Joint Press Statement of Estate Doctors Association, Hong Kong Dental Association and Estate Dentists Group

Estate Doctors Association (EDA), Hong Kong Dental Association (HKDA) and Estate Dentists Group (EDG) express grave disappointment at the Hong Kong Housing Authority's insistence on using the Open Tender method as a means of letting out public housing estate clinics, closing her ears to the voices of the people and seriously ignoring the quality of health care for the public housing estate residents.

We emphasize here that health care is an essential element in supporting the entire livelihood, welfare, stability and prosperity of the community. It is extremely dangerous and does not do anybody any good if the HKSAR crudely and violently categories health care services as a purely commercial commodity.

In a Press Statement of 22.11.1999 we have issued the following two points:

  1. After a survey on citizens・ opinion towards estate doctors in November 1999, the Social Sciences Research Centre of the University of Hong Kong pointed out that the majority of public housing estate residents are satisfied with their estate doctors and are unanimously against the open tender method in leasing out estate clinics.
  2. In July 1999, a named referendum by EDA of 1,524 doctor members (including 467 doctors in public service and 1,057 private practitioners) revealed that over 91% are against using an open tender method for letting public estate clinics.

In order to obtain a fairer and more comprehensive opinion from our professions and citizens, our professions undertook the following actions:

In early December 1999, 42 doctors and dentists issued an open letter to the over ten thousand registered doctors and dentists in Hong Kong to obtain a comprehensive named survey to collect the professions・ opinion towards the method of letting estate clinics. The results was:

There were 1,405 replies (Please see Appendix A). Among the respondents were a significant number of University professors, superintendents of public and private hospitals, consultants of public and private hospitals; over 85% are not estate doctors. The conclusion was that over 91% were against the open tender method as a means of letting estate clinics, a figure similar to that of EDA・s survey.

The problems that our colleagues are concerned most are the following:

  1. Since Open Tender means going to the highest bidder, clinics' operational costs are most likely to rise and in spite of how efficient the tenant doctor/dentist is, he will be forced to raise patient charges in order to make ends meet. If one talks about fairness and equal opportunity, then consider the less well to do or young graduates without the means to compete with the more well off and well established doctors or doctors backed up by Health Maintenance Organizations (HMOs);
  2. Open Tender System poses an extremely high possibility of estate clinics being monopolised by large financially capable bodies such as HMOs or rich individuals or conglomerates. If monopoly does occur, medical charges can be easily manipulated and the quality of health care can be jeopardised through restriction of treatment methods and investigations by HMOs which was proven in the USA and here. Even if tender can be intentionally controlled by limiting to only individual doctors/dentists, there is NO guarantee that those doctors/dentists entering the Open Tender exercise will not be controlled by rich conglomerates or HMOs.
  3. As a result of not willing to bind the successful tenderer to be the actual tenant and therefore change of hands be allowed under the table there will be:

They believe that opening up more clinics in public housing estates is not a solution to the above problems.

Again, we have received the signatures from 7,153 Hong Kong Citizens (including estate residents) expressing strong objection to the decision of the Commercial Properties Committee of the Hong Kong Housing Authority (HKHA) of using open tender method to allocate estate clinics.

We feel that HKHA should not ignore such strong voices and demand from within and without the medical and dental professions. She should bear in mind her policy of service to the community and once more pick up the courage to discuss with us all and stop pursuing impractical and unrealistic solutions!

With the latest information as mentioned above, after thorough study and debate and based on our:

  1. belief that health care is not a pure commercial commodity.
  2. belief to maintain continuous health care for the population.
  3. belief to maintain strong doctor-patient relationship.
  4. determination to fight against profiteering commercially owned health service merchants and organisations such as HMOs, the expansion of which adversely affects quality of health care in Hong Kong.

EDA and HKDA resolutely and forcefully demand the HKHA, for the good of Hong Kong as a whole, to adhere to the opinions of the people and without making HKHA losing one cent, to withdraw and rescind her decision of using open tender method for letting estate clinics.

We ask for a Genuine, Open and Fair Balloting System allowing local doctors and dentists to participate in allocation of estate clinics! We have to reiterate once more that such balloting system should be open to all registered medical and dental practitioners in Hong Kong with no requirement on affiliation to any organization.

Regarding the future arrangements of medical and dental clinics in the public housing estates, we have the following suggestions to HKHA:

  1. Clinics in public housing estates should be allocated to individual doctors and dentists. The successful doctor/dentist must be the person running the clinic.
  2. Subletting or reassignment by the tenant should not be allowed.
  3. HKHA should take reference to our By-laws on Clinic Practice that have been used for many years to establish an effective control mechanism to monitor estate clinic practice and to supervise the running of future estate clinics so that the public estate residents can receive optimal health care.
  4. To establish an independent appeal mechanism for estate clinics・ rentals to handle all rental complaints.

We would like to clarify the following misconception of the public:

(1) Estate Clinic to Population Ratio

This ratio has all along been suggested and determined by HKHA alone. Our two Associations welcome the suggestion of HKHA to reduce the ratio. Afterall, every Hong Kong Citizen should enjoy the same quality of health care delivered.

(2) :Estate doctors are reluctant to receive continuing medical education;

Like other doctors in Hong Kong, estate doctors are not privileged as described by the Chinese term :殉鄭J堯. Estate doctors, like other doctors, have the same and similar qualification registered in the Medical Council of Hong Kong. And like non-estate doctors, estate doctors are also keen on improving their medical knowledge through continuing medical education.

(3) :Allocation of estate clinics are not supervised;

The allocation of estate clinics have all along been supervised by HKHA and even the ICAC.

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