Pub­lic health­care un­der mi­cro­scope

HK govt forms com­mit­tee to as­sess ef­fec­tive­ness of Hos­pi­tal Au­thor­ity

China Daily (Hong Kong) - - FRONT PAGE - By KAHON CHAN in Hong Kong kahon@chi­nadai­

The govern­ment’s long-promised re­view of the Hos­pi­tal Au­thor­ity ( HA) was an­nounced on Wed­nes­day with the for­ma­tion of a steer­ing com­mit­tee to eval­u­ate the statu­tory body that runs all pub­lic hos­pi­tals and some of the clin­ics in the city.

The com­mit­tee will scru­ti­nize is­sues in­clud­ing the “clus­ter” sys­tem, HA’s man­age­ment cul­ture and fi­nan­cial re­sources, en­gage­ment of stake­hold­ers, and choices of drugs, ac­cord­ing to its chair­man and mem­bers who talked to China Daily.

Chief Ex­ec­u­tive Le­ung Chun-ying cited a re­view of the HA as one of his key pledges dur­ing the elec­tion plat­form and his first pol­icy ad­dress. Wed­nes­day’s mes­sage fi­nally out­lined that com­mit­ment.

The 13 non-of­fi­cial mem­bers of the com­mit­tee in­clude Lam Woon-kwong, Ex­ec­u­tive Coun­cil con­venor, and Joseph Sung Jao-yiu, vice-chan­cel­lor of the Chi­nese Univer­sity of Hong Kong, as well as doc­tors, pa­tients’ rights ad­vo­cates and ex­perts in the busi­ness field.

Sec­re­tary for Food and Health Ko Wing- man will chair the com­mit­tee. Four other of­fi­cials and two HA ex­ec­u­tives, in­clud­ing Chair­man An­thony Wu Ting-yuk, are also part of the group. Wu said he sup­ports the re­view and has “to­tal con­fi­dence” that the com­mit­tee will bring valu­able in­sights for the HA.

Ko said the pri­or­i­ties, timetable and ap­proach of the re­view were still to be de­ter­mined by the com­mit­tee when it calls its first meet­ing as early as Septem­ber. No dead­line was fixed for the re­view.

The re­view will cover the au­thor­ity’s man­age­ment, re­source al­lo­ca­tion, over­all cost ef­fec­tive­ness and the setup of the “clus­ter” sys­tem.

Pub­lic hos­pi­tals, spe­cial­ist clin­ics, gen­eral out-pa­tient clin­ics and other re­lated ser­vices in the city are grouped un­der seven “clus­ters”, but the HA has of­ten drawn crit­i­cism over the un­even spread of re­sources and sec­tar­ian ten­sion be­tween clus­ters.

The sys­tem has worked well in their quick re­sponse to par­tic­u­lar lo­cal needs, Ko said, but he agreed there is a need to eval­u­ate the “setup” of clus­ters and their pow­ers of ap­point­ment.

Com­mit tee mem­ber An­drew Yip Wai-chun was a deputy ex­ec­u­tive di­rec­tor of the HA be­fore he quit last year. He cred­ited the clus­ter sys­tem for “healthy com­pe­ti­tion”, but says it also sets bar­ri­ers for doc­tors from get­ting cross-clus­ter pro­mo­tions. Some ter­ri­to­ry­wide poli­cies have also failed to be con­sis­tently ex­e­cuted in all clus­ters.

Apart from strik­ing a new bal­ance in the re­la­tion­ship be­tween clus­ters and HA head­quar­ters, Yip says he will also high­light the shift in man­age­ment cul­ture over the past decade at the HA that has led to a loss of co­her­ence within the body and slip­ping morale at the front­line.

“Over a decade ago, (ex­ec­u­tives of the HA) would go to the front­line to check out how the ser­vices were go­ing. Now they just give you the fund­ing and leave ev­ery­thing else to your­self,” said Yip, who found there are mul­ti­ple op­tions for HA ex­ec­u­tives to ex­hibit the per­sonal touch in their in­ter­ac­tion with staff.

Tim Pang Hung- cheong, who rep­re­sents the Pa­tients’ Rights As­so­ci­a­tion in the com­mit­tee, will push the govern­ment to con­sider its long-term fi­nan­cial com­mit­ment in the process to en­sure es­sen­tial fi­nanc­ing will also be avail­able to the HA.

Pang will also pro­pose di­rect en­gage­ment of more stake­hold­ers through­out the re­view. The com­mit­tee will de­cide how it would be done, but the health sec­re­tary said he had con­sid­ered hold­ing fo­cus group dis­cus­sions for pa­tients and trade rep­re­sen­ta­tives.

Ser­vice qual­ity is also a key re­view as­pect. Yip said one im­por­tant ques­tion would be whether or not the HA’s choice of drugs and equip­ment is outof-date, while Pang said stan­dards must be fixed be­fore an as­sess­ment of ser­vice lev­els is pos­si­ble.

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