.

The implementation of these proposals is in progress. For instance, the Working Group on Primary Care and its Task Forces have held quite a number of meetings and countless discussions and researches. It is expected that the Working Group can submit its initial recommendations in the coming few months. Meanwhile, we plan to launch a series of pilot projects based on the research and discussions of the Working Group at the end of this year to enhance primary care and strengthen the support for chronic disease management with a view to putting the vision and recommendations of the Working Group into practice. Besides, public-private-partnership projects such as the subsidised "Cataract Surgeries Programme", Elderly Health Care Voucher Scheme, Tin Shui Wai Primary Care Partnership Project are also in progress.

To strengthen preventive care, the Government has launched the Influenza Vaccination Subsidy Scheme in November 2008 for the first time to provide subsidy for children to receive influenza vaccination from the private medical sector to lower their chance of hospitalisation during the peak season of influenza in winter. At the same time, we are preparing to seek funding approval for around $1 billion from the Finance Committee of the Legislative Council (FC) to provide free HSI vaccination for four target groups (i.e. healthcare workers; children aged from six months to below six years; elderly aged 65 and above; and people with pre-existing medical conditions), and free pneumococcal and seasonal flu vaccinations for elderly aged 65 and above. If the funding is approved, these vaccination programmes will strengthen our capacity for preventing and fighting against the diseases.

As to the development of electronic health record (eHR) sharing as an essential infrastructure for healthcare reform, we propose to establish a dedicated eHR Office to plan, develop, execute and manage the complex and multi-faceted programme involving policy issues such as data privacy, system security and legal protection. The eHR Office will also coordinate the consultation with and participation of stakeholders from different sectors as well as members of the public, so as to ensure that the programme is supported by various sectors, including the private healthcare and IT sectors, and accepted by a wide spectrum of the general public. We are preparing to apply for funding approval from the FC for the capital cost of $702 million for the first stage of the development programme (2009/10 to 2013/14). Subject to approval of the funding application, the relevant work will commence in the third quarter of this year.

I have to reiterate that the work on fighting against HSI would not affect our plan to allocate more resources to take forward service reform initiatives. The Government will increase its recurrent healthcare expenditure to 17% of the total recurrent expenditure by 2011/12 as pledged. In 2009/10, the recurrent healthcare expenditure increased by $1.8 billion to $35.7 billion as compared with last financial year, which accounts for 15.7% of total recurrent Government expenditure. The increase in expenditure includes additional resources for the Hospital Authority to meet increasing demand and strengthen services, to implement service reform proposals and to develop the eHR sharing system.

(c) As many areas of work are involved in the fight against HSI, most of the staff in FHB are required to assist in the co-ordination work, such as providing secretariat support for the Emergency Response Level Steering Committee, as well as coordination with bureaux and departments concerned on work relating to quarantine measures, operation and related arrangements of quarantine camps, health declaration and related boundary control measures, and the formulation of vaccination programme against HSI. As the staff who are responsible for the formulation of financing proposals for second stage healthcare reform public consultation have to assist in the above tasks, the timetable set before has to be deferred.

Nevertheless, I have to reiterate that we will continue to implement the service reform proposals that have broad support from the public in the first stage public healthcare reform consultation despite the deferral of the second stage public consultation. No other tasks in FHB have been deferred due to the fight against HSI.


Ends/Wednesday, June 17, 2009
Issued at HKT 15:02

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