XN000022-1993-07-14 — Page 19

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WEDNESDAY, JULY 14, 1993

TO ENSURE THAT A BALANCE WAS STRUCK BETWEEN THE PROVISION OF SERVICES AND THE LEVEL OF SUBSIDY FOR THESE SERVICES.

MRS WONG MADE THE REMARKS WHEN TABLING THE CONSULTATION DOCUMENT IN THE LEGISLATIVE COUNCIL THIS AFTERNOON.

PUBLIC

TO ENSURE THAT THE GOVERNMENT'S COMMITMENT TOWARDS HEALTH SERVICES REMAINS PARAMOUNT, THE GOVERNOR PLEDGED IN HIS POLICY ADDRESS LAST OCTOBER "TO INCREASE RECURRENT SPENDING ON HEALTH CARE BY 22 PER CENT IN REAL TERMS BY 1997".

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'ACCESS TO AFFORDABLE HEALTH CARE IS A PUBLIC RIGHT, MRS WONG STATED, ADDING THAT THIS RIGHT REMAINED THE CORNERSTONE OF GOVERNMENT POLICY.

COMING

LIKE MANY OTHER COUNTRIES, SHE CONTINUED, HONG KONG WAS UNDER INCREASING STRESS DUE TO ESCALATING MEDICAL COSTS, AN AGEING POPULATION AND RISING EXPECTATION FOR IMPROVED SERVICES.

FEES CHARGED BY THE PUBLIC HOSPITAL SYSTEM HAD THEIR ORIGINS IN THE POST-WAR YEARS WHEN THEY WERE ORIGINALLY BASED ON THE COST OF CATERING, WHILST THE FEES CHARGED BY PUBLIC OUT-PATIENT CLINICS WERE BASED ON OPERATING COST.

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AND FEES LEVIED IN PUBLIC HOSPITALS BE THEY ACUTE GENERAL, INFIRMARY AND PSYCHIATRIC ARE THE SAME IRRESPECTIVE OF THE DIFFERENT LEVELS OF SERVICE, OPERATING COST AND PATIENT'S ABILITY TO PAY.

MRS WONG EXPLAINED THAT ALL FEES WERE UPDATED EVERY YEAR, BASED ON AVERAGE OPERATING COST AND IN LINE WITH THE MOVEMENT OF GOVERNMENT CONSUMPTION EXPENDITURE DEFLATOR.

FURTHERMORE, SHE SAID, PRIOR TO THE SETTING UP OF THE HOSPITAL AUTHORITY, DIFFERENT HOSPITALS HAD DIFFERENT CHARGING POLICIES.

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'WHEREAS EX-GOVERNMENT HOSPITALS IMPOSED AN ALL-INCLUSIVE FLAT RATE, THAT IS, 'STANDARD CHARGE FOR THE OCCUPATION OF A GENERAL WARD BED, SOME EX-SUBVENTED HOSPITALS CHARGED SEPARATELY FOR ADMISSION, SURGICAL OPERATIONS AND DRUGS IN ADDITION TO THE BASIC RATE, SAID MRS WONG.

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UNLESS "THESE

"THUS THE CURRENT SYSTEM OF FEES CHARGED IN THE PUBLIC SECTOR IS NEITHER RATIONAL, CONSISTENT NOR CLEARLY UNDERSTOOD. OPTIONS ARE ADOPTED, THE EXISTING SYSTEM WILL CONTINUE. HISTORICAL METHODS OF CHARGING STILL APPLY TODAY IN SOME CIRCUMSTANCES.

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"THESE HISTORICAL ANOMALIES IN FEE STRUCTURE CREATE CONFUSION AND NEED TO BE RATIONALISED.

POLICY

MRS WONG ALSO NOTED THAT HONG KONG'S HEALTH AND WELFARE HAD ALWAYS FOCUSED ON THE PHILOSOPHY OF HELPING THE VULNERABLE AND THOSE WITH SPECIAL NEEDS.

YET, UNDER THE EXISTING HEALTH CARE SYSTEM, THE LESS WELL THE ELDERLY AND LONG-STAY PATIENTS DO NOT HAVE CERTAINTY OF ACCESS WAIVER BECAUSE THE CURRENT FEE CHARGING SYSTEM DOES NOT CARRY WITH A CLEAR-CUT WAIVER SYSTEM EXCEPT FOR PUBLIC ASSISTANCE RECIPIENTS.

OFF,

TO

IT

/FOR EXAMPLE