Published on: 9 January 2014 by Michael Lamb
According to articles released in both the South China Morning Post* and The Standard newspapers this morning, there may be some major issues at Hong Kong’s public hospitals. From rampant overcrowding, to higher than expected death rates, Hong Kong’s renowned government-run healthcare service may not be exactly as advertised.
Hong Kong has long boasted one of the most sophisticated public/private healthcare systems in the world with an extensive range of private medical options supported by comprehensive public healthcare services. With hospitals like the Queen Mary, Queen Elizabeth, and Prince of Wales able to provide high-quality low-cost healthcare treatment to Hong Kong residents, locals have never been overly concerned about issues like medical insurance or private medical treatment – the public system has always been able to provide adequate healthcare services.
However, in recent years there have been myriad growing problems within Hong Kong’s public healthcare offerings which include overcrowding, elongated waiting periods for treatment, and extreme bureaucratic red-tape. These historical issues have been exacerbated by an aging population and increasing demand for medical services from Mainland nationals, which have resulted in increasing strain on Hong Kong’s overall public medical services.
The Hong Kong Hospital Authority has, in recent years, suggested a raft of measures which were aimed at improving the overall effectiveness of the city’s healthcare system. However, according to the Authority’s latest annual report the overall picture of Hong Kong’s public healthcare system is less than perfect.
In the report the Authority noted that the number of deaths at leading Hong Kong public hospitals was “unsettling.” Tuen Mun Hospital, Prince of Wales Hospital, and Queen Elizabeth Hospital – all historically high quality institutions –recorded high death rates following emergency operations in the report; and in the case of Tuen Mun Hospital it was the 5th year in a row for which the institution had been found guilty of unusually high patient mortality in emergency situations.
Dr Kenneth Fu Kam-fung, head of the Public Doctor's Association, identified Tuen Mun Hospital’s high death rate as being caused by overcrowding in surgical wards and a lack of intensive care beds. Dr. Fu then stated that the situation at both the Prince of Wales and Queen Elizabeth hospitals were due to similar problems.
One of the core issues facing public hospitals in Hong Kong is the problem of overcrowding. Tuen Mun Hospital’s surgical ward occupancy rate was over 100% and averaged 106%. This meant that more than one individual was using a bed in the hospital’s surgical ward each day – a level of patient demand which is obviously outpacing the hospital’s ability to properly provide adequate treatment as evidenced by the high rate of deaths for both emergency and elective surgeries at the institution. The occupation levels being experienced at Tuen Mun hospital have directly lead to this facility using more temporary beds than any other public hospital in Hong Kong, and the report indicated that there was a strong correlation between death rates and public hospitals which had high surgical bed occupancy.
Hospital Authority Programme Director, Dr Yuen Wai-cheung, said of the situation “Tuen Mun Hospital has rated poorly for five consecutive years. This is unsettling to us… What went wrong with Prince of Wales Hospital this year? The difference in its emergency and elective performances is very strange. No other hospital has had this difference and such polarisation is seen for the first time.”
The report identified a potential reason for the higher than expected patient mortality rates following emergency services at the Prince of Wales hospital as being due to lowered levels of after-surgery intensive care.
The Prince of Wales hospital saw the lowest number of patients being sent to after-surgery intensive care following emergency operations. The hospital only sent 19% of emergency surgical patients to intensive care facilities, in direct contrast to the 54% of emergency surgical patients receiving intensive care services at the Queen Mary Hospital – one of the top facilities for emergency surgical treatments in Hong Kong.
As such, there may be a growing demand for post-surgical support by both patients and the hospital authority following the publication of the report. Although, this would mean more duties for staff at public medical institutions around the city; which could cause additional problems for already-overburden facilities. Dr. Fu stated that it was his belief that while overcrowding was the cause of the higher death rates at a facility like Tuen Mun hospital, a lack of experienced doctors and proper supervision of more junior healthcare staff may also be major factors.
However, it is not all bad news with a number of Hospitals performing better than expected for both elective and emergency surgical mortality rates. Queen Mary Hospital, Yan Chai Hospital, and Pamela Youde Nethersole Eastern Hospital were the top 3 facilities for emergency surgical treatments with the death rates much lower than expected. For elective surgery, Prince of Wales Hospital, Ruttonjee Hospital, and Tung Wah hospital were the top 3 institutions for their mortality rates following treatment.
Whilst the public healthcare system in Hong Kong is evidently beginning to show the strain of its age and capacity, the private facilities in the city are constantly revamping and revising their care offerings. With institutions like the Adventist Hospital, Hong Kong Sanatorium, and Matilda Hospital, there are alternatives to the city’s public system; albeit options which come at a price.
However, the high-cost of receiving treatment at a private Hong Kong hospital can be offset through a comprehensive Hong Kong Health Insurance plan, whilst the security of knowing you are being treated at a medical facility with a low death rate can mean that you are able to recover following your operation knowing that you are in safe hands.
For more information about the private health insurance options available in Hong Kong please click Hong Kong Health Insurance.