Hong Kong's dedicated team of medical professionals is the cornerstone of our healthcare system. Over the years you have delivered quality healthcare to the people of Hong Kong, and protected us during some of the city's most difficult times. Examples abound, the most recent one being the quick response and joint efforts of the public hospital system to rescue the victims of the tragic traffic accident on May 1st.
Our health indicators rank among the best in the world and our system is highly regarded internationally. I speak for many when I say I am proud of our healthcare system and of the people who make the system work.
The question we are asking ourselves these days is, how can we ensure the system remains effective for many years to come? The community is trying to find a consensus on the way forward through the ongoing healthcare reform consultation. The first stage of the consultation is now in its eighth week.
I assure you, the government places great importance on this consultation. We have so far attended about 90 public briefings and forums involving various sectors, political parties, local communities, and other stakeholders and organisations. Another 40 sessions are lined up in the coming month.
We are also consulting all the 18 District Councils. If we assume the average session lasts two hours, it adds up to over 250 hours of briefings and discussions. In addition, about 550 written submissions have been received through various channels. And we are canvassing public views through opinion surveys and focus groups.
At the end of the first-stage consultation on June 13th, there will be a comprehensive analysis of the views received. Allow me to share with you some of the preliminary results.
Community supports healthcare reform
First and foremost, there is broad support in the community for reform of the current healthcare system. While people value the quality services currently provided, there is a strong feeling that reform is needed to sustain and enhance the system.
As people generally become wealthier they want better quality healthcare for themselves and their families. There are also demands for a stronger safety net and a wider choice of value-for-money services.
The second point is about maintaining the strengths of the current system throughout the reform process. This includes continuing to ensure that no one is denied healthcare for lack of means. The system should continue to take care of low-income families and the under-privileged. It should keep providing acute and emergency services as well as cater to people with illnesses that require more complex and expensive treatments.
Another strength of the current system is its focus on training healthcare professionals. In short, the public health system should remain affordable, accessible and wide-ranging.
Thirdly, there is broad consensus that the shortcomings of the current system should be addressed. These include enhancing primary care, promoting public-private partnership, developing electronic health records, and strengthening the safety net.
Many people want to see these reforms implemented as early as possible. Indeed, the Government and the Hospital Authority have already jointly kick-started these reforms through various pilot projects and initiatives.
Sustainability key
The fourth and final point that I will touch on today is financing. Many respondents to the consultation recognise that demographic changes and rising medical costs are posing huge challenges to the sustainability of the healthcare system. They agree on the need to address the question of financing in parallel with taking forward services reform.
Views may differ on how best to address the issue of financing. But the community recognises the importance of ensuring stable and sustainable resources both for improving healthcare services and for meeting the healthcare needs of the population.
Given the pros and cons of the different supplementary financing options and the different societal values they represent, opinions inevitably vary among respondents depending on their respective stand-points. But overall, the discussion has been rational.
It is only natural that a doctor's view will differ from that of a patient. And people from different sectors of society will have their own issues to raise. The Government welcomes these views and appreciates the concerns within the different strata of our community.
Interim observations
We can draw some interim observations from the views expressed so far, especially on the societal values they reflect. Some respondents point to the merits of a tax-funded public healthcare system. And many support increasing government funding for healthcare.
But raising taxes or using tax-like schemes to fund the system is so far the least-favoured of the options put forward. Some political parties and other organisations also reflect this in the opinion polls.
It appears the majority of people believe the current financing system serves the purpose of providing equitable access to basic healthcare for all, especially taking care of the low-income and under-privileged. I believe the public also consider that the low tax regime and principle of small government serves the best interests of Hong Kong.
The general preference appears to be that any individuals' additional contributions should go towards funding their own healthcare. This would give them access to a more personalised choice of healthcare.
Concerns over controls
There is rational discussion on the option to adjust fees for public healthcare services, alongside the proposals to strengthen the public safety net. This probably reflects a belief that users of subsidised public healthcare should in general shoulder a higher share of the cost, except those who cannot afford to do so. People are also concerned about control over healthcare utilisation and costs. Increasing public fees would be an effective means to encourage judicious use of medical resources.
The contributory options attracted the most opinions. Many express concerns on the mandatory nature of these options and that the low- to middle-income group could ill afford to make any contributions. Some also point out the pros and cons inherent in each of these options.
Some respondents believe that individual accounts accumulating their own savings for future healthcare would be attractive. Some think it is only fair that those who can afford it, bear a greater share of their own future healthcare costs, instead of passing the burden to others.
There are also concerns among the public, that savings alone will not be sufficient, given the unpredictability of healthcare needs and the significant financial risk. Some form of effective risk pooling may be necessary.
Questions raised
Many questions have been raised about the details of the supplementary financing options. For instance, if contributory options are to be adopted, who should contribute? Also, what should be the level of contributions and what tangible benefits would be gained? How would savings be invested, and what would happen to existing health insurance?
What would the operating costs be, and how would healthcare utilisation and costs be controlled under a third-party-pay system? We will examine all these issues carefully and address them during the second-stage consultation, when specific proposals will be put to the public.
There are still five weeks to go before the end of the first-stage consultation period. I encourage the community, including medical professionals and other stakeholders, to continue to contribute to the discussion on the financing options as well as service reforms.
The success of healthcare reform depends on the support and involvement of the entire community. Only through constructive engagement in the consultation process can we build towards a community-wide consensus.
Chief Secretary Henry Tang gave this address at the opening ceremony of the Hospital Authority Convention 2008 at the Hong Kong Convention & Exhibition Centre.