Replies to LegCo questions
LCQ8: Non-local pregnant women giving birth in Hong Kong
Following is a question by the Hon Cheung Man-kwong and a written reply by the
Secretary for Food and Health, Dr York Chow, in the Legislative Council today
(May 9):
Question:
The Secretary for Food and Health (SFH) earlier advised that he was in
discussion with private hospitals on the delivery quota for pregnant mainland
women whose spouses were not permanent residents of Hong Kong (doubly
non-permanent resident pregnant women) giving birth in Hong Kong for the year
2013 and expected that there would be result before end of April this year.
However, the Chief Executive-elect (CE-elect) put forth on April 16 this year
that private hospitals should stop admitting doubly non-permanent resident
pregnant women in 2013, and indicated that babies born to doubly non-permanent
resident pregnant women in Hong Kong (doubly non-permanent resident babies) in
2013 would not be guaranteed Hong Kong permanent resident status. He also said
that other legal means, apart from the interpretation of the Basic Law, might be
used to revise the current arrangement for granting permanent resident status to
doubly non-permanent resident babies. In this connection, will the Government
inform this Council:
(a) whether the authorities have examined what legal means, other than the
interpretation of the Basic Law, can be adopted to revise the current
arrangement for granting permanent resident status to doubly non-permanent
resident babies; if they have, what means they have examined and what the
results are; if not, whether they have any idea about the legal means referred
to by the CE-elect;
(b) given that after the CE-elect has made the aforesaid remarks, SFH advised
that the Department of Health would not issue confirmation certificates to
pregnant mainland women seeking to give birth in Hong Kong in 2013, and the Hong
Kong Private Hospitals Association had also decided not to admit doubly
non-permanent resident pregnant mainland women to give birth in Hong Kong
starting from 2013, whether the authorities have examined adopting other
concurrent measures to stop the entry of doubly non-permanent resident pregnant
women; whether the authorities will strengthen manpower in public hospitals to
deter doubly non-permanent resident pregnant women from seeking emergency
deliveries through the Accident and Emergency Departments (A&EDs), so as to
avoid affecting the other patients and pregnant women receiving services in
public hospitals; and
(c) given that the Hospital Authority (HA) is planning to increase with effect
from May 2012 the obstetric package charge to $90,000 for non-booked cases of
non-local pregnant women seeking emergency deliveries through A&EDs, whether it
knows if pregnant mainland women whose spouses are permanent residents of Hong
Kong (singly non-permanent resident pregnant women) will be dealt with
separately from doubly non-permanent resident pregnant women under HA's charging
policy, and sufficient maternity beds will be made available for singly
non-permanent resident pregnant women in public hospitals; if not, of the
reasons for that?
Reply:
President,
(a) and (b) The Government of the Hong Kong Special Administrative Region has
implemented a number of policy measures to ensure that Hong Kong pregnant women
are given priority for proper obstetric services and neonatal services. The
Government also limits the number of non-local pregnant women coming to Hong
Kong to give birth to a level that can be supported by our healthcare system.
These policy measures include strengthened complementary immigration measures to
fully support the arrangements for implementing a delivery quota for local
hospitals and the issue of "Confirmation Certificate on Delivery Booking"
(Booking Certificate). Under the arrangement, non-local women who will soon give
birth are required to have a Booking Certificate and produce it for checking by
officers of the Immigration Department (Imm D) when they enter Hong Kong. Those
who cannot produce a Booking Certificate may be refused entry.
Specific immigration control measures to prevent non-local women without a
Booking Certificate from crossing the border to deliver in Hong Kong include
stepping up inspection of non-local pregnant women at major control points
through internal re-deployment; analysing the common tactics and trend of
"gate-crashing" by non-local pregnant women through collection of intelligence
and data, taking corresponding surveillance measures, and conducting joint raids
with other departments; stepping up enforcement and removal actions against
overstaying pregnant women; strengthening cooperation with the Police,
conducting investigation and initiating prosecution under the law against
individual or corporate intermediaries that are involved in illicit activities
in arranging for non-local women to give birth in Hong Kong.
The Department of Health (DH) has deployed doctors and nurses to assist
immigration officers in assessing the gestational age of incoming non-local
pregnant women, and arranged Health Surveillance Assistants to identify
non-local pregnant women. To prevent non-local pregnant women from entering Hong
Kong early and going into hiding in order to evade the screening process, the
Home Affairs Department has stepped up inspection and enforcement efforts
against unlicensed guesthouses. The Housing Department will also detect and
follow-up any suspected tenancy abuses cases under the established mechanism
(including renting flats to non-local pregnant women), such as through routine
and surprise flat inspections. Through the above measures, the average number of
delivery cases through gate-crashing the A&EDs by Mainland pregnant women who do
not have prior booking has declined substantially from about 150 recorded each
month in the fourth quarter of 2011 to an average of around 90 per month for the
first four months of this year.
As the Chief Executive-elect has not mentioned any specific legal arrangements
on the permanent resident identity of babies of doubly non-permanent residents,
we do not have any comment at this stage.
For public hospitals, although most of the cases of non-local pregnant women
giving birth in A&EDs took place in hospitals with obstetrics and neonatal
intensive care units, it is irresponsible for pregnant women to seek emergency
delivery through A&EDs shortly before labour without any antenatal checkup as it
is dangerous to both the pregnant women and their babies. In the absence of past
medical records of these non-local pregnant women, healthcare staff face
limitations in taking care of them. It may also be necessary to transfer those
complex cases which cannot be handled by A&EDs to other hospitals with
obstetrics and gynaecology services for further treatment and such cases will
inevitably involve risks. In this connection, we strongly appeal to the public
to stop such dangerous behaviour in order to protect the safety of pregnant
women and their babies.
HA has enhanced the preparedness of A&EDs to deal with such cases, including
strengthening emergency delivery training for healthcare staff of A&EDs, and
providing additional equipment for maternal and neonatal care in A&EDs. HA will
closely monitor the situation and review the service capacity of A&EDs from time
to time.
(c) Hong Kong's healthcare system is provided primarily for Hong Kong residents.
As our public healthcare services are heavily subsidised by the Government, it
is necessary for the Administration to ensure that our public healthcare
services can meet public demand and at the same time can sustain in the long
term within the limited financial resources. Therefore, we need to draw up
eligibility criteria for receiving the heavily subsidised public healthcare
services and accord priority to taking care of the needs of Hong Kong residents.
At present, only holders of Hong Kong Identity Card or children under 11 years
of age who are Hong Kong residents are eligible persons entitled to use the
healthcare services heavily subsidised by the Government. As for non-Hong Kong
residents, including Hong Kong residents' spouses who are not Hong Kong
residents, they may seek non-emergency public healthcare services when there is
spare service capacity. However, they are required to pay a fee at the rates of
charges applicable to non-eligible persons. At present, we have no plan to
change HA's fee-charging policy to differentiate non-local women giving birth in
Hong Kong into different categories for different treatment.
Taking into account the costs of services, the price being charged for
comparable services by private hospitals and the affordability of service users,
HA will increase the fees of emergency delivery to $90,000 to deter non-local
pregnant women from seeking emergency admission through A&EDs for delivery to
bypass the booking system. The new fees will take effect on May 12 this year.
Since it is a dangerous behaviour for non-local pregnant women without prior
booking to seek emergency hospital admissions through A&EDs for delivery, HA has
set the fee at a level higher than that charged for booked cases regardless of
whether the husbands of these non-local women are Hong Kong residents or not in
order to achieve a deterrent effect.
In order to maintain adequate maternity services and neonatal intensive care
services and accord service priority to local pregnant women, HA has since April
26, 2012 stopped accepting bookings from non-local women with expected dates of
delivery in 2012 for delivery in public hospitals.
We understand that some Mainland pregnant women whose husbands are Hong Kong
permanent residents hope to give birth in Hong Kong but are unable to make their
bookings in hospitals this year. There is a consensus in the community that the
Government should provide assistance to this group of expectant mothers as far
as possible. At the beginning of this year, we began to study the mechanism and
detailed arrangements for effective verification of the identity of Mainland
pregnant women whose husbands are Hong Kong permanent residents. We have just
reached a consensus with the private hospitals for at least four private
hospitals (namely Hong Kong Baptist Hospital, Precious Blood Hospital (Caritas),
Union Hospital and St. Teresa's Hospital) to provide obstetric services for
Mainland pregnant women whose husbands are Hong Kong permanent residents and who
hope to give birth in Hong Kong but are unable to make their bookings in
hospitals this year. If necessary, DH will allocate additional delivery quota
accordingly to private hospitals willing to provide obstetric services to this
group of women.
Based on the documents submitted by Mainland pregnant women whose husbands are
Hong Kong permanent residents, the private hospitals will issue them with a
Confirmation Certificate on Delivery Booking. DH will closely monitor the
process and conduct checks with authorisation from the couples concerned.
Suspicious cases, if any, will be referred to law enforcement agencies for
follow-up action.
In the past three years, we have in each year handled an average of 6 000 cases
of delivery by Mainland pregnant women whose husbands are Hong Kong permanent
residents. With private hospitals terminating the admission of Mainland pregnant
women whose husbands are non-local residents for delivery in the coming year,
there should be adequate manpower capacity and facilities for private hospitals,
after giving service priority to local pregnant women, to take care of the
Mainland wives of Hong Kong residents.
Ends/Wednesday, May 9, 2012
Issued at HKT 14:25
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