Waiting List for Specialist Care in Hong Kong’s Public System Over 100 Weeks

The waiting time to see a specialist doctor in Hong Kong’s public healthcare system is now over 100 weeks in some specialist outpatient clinics, according to report published by the South China Morning Post.

CCW Global previously noted the excessive waiting period’s present within Hong Kong’s government run healthcare services in our July 2013 article Is Health Insurance Right For You? where we illustrated the current expected waiting periods for a range of publically funded specialist services. In that article we listed Plastic Surgery as the speciality medical service which had the longest waiting time (108 weeks), with FM Triage and Psychosomatic Clinics having the shortest average waiting time (1 week each).

However, according to the report published by the SCMP, the total waiting list for all specialist clinics in Hong Kong now averages over 100 weeks – leading to increased delays for patients and further burden on the city’s publically funded healthcare system.

Part of the problem in the availability of specialist doctors in Hong Kong can be seen in the increased demand for the services; bookings at specialist outpatient clinics have risen 3 per cent per year over the last 3 years. Hong Kong’s Specialist outpatient clinics had to deal with more than 800,000 bookings during 2012 and 2013, equalling an estimated 680,000 new patients, on top of more than 6,000,000 follow up cases each year.

The spike in patient demand for specialist services since 2011 has been attributed, primarily, to Hong Kong’s aging population and the increased prevalence of lifestyle-related chronic medical conditions, including illnesses such as heart disease and diabetes. Furthermore, the Hong Kong Hospital Authority has cited a tendency amongst local residents to seek specialist care when primary healthcare services would have been adequate to treat the medical complaint.

An example of the preference for the government’s outpatient Specialist clinics over primary healthcare providers, including general practitioners, was given in the case of the 10 per cent of specialist patients seeking orthopaedic treatment for back pain. Many of these individuals would have been adequately treated by a primary care physician, but instead opted to receive their care via specialist services increasing the burden on these facilities.

Additional issues within Hong Kong’s specialist care market were deemed to be man-power and space oriented; the Hospital Authority, and consequently the public healthcare system as a whole, is experiencing significant problems in terms of staffing as turnover in a number of speciality areas, while specialist clinics not experiencing high turnover levels are finding it difficult to expand their facilities to provide capacity for the increased patient demand.

Whilst some specialist clusters have introduced a cross clinic referral system, enabling patients to transfer to alternative clinics with shorter waiting periods, the length of time it takes to see certain specialist doctors is still high. For example, a number of ENT, Gynaecologist and Ophthalmologist clinics have reduced their waiting times from over 100 weeks to an average of 20 weeks. In the case of Ear Nose and Throat Specialist Clinics, this is a significant improvement given that the average waiting time to see an ENT specialist last year was around 96 weeks. Further, Gynaecology specialists have managed to cut waiting times almost in half, from 41 to 20 weeks, enabling patients to receive slightly faster treatment.

However, despite the improvements being seen by the referral system currently being used for a small number of specialities, there still exists a relatively major needs gap where individuals who require specialist treatment have to wait for an extortionate period of time before being able to receive the treatment and care they require.

Over the near term future the Hospital Authority is putting an incentive scheme into place for staff at Specialist Outpatient Clinics, intended to enable extra care sessions aimed at a slight reduction of the overall waiting period. This incentive scheme is rewarding doctors who have sacrificed their rest periods to try and clear the city-wide patient backlog as well as enticing retired and private-sector doctors to help keep the low-cost government provided services operational.

Over the long term future it is quite clear that a drastic overhaul of Hong Kong’s public healthcare system is required – from hospital overcrowding through to outpatient specialist care, there are a number of major concerns which the government is attempting to address via the HPS reform proposals.

Patients can try to utilize the available specialist treatment capacity in the city’s private medical facilities; however the costs of treatment for private medicine in Hong Kong are the second highest, on average, in the world – putting private healthcare services beyond the reach of many of Hong Kong’s residents. While a scheme has been proposed which would subsidize the purchase of private health insurance in the city through tax breaks, no reform has yet been pushed through on this front.

Only time will tell whether the Government and Hospital Authority are able to adequately address the increasing waiting periods for specialist care in Hong Kong – unfortunately, until a solution is found a majority of local patients simply have to put up with the ungainly system as it currently exists.