THE influenza epidemic sweeping across the city has left public hospitals bursting at the seams and rendered hospital wards little more than warzones. Healthcare workers overwhelmed by workload have held protests one after another. This has once again put on full display the grim reality of a serious lack of healthcare professionals in public hospitals.
That Hong Kong's public healthcare system has reached a breaking point is a problem requiring a solution of pinpoint accuracy. Some blame the problem on new immigrants, a theory based more on impressions and instincts than on scientific evidence. The impact of population ageing, in contrast, is clear and visible. As mentioned by Leong Chi-yan, Chairman of the Hospital Authority, elderly people have more complicated conditions and usually spend more time in hospital, exacerbating the shortage of beds in public hospitals. As population ageing is expected to continue in the future, the public's reliance on the public healthcare system will only increase. While Hong Kong's land and housing problems are dire, the situation of public healthcare is not much better. A look at the backgrounds and causes reveals quite many parallels: myopia on the part of the government, officials' failure to rise to the challenge, failed policies, lack of planning and mismanagement all contribute to the serious imbalance between demand and supply in both areas. Furthermore, some stakeholders are too self-centred to consider the common good, leaving society purposelessly spinning its wheels without making any progress and unable to find a way out.
The government has not actively expanded the capacity of the public healthcare system. Not a first-rate hospital has been built over the past 20-odd years, nor has the government allocated any additional resources to the training of healthcare workers. Some high-ranking officials in the past even believed that the public healthcare system should not provide excellent services, otherwise more and more people would be drawn to inexpensive public healthcare services and the government's fiscal burden would be increased. The government has been talking about cooperation between public and private healthcare providers to distribute patients for years, but the result has been limited. Public hospital doctors are overwhelmed. Even if they become consultant doctors, they earn a salary of just over $200,000. If they join the private market, they might become what are publicly known as "moon doctors" or even "star doctors" (doctors earning more than $1 million monthly or weekly). A world of difference between the remunerations of public and private doctors means that even if the government tries to lure doctors to stay with money, it will still be difficult to reverse the brain drain.
In recent years, the SAR government has been advocating for recruiting more overseas doctors for Hong Kong through a "limited registration" scheme. The government has even amended the respective law to lengthen such doctors' "limited registration" from one year to three years in the hope that Hong Kong doctors practising overseas might return. However, owing to resistance from the medical industry, progress has been limited. The Hospital Authority employs nearly 6,000 doctors, while doctors with limited registration number just over 20. Some representatives of the medical industry claim that applicants for limited registration do not have to sit a local licensing examination or speak Chinese, so their employment might "hurt the public interest". What they have failed to mention is that all of the doctors with limited registration are approved by the Medical Council. The prerequisite to the self-regulation of a professional body is that it must be in the public interest. For the sake of the common good, the medical industry should do away with protectionism and support the recruitment of qualified doctors from overseas. The government and the Medical Council should also provide more incentives to attract overseas doctors — especially those of Hong Kong descent — to practise in the city, an example being exemption from the licensing examination. A career ladder should be provided to enable them to become registered doctors in Hong Kong.