1 Health Care Reform in Hong Kong - Department of Health ’ s Perspective Dr Constance Chan Assistant Director of Health May 2001

2 Current Organization of Health Care System Public sector Health & Welfare Bureau Department of Health Hospital Authority Private sector GP (solo/group) practice Private hospitals and nursing homes Dual public-private system

3 Provision of Health Services Public Health Services Ambulatory Care Inpatient Care Chinese Medicine

4 Public Health Services Department of Health is Health advisor to the Government and other sectors Law enforcement agency for all public health ordinances Responsible for preventive programmes

5 Ambulatory Care 85% by private sector physicians 15% by public sector Inpatient Care 92% of total bed days by public sector 8% of total bed days by private sector 85% by private sector physicians 15% by public sector Inpatient Care 92% of total bed days by public sector 8% of total bed days by private sector (Reference : Harvard’s Report P 27-8)

6 Health Care Financing Trends in Total Domestic Health Expenditures, 1989/90 – 96/97 In 1996/97 - Total domestic health expenditures: HK$56,237 millions (US$7,210 millions) Per capita spending: HK$8,911 (US$1,142) Health spending as a share of GDP: 4.6% (Ref : Harvard’s Report - Special Report No.1 P. 20)

7 Regulation of Health Services Regulation of Professional Standards Regulation of Hospital Standards Regulation of Pharmaceutical Industry Regulation of Chinese Medicine

8 Health Care System: Strengths Relatively equitable Improvements in quality of care and technical efficiency with setting up of HA Cost-effective

9 Health Care System: Weaknesses Long waiting time in public sector Inequitable fee structure Variable quality of health care Hospital-dominant services Inadequate interface and compartmentalization Issue of long-term financial sustainability

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11 Consultation Document on Health Care Reform Review of the 3 pillars of our health care system 11 strategic directions

12 Pillars of the Health Care Systems Reforms to the Health Care Delivery System Improvements to the System of Quality Assurance Options for Financing Health Care Services

13 Health Care Delivery System Strengthen preventive care Re-organize primary medical care Develop community-based integrated services Improve public/private interface Facilitate dental care Promote Chinese Medicine

14 System of Quality Assurance Enhance quality assurance Improve patient complaint mechanisms

15 Health Care Financing Reduce costs and enhance productivity Revamp public fees structure Establish individual Health Protection Account

16 Role of Department of Health Strengthen preventive care Reorganize primary medical care Facilitate dental care Promote Chinese medicine Enhance quality assurance Improve patient complaint mechanism

17 Strengthen Preventive Care (1) Health Promotion & Disease Prevention –Enhance health promotion capacity –Adolescent Health Program –Cervical Screening Program –Men’s Health Program –Tobacco Control Office

18 Strengthen Preventive Care (2) Disease Surveillance & Control –Cancer Coordinating Committee –Public Health Information System –Regular reports on the health status of the community

19 Reorganize Primary Medical Care Transfer General Out-Patient Clinics to the Hospital Authority

20 Facilitate Dental Care Continue educational and promotional efforts Set oral health goals and standards Conduct surveillance programmes Encourage Non-governmental Organizations to offer affordable care

21 Promote Chinese Medicine Introduce Chinese medicine into the public sector Establish a regulatory framework and assist to enhance standards Develop models of collaboration between western and Chinese medicine

22 Enhance Quality Assurance Take up the role as the coordinator or regulator to ensure quality Review regulations relating to –private hospitals –health care facilities –health claims –use of medical devices

23 Improve Patient Complaint Mechanism Set up a Complaint Office in DH Work with the Legislative Council Special Sub-Committee in drawing up the complaint mechanism Devise improvement measures which are user-friendly, transparent and unbiased

24 AdvantagesAdvantages More effective health promotion and disease prevention Improved oral health More choices of health care service available with the promotion of Chinese medicine Patients’ safety and quality of service assured More transparent and unbiased complaint mechanism

25 ConclusionConclusion People of HK are enabled to