Chief Executive Carrie Lam

It is a great pleasure to be back speaking at a symposium organised by Our Hong Kong Foundation on Hong Kong's healthcare system. In December 2016, I spoke then in my capacity as Chief Secretary for Administration at the foundation's summit on "An Investment for the Celebration of Aging". Two years later, in November 2018, the foundation hosted its first Health Systems Summit and published a healthcare report titled "Fit For Purpose". I remember on both occasions, I consistently championed for a shift to primary healthcare in order to ensure a more sustainable healthcare system in Hong Kong. Now, coming to the last six months of my five-year term, I would say that my Government has made some good efforts and invested more in primary healthcare, but definitely there is still a long way to go to deliver a system that is affordable and fit for purpose. I therefore very much welcome another diagnosis by the foundation under a research team led by my good friend Prof Yeoh Eng-kiong, whose passion and drive for improving Hong Kong's healthcare system has never waned throughout these years. Today we will witness the launch of Our Hong Kong Foundation's latest health policy report, titled "Strategic Purchasing: Enabling Health for All", which zeroes in on the aspects of financing and procurement of services to deliver the best results.

On this occasion, I have not been given the privilege to preview the research findings, but in his invitation letter to me, Prof Yeoh has mentioned a very attractive proposition - that this healthcare research has investigated into how health financing could serve as a key strategic lever to facilitate the establishment of a sustainable primary healthcare ecosystem for Hong Kong. This is certainly music to my ears for the following reasons:

Firstly, the research is premised on promoting primary healthcare - a policy direction that I have been advocating within the Government since my association with the Primary Healthcare Review, led by the distinguished Prof Rosie Young 30 years ago, but I was certainly not the brain for this review - I was more or less the pen to write the report. This term of Government has certainly put words into actions in promoting primary healthcare but we need concerted actions by all, including medical professionals and patients, in order to achieve a paradigm shift in service provision;

Secondly, I have a strong feeling that the provision of a network of district health centres (DHCs) pressed ahead by my health colleagues diligently would not take us very far and some further policy steer with innovation is probably needed. That said, I must pay tribute to Secretary for Food & Health Prof Sophia Chan and her team as well as our non-governmental organisation partners for their hard work with the opening of the Kwai Tsing and Sham Shui Po district health centres and another five in 2022 plus smaller interim DHC Express to be set up in the remaining 11 districts, which is of course no small achievement especially when the team has been fighting the COVID-19 pandemic concurrently. In my 2021 Policy Address, I announced that we are conducting a comprehensive review on the planning of primary healthcare services and the related governance framework with a view to formulating a blueprint for its sustainable development. One of the major aspects that we shall look into in the blueprint is health financing; and

Thirdly, with rapid ageing of Hong Kong's population coupled with a manpower shortage, let alone fiscal pressure, the current financing model is hardly sustainable. According to the latest provisional census figures, the population aged 65 and over in mid-2021 amounted to over 1.43 million or 19.3% of the total population, and this is expected to surge to 31% by the year 2036. A survey released last Friday by the Census & Statistics Department indicated that some 24% of our total population (amounting to some 1.8 million people) had chronic diseases that required medical treatment, consultation or medication. To enable the Hospital Authority (HA) to cope with this growing demand, this term of Government has adopted a funding formula to calculate recurrent subvention to HA taking account of demographic changes. As a result, recurrent subvention to HA this year amounts to $80.7 billion, which represents a 45% increase over that of 2017-18, that is, the beginning of this term of Government.

With these challenges at the back of my mind, I do earnestly await the release of the research findings by Prof Yeoh and his team. However, let me first share a few thoughts on what more we should do to ensure people of Hong Kong will continue to enjoy quality medical care.

First and foremost, in my view, is research and development (R&D). Life scientists are often working hard to discover new drugs, invent new diagnostic equipment, adopt new procedures and as in the case of fighting COVID-19, discover effective vaccines, to identify abnormalities as early as possible, to reduce pain and to save lives. But there is a lot more we could do. In pressing ahead with innovation and technology development in this term of Government, we have put special emphasis on health technology with the setting up of the InnoHK clusters, now housing 16 laboratories in various aspects of life sciences; we have started the Hong Kong Genome Institute; and I have announced in my 2021 Policy Address the establishment of an InnoLife Healthtech Hub at the Hong Kong-Shenzhen Innovation & Technology Park in the Lok Ma Chau Loop. I have asked both the Department of Health and the HA to review their current practices comprehensively to support clinical data sharing, clinical trials and drug registration, etc. I have also met over 10 major pharmaceutical companies last month via a webinar to encourage them to set up research bases in Hong Kong.

Second, Hong Kong is blessed with well-trained and regulated healthcare professionals. We must strengthen the roles of all healthcare professionals in the local healthcare system. As you are aware, I have since the 2018 Policy Address confirmed the positioning of Chinese medicine in the development of medical services in Hong Kong and the first-of-its-kind Chinese Medicine Hospital will have its groundbreaking next month. In the 2021 Policy Address, I have asked the Food & Health Bureau to follow up on previous recommendations to allow patients to have direct access to healthcare professional services such as physiotherapy and occupational therapy without a doctor's referral and to explore the feasibility of introducing a statutory registration regime for those healthcare professionals who are currently not subject to any statutory registration requirements such as clinical psychologists, speech therapists and dietitians. Apart from protecting public interest, such efforts will enable these healthcare professionals to play a more active role in our healthcare system.

Third, hitherto, any initiative to engage the private sector to provide services is restricted to within Hong Kong. However, the experience of the Hong Kong Special Administrative Region Government contracting with the University of Hong Kong-Shenzhen Hospital to serve Hong Kong residents living in Guangdong as a result of COVID-19, which prevents travelling, has inspired us to think broader. This will particularly make good sense when there is now a one-hour living zone within the Guangdong-Hong Kong-Macao Greater Bay Area and more Hong Kong-invested or Hong Kong-managed medical facilities in the Greater Bay Area Mainland cities, for example a 3,000-bed teaching hospital of the Chinese University of Hong Kong in Shenzhen. When Hong Kong businesses could have seized the opportunities of cheaper land and labour across the boundary to move their factories northwards four decades ago, we should not forgo the possibility of public-private partnership across the boundary. This is what I called a "new spatial conceptualisation" in coming up with the Northern Metropolis Development Strategy in my 2021 Policy Address.

I am sorry for making my opening remarks rather lengthy but I hope you appreciate that this is a subject very close to my heart as I understand how important quality healthcare is to our people.

Chief Executive Carrie Lam delivered this speech at A Fit-For-Purpose Health System: Enabling Health for All Symposium on December 20.