Thursday, July 7, 2016

Hong Kong is ailing from an attack of selfish doctors

Philip Yeung says there is little hope of addressing the lack of staff and other issues in public health care, given the grip the medical cartel has on the city

The medical cartel is a misbegotten creature of the SAR government. Before the handover, local doctors were politically docile and professionally unselfish. Since then, the Medical Council has turned itself into a doctors’ super-union. By tightly controlling the intake of foreign-trained doctors, it has created a severe shortage of physicians. And, in one outrageous case, it took nine years to investigate a fatal medical mishap, an eternity for a grieving family. The patients are up in arms. But they are no match for the powerful medical lobby.

Here are some telling statistics. In OECD countries, the median ratio of doctors to the general population is 3.2 per 1,000. In Hong Kong, the ratio is a pathetic 1.9 per 1,000. For admitting foreign doctors, Singapore has instituted a flexible and sensible system. Instead of imposing a qualifying exam, calculated to keep foreign doctors out, it lists 159 of the world’s top medical schools whose graduates could register as doctors in the Lion City. Both of our medical schools are on that list. Ranked among the world’s best, Singapore is popular for medical tourism, as is Thailand.

There are other invisible victims: the many local families who, at great expense, have sent their children overseas for medical training. Few will ever be allowed to practise in their home town.

The government has set aside HK$50 billion for a proposed private health insurance programme. But if the artificially created doctor shortage remains, it is doomed. The only ones to benefit would be the insurance companies and doctors in private practice. There is already an alarming exodus of overworked doctors from public hospitals.

Meanwhile, Taiwan’s health care service receives the thumbs-up from more than 80 per cent of its users. There, the professional interests of doctors are aligned with public interests.

The Hong Kong government’s latest move in changing the composition of the Medical Council is cosmetic. Half of the 28 members may have been appointed by the chief executive, but only four are non-doctors. Adding another four will hardly alter the power structure. And yet the medical lobby is fighting this tooth and nail. They will brook no change to the status quo, guaranteeing more misery to the public. By wielding their 30 votes in the Election Committee, the doctors are likely to prevail.

Once known for its efficiency, Hong Kong is now just treading water, and at the mercy of self-seeking doctors who see the provision of health care not as a livelihood matter, but as their private preserve. Their clout has become our curse.


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