Flu outbreak tests HK’s health service

The flu outbreak since early January has claimed 120 lives, including two children, and has thrown health services into chaos, sparking protests by many over-worked nurses at government hospitals.

Patients have to wait as much as eight hours for treatment in many public hospitals. Not enough beds are available for all patients admitted. Some have had to sleep in corridors and even lift lobbies.

This year’s flu outbreak is much more serious and has affected many more people than past occurrences. More worrying is that children and elderly people are particularly vulnerable to the virus.

The worsening problem has led many civic leaders and social workers to question the core issues facing the public health service in Hong Kong. Certainly, this city provides one of the world’s most affordable medical services at affordable costs to its people. But increased government spending on healthcare has failed to resolve the manpower shortage problem.

There are just not enough doctors and nurses in public hospitals to adequately service the increasing number of people seeking treatment every day. The flu outbreak has not only made matters worse but also led to strong calls for reform– focusing on recruiting overseas medical staff.

Back in the summer of last year, the Food and Health Bureau published a study projecting a manpower crisis affecting nine out of 13 medical professions. They include dentists, general nurses, occupational therapists, physiotherapists and doctors.

The report specifically predicted a shortage of doctors would be 500 in 2020 and 1,007 by 2030. There will be a shortage of 1,669 nurses in the next 13 years compared with 1,485 in 2016, the report said.

The report’s findings have led to a renewed call for loosening the vetting procedure to allow the recruitment of more overseas doctors. At present, only a small percentage of applicants can pass the test to qualify for practicing in Hong Kong.

Medical experts, however, argued that the shortage of doctors in public hospitals is due to a large turnover rate. Experienced doctors prefer to go into private practice rather than stay in public hospitals for a number of reasons. Money is of course an important factor. Public hospital pay is high, but a doctor with years of experience can earn much more in private practice. Job satisfaction is also a deciding factor. Many young doctors just don’t feel they have the respect they deserve or the opportunities to advance their skills in the rigid system of public hospitals.

To avoid litigation, public hospitals have laid down strict guidelines to stop junior doctors from performing operations considered routine in earlier times. This has denied young doctors the chance to acquire the necessary experience to help improve their skills and knowledge.

There is the added problem of overtime work that has become intrusive to the private life of many young doctors. More and more frustrated young doctors have chosen to go into private practice or further their studies in Hong Kong or elsewhere.

Medical professionals are uncomfortable with the proposal to lower admission standards for overseas doctors. They contend that the shortage crisis can be addressed by raising the pay of doctors and nurses at public hospitals, reducing their workload by streamlining schedules and relieving them of some paperwork which can be done by trained clerical staff.

Results of a poll in early 2017 commissioned by medical sector lawmaker Dr Pierre Chan Pui-yin show that most of those interviewed opposed the proposal to make it easier for overseas doctors to practice in Hong Kong. Those opposing it included 78 percent of the 1,003 respondents from the public and 83 percent of respondents from among medical practitioners.

The latest flu outbreak may change the public’s minds about the proposed reforms. But it is important to take into full account the views of the medical professionals who understand the problem better than anyone else.