1926-12-01 — Page 8

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THE HONGKONG TELEGRAPH,

HOSPITAL FEES.

GOVERNMENT PUBLISHES

CORRESPONDENCE.

Whon recently the Government increased the foes of the Govern ment Civil Hospital there was a public outery and, the matter was raised In Council,

In reply to the request for in- formation, the Government has now printed the correspondence on the subject:

WEDNESDAY, DECEMBER 1, 1926.

Government Hospitale in Singa- pore and the Dominions Committee. scea no reason why a similar arrangement should not be set up in Hongkong.I am, ote,,

(Sd.) G. C. Anderson, Deputy Medical Secretary.",

Governor's Reply.

In reply the following despatch was, addressed to the Secretary of State.

Government House, Hongkong, 11th March, 1926.-

A RANCH FIGHT.

MEXICAN AGRARIANS

KILLED.

Brownville, Texas, Nov. 30. Eight persons werd killed and five wounded in an attempt by Mexican agrarians to seize."na ranch near American-owned :

Matamoros.

Sir-I have the honour to ack The band had been transporting nowledge the receipt of your des house round the countryside as patch No. 359 of the 15th Novom-headquarters, When they began ber with regard to the terms on to move the house into the 'ranch, which patiente" aro admitted to the ranchors, after warning fired. Government Hospital. In this Tho agrarians, who were all kill- Colony.

ed, include a girl agrarian Reuter's American Service.

4. The chief points of differ- ence between the present and the| now scales are:

(1) the, charges for medical attendance at a rate of one-third of the maintenance rate in the case of 1st and 2nd class private the Erincipal Civil patients: Medical Officer is of opinion that this charge approximately .equals the charge that private medical practitioners would make in or dinary cases;

7.

The paper sets out as follows: In 1920 the local branch of the British Medical Association raised the question of the fees charged in Government hospitals, Govern, 2. After enreful consideration | ment replied that. did mot pro-I have come to the conclusion that pose to increase the fees.

it would not be possible to work. In 1928 three local firms of such a system as is suggested in medical practitioners again took the letter from the British Medical up the mattor stating that they Association of the 22nd October, considered that local doctors were trnless tats Government, defnitely subjected to unfair competition by adopted the principle of allowing the low rates charged in Govern- all medical officers the right of ment hospitals and more particu-private practice. There is some- larly by the fact that surgical thing to be said for the adoption operations were performed free of this principle aa competition" those hospitala. The matter was would reduce the very bigh Tees referred to the Secretary of State, charged by private practitioners who replied that "it appears to be here, but I do not think that the the general practice in the Colonies proposal would be regarded as

the for Government Civil Hospitals to satisfactory by existing afford treatment to the general medical firms. I have, etc.,

R. E. Stubbs, Governor, &c." fees,

These fees how-

B. M. A. Writes Again. ever are clearly intended to cover anly the cost of maintenance,

Copy of a further letter from nursing attendance, étc., and aré paid into the Government Chest as the British Medical Association, revenue derived from the Medical London received from the Secre- department, and no special effort tary of State. seems to be made to avoid competi- tion, with private practitioners."

In view of this reply the Govern-15th December, 1925.

Si am Instructed by the ment informed the three firms that it was not prepared to establish Dominions Committee of the Bri a scale of special fees for opera-tish Medical Association to advert to my letters of the 22nd October, tions in Government hospitals.

The matter was then taken up 1924 and 9th February last and by the British Medical Association, Mr. Grindle's reply to May 5th London, and a copy of the follow-(Reference No. 17833/25).

7. The Government consultants The Committea, is advised that Association was forwarded by the Sir R. Stubbs refused to receive referred to in the notification are Secretary of State for considera-a deputation from the general the Professors of Surgery, Medi-

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tion.

B. M. A. Letter to Secretury of State. British Medical Association, Medical Department, 22nd October,

1024.

Sie,-I am instructed by the Dominions Committee of this Association to bring to your notice certain circumstances 'in connec tion with the Hospital Medical Service under the Hongkong Gov-

crnment,

British Medical Association, British Medical Association House,

(2) the fees charged for, sur- gical operations and maternity 2a5c8,

6. It is considered that the Principal Civil Medical Officer) should have discretionary power to waive the extra fees, in view of the fact that there is a class of person, who, whilst they can afford to pay 1st or 2nd class rates for maintenance, cannot charges for afford to pay extru medical attendance, surgical opera- tions or maternity cases.

All fees with the exception of the consultants' fees will be paid into the ordinary revenue of the Colony.

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practitioners of Hongkong who decine, Obstetrics and Gynaecox GREEN ISLAND CEMENT Co., Ltd.

University of Hongkong. have always

sired to explain their position and at the has never given them any facili- These professors ties for laying their case before him in these circumstances the Committec is unable to concar in the statement that the matter has been carefully considered by the Colonial adminstration, and would request, in view of the recent change of Governor, that the question may be re-opened,

the

been connected with the Govern- ment hospitals, though hitherto their exact status has not been clearly defined. The matter was discussed with the Vice-Chan- cellor who concurs in the present proposals affecting these profes sors.

at this hos-1

pital are attended at their own, charges by their own doctors.— "I have, etc.,

(Sd.) C. Clementi, Governor

8 The rates for maintenance: I am to emphasize the fact that. at the Peak Hospital will remain It is understood that the Hospital the proposition, with regard to the the same as they are at present, namoly $10 per diem, for 1st class fces for medical Medical Service is maintained by imposition of the Hongkong Government for the and surgical consultations and and $5 per diem for 2nd class

patients. Patients Government purpose of supplying the medical treatment at needs of Government servants and Hospitals to persons not entitled the poor and that those Hospitals by their contracts to free medical are staffed by Medical Officers service and unable to pay for employed by the Government, and such service was not necessarily &c. that private practitioners are de- meant to imply that such fecs barred from attending or operat- should pass to the Government. ing on their own patients in the medical officers concerned. The Hospitals. Other patients, how point would be fully met if they ever, who do not belong to the were credited to the ordinary Governmnet Service and who are

revenue of the Hospitals. not in need of financial assistance to defray their medical expenses are also admitted for treatment and it happens that in many cases those admitted are not even re- sidents of the Colony. The fees charged are: $8.00 per day for the 1st class, $5.00 per day for the 2nd class, $2.00 or $1.00 per day for the 3rd class.

These fees include not only Hospital maintenance but also medical, surgical and obstetric treatment, and drugs, whilst at the same time other Hospitals avail able in the Colony for the patients of private practitioners. charge.

As regards Sir R. Stubb's re mark upon ""the very high fees charged by private practitioners in the Colony" I am to add that the Committee has been advised. of the ordinary level of feea, in the Colony. It would appear that these fees are actually lower than those actually charged in Shang- hai and Singapore and that in general they do not appear to be unduly high, having regard to the general "level of fees In this country and the relative expenses of medical practice in Hongkong and elsewhere. I am, etc.,

similar fees for maintenance only. (Sd.) G. C. Andersen, Deputy

The result is that regardless, of the financial position of the patient

anyone, whether resident, transient

Medical Secretary.

View Changed.

The whole matter was reconsi-

or tourist, of whatever nationality,dered by the Hongkong Govern-

is admitted, into the Government ment and on 22nd October, 1926, Hospital, and simply on payment the following despatch was sent of the approximate cost of board in reply to the Secretary of State and lodging according to the class Government House, Hongkong, of room taken, receives free, all 22nd October, 1926. medical treatment, and anything Sir With reference to your that may be required in the way despatch No. 462 of 28th Decem- of operation, X-ray or obstetrical ber, 1925, on the subject of the work, etc. In other words thero terms on which patients are ad- is a considerable class of patientsmitted to Government hospitals, receiving from the Government I have the honour to state that' medical and surgical treatment at the matter has been fully recon- a charity to which they are in no sidored, since my predecessor's way entitled.

despatch. N. 102 of 11th March, The Dominions Committee is 1926, was written. therefore of the "opinion that the

2. After consultation with the. private practitioners in the Colony Principal Civil Medical Officer. I dre at a disadvantage in that their have come to the conclusion that patients are freely admitted and there is force in the contention. treated by operation or otherwise of the British Medical Association in Government Hospitals by Gov ernment Medical Officers, or in that private medical practitioners other words that there is unfair unfair competition. In that a per- in this Colony are subjected to competition.

ہیں

The Committee would be glad son would ordinarily prefer to If the Secretary of State would, enter a hospital, such as a Govern- approach the Hongkong Government hospital, where charges for ment in order to ascertain if it maintenance only and not for would not be possible for the medical treatment could be made a private hospital Government, Hospitals to charge rather than tens for medical and surgical con-whore charges both for mainten sultations and treatment given by ance and for medical treatement the medical staff to all persons by private medical practitioner admitted to the hospital except would be made.

these Government Servants who 3. It has therefore been decid- aro entitled by their contracts to ed that a new scale of chargos, free medical service and those as set out in the enclosed copy members of the community who of Government Notification No. have not the means to pay for 556 of 8th October, 1926, shall uch services. Such foes should, be substituted for the present of course, be approximately on the scale of charges which is shown. same scale as the fees, charged by in the enclosed copy of Govern- private practitioners. It is under ment Notification No. 820 of 24th stood that arrangements on those December, 1909, us from Ines are at present In force at the January 1927,

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