Generation 40s – 四十世代

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Hong Kong’s struggling public hospitals need a transfusion of doctors and nurses from overseas

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CommentInsight & Opinion

Albert Cheng says Hong Kong compares poorly with other developed economies in the proportion of medical practitioners in a population, and the government must be proactive in tackling the severe shortage

The new year started with a flu outbreak across the city. The early commencement of the Lunar New Year holiday for kindergartens and primary schools has not stopped influenza from spreading. Public hospitals are overburdened, medical staff are stretched to breaking point, and health officials warned that the flu surge has not peaked.

In January, the government announced extra funding of HK$500 million for public hospitals after the nursing staff association ran a full-page newspaper advertisement urging the government to tackle the manpower shortage at public hospitals. However, one-off extra funding is not the solution to a long-standing problem. The root of the problem is that the government has been neglecting the health-care system, which is on the verge of collapse.

The two former secretaries for health, York Chow Yat-ngok and Ko Wing-man, were both inclined towards the private medical sector. The bureau has been reluctant to allocate sufficient funding and resources to address the manpower shortage.

Adding to the problem is the deep-rooted protectionism in the local medical sector, which refuses to welcome overseas medical professionals. Given the worsening working conditions and the inadequate compensation, it is impossible to attract new and retain existing medical talent.

Last year, the new Tin Shui Wai Hospital failed to operate at its full capacity due to manpower shortage. The latest Audit Commission report also revealed a huge wastage of medical resources at North Lantau Hospital, where equipment has been left unused and one-fifth of the total area is not utilised.

In fact, in Hong Kong, the proportion of medical professionals in a population has fallen behind other developed countries’. In 2016, there were 52,389 nurses in Hong Kong, or 7.1 nurses per 1,000 population. According to Organisation for Economic Co-operation and Development figures in 2015, the highest number of nurses per 1,000 population is 17.9 in Switzerland, followed by 17.3 in Norway, 11.3 in the US and 7.9 in Britain. Hong Kong lags even Lithuania at 7.7.

To catch up to the OECD standard of 9 nurses per 1,000 population, the city needs 13,000 more nurses. The Hospital Authority hires 40 per cent of nurses in Hong Kong; in other words, the public hospitals are understaffed by 6,500 nurses.

But the nursing industry is exercising protectionism as much as the doctors. Nurses trained overseas are required to pass professional examinations to register here. However, the passing rate has sharply declined and was only 4.95 per cent in 2016. Also, if a candidate fails the exam three times, he or she cannot retake the exam before undertaking a 200-hour course. It has been very difficult to recruit new nurses to fill the gap.

The shortage of doctors is the elephant in the wards. There are 14,031 doctors in Hong Kong in total, 1.9 doctors per 1,000 population, lagging behind 5.1 in Austria, 2.8 in the UK, and 2.3 in Singapore. Hong Kong lacks 3,000 doctors to meet OECD standards.

There are only two medical schools in Hong Kong. It takes seven years to train a doctor, and at least 10 to train a specialist. It is impossible to solve the shortage of doctors in the next 10 years. Thus, employing overseas doctors] and nurses is the only way out, and Hong Kong citizens who are trained in other countries should be given the highest priority.

A protectionist mindset no longer works in this city, which is understaffed almost wherever you look.

The requirements for overseas doctors to practise in Hong Kong should be thoroughly reviewed. The Medical Council should also consider cancelling the compulsory examination. To balance public and professional interests, overseas practitioners should be required to work at public hospitals for the first three years before turning to private practice.

Albert Cheng King-hon is a political commentator.


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