XN000022-1986-03-25 — Page 8

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TUESDAY, MARCH 25, 1986

THE SPOKESMAN SAID THAT IT WAS TOO EARLY TO COMMENT ON THE FINANCIAL IMPLICATIONS OF THE INDIVIDUAL RECOMMENDATIONS, MANY OF WHICH WERE COUCHED IN BROAD TERMS. IT WOULD ONLY BE POSSIBLE TO ARRIVE AT ACCURATE COSTINGS, WHICH WOULD BE ESSENTIAL, WHEN DECISIONS HAD BEEN MADE ON HOW PRECISELY THE RECOMMENDATIONS MIGHT BE IMPLEMENTED. HOWEVER, HE NOTED THAT THE CONSULTANTS' FIGURES DID NOT INCLUDE ADDITIONAL STAFF AND OTHER COSTS THAT WOULD BE INCURRED IN IMPLEMENTING A NUMBER OF RECOMMENDATIONS ON THE OTHER HAND, NEITHER HAD THEY TAKEN INTO ACCOUNT ANY INCREASED REVENUE FROM THE INTRODUCTION OF THE PROPOSED NEW AND INCREASED CHARGES OR SAVINGS FROM IMPROVEMENTS TO COST CONTROL PROCEDURES.

THERE WERE OBVIOUS DIFFICULTIES IN ARRIVING AT ANY ACCURATE ESTIMATE OF THE LIKELY SAVINGS TO BE DERIVED FROM THE AUTHORITY STRUCTURE. FURTHERMORE, IT APPEARED THAT VERY CONSIDERABLE UP-FRONT COSTS WOULD HAVE TO BE INCURRED BEFORE ANY SAVINGS COULD BE MADE. AND THIS IN TURN SUGGESTED THAT IT WAS UNLIKELY THAT SAVINGS OF THE ORDER INDICATED BY THE CONSULTANTS WOULD ARISE WITHIN FIVE YEARS OF THE AUTHORITY'S ESTABLISHMENT.

THE SPOKESMAN SAID THAT THE GOVERNMENT WELCOMED THE REPORT. THE LAST DECADE HAD SEEN AN ENORMOUS EXPANSION OF MEDICAL SERVICES AND THIS EXPANSION WOULD CONTINUE IN THE YEARS AHEAD.

RAPID EXPANSION OF ANY SYSTEM WAS LIKELY TO CREATE ORGANISATIONAL PROBLEMS AND IT WAS AGAINST THAT BACKGROUND THAT THE GOVERNMENT HAD DECIDED TO CONDUCT THE REVIEW. IN PARTICULAR IT WAS ACKNOWLEDGED THAT GREATER VALUE FOR MONEY COULD BE OBTAINED WITH BETTER INTEGRATION BETWEEN GOVERNMENT AND SUBVENTED HOSPITALS AND A MORE EFFECTIVE MANAGEMENT STRUCTURE IN ALL PUBLIC HOSPITALS.

THE CONSULTANTS HAD MADE RECOMMENDATIONS ON HOW IMPROVEMENTS COULD BE MADE AND THESE CONSTITUTED A FIRM BASE ON WHICH TO FORMULATE PLANS FOR THE REORGANISATION OF THE HOSPITAL STRUCTURE. HOWEVER, THE GOVERNMENT WAS NOT YET IN A POSITION TO ENDORSE ANY SPECIFIC RECOMMENDATION IN THE REPORT. IT WAS NECESSARY FIRST TO SEEK THE VIEWS OF THE PUBLIC AND IN PARTICULAR THOSE INVOLVED IN THE HEALTH CARE SYSTEM.

MANY OF THE RECOMMENDATIONS HAD FAR REACHING IMPLICATIONS. THE PROPOSAL TO ESTABLISH A STATUTORY AUTHORITY WITH OVERALL RESPONSIBILITY FOR HOSPITALS WOULD HAVE AN ENORMOUS IMPACT ON HONG KONG'S MEDICAL SERVICES AND WOULD HAVE TO BE DISCUSSED IN DETAIL WITH THOSE RESPONSIBLE FOR THE DELIVERY OF MEDICAL SERVICES IN THE PUBLIC SECTOR, INCLUDING STAFF ASSOCIATIONS AND THE BOARDS OF MANAGEMENT OF SUBVENTED HOSPITALS.

THE SPOKESMAN EXPLAINED THAT EXTENSIVE CONSULTATION WOULD ALSO HAVE TO BE UNDERTAKEN IN RELATION TO THE RECOMMENDATIONS WHICH TOUCHED ON THE INTERNAL ADMINISTRATION OF PUBLIC HOSPITALS.

THE SPOKESMAN