"Hong Kong Model" of Medical Reform: Doctors Take Standard Salary to Avoid "Grey" Means


Release time:

2017-08-25

On the north side of Argyle Street in Kowloon, Hong Kong in early August, the Hong Kong Hospital Authority building was hidden in a bush of green trees. In the hustle and bustle of the downtown, there is a bit of silence. What is the current model of Hong Kong's health care system? What efforts have been made to rationalize the doctor-patient relationship?

A few days ago, the reporter rushed to Hong Kong to visit the Hong Kong Hospital Authority, the legal management body of Hong Kong public hospitals, in an attempt to get a glimpse of Hong Kong's mode of operation and understand the relevant system support.

Tube-to-Office Separation

Headache brain fever no longer go to squeeze big hospital

Hong Kong's current health care system has two health care systems. One is a highly government-subsidized public health care system. One is the private medical system. The Hong Kong Hospital Authority is the statutory body of public hospitals and clinics in Hong Kong. It formally took over all public hospitals in Hong Kong on December 1, 1991. Unlike the mainland, most of them are funded by the government, which is separate from the government and responsible to the government.

Liu Shaohuai, chief administrative manager of the Hong Kong Hospital Authority, told reporters that more than 40 public hospitals and hundreds of outpatient institutions under the Hospital Authority are divided into seven hospital networks according to their areas. The introduction of hospital networking ensures that patients receive quality and continuous treatment in the same area, regardless of any needs they may have in the course of their illness. The course of illness includes onset, recuperation, rehabilitation and community care after discharge. To achieve this, each of the networked hospital operations will work together to enable the networked hospitals to work together to provide comprehensive and complementary services to their communities. In addition, there is a management structure between the networks to coordinate intra-and inter-network affairs and to monitor the performance of services.

Under such a pattern, there will naturally be high and low points. But overall, the level of medical care is more average. No matter which hospital the public go to, they are full of confidence in the level of the hospital.

In Hong Kong, patients used to prefer famous hospitals. Later, these hospitals included hospitals in the surrounding and distant places in their management, and the level of hospitals was also equal. "The establishment of the Hospital Authority, unified management, unified procurement, to create a hospital of the same level, doctors can flow between hospitals." This also means that people no longer have to find a famous doctor and squeeze into a big hospital.

Doctors get paid.

Enjoy standard pay like a civil servant

In addition to the separation of management and management, the Hong Kong SAR government has always invested heavily in the medical field, so that hospitals do not have to rely on charging patients to make up for expenses, and patients can enjoy low-cost and high-quality services.

"Hong Kong doctors are paid relatively well." An industry insider said that when doctors have a sunny and decent salary, they don't need to use "gray" methods, as long as they work hard in the hospital, they can also get high salaries.

In addition, and the mainland establishment management is not the same. Liu Shaohuai told reporters that all employees use the employment system and are managed by the Hospital Authority. Medical staff no longer have the titles of subtropical high and senior high. Instead, they follow the Hong Kong system and are divided into resident doctors, deputy consultants and consultants. With the change of identity, the supporting salary reform is also carried out. According to a person from the Hospital Authority, unlike hospitals that implement establishment management, salaries are no longer fixed by level, but by post, and the salary standard for each post is independently set. "This design is based on the strength and contribution of doctors, and can encourage doctors to work hard to improve their medical skills and treat patients well."

In addition, in order to evaluate the salary level of doctors, the Hong Kong government has also established a medical information system through which medical management can see the diagnosis and treatment behavior of any doctor and evaluate the level of doctors accordingly.

In the drug price link, Liu Shaohuai also introduced that in order to ensure that hospitals can purchase relatively low-priced drugs, Hong Kong implements a strict open drug procurement system, and doctors will not participate in the entire process. In addition, all links are subject to strict supervision from all aspects. Once there is favoritism, they will be severely punished.

Can it be copied?

To build on the government's high investment

Is the Hong Kong model operable in the Mainland? In fact, as early as 2012, this model was piloted in Shenzhen. In July of that year, the Hong Kong University Shenzhen Hospital opened for business. The Shenzhen Hospital of HKU was built by the Shenzhen Municipal Government with an investment of 3.5 billion yuan, and its operating expenses were also subsidized by the Shenzhen Government. It is also the first public hospital to cooperate with Shenzhen and Hong Kong. The hospital has basically adopted the Hong Kong model in the operators, limiting excessive medical treatment and being praised by patients. As a sample of medical reform, the current situation and future of HKU Shenzhen Hospital in Shenzhen are full of expectations. At the same time, speculation about whether HKU Shenzhen Hospital can be replicated by other public hospitals in China is also rampant.

A medical person in Sichuan told reporters that in addition to the task of medical treatment, public hospitals are also responsible for teaching and scientific research, public health, medical treatment of emergencies, and treatment of unowned patients. Moreover, government funding accounts for a very small proportion of the revenue of public hospitals. Therefore, from this point of view, the reform of public hospitals must start with the mechanism and system, and relevant measures can be matched, such as the financial allocation mechanism, the performance incentive mechanism for public hospitals to engage in public welfare services, and so on. "Of course, the first is to build on the basis of high government investment." The person in charge said.