An­nual flu cri­sis puts spot­light on over­stretched med­i­cal ser­vices

China Daily (Hong Kong) - - COMMENT -

It is very wel­come that Chief Ex­ec­u­tive Car­rie Lam Cheng Yuet-ngor is in­di­cat­ing that a hall­mark of her ad­min­is­tra­tion will be a will­ing­ness to spend pub­lic money on so­cially im­por­tant ob­jec­tives. The first an­nounce­ments were about ed­u­ca­tion but, given the cur­rent flu cri­sis, it seems likely that our med­i­cal ser­vices will also be able to hand in their shop­ping list. This is all to the good but I would like to re­spect­fully make a few sug­ges­tions and also draw at­ten­tion to two old English proverbs which may seem con­tra­dic­tory but each have their uses at dif­fer­ent times. The first is “Penny wise but pound fool­ish” — a warn­ing against penny pinch­ing that un­der­mines vi­tal, if ex­pen­sive, in­vest­ment. The sec­ond is “Has­ten slowly” or “More haste less speed”, warn­ing that it may be bet­ter to take time for con­sid­er­a­tion in order to make wise de­ci­sions.

So be­low I of­fer a hum­ble yes, no or maybe to some of the ideas floated as pos­si­ble so­lu­tions to our med­i­cal woes.

More vac­ci­na­tions — yes, yes and yes again! Our flu vaccination pro­gram seems so tim­o­rous! Read­ing the Leg­isla­tive Coun­cil pa­pers sug­gests there is lit­tle dis­agree­ment about the value of this strat­egy but there is cau­tion over its im­ple­men­ta­tion, with lim­ited sub­si­dies only for par­tic­u­larly vul­ner­a­ble groups. Why not make vaccination avail­able free of charge to any­one and as eas­ily ac­ces­si­ble as the blood donor vans that are now parked on street corners and vis­it­ing peo­ple in their work­places?

More doc­tors and nurses — maybe. These are clearly needed but they must surely be the right type. It may be that med­i­cal staff who have be­come ad­min­is­tra­tors would not be suited to pound­ing the wards again. On the other hand, it would be great to adopt more flex­i­ble work prac­tices so those with fam­ily com­mit­ments could con­tinue on a part-time ba­sis to en­sure they will be re­tained longterm in the pro­fes­sion.

It is of­ten ar­gued that Hong Kong should open up to over­seas qual­i­fied doc­tors but this will only be ef­fec­tive if they are in tune with lo­cal pa­tients, and in par­tic­u­lar if they are pro­fi­cient in Can­tonese to na­tive stan­dards. English is con­sid­ered the universal lan­guage but this means that, to an ex­tent, the United King­dom Na­tional Health Ser­vice is staffed by peo­ple whose ac­cents are hard to un­der­stand. Of course, the real so­lu­tion is to pro­vide plenty of new home-grown medics, not just to meet present short­falls but, as Pro­fes­sor Gabriel Le­ung has sug­gested, to al­low for en­hanced ser­vices.

Buy­ing places in pri­vate hos­pi­tals — doubt­ful. We used to do this with schools in “the bad old days” as a stop­gap and it spawns com­plex bu­reau­cracy and a two-tier sys­tem. The au­thor is a for­mer se­nior ad­min­is­tra­tive of­fi­cer hav­ing han­dled some of the is­sues just dis­cussed. She is a co-host on RTHK’s Backchat pro­gram and sup­porter of various wel­far­ere­lated NGOs.

More fam­ily physi­cians — think care­fully. This is of­ten touted as a so­lu­tion to our crowded ac­ci­dent and emer­gency ser­vices but it re­quires far-sighted plan­ning. Peo­ple are not stupid and among the rea­sons they mis­use A&E is the ready ac­cess to so­phis­ti­cated tech­nol­ogy not avail­able in the gen­eral prac­ti­tioner’s of­fice. The model used by fam­ily physi­cians de­scends from a time when knowl­edge was lim­ited as were the tools avail­able to un­der­stand what was go­ing on inside the hu­man body. The in­ven­tions and dis­cov­er­ies of the past 80 years or so have rad­i­cally changed the sit­u­a­tion. In this case, Hong Kong’s com­par­a­tively un­de­vel­oped state gives it the ad­van­tage of be­ing able to come up with in­no­va­tive so­lu­tions more in keep­ing with the mod­ern age.

Ed­u­ca­tion, ed­u­ca­tion, ed­u­ca­tion — yes, yes and yes. Last but far from least, the gen­eral pub­lic needs to have a de­tailed un­der­stand­ing of what will keep them healthy and away from hos­pi­tals and their risks of cross-in­fec­tion! And they need to be fa­cil­i­tated in putting those healthy habits into prac­tice in our daily lives. It all needs to start from school­days on­wards, not only in lessons but also in ex­tracur­ric­u­lar ac­tiv­i­ties or­ga­nized by groups like the Red Cross. We hear a lot about di­et­ing and food fads but where are the recipes that time-pres­sured fam­i­lies can use ev­ery day in pref­er­ence to buy­ing junk foods? Ex­er­cise is im­por­tant for health but is the govern­ment pro­vid­ing suf­fi­cient sports fa­cil­i­ties and ur­ban open spa­ces? Air qual­ity is an area of con­cern and that should in­clude in­doors too, as most of Hong Kong’s work­force spend their days in the com­pany of many oth­ers in multi-story build­ings with the same dirty air cir­cu­lat­ing over and over again. The govern­ment pub­lic­ity ma­chin­ery needs to be revved up to en­sure our cit­i­zens, young and old, are pe­ri­od­i­cally re­minded of these el­e­men­tary health truths.

These are a few ideas and oth­ers might come up with bet­ter ones. What is cer­tain, how­ever, is that de­bate does need to be stirred up and the best brains brought to bear to cure the sick­ness of our med­i­cal ser­vices.

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