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Public comments of overcrowding, inadequacy and
inefficiency of service, poor attitude of staff, long hours of waiting at clinics, accident and emergency departments, and X-ray investigations, etc. are not entirely unfounded. Discontentment of staff on inadequate training opportunities and poor working environment are not completely unjustified. All of these criticisms are not necessarily directed at the Administration which has in fact done a most admirable job in ma in ta in ing Hong Kong at a very high standard of public health. They could be the result of the rapid increase in our population, the increasing affluence and aspirations of our people, and the fact that our present system of hospitals and
clinics needs changing.
For many years our medical budget has remained roughly at the level of 8% of the total Government annual expenditure,
This although the actual amount in money terms has increased. state of affairs would mean that to improve our medical care from the present level would be quite impossible as it will have to compete with other services for the limited funds.
But by changing the present system and allowing Government hospitals and clinics to be managed independently, each with an autonomous board of governors and a block grant, a great deal of improvement can be achieved. Because each hospital will then be made directly accountable for its operation and competition will increase efficiency and improve staff attitude and performance. Money will be saved, for example, by putting staff, especially doctors, on contract terms on full time or part time (sessional) basis. They need no longer be in the civil service. Although the hospitals would become non-profit-making institutions, additional funds can be generated from moderate increases in fees for various services, while keeping them within the means of the average
wage earner.