Information Note

LegCo Panel on Health Services
Review of the Healthcare System


At Members' request we presented a paper outlining a tentative timetable for the review of the healthcare system (the review) at the June Panel meeting. As stated in paragraph 3 of the paper, the timetable represented no more than the Health and Welfare Branch (HWB)'s preliminary thoughts on this subject at that time, and would be revised constantly.

2. Since the issue was last discussed at this Panel, we have been pressing on with the review. As we expected, the inter-dependence of the issues involved has rendered it impossible to follow a pre-determined sequence, given that each of the issues cannot be considered in isolation but should be examined as part of an entire healthcare system. This means that consideration of a specific issue often depends on the outcome of another decision, and/or has to proceed concurrently with other issues, and/or requires re-visiting with the development of new ideas.

Country Analysis

3. As part of the review, we are researching into the healthcare systems of a number of overseas countries. We have already looked at several countries, namely, New Zealand, the United Kingdom, Singapore and Korea. From this we can see there are a number of options on "funding" such as national insurance and national savings; on "providing" such as a national health system, a one-sector (public) system and a dual-sector (public and private) system; and on "purchasing", such as the model of purchaser-provider-split. We will conclude with research into countries with insurance/savings - based healthcare funding systems.

Interface in the Healthcare System

4. One of the first issues we are tackling in our review is the problem of "interface" in our healthcare system. To this end, HWB has set up an organising committee with representatives from the Department of Health (DH), Hospital Authority (HA), Social Welfare Department (SWD), as well as the health, welfare, elderly services and rehabilitation divisions of this Branch. The committee is tasked to establish an effective channel of communication for providers of primary, secondary/tertiary care in both the public and private sectors.

5. As a preliminary plan, at stage one there will be a workshop where all players (including DH, HA, SWD, public and private hospitals, private medical practitioners, and non-government welfare organisations) can share problems of common concern. At stage two, measures to promote a better interface in the delivery of healthcare will be drawn up with inputs from all relevant parties.

Task Force and Working Group on the Review

6. We are also setting up a special task force within HWB and are in the process of creating additional posts to carry out the review. The task force undertakes research both locally and on overseas systems, liaises with other Government and non-Government organisations, and conducts qualitative and quantitative analysis with a view to developing viable options for the review. The Working Group on the Review of the Healthcare System, set up in May 1996 with core members from HWB, DH and HA, has been meeting regularly to discuss proposals for the review. Two of the issues being examined are outlined below for Members' information:

(a) whether public healthcare should be provided to all cheaply/freely (irrespective of financial need), or only to the financially needy (who cannot afford private treatment) -- UK and Australia adopt the former ideology and offer comprehensive public healthcare services for all their citizens within the framework of a high-tax welfare-state regime. US and Singapore follow the latter and only take care of the financially-needy, the elderly and disabled;

(b) personal responsibility -- In Singapore, for example, the Government strongly advocates healthcare as a personal responsibility. Individuals are required to co-pay part of their public medical treatment and to save regularly for their own medical expenses. In this way, individuals are encouraged to take good care of their health to minimise the amount of medical care, and also not to over-use public medical facilities.

Health and Welfare Branch
January 1997

Last Updated on 19 August 1998