Primary care services in the Pearl River Delta

22 Feb

Press release

(22 February 2013) In a research study released today, the Bauhinia Foundation Research Centre called for closer working relations and cooperation between Hong Kong and the Mainland in the healthcare sector.

The study, commissioned by the Centre and conducted by the Jockey Club School of Public Health and Primary Care of the Chinese University of Hong Kong, aims to enable Hong Kong residents working, studying or retiring in the Pearl River Delta (PRD) to have a better understanding of the primary care services in the region , as well as to provide an overview of the current situation and prospects relating to Hong Kong doctors operating in the region.

Covering six major PRD cities, namely Shenzhen, Guangzhou, Zhuhai, Foshan, Dongguan and Zhongshan, the study involved literature reviews and in-depth interviews with Mainland health officials, medical professionals and patients. As part of the study, a forum, jointly organised with the Greater Pearl River Delta Business Council, was held today to exchange and collect views of some 150 participants from the academic, medical and government sectors.

The Bauhinia Chairman and Convenor of the study Dr Donald Li said, “The increasing socioeconomic integration between Hong Kong and the Mainland, especially in the PRD, has generated greater demand for medical information and healthcare services in the region. Moving forward, we see more room for cooperation between the two places, especially in the area of healthcare services where Hong Kong has a competitive edge.”

Providing a general picture of medical services in the region, the first part of the study introduces the classification of hospitals, doctor qualifications, medical insurance schemes, as well as charging policies of public hospitals in the Mainland.

Dr Li reminded Hong Kong residents working, studying or retiring in the PRD to pay special attention to the differences in system, culture, pricing scheme and consultation process between Hong Kong and the Mainland when seeking medical care in the region.

The clinical medical sectors of the Mainland mainly consist of hospitals and community health centres (CHCs). While it is Government’s target for CHCs to play a crucial role in primary care in the long term, hospitals are still dominant in the healthcare system. Mainland hospitals are classified into three levels and each level is further subdivided into three classes, with those of Class A, Level 3 being the top, providing specialised medical services.

The most commonly used services by Hong Kong people are Chinese medicine, dental care, medical examinations, cosmetic medicine, and accident and emergency services. Hong Kong people working in the six cities are allowed to join local medical insurance schemes. Though the insurance schemes and regulations of different cities vary, usually 50% to 95% of hospitalisation expenditure and 20% to 100% of out-patient expenditure could be reimbursed for the regulated items, the study found.

As of 30 June 2012, nine private clinics have been set up by Hong Kong service providers in the six cities under CEPA. To foster healthcare cooperation between the two places, the Centre has put forth nine policy recommendations under four main directions.

Dr Li said, “The liberalisation measures on medical services under CEPA have made available a favourable policy environment for Hong Kong service providers to set up medical institutions in the Mainland. However, there are still obstacles in practice and our recommendations attempt to further facilitate their entry into the market, which will eventually help the Mainland carry out its healthcare system reforms more thoroughly and effectively.”

The Centre’s recommendations are summarised below:

Attracting high-end healthcare services

To attract Hong Kong service providers to offer quality healthcare services in the Mainland, the Centre recommends the Mainland Government to offer tax concessions and relax restrictions on the import of high-end medical equipment and medicine, and to develop a simpler set of standards for setting up out-patient clinics as compared to those for setting up hospitals.

To shorten the approval process and facilitate Hong Kong medical practitioners to set up businesses under CEPA, the Centre recommends the establishment of one-stop offices in various cities to coordinate the approval procedures and requirements of the different departments involved in processing applications.

Facilitating development of general practice clinics

The Centre also points out the need to promote the development of ancillary medical services, such as laboratories, in the region in order to reduce the investment and operating costs of individual general practice clinics. Providing personal tax concessions would also encourage Hong Kong healthcare professionals to practise in the Mainland.

Addressing demand for cross-boundary patient transfer services

The arrangement for cross-boundary patient transfer has been an issue of ongoing concern. To address the demand for cross-boundary ambulance services, the Centre recommends the Mainland and Hong Kong Governments to consider issuing cross-boundary ambulance licences to allow qualified service providers to operate commercial cross-boundary patient transfer services.

To meet the demand of those patients who wish to return to private hospitals in Hong Kong for continued treatment, the Centre suggests Hong Kong Government to consider issuing additional private ambulance licences. This would also help alleviate the burden on public healthcare services.

Allowing portability of healthcare benefits

The Centre also recommends the Hong Kong Government to consider allowing portability of healthcare benefits. Holders of elderly healthcare vouchers issued by Hong Kong Government should be allowed to access healthcare services offered by designated healthcare institutions in the Mainland, such as clinics operated by Hong Kong providers; and the proposed voluntary Health Protection Scheme should be extended to cover treatments in the Mainland.