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Uniformity of charges.
(b) raising Tung Wah Eastern to district hospital capability,
by the provision of staff quarters;
(c) raising Fanling Hospital to district hospital capability- with additions and improvements to be made after the completion of a detailed survey;
(d) relieving the overcrowding at the Queen Elizabeth Hospital
casualty department by building an extension;
(e) providing additional facilities at Queen Elizabeth Hospital by means of an extension of "B" Block for open heart surgery and a better clinical pathology service, and 100 additional beds; and
(f) adding a Burns Unit to Queen Mary Hospital.
6.9 The scheme described in this chapter cannot be fully carried out without the participation of the general beds in the hospitals of the Tung Wah Group. The scheme as described hitherto envisages that the Kwong Wah Hospital (with improve- ments) would become a regional hospital serving West Kowloon and the Tung Wah and Tung Wah Eastern would act as district hospitals on Hong Kong Island.
6.10 An integrated scheme of this sort for third class patients would undoubtedly achieve a more even use of beds in different hospitals, and be more fair to patients who frequently have no choice as to which hospital they go to, if all participating hospitals charged uniform fees. At present there is considerable disparity even though all are funded to a more or less equal extent by the taxpayer. Although the full cost of a third class bed is about $100 a day the all-inclusive charge in Government hospitals is $2 a day with a system of remission in case of need. Amongst assisted hospitals, the Tung Wah Group traditionally charges no fees to third-class patients, but others for the most part charge fees in excess of those in Government hospitals (see appendix 2). These differences might impede the smooth working of an integrated scheme. For instance the scheme would envisage the movement of a patient for convalescence in a district hospital after completion of acute treatment in a regional hospital. How- ever a patient in a regional hospital such as the Queen Elizabeth, where he is charged $2 a day, would presumably be reluctant to accept transfer to a district hospital if the fee were higher.
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6.11 The Government considers that ideally Government and Government-assisted hospitals should provide medical treatment free to third-class patients, but that all should be charged a uniform fee for subsistence based on that charged by Government hospitals but with a remission scheme in case of need. While this is the goal which the Government considers desirable, and which logic dictates, it is appreciated that assisted hospitals have their own traditions and that the goal may not be easy to achieve in the short term. The Government has no wish to disturb the chari- table instincts on which these hospitals were founded, and it would be unfortunate if the contributions received by these hospitals towards their expenses were to be lost to the community. Ac- cordingly the Government proposes that the position of each hospital or group of hospitals should first be examined and the most appropriate arrangement reached by mutual agreement.
6.12 If charges were standardized in the way proposed it would mean that the fee income of some Government-assisted hospitals would be reduced. This issue would arise immediately in relation to the Buddhist Hospital and the Caritas Medical Centre, both of which are presently assisted by way of a cost-per- bed subvention. If they agree to participate in these integrated arrangements it would be necessary to review the manner in which they are subvented. The MDAC suggested that this might be achieved by applying the deficiency grant system of subvention (now applied to the Tung Wah Group and the United Christian Hospital).
6.13 The position of the Tung Wah Group, with its fine charitable tradition of charging nothing to third-class patients, even for subsistence, presents particular difficulties. But the Government believes it should be possible to work out some mutually acceptable arrangement which might reconcile the chari- table tradition of the Group with the public interest in an integrated system.
6.14 The MDAC recommended that some increases should be Charges in made in the charges presently made in Government hospitals. Government
hospitals. The present daily maintenance charge was instituted in 1961.
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