Full support for healthcare

May 14, 2019

Chief Executive Carrie Lam

For those who have heard me speak on the subject of health policy on previous occasions, you may recall my passion and compliment of Hong Kong's healthcare system. I'm proud to say that our healthcare system has been ranked as the most efficient in the world among the 56 economies covered by Bloomberg Health Care Efficiency Index published last September. It means that the people of Hong Kong can enjoy equitable access to quality healthcare services at affordable prices. Such impressive results cannot be achieved without the dedication and commitment of each and every colleague in the public health system, particularly the Hospital Authority which takes care of the lion's share of inpatient services, together with the support of the entire healthcare professional community.


However, this valuable system much treasured by the people of Hong Kong is facing some formidable challenges. Along with our ageing population and longer lifespan, we are dealing with a rise in chronic, lifestyle-based diseases. And access to health knowledge through the Internet raises people's awareness of what they may look for from our service providers. That has created higher public expectations and surging demand for even better services, straining our healthcare system.


My Government is committed to the sustainable development of our public healthcare system. In 2019-20, our estimated recurrent government expenditure on public healthcare services will increase by nearly 11% to more than $80 billion. We are also committed to progressively increasing the Hospital Authority’s recurrent funding under a new arrangement, responding both to population growth and demographic challenges. In the current financial year, the recurrent subvention provided for the Hospital Authority totals nearly $70 billion, representing an increase of 8.3% over that of last year.


Full support

I just heard John talking about the two bottlenecks in the delivery of healthcare services, which I totally agree. On the hardware side, I should add that the first 10-year hospital development plan, with a budget of nearly $200 billion, is in full swing. We are also working with the Hospital Authority on our second 10-year hospital development plan. It will cover another 19 projects, involving around $270 billion.  


While hardware and funding are important, it is our devoted team of doctors, nurses, allied health professionals, and supporting staff in the Hospital Authority that we treasure most. Since taking office, I have visited several public hospitals. Despite the heavy patient load and overcrowdedness in our hospitals, I was impressed by the staff’s dedication and professionalism. Allow me to take this opportunity to once again express my gratitude, on behalf of the Government and the people of Hong Kong, to Hospital Authority colleagues, especially the front line staff, for their hard work in coping with the heavy workload. The Government is doing all we can to alleviate their pressure, but I would say that the manpower bottleneck is even more difficult than the hardware bottleneck. In addition to longer-term measures like increasing our medical student intake which would take time to realise its effect, we have pledged to give the Hospital Authority full support and facilitation for improving remuneration and promotion opportunities for its staff so as to attract and retain talent.


We are also trying to bring in reinforcements. Over the past couple of weeks, stakeholders of the medical profession in Hong Kong have been actively working towards a common goal - to attract more non-locally trained specialist doctors to serve in Hong Kong to help address the manpower shortages in the public sector. We welcome the decision of the Medical Council of Hong Kong last week in waiving the assessment for non-locally trained specialist doctors before getting full registration, which is a good start. We will monitor the effectiveness of the measure, while at the same time continue our discussion with stakeholders to explore further options.


Beyond increasing healthcare expenditure and enhancing our healthcare infrastructure, beyond ensuring a sustainable flow of fresh talent, we must recalibrate our long-term direction. In particular, we need to redirect our healthcare focus from treatment in public hospitals to prevention and management within the community itself. This is the reason why we are so keen to promote primary healthcare.


Primary healthcare

When it comes to primary healthcare, we are focused on reducing hospital readmissions, rectifying the common practice in which accident and emergency services are considered the first point of contact in medical consultation. We need, instead, to strengthen policy co-ordination and cross-sector collaboration service provision at the district level. Boosting the health consciousness of the community is essential to making this a reality.


To that end, my Government is introducing a new District Health Centres' model. The objective is to enhance district-based primary healthcare through medical-social collaboration and public-private partnerships. The first District Health Centre, in our Kwai Tsing District, will begin operation in the third quarter of this year. It will provide a variety of primary healthcare services, but its emphasis will be on prevention. That means targeting health promotion and education, health assessment, chronic disease management and community rehabilitation. The hope is that this district model of health management will reduce the use of hospital services in the long run. Taking into account the experience gained from the first Kwai Tsing Centre, we will progressively, and hopefully quickly, set up centres in all other districts.


Health innovation

Now let me turn to innovation and technology, which is also a focus of this year's convention. Indeed, I&T is having an impact on every aspect of our life, healthcare very much included. I believe that Hong Kong has what it takes to do well in I&T, including our world-class universities and strong research and development capabilities. My Government has identified I&T as a major policy priority, and has been doing all we can in promoting its development. Some $100 billion has been allocated for various policies and programmes since I became Chief Executive in July 2017. We have identified health technology as the focus of one of our major initiatives in setting up research clusters at the Hong Kong Science Park. That choice is obvious given our two high quality medical schools, centralisation of inpatient service in one single provider – the Hospital Authority, and hence good access to big data as well as accredited centres for clinical trials, etc.  


Data availability is one of the aspects I am giving a push within Government through the Steering Committee on Innovation & Technology that I chair. I am pleased to have the Hospital Authority as a partner in the provision of clinical data for healthcare-related research. In December 2018, the Hospital Authority launched its Data Collaboration Lab. It gives researchers a freer hand in exploring the Hospital Authority's patient data for research ideas and the testing of promising hypotheses. Researchers will also collaborate with the Hospital Authority in projects that improve clinical and healthcare services and promote innovation in healthcare. I am delighted to know that six projects, led by researchers from Hong Kong universities, have been selected in the plan's first stage, covering a number of diseases and clinical work, including stroke, hepatitis, hip fractures, the development of data-driven algorithms, etc. I am hopeful that these and other projects in the future will bring us fresh insight into healthcare and contribute to Hong Kong's research and development success.


Huge potential

Genomic medicine is another medical discipline that warrants our attention. Given the huge potential of genomic medicine in screening, diagnosis and precision medicine, my Government has established a steering committee led by Prof Raymond Liang to study strategies for developing genomic medicine. I have also announced the introduction of the Hong Kong Genome Project in my Policy Address last year, under which about $1.2 billion would be allocated to perform up to 50,000 whole genome sequencing in six years. An expert working group is now examining the project framework, and we will set up the Hong Kong Genome Institute to co-ordinate the implementation of the project in partnership with the Hospital Authority, universities, research sectors and other key stakeholders. I am confident that with the Hospital Authority's full support for the project, patients could benefit from the scientific advancement in genome sequencing.


The Hospital Authority is also working on a strategic service framework for genetic and genomic services. And I'm pleased to say that Prof Sue Hill, NHS England's Chief Scientific Officer, will be offering her invaluable experience in this development. Prof Hill is the mastermind behind the genome sequencing project in the UK and genomic medicine services in the NHS. She will address this morning's plenary session, as well as tomorrow morning's symposium on Genomic Care in the Era of Big Data.


Prof Hill is one of some 90 prominent speakers taking part in more than 50 sessions over these next two days of discussion, intelligence and insight. They will showcase the latest research excellence, while helping to boost healthcare for patients and the communities they live in. That will no doubt be for the benefits for all of us.


Chief Executive Carrie Lam gave these remarks at the Hospital Authority Convention on May 14.

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