Annual flu crisis puts spotlight on overstretched medical services

It is very welcome that Chief Executive Carrie Lam Cheng Yuet-ngor is indicating that a hallmark of her administration will be a willingness to spend public money on socially important objectives. The first announcements were about education but, given the current flu crisis, it seems likely that our medical services will also be able to hand in their shopping list. This is all to the good but I would like to respectfully make a few suggestions and also draw attention to two old English proverbs which may seem contradictory but each have their uses at different times. The first is "Penny wise but pound foolish" - a warning against penny pinching that undermines vital, if expensive, investment. The second is "Hasten slowly" or "More haste less speed", warning that it may be better to take time for consideration in order to make wise decisions.

So below I offer a humble yes, no or maybe to some of the ideas floated as possible solutions to our medical woes.

More vaccinations - yes, yes and yes again! Our flu vaccination program seems so timorous! Reading the Legislative Council papers suggests there is little disagreement about the value of this strategy but there is caution over its implementation, with limited subsidies only for particularly vulnerable groups. Why not make vaccination available free of charge to anyone and as easily accessible as the blood donor vans that are now parked on street corners and visiting people in their workplaces?

More doctors and nurses - maybe. These are clearly needed but they must surely be the right type. It may be that medical staff who have become administrators would not be suited to pounding the wards again. On the other hand, it would be great to adopt more flexible work practices so those with family commitments could continue on a part-time basis to ensure they will be retained long-term in the profession.

It is often argued that Hong Kong should open up to overseas qualified doctors but this will only be effective if they are in tune with local patients, and in particular if they are proficient in Cantonese to native standards. English is considered the universal language but this means that, to an extent, the United Kingdom National Health Service is staffed by people whose accents are hard to understand. Of course, the real solution is to provide plenty of new home-grown medics, not just to meet present shortfalls but, as Professor Gabriel Leung has suggested, to allow for enhanced services.

Buying places in private hospitals - doubtful. We used to do this with schools in "the bad old days" as a stopgap and it spawns complex bureaucracy and a two-tier system.

More family physicians - think carefully. This is often touted as a solution to our crowded accident and emergency services but it requires far-sighted planning. People are not stupid and among the reasons they misuse A&E is the ready access to sophisticated technology not available in the general practitioner's office. The model used by family physicians descends from a time when knowledge was limited as were the tools available to understand what was going on inside the human body. The inventions and discoveries of the past 80 years or so have radically changed the situation. In this case, Hong Kong's comparatively undeveloped state gives it the advantage of being able to come up with innovative solutions more in keeping with the modern age.

Education, education, education - yes, yes and yes. Last but far from least, the general public needs to have a detailed understanding of what will keep them healthy and away from hospitals and their risks of cross-infection! And they need to be facilitated in putting those healthy habits into practice in our daily lives. It all needs to start from schooldays onwards, not only in lessons but also in extra-curricular activities organized by groups like the Red Cross. We hear a lot about dieting and food fads but where are the recipes that time-pressured families can use every day in preference to buying junk foods? Exercise is important for health but is the government providing sufficient sports facilities and urban open spaces? Air quality is an area of concern and that should include indoors too, as most of Hong Kong's workforce spend their days in the company of many others in multi-story buildings with the same dirty air circulating over and over again. The government publicity machinery needs to be revved up to ensure our citizens, young and old, are periodically reminded of these elementary health truths.

These are a few ideas and others might come up with better ones. What is certain, however, is that debate does need to be stirred up and the best brains brought to bear to cure the sickness of our medical services.

(HK Edition 07/28/2017 page10)