Hong Kong Needs to Reallocate its Medical Resources Due to the huge amount of subsidy, people in the lower

and middle class frequently use the low-fee public medical service. Thus the service is very important to maintain public health. In my opinion, it is the time for the government to evaluate on the current medical resource distribution mechanism. Through data analysis, it can be concluded that the current distribution is uneven and unfair. It directly affects the workload and pressure of doctors, altering the quality of public medical service which may eventually threaten the health of the general public. It is fundamental to understand the medical system before the discussion. To have a better and efcient management, all the public hospitals in Hong Kong were classied based on different regions, 7 hospital clusters were partitioned. The Hong Kong Hospital Authority distributes resources to the 7 hospital clusters for whole year operation and development of public hospitals. In the old past, the medical resource distribution mechanism designes was opaque. In 2004, the government introduced a new distribution mechanism which is called Pay for performance. It would be launched during the nancial year 2009-2010. The government claimed that the medical resource will be allocated according to the actual needs of the hospital clusters and it is designed to encourage and reinforce the delivery of evidence-based practices and health care system transformation that promote better outcomes as efciently as possible (Dr. Koon Hung LEE, 2011). Current distribution is uneven and unfair According to statistics, the medical resource distribution in respect to each hospital cluster during 2008-2009, the nancial year which the Pay for Performance had not yet been implied, was unequal. In terms of money, the number of hospital beds and doctors, the resource distribution of resources in various hospital clusters had failed to reach the average level. Take the New Territories West as an example. During the nancial year, New Territory West held budgets of 38.9 billion dollar. It is 300 million dollar less than Kwoloon Central, which has 4.18 billion dollar instead. The total number of hospital beds per 1,000 people in New Territory West was counted as 1.8, which is the lowest comparing with all regions. Whereas for Kwoloon Central, there were 6.2 sickbeds available for each 1000 people in the region, which is nearly 3 times richer than New Territory West. In terms of the number of doctors, the number of doctors to 1000 people in Kwoloon Central is 1.28, which is more than twice of New Territories West, where there was be only 0.6 doctors facing 1000 people in the region. All of these show that the resource distribution before the transparent mechanism is unreasonable and unfair. However, in nancial year 2009-2010, when the Pay for Performance system was just started, the amount of network resources has not changed signicantly. Comparing with the same area, Budget received in New Territories West is 39.8 billion dollar, which is $300 million less than Kowloon Central (42.8 billion dollar). New Territories West has 1.9 hospital beds per 1,000 people, while 6.2 in Kowloon Central, which is still 3 times more than New Territories West. There are also 0.62 doctor available for 1000 people in New Territories, which is halve of that in Kowloon Central, which has 1.31. it is clear that the Pay for Performance has low effectiveness in treating the problem of uneven distribution of medical resource, the problem is still existing which forms a chain reaction and eventually affects the public health. There are excess workload and stress of doctors

According to the data analysis, there are uneven distribution on medical resources. Some hospital clusters will receive less budget, doctors and sickbeds. According to a survey organized by the Frontline Doctor Union, which asked 711 doctors working in different public hospitals. The average working hours of the doctors are 65.6 hours per week, there are even 16% of the doctor claimed that they need to work more than 80 hours per week. It shows that doctors working in public hospital need to face an unreasonable high amount of workload everyday. 79.6% and 75.5% of the doctors claim that such a high working pressure alter their clinical judgement and shorten the time of medical consultation for each patients respectively. 39.4% of them even admitted that there were medical incidents caused by the huge workload. All of these are directly related to the quality of medical service provided to the general public, as there are increased medical incident, the public health is hindered. It should be also noticed that 86% of the doctors mentioned that if the situation of excess workload has not yet been improved in the future, they would consider resignation. The number of doctor may even decrease and the doctor left in the hospital will bear even higher workload, creating a vicious cycle. Patients health are threatened As mentioned that such a high workload and working pressure caused by the uneven medical distribution will affect the quality of medical service, there are a lot of evidence and incidents that prove the fact. Tuen Mun hospital, one of the public hospital located and classied as New Territories West hospital cluster, has faced a lot of medical incidents caused by carelessness of doctors. There were 4 malpractice medical incidents within four months consecutively, doctors didnt see the blood leakage in a patients head and did the wrong treatment, which eventually brought him to death. A newborn even had to have his leg being amputated after an intravenous needle penetrated the artery and break down the blood circulation of his leg. The above two incidents have happened just because of carelessness. They can be avoid easily. Although it is important for doctors to take care of every patient, The heavy workload has also bear a great responsibility in altering the accuracy of the medical judgement which lead to medical incidents. Throughout the deep analysis, it is sure that the current medical resource distribution is uneven which forms a chain reaction leading to the high working pressure of doctors, eventually threaten the health of the general public. Government should denitely evaluate on the current distribution mechanism and reallocate the resource in a fairer way! Reference Dr. Koon Hung LEE (2011), Pay for Performance in Hospital Authority, Retrieved from: http://www.ha.org.hk/haconvention/hac2011/proceedings/pdf/Symposiums/S7.3.pdf Frontline Doctor Union(2011), Survey about the working hour of the doctors working in public hospital. Legislative Council (2008-2009), Replies to initial written questions raised by Finance Committee Members in examining the Estimates of Expenditure 2009-10, Retrieved from: http://www.legco.gov.hk/yr08-09/english/fc/fc/w_q/fhb-h-e.pdf Legislative Council (2009-2010), Replies to initial written questions raised by Finance Committee Members in examining the Estimates of Expenditure 2010-11, Retrieved from: http://www.fhb.gov.hk/download/legco/replies/100324_sfc/e-fhb-h.pdf