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fluous. A year ago I outlined achievements in the control of disease and repetition to-day would be tedious. But to bring things up-to-date I must mention two new facets, the first being the commencement of "open-heart" surgery, now firmly established on the local medical scene through co-operation between the Hong Kong Anti-Tuberculosis and Thoracic Diseases Association, the Medical Faculty of the University of Hong Kong and the Medical and Health Department. The second is the inoculation campaign against measles which has been progressing steadily through the year; although it would be premature at this moment to make any firm assessment, I may say there is as yet no indication of the anticipated biennial outbreak.
On the obverse side of the coin, however, we are facing a serious staffing problem caused by a sudden and considerable acceleration in the drain of professional manpower, particularly of doctors, from the public service and, although all possible avenues within the existing framework are being explored, major alleviation is unlikely until the full effect of the expansion of the Medical Faculty of the University of Hong Kong can be felt. Dr. HUANG proposed the establishment of a medical school in the Chinese University as I quote "a radical solution to this grave and pressing problem", but I submit, Mr. Chairman, that this statement is completely misleading for no practical results could be seen in less than a decade. That this is not a douche of cold water but a plain statement of fact can be demonstrated by the compilation of a simple time-table covering establishment of the faculty, planning and construction of the pre-clinical buildings, and the subsequent five years' training and one year's internship of the students. To claim that all this could be done within ten years would be to assume a very tight and probably over-optimistic progress schedule, even here in Hong Kong where the impossible takes a little longer.
Dr. HUANG also stated I quote "it is generally agreed by medical educators that a smaller class is always more desirable than a large one." I would appreciate information as to where I can find evidence of this general agreement because the relative merits of more as opposed to larger medical schools are being debated vigourously in many countries; for example, in the United Kingdom (used by Dr. HUANG as the basis for comparison in respect of doctors) a Royal Commission on Medical Education reporting this year has come down firmly on the side of expansion of existing schools; they said--"We think that the provision of the complex and expensive facilities required in a medical school in the future cannot be economically justified for those with an annual intake of less than 150-200 medical students." The Medical Faculty of the University of Hong Kong is already studying a proposal to expand again its annual intake, for the problems presented by such expansion are of a lesser degree than those poised by the establishment of a new medical school: on the one hand there are well-established departments in the basic sciences and other non-clinical disciplines while
HONG KONG URBAN COUNCIL
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on the other the Queen Elizabeth and the Kwong Wah Hospitals appear more suitable for expansion of clinical instruction within the framework of the present Medical Faculty than for ad hoc adaptation to complete and self-contained teaching institutions. Furthermore, I have been informed by the Dean of the Medical Faculty that very sympathetic consideration is already being given to the possibility of accepting into the Faculty certain students of the Chinese University who can be considered as suitable matriculants.
Mrs. ELLIOTT expressed concern about forward planning in professional education. Although her questions were couched in somewhat rhetorical terms, I would like to reply that, in the sphere of medical and health activities, development of training facilities is following the general outlines laid down in the 1964 White Paper, emphasis being placed on local instead of overseas tuition wherever and whenever such facilities are economically and practically warranted. As I said earlier, our problems result generally from a drain of skilled persons rather than from their provision.
The Select Committee on Health Education has done a very good job since the time eleven years ago when I had the privilege of working with Dr. Woo in establishing it as an integral part of this Council, and I am sure he will agree that there has been increasing co-operation between the Committee and the Medical and Health Department towards maximum co-ordination and supplementation of effort. But I cannot subscribe to his claim that rejection of the Committee's request to be—I quote "fully in charge of the whole programme of Health Education within the Colony" can be classified as stubbornness over a simple matter. Health Education is not only extensive but also complex in its scope, and I suggest that the Committee through its nucleus of inspectors holding the Diploma in Health Education, while admirably suited and adapted for activities relating to personal and community hygiene and environmental sanitation, is not suited for nor in a position to handle matters about preventive medicine and the personal health services which require the continual augmentation of mass publicity medial by more specialized and intensive individual or group education. However, I do assure Dr. Woo that co-operation and assistance will continue to be extended by the Medical and Health Department with, I trust, further gratifying results.
I am pleased that Mr. Lo referred to the speed-up in the processing of applications for various licences and permits by the Central Licensing Unit of the Urban Services Department, and I assure Members that the procedure is under continual review to produce the most rapid action that is possible. Furthermore, there is increasing co-operation with and assistance from other interested departments of Government. For example, the Director of Fire Services has agreed to take action under the Fire Services Ordinance in cases where food businesses fail to
Page 218 of 243
Page 218 of 243
348
HONG KONG URBAN COUNCIL
fluous. A year ago I outlined achievements in the control of disease and repetition to-day would be tedious. But to bring things up-to-date I must mention two new facets, the first being the commencement of "open-heart" surgery, now firmly established on the local medical scene through co-operation between the Hong Kong Anti-Tuberculosis and Thoracic Diseases Association, the Medical Faculty of the University of Hong Kong and the Medical and Health Department. The second is the inoculation campaign against measles which has been progressing steadily through the year; although it would be premature at this moment to make any firm assessment, I may say there is as yet no indication of the anticipated biennial outbreak.
On the obverse side of the coin, however, we are facing a serious staffing problem caused by a sudden and considerable acceleration in the drain of professional manpower, particularly of doctors, from the public service and, although all possible avenues within the existing framework are being explored, major alleviation is unlikely until the full effect of the expansion of the Medical Faculty of the University of Hong Kong can be felt. Dr. HUANG proposed the establishment of a medical school in the Chinese University as I quote "a radical solution to this grave and pressing problem", but I submit, Mr. Chairman, that this statement is completely misleading for no practical results could be seen in less than a decade. That this is not a douche of cold water but a plain statement of fact can be demonstrated by the compilation of a simple time-table covering establishment of the faculty, planning and construction of the pre-clinical buildings, and the subsequent five years' training and one year's internship of the students. To claim that all this could be done within ten years would be to assume a very tight and probably over-optimistic progress schedule, even here in Hong Kong where the impossible takes a little longer.
Dr. HUANG also stated I quote "it is generally agreed by medical educators that a smaller class is always more desirable than a large one." I would appreciate information as to where I can find evidence of this general agreement because the relative merits of more as opposed to larger medical schools are being debated vigourously in many countries; for example, in the United Kingdom (used by Dr. HUANG as the basis for comparison in respect of doctors) a Royal Commission on Medical Education reporting this year has come down firmly on the side of expansion of existing schools; they said--"We think that the provision of the complex and expensive facilities required in a medical school in the future cannot be economically justified for those with an annual intake of less than 150-200 medical students." The Medical Faculty of the University of Hong Kong is already studying a proposal to expand again its annual intake, for the problems presented by such expansion are of a lesser degree than those poised by the establishment of a new medical school: on the one hand there are well-established departments in the basic sciences and other non-clinical disciplines while
HONG KONG URBAN COUNCIL
349
on the other the Queen Elizabeth and the Kwong Wah Hospitals appear more suitable for expansion of clinical instruction within the framework of the present Medical Faculty than for ad hoc adaptation to complete and self-contained teaching institutions. Furthermore, I have been informed by the Dean of the Medical Faculty that very sympathetic consideration is already being given to the possibility of accepting into the Faculty certain students of the Chinese University who can be con- sidered as suitable matriculants.
Mrs. ELLIOTT expressed concern about forward planning in pro- fessional education. Although her questions were couched in somewhat rhetorical terms, I would like to reply that, in the sphere of medical and health activities, development of training facilities is following the general outlines laid down in the 1964 White Paper, emphasis being placed on local instead of overseas tuition wherever and whenever such facilities are economically and practically warranted. As I said earlier, our problems result generally from a drain of skilled persons rather than from their provision.
The Select Committee on Health Education has done a very good job since the time eleven years ago when I had the privilege of working with Dr. Woo in establishing it as an integral part of this Council, and I am sure he will agree that there has been increasing co-operation between the Committee and the Medical and Health Department towards maximum co-ordination and supplementation of effort. But I cannot subscribe to his claim that rejection of the Committee's request to be-I quote "fully in charge of the whole programme of Health Education within the Colony" can be classified as stubbornness over a simple matter. Health Education is not only extensive but also complex in its scope, and I suggest that the Committee through its nucleus of inspectors holding the Diploma in Health Education, while admirably suited and adapted for activities relating to personal and community hygiene and environmental sanitation, is not suited for nor in a position to handle matters about preventive medicine and the personal health services which require the continual augmentation of mass publicity medial by more specialized and intensive individual or group education. However, I do assure Dr. Woo that co-operation and assistance will continue to be extended by the Medical and Health Department with, I trust, further gratifying results.
I am pleased that Mr. Lo referred to the speed-up in the pro- cessing of applications for various licences and permits by the Central Licensing Unit of the Urban Services Department, and I assure Members that the procedure is under continual review to produce the most rapid action that is possible. Furthermore, there is increasing co-operation with and assistance from other interested departments of Government. For example, the Director of Fire Services has agreed to take action under the Fire Services Ordinance in cases where food businesses fail to
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