MR CHAN CHUN-YING (in Cantonese):
President, the veto of the proposed arrangement to relax the internship requirement for overseas specialists by the Medical Council of Hong Kong (“MCHK”) last month sparked a public outcry. MCHK held another meeting very soon afterwards and passed a proposal which is regarded as more lenient. However, it seems that the proposal cannot completely solve the shortage of doctors in Hong Kong at root. I am very grateful to Mr Tommy CHEUNG for moving the adjournment debate today so that the Legislative Council can objectively discuss how to detonate this bomb concerning people’s livelihood.
Hong Kong is entering an era of population ageing. According to the estimation of the Census and Statistics Department, the number of people aged 65 or above will increase from 1.16 million in 2016 to 2.37 million in 2036. In 20 years, the number of senior citizens will increase by over 1 million. The most direct effect of an ageing population is a keen demand for hospital services.According to the Report of Strategic Review on Healthcare Manpower Planning and Professional Development released by the Government in 2017, the requirement of hospital-bed use of those aged 65 or above is about nine times more than younger people, and for those aged 85 and above, their hospitalization need is almost 20 folds that of the under-65s. The average life expectancy in Hong Kong at present is the highest in the world and for women, it is about 87. Undoubtedly, the demand for public health care services will continue to rise.
Since it is beyond doubt that the demand for health care services will be keen, we have to consider how to respond to this need in terms of hardware and software. As the focus of our discussion today is not the hardware of hospital planning, we should concentrate on the software, particularly the demand and supply of medical practitioners. In the past 10 years, the University Grants Committee has significantly increased the places for training doctors, from 250 in 2005 to 470 in 2016; and the number will be further increased to 530 in 2022. At a glance, these figures show that the number of places for training doctors has almost doubled, which is good, but if we compare the numbers with the information provided by the Research Office of the Legislative Council, we will notice that there is actually a severe shortage of medical practitioners in Hong Kong.
Dr CHIANG Lai-wan mentioned some figures earlier. Let us suppose that there were 2 registered doctors for every 1 000 persons in Hong Kong in 2018. However, Dr CHIANG has not mentioned that the Organisation for Economic Co-operation and Development (“OECD”) recommends that there should be 3.4 doctors for every 1 000 persons in Hong Kong. Mr Franklin LAM, founder of HKGolden50, pointed out in his article published in the Hong Kong Economic Times that if Hong Kong was to catch up with the standards of developed economies, we had to increase the number of doctors by 7 000, but not 3 000, which was the recommendation of World Health Organization mentioned by Dr CHIANG Lai-wan.
How can we expedite the process of increasing the number of doctors? In the same report of the Legislative Council, it was pointed out that before the reunification, Hong Kong accepted doctors trained in six Commonwealth countries to practise in Hong Kong without requiring them to pass any examination and no threshold was set. From 1990 to 1995 in the last century, among the 200 newly registered medical practitioners every year, about 42% were doctors admitted from Commonwealth countries to meet the demand. Nevertheless, with the passage of the Medical Registration (Amendment) Ordinance 1995, all overseas graduates of Medicine, and even Hong Kong graduates, have to pass the Licensing Examination of MCHK before they could practise in Hong Kong. Overseas medical practitioners were a main source of doctors in Hong Kong before the reunification, why was it that the standard of these doctors suddenly became unsatisfactory and even undermined the quality of our health care services after the reunification? That is really baffling.
If the pace of our local training cannot meet the demand, I believe it is the consensus of the majority Hong Kong people to increase the number of overseas doctors to meet the urgent need. The proposal passed by MCHK this time is not an adequate solution and the real hurdle preventing overseas doctors to practise in Hong Kong is the Licensing Examination. Prof FOK Tai-fai, Pro-Vice-Chancellor of The Chinese University of Hong Kong and a renowned paediatrician, said during an interview that if he had to take the examination, he might not pass. He explained that since he had been practicing in the specialty of paediatrics for many years, it would be difficult for him to other questions on other subjects unrelated to his specialty.
All in all, apart from providing local training, admitting medical practitioners from overseas will be a very effective way to address the shortage of medical practitioners in Hong Kong. The key is how to assess the practical experience of senior specialists so that they can be exempted from examination. I hope that MCHK will not neglect the views of society, or even create doubt among the public whether professional autonomy has deprived the medical profession of its self-regulatory power. If that is the case, the Government should rectify the mistakes by administrative measures without delay.
President, I so submit.