For discussion EC(96-97)33
on 9 July 1996
ITEM FOR ESTABLISHMENT SUBCOMMITTEE
OF FINANCE COMMITTEE
HEAD 149 - GOVERNMENT SECRETARIAT: HEALTH AND WELFARE BRANCH
Subhead 001 Salaries
Members are invited to recommend to Finance Committee the creation of the following permanent post in the Health and Welfare Branch of the Government Secretariat -
1 Administrative Officer Staff Grade C
(D2)($95,550 - $101,450)
The Secretary for Health and Welfare (SHW) needs an additional officer at the appropriate level in the Health and Welfare Branch (HWB) to cope with the increase in complexity and volume of work relating to the medical and health policy issues.
2. SHW proposes to create a permanent post of Administrative Officer Staff Grade C (AOSG'C')(D2) to formulate and review policies on healthcare reform, human organ donation and transplant, reproductive technology, smoking and health, food hygiene and other medico-ethical matters.
3. SHW is currently underpinned by two deputy secretaries, viz. the Deputy Secretary for Health and Welfare (1) and Deputy Secretary for Health and Welfare (2) in charge of the medical and health policies and the welfare and rehabilitation policies respectively. On the medical and health side, the deputy secretary supervises three AOSG'C's, designated as Principal Assistant Secretary (Health and Welfare) Medical 1 (PAS(HW)M1), PAS(HW)M2 and PAS(HW)M3.
4. At present, PAS(HW)M3 is on loan from the Civil Service Branch. He is responsible for the following policy issues -
- healthcare reform and related issues such as healthcare funding and financing, medical insurance, private hospitals, and fees & charges at public hospitals;
- reproductive technology, human organ donation, trading and transplant and medico-ethical issues like euthanasia and brain death;
- smoking and health; and
- other matters including food health and food hygiene, control of pesticides and the medical implications of toxic substances, the Academy of Medicine and review of existing laws in the context of adaptation and localisation.
5. Healthcare reform is a very complex and contentious issue. We need to uphold our policy commitment that we deprive no one of adequate medical treatment due to his financial difficulties. We must also ensure our healthcare system is one which the community as a whole can afford. The complex intricacies of the healthcare system in Hong Kong warrants a review with due regard to funding and financing arrangements, interface between the public and private sectors, the interests of the various parties at stake as well as the need for a continuum of primary, secondary and tertiary care. This requires considerable policy input to chart the way forward for the development of a system that is fair, equitable and transparent. PAS(HW)M3 is currently conducting a comprehensive review of the present system. This may necessitate the development of an entirely new philosophy and an overhaul of the whole system. We expect the process to be long, involving policy formulation, consultation with parties concerned, implementation, close monitoring, evaluation and necessary adjustments.
6. Human organ transplant, donation and trading, and reproductive technology are relatively new areas of medical concern. Their rapid development over the past decade or so has necessitated legislative control to regulate service providers and to safeguard the interests of service users and others concerned. The Legislative Council passed the Human Organ Transplant Ordinance in February 1995, and we established a Statutory Board in February 1996. We set up a Provisional Council in December 1995 to advise on the draft Reproductive Technology Bill and to formulate a Code of Practice. We will replace the Provisional Council with a statutory one upon enactment of the legislation. These subject areas as well as other medico-legal issues such as euthanasia, brain death and trading in human embryos involve policy considerations that cut across not only medical, but also legal, ethical, social and religious boundaries. All these require constant review and monitoring to keep the policy abreast of the latest development. Given that these issues are only at their developmental stage, there has been a heavy demand on PAS(HW)M3 to cope with the workload on those subjects which will increase substantially in the years to come.
7. Government's long-term policy commitment is to discourage smoking. Therefore, Government needs to constantly review statutory and other control measures on smoking and tobacco in the light of local development and overseas trend. During the process, PAS(HW)M3 needs to maintain regular liaison with the Hong Kong Council on Smoking and Health and hold frequent discussions with the tobacco institutes and the advertising and publishing industries. He has to weigh and balance the competing claims among non-smokers, smokers and commercial enterprises. At present, he is working on measures to tighten controls over tobacco advertising.
8. Having regard to the complexity and long-term policy implications of the work set out in paragraphs 5 - 7 above, SHW proposes to create a permanent post of AOSG'C', designated as PAS(HW)M3, to take charge of the duties. A job description of the proposed post is at Enclosure 1. The existing and proposed organisation chart of HWB is at Enclosure 2.
9. It would be impossible for PAS(HW)M1 and PAS(HW)M2 to absorb PAS(HW)M3's duties. PAS(HW)M1 is already heavily involved in policy matters on primary health care, student health service, traditional Chinese medicine, AIDS and registration of professionals, clinics and other medical institutions, whilst PAS(HW)M2 has a full schedule on the funding and performance of the Hospital Authority, supply and demand of public hospital beds, hospital development projects, and manpower planning of healthcare professionals.
10. The additional notional annual salary cost of this proposal at Mid-Point is -
No. of Post
New permanent post
The full annual average staff cost of the proposal, including salaries and staff on-costs, is $2,187,240.
11. In addition, this proposal will necessitate the creation of one additional post of Personal Secretary I at a notional annual mid-point salary cost of $239,880 and a full annual average staff cost of $387,252.
12. We have included sufficient provision in the 1996-97 Estimates to meet the cost of this proposal.
13. The grading and ranking of the proposed post are considered appropriate having regard to the complexity and scope of work.
14. The Standing Committee on Directorate Salaries and Conditions of Service has advised that the grading proposed for the post would be appropriate if the post were to be created.
Health and Welfare Branch
Enclosure 1 to EC(96-97)33
Responsible to Deputy Secretary for Health and Welfare (1) for the following main responsibilities -
- formulating, implementing and monitoring policies on healthcare reform, with special consideration on funding and financing arrangements ;
- monitoring the development of private hospitals and medical insurance;
- overseeing the policy on human organ donation, transplant and trading, including the introduction of legislative control, the operation of a statutory Human Organ Transplant Board; and constant review and monitoring to keep abreast of the latest developments;
- overseeing the policy on reproductive technology procedures, including the introduction of legislative controls, the operation of a provisional and later a statutory Council on Reproductive Technology and constant review and monitoring to keep abreast of the latest developments;
- overseeing the policy on other medico-legal issues including euthanasia, brain death and trading in human embryos and keeping in view the developments of these issues;
- overseeing the policy on smoking and health, and tobacco control including devising strategies and legislative measures to prohibit tobacco advertising and promotion, and promulgation of smoke-free workplaces and public enclosed places;
- overseeing food health and hygiene matters, control of pesticides and the medical implications of toxic substances, and the Hong Kong Academy of Medicine; and
- co-ordinating inter-divisional matters including the adaptation and localisation of laws exercise.
Enclosure 2 to EC(96-97)33
Warning : The chart is quite large and may take some time to download.
Last Updated on 3 December 1998