Title

An evaluation on 2007 obstetric service policy in Hong Kong : a solution to the service-seeking behaviour of Mainland pregnant women? Shiu, Wan-yee, Ruby; •µ—ûQ

Author(s)

Citation

Issue Date

2007

URL

http://hdl.handle.net/10722/52547

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unrestricted

An Evaluation on 2007 Obstetric Service Policy in Hong Kong – a Solution to the Service-seeking Behaviour of Mainland Pregnant Women?

By SHIU Wan-yee, Ruby June 2007

Degree of Master of Public Administration The Department of Politics and Public Administration Faculty of Social Science University of Hong Kong

i

I, Shiu Wan Yee, attest that this thesis, ‘An Evaluation on 2007 Obstetric Service Policy in Hong Kong – a Solution to the Service-seeking Behaviour of Mainland Pregnant Women?’, submitted for fulfillment of the Master of Public Administration is fully my own work unless otherwise quoted and cited.

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Table of Content Content Page Chapter One Introduction Introduction Undesirable Phenomena Diagnosis to the Phenomena Economic Environment Legal Ambiguity Failure of Charging Policy Government Action Framework of Study Research Questions Methodology Dissertation Plan 1 2 5 5 6 7 9 11 12 12 13 Chapter Two Hong Kong’s Immigration Policy on Mainlanders Introduction 14 Immigration Policy on Mainlander in Colonial Era 14 Entry to Hong Kong for Settlement 17 Entry to Hong Kong for Visit 18 Immigration Policy on Mainlanders after 1997 20 Contradiction between Basic Law and Immigration 25 Ordinance Immigration Ordinance 25 Basic Law 26 CHONG Fung-yung v. the Director of Immigration 28 Chapter Three Diagnosis of the Problem from an Economic Approach Introduction Common Pool Resources Problem of Collective Actions Externalities 31 31 32 34 iii .

Public Obstetric Service in Hong Kong Cost of Giving Birth in Hong Kong I) Short-term costs II) Long-term costs Benefits of Giving Birth in Hong Kong I) Fleeting from one-child policy penalty II) Advanced medical care III) Hong Kong Residency Externalities Policy Before September 2005 Policy After September 2005

38 40 41 41 43 45 45 45 46 48 48

Chapter Four

New Policy in February 2007 Introduction The New Policy Increase in Charge Defaulted Payment Prevention Mechanism Centralized Registration System Tightened Immigration Control

51 51 52 53 54 55

Chapter Five

Evaluation of the New Policy Introduction What is Evaluation Classification of Policy Regulatory Instrument Economic Instrument Information Evaluation of 2007 Policy Policy Instrument Choice of Instrument Design of Policy Conclusion

56 58 60 60 61 62 63 63 64 68 69

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Chapter Six

The Way Forward Introduction 71 Long-term Implication 71 Social Disintegration 72 Restructuring of Obstetric Service Policy 73 Reorienting Policy Target 73 Extending Quota Coverage 74 Increasing Charge for Couples who are both 74 non-Hong Kong residents Supportive Measures 75 I) Immigration control 75 II) Defaulted Payment Prevention System 78 Civil Education 78 Vision in Education, Housing, Medical Service and other 79 Welfare Policies Education 79 Social Welfare Assistance 81 Conclusion 82

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CHAPTER ONE INTRODUCTION Introduction In the past five years, the number of Mainland women coming to Hong Kong for obstetric services has risen from 7810 cases in 2001 to 20,577 cases in the first ten months of 20061. The percentage to the number of local pregnant women rose from Before 2001, majority of Mainland women came to

16% in 2001 to 39% in 2006.

Hong Kong for obstetric services were wives of Hong Kong males. While in recent years, there was an upsurge in the number of Mainland women, whose husbands were also Mainlanders, came to Hong Kong for giving birth. Among the 20,577 Mainland

women giving birth in Hong Kong, 61% of them were married to non-Hong Kong residents. Detailed figure on the number of birth by Mainland mothers in Hong Kong appear in Annex A.

With only eight public hospitals providing obstetric services in Hong Kong, handling around 42,000 deliveries per year 2 , the large influx of Mainland women poses significant pressures on the scarce health care resources in Hong Kong. Some public

Discussion Paper on ‘Impact of the use of Obstetric Services by Mainland Women on Public Hospital Resources’ by Legislative Council Panel on Health Services. (8 January 2007), LC Paper No. CB (2) 761/06-07(03). 2 ‘Hospital booking rule for Mainland mothers’, Global News Wire - Asia Africa Intelligence Wire, 2007-01-17. 1

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Some did not receive the same amount of prenatal checks as they used to have. 3 4 ‘醫管局擬五招防病人走數’. Apple daily.4 It was because they knew that those gave birth by surgery (elective caesarean section) were allowed to stay for maximum three nights while those had their babies naturally born (spontaneous vaginal delivery) could only stay one night in the hospital. some pregnant women deliberately chose to deliver their babies by surgery instead of natural labour just to secure a stay in the hospital. The privacy of these mothers-to-be was not respected. There were reports that that more than one woman gave birth in one delivery room at the same time. Some were even left in the corridor.3 Undesirable Phenomena There were intermittent reports on the plight of local pregnant women. Apple Daily (2006-12-07) 2 . Worse still. Extra beds made of canvas were placed inside public wards to cater for the excessive numbers of expectant mothers who were waiting for giving birth. (2006-12-8) “港婦:被迫開刀分娩 確保有牀位”.hospitals have already announced that no further registration for obstetric services would be accepted in the first half year of 2007 due to the excessive workload they encountered due to the influx of Mainland women.

Hong Kong public medical care is funded mainly by the HKSAR government. Before the imposition of the HK$20.2 billion in 2006 which was around 13% of the overall government expenditure. Approximately HK$300 million revenue of Hospital Authority in 2006.Local pregnant women showed concern about deteriorating standards of care and were resentful of outsiders coming in. 90% was government subvention. prior to this. the charge was standardized across all public hospitals at a highly subsidized rate at HK$100 per day for Hong Kong residents and HK$3. the charge for obstetric services was calculated based solely on the number of days of hospitalization. 2006. A group of 30 angry Hong Kong mothers marched to Central Government Office to air their resentment in order to push the Government into taking action on November 19.000 obstetric package in September 2005. HKSAR Government. and getting services they had not wholly paid for. Sources : Census and Statistics Department.300 5 Public money spent on medical service amounting to $32. jumping queues. 3 . Hong Kong taxpayers generally have the feeling that money they spent went to subsidize Mainland women instead of provide quality medical service to Hong Kong people5 as the obstetric services were provided to everyone at a highly subsidized rate regardless of the service seekers’ nationality. which was believed to be the major factor that triggered the implementation of new measures in February 2007.

000. and the babies because illness. (2006-12-07) & ‘內地婦港產嬰 5 年升 16 倍’. Singtao Daily. especially when the pregnant woman has Viral Hepatitis Type B or Acquired Immune Deficiency Syndrome. defects and other possible problems could not be detected before delivery. 4 .7 What made the situation even worse was that many of these Mainland pregnant women did not receive any antenatal examination before they came to Hong Kong for giving birth.pdf) Discussion Paper on ‘Impact of the use of Obstetric Services by Mainland Women on Public Hospital Resources’ by Legislative Council Panel on Health Services. (http://www.000 to $14.legco. 8 In 2006.6 The influx of Mainland women seeking obstetric What is services imposed significant financial burden to our health care system.gov. 2004. some of these Mainland women did not settle the bill before they left the hospitals. (8 January 2007).hk/yr04-05/english/counmtg/hansard/cm1110ti-translate-e.000 Mainland women gave birth in Prince of Wales Hospital. the bad debts of Hospital Authority amounted to $2. more. there were almost 20. Together with the inefficient default payment collecting mechanism. hospital staff. Source : ‘內地婦來港產子要做產前檢查’. this also brought risk to the hospital staffs and other pregnant women staying in the same hospital. CB (2) 761/06-07(03). as the service seekers’ medical history and the health condition of their babies are all unknown to the hospitals. (2006-12-07). Besides. More than 70% of them did not receive antenatal examination.per day for non-Hong Kong residents while the average cost of delivery for a pregnant woman was $12. 6 7 Legislative Council Meeting on November 10. LC Paper No. Mingpao.800 million in 2005/06.8 It posed considerable risks to both the mothers-to-be. other patients.

political stability attracted immigrants from Mainland China.27 million in 1997 to 4. It is the result of political. its economic development. To revive the economy.9 When Hong Kong economy rebounded in 2003. After 1997. and social changes after the handover of sovereignty in 1997. tourism.Diagnosis to the Phenomena Economic environment Mainland women giving birth in Hong Kong is a complex issue and cannot be easily explained by one single reason. Hong Kong experienced an economic downturn due to Asian Financial Crisis. 5 . the Severe Acute Respiratory Syndrome (SARS) outbreak seriously hit Hong Kong retail. when Hong Kong was still a British colony. The number of Mainland visitors increased from 2. and catering industries. Before 1997. The purpose was to control the number of influx of Mainland China to avoid unbearable pressure on the resources of Hong Kong.86 million in 2001. Hong Kong government agreed to increase the Two-way Permit quota three folds to encourage Mainland visitors traveling Hong Kong. job opportunities. The restrictions on Mainland visitors were further relaxed by the 9 Immigration Department Annual Reports 96-97. Hong Kong government enacted Immigration Ordinance and imposed strict control over Mainland migrants and visitors. economic. 03-04.

The relaxation of immigration control has paved way for the large influx of Mainland pregnant women coming to Hong Kong for the purpose of giving birth. Ambiguity over the definition of Hong Kong residency was cleared on 20 July 2001 when the Court of Final Appeal ruled in the Chong Fung-yuen case that Chinese citizens born in Hong Kong have the right of abode in Hong Kong regardless of the status of their parents. the definition of Hong Kong citizens under Immigration Ordinance was challenged as it was found to be contradictory with Article 24(2)(1) of the Basic Law which provides that Chinese citizens born in Hong Kong Special Administrative Region have the right of abode in Hong Kong. Legal Ambiguity Before 1997. Hong Kong residents were defined as Chinese citizen born in Hong Kong if one of his/her parents had settled or had the right of abode in Hong Kong at the time of his/her birth or at any later time. With the introduction of Basic Law in 1997.introduction of Individual Visit Scheme in 2003 that allowed Mainlanders to visit Hong Kong in their own capacity (i.e.. when the people moving in and out from Hong Kong were governed by Immigration Ordinance Chapter 115 (Cap. 115). 6 . without being part of a tour group) for a maximum of seven days.

7 . South China Morning Post. healthcare. will have free education. the number of babies born to Mainland women is large enough to have implication on Hong Kong’s planning and policy on population. Many Mainland parents have expressed that they will have their children in care of relatives in Hong Kong and to be educated in Hong Kong. The same fee 10 ‘Authority cashes in on pregnancy policy’. Requests from any person. regardless of their citizenship and financial condition. welfare. and education. housing benefit and social welfare.The decision of Court of Final Appeal gave all babies born to Mainland women in Hong Kong. as Hong Kong citizens.10 Some said that these newborn babies would be a solution to our ageing problem while some argued that they might be the heaviest financial burden to Hong Kong society. residency in Hong Kong. Health care services in Hong Kong are distributive in nature. Although either hypothesis is anticipation. (2007-02-02). which is also the main reason for Mainland women coming to Hong Kong for giving birth. would be contemplated. They know that their babies. Failure of Charging Policy Another reason for the large influx of Mainland mothers-to-be was the low charge for obstetric services in Hong Kong. Fees and charges for different medical services are standardized across all public hospitals at a highly subsidized rate.

nothing to lose.300 for one-day hospitalization in a public general ward. It stipulates that each couple is only entitled to have one child.000 as penalty. The low charge level attracted Mainland women since they could enjoy enormous benefits including better medical care and Hong Kong residency for their children born in Hong Kong. Every extra child will cost the couple around RMB80. Mainland parents could avoid the penalty for having more than one child under One-child policy. Despite the low medical charge. further encouraged such free-riding behaviour. seeking payment is made before they left. obstetric service for Mainland women only costed HK$3. obstetric services in Hong Kong have everything to gain. many Mainland women did not settle the bill before leaving the hospitals. by giving birth in Hong Kong. This policy was adopted by Mainland China since late-1970s as a measure to control its population. This charge has already included The charge was so low that it could not even cover the cost of delivery. What is more. In addition. Since children born in Hong Kong 8 . there is no policy or system in place to ensure full The ineffective default payment mechanism For Mainland women. Before September 2005. the baby delivery service.structures applied to Hong Kong and non-Hong Kong residents alike.

The whole package charges each service seeker HK$20.are Hong Kong citizens and will not have Mainland Hukou. their parents would not be fined. the Hospital Authority introduced a new charging system as a rational basis for the allocation of resource in September 2005. Private consultation fees were also revised from fixed standard charges to pre-sent ranges to reflect variations in the complexity of the patients’ clinical conditions and in the expertise that might be required for treatment. 9 . causing market disequilibrium. As services were provided based on medical need regardless of the patients’ or service seekers’ citizenship. bring the market to optimum. Government Actions The ever-increasing number of Mainland mothers giving birth in Hong Kong made the government realize the problem. citizenship. Each non-Hong Kong pregnant woman giving birth in Hong Kong will be provided with a minimum obstetric package. requests from local and Mainland pregnant women were handled in the same manner. It is recognized that the obstetric service charge To for non-Hong Kong residents was set too low. which included delivery and three days 2 nights of hospitalization in a public general ward.000.

pdf 12 ‘4 日男嬰 離奇猝死’.aud. the Bureau came up with some measures to tackle with the problem. The minimum obstetric service package required all non-Hong Kong residents to pay a deposit of $19.gov. and Mainland China Authorities on the issue.800 upon admission at a public hospital. the defaulted payment arisen from obstetric services by Mainland women amounted to HK$1. and Food Bureau Dr. York Chow. There were intermittent reports that babies died due to inadequate postnatal care as the babies’ mothers left hospitals for avoiding payment. (2006-12-27). Aims of the measures are to ensure that local pregnant women would be provided with proper and 11 In 2004/2005 financial year. However. Wenweipo. the Mainland mothers left with their babies prematurely to evade payment. After delivery. Audit Commission. Secretary for Security Mr. they avoided paying deposit by seeking service from accident and emergency (A&E) ward when they approached to deliver. Source : ‘Hospital Authority : management of outstanding medical fees’.hk/pdf_e/e47ch05.The alarming figure of bad debt11 also pushed the authority to introduce measures to avoid defaulted payment. Ambrose Lee. HKSAR Government. After several meetings among the Secretary for Health. These acts pose significant risks to both the mothers and babies.12 Noise from the public and the pressure groups formed up by pregnant women had pushed the government in facing the problem in a more active way. http://www.200 million. Welfare. 10 . as many Mainland pregnant women know that they would not be denied medical service due to lack of means.

Va. COWen. Cambridge University Press. Governing the Commons.. Advanced in Policy Studies since 1950. The Theory of Market Failure : A critical Examination. www.priority obstetric services through restricting the number of non-local pregnant women giving birth in Hong Kong to a level that can be supported by Hong Kong’s healthcare system. problem of ‘free-riders’. they only see the cost imposed on them and neglect the cost imposed on the society as a whole. Cambridge : NewYork.info. Press Release. The problem of externalities resulted in market inequilibrium and inefficiency. : George Mason University Press and DUNN.M. R. 2007. The following are the major presumptions in the framework14 – i) Public obstetric service is common-pool resources that are non-excludable and subtractive. Fairfax. (eds). KELLY.. 11 .13 Framework of Study This paper will employ market theories to explain the problem of insufficient public obstetric service in Hong Kong.. (eds). E. T. iii) The problem of externalities can be solved by internalizing the social cost to individual through Pigouvian tax so that the consumer can see 13 ‘New measures on obstetric services and immigration control’ on January 16. 14 The presumptions are the summary of reference drawn from OSTROM. ii) Its nature inevitably results in the As human beings are rational and self-interested. (1990)..hk. New Brunswick and London : Transaction Publishers (1992).gov. W.

magazines. I will ask the following questions: What makes the public obstetric services become so scarce? Why could the policy adopted in 2005 not solve the problem? Can the new policy implemented in 2007 solve the problem of Finally. Research Questions In this dissertation. Extensive research on academic Additionally. and websites. 12 . ‘externalities’ and ‘Pigouvian tax’ to illustrate the problem of insufficient public obstetric service in Hong Kong in recent years.the real cost of their consumption. can the policy mark an end to Hong insufficient public obstetric services? Kong people’s anxiety over Mainland women’s utilization of obstetric services? Methodology This paper employs the theoretical frameworks of ‘common pool resource’. iv) One of the greatest challenges to Pigouvian tax is that the government is not able to have perfect information to set the optimal tax level. useful information will be collected from newspaper. journals and reports and meeting records of Legislative Council. literature will be conducted on these theories.

The last chapter will round up the whole dissertation by proposing suggestions on the way forward. the evolution of Hong Kong’s immigration policy on Mainlanders before and after 1997 will be discussed. Chapter 3 will explain the Mainland women’s service-seeking behaviour from This chapter will apply the Pigouvian theorem in economic point of view. Dissertation Plan The whole dissertation comprises six chapters. In Chapter 2. five by applying Policy Instrument theory. 13 . this chapter will analyze the policy effectiveness and legitimacy by referring to the choice of policy tools and the design of policy. The discrepancies between Immigration Ordinance and Basic Law after 1997 will be emphasized to illustrate the reason for the influx of Mainland pregnant women after 2001.Interviews will be conducted with representatives of interest groups. Chapter 4 is the detailed description of the new policy implemented in February 2007. representatives of enforcement agencies and professionals such as doctors and nurses to seek their views on the feasibility and effectiveness of the new policy. This policy will be evaluated in Chapter Instead of evaluating the policy outcome. answering the failure of 2005 policy.

CHAPTER TWO HONG KONG’S IMMIGRATION POLICY ON MAINLANDERS Introduction Hong Kong has long been an immigration city.16 From 1842 when Hong Kong became a British colony. to now. Pp. (eds) Immigration Law in Hong Kong : An Interdisciplinary Study. Since the British occupation of the territory in 1842. Some treasure political stability while some cherish rapid economic development. 1. Hong Kong’s immigration policies for Mainlanders have aimed at controlling the number of migrants from Mainland China to avoid unbearable pressure on the resources of Hong Kong. 14 . 16 Ibid. Rwezaura. Immigration Policy on Mainlanders in Colonial Era Hong Kong had no immigration control measures on Mainlanders until 1938 when the 15 CHAN. B. J. Hong Kong : Sweet & Maxwell Asia (2004). Hong Kong has been a favorite sanctuary for those looking for a better life. Evolution of Hong Kong immigration policy on Mainlanders since 1842 is outlined in Annexure B.. more than half of Hong Kong population is immigrants from Mainland China. ‘The Evolution of Immigration Law and Policies : 1842-2003 and Beyond’ in CHAN J. At present.15 People from Mainland China come to Hong Kong for different reasons.

Source : CHAN.. the Hong Kong Government realized that the society could not cope with the influx of people from Mainland China in terms of physical.17 At the time. ‘The Evolution of Immigration Law and Policies : 1842-2003 and Beyond’ in CHAN J. J. The United Nation and the United States 17 Growth of Population in Hong Kong 1841-2006. the immigration authority adopted an ‘open door’ policy. The Immigration Control Ordinance of 1949 was enacted which provided that any person not in possession of relevant travel documents. Notwithstanding the introduction of the Immigration Control Ordinance. B. visas or entry permit. Pp. Rwezaura. Details at Annexure C. 18 Natives of Guangdong Province were exempted from this Ordinance. 1. Instead of being repatriated to Mainland. One of the reasons was that Hong Kong economy suffered badly in the fifties after the outbreak of the Korean War in June 1950. social.population grew from 878.947 in 1931 to over 1.000.500. 15 . enter or remain in Hong Kong18. every illegal immigrant could obtain entry permit by reporting to the immigration authorities so that their stay could be regulated. Hong Kong : Sweet & Maxwell Asia (2004). and economic infrastructure. frontier passes or certificates of residence issued under the Ordinance were illegal immigrants and would not be permitted to land. (eds) Immigration Law in Hong Kong : An Interdisciplinary Study. with or without conditions. to allow an illegal immigrant to stay in Hong Kong. How an illegal immigrant was to be dealt with was decided by the prevailing executive policies and not by the law. Immigration officers could exercise their discretions in granting permits.

These refugees were the major force of economic growth at that time which explained why the government adopted such a lenient policy toward illegal immigrants from Mainland China in the fifties and sixties. (eds) Immigration Law in Hong Kong : An Interdisciplinary Study. J. 6-9.imposed embargoes on Mainland China and Hong Kong.19 Under this ‘open door’ policy. HKSAR Government. the figure was quite alarming. 21 Hong Kong Population Projection 1971-1991. in 1973 alone.. Census and Statistics Department.000 illegal immigrants arrived from the Mainland. entered the urban areas and subsequently gained a home with relatives or otherwise found proper 19 CHAN. illegal immigrants who were arrested in the border region or in Hong Kong territorial waters during their attempt to enter Hong Kong would be repatriated.700 in 197321. Trading of Hong Kong almost came to a standstill. However. about 60.000 Chinese persons entered Hong Kong illegally between 1962 and 1972 and were subsequently permitted to stay. Pp. B. ‘The Evolution of Immigration Law and Policies : 1842-2003 and Beyond’ in CHAN J. in 1974. but all others who evaded immediate capture. 56. 20 Ibid. Hong Kong : Sweet & Maxwell Asia (2004). intelligent.203. 20 When comparing with the total population of 4. Rwezaura. At the same time. It pushed the Hong Kong Government to impose a ‘reached-base’ policy Under this policy. political uncertainties pushed refugees from Mainland China who brought to Hong Kong capital and industrial expertise as well as a pool of skilled. and industrious labour. 16 .

the introduction of quota was opposed by the Mainland authority as ‘unreasonable and unfriendly act towards the PRC and its people’. B. J. However. 12-13. the number of Mainlander arrested on arrival and repatriated was 89. Hong Kong : Sweet & Maxwell Asia (2004). ‘The Evolution of Immigration Law and Policies : 1842-2003 and Beyond’ in CHAN J. 23 Illegal immigrants from Mainland who successfully evaded capture and remained in Hong Kong increased from 6. Some condemned that this policy positively encouraged illegal immigrants from Mainland and led to an influx of illegal immigrants who arrived and reached base.700 (1979).100 (1978) to 107.22 In 1979. 12.24 All illegal immigrants from Mainland China were to be Entry to Hong Kong for Settlement Since the abolishment of the ‘reach-base’ policy in 1980. Pp. the first year of the abolishment of ‘reach-based’ policy. OWP scheme is a quota system introduced in 1950 with maintaining a rough balance between the inflow and outflow of people as its major objective.900 while those evaded capture and remained in Hong Kong was 107. Ibid Pp.23 This ‘reached-base’ policy was thus abolished in 1980.700. Rwezaura. five years after the implementation of ‘reach-base’ policy.600 (1977) to 28.700 in 1979 to 69. the only legal way for people from Mainland China to come to Hong Kong for settlement was entry under One-way Permit (OWP) scheme. removed. It was also a sensitive political matter to have an agreement on the quota.accommodation would be given permission to stay in Hong Kong. as this might 22 CHAN. (eds) Immigration Law in Hong Kong : An Interdisciplinary Study. 17 . 24 The number of legal immigrants from Mainland China dropped from 107..500 in 1980.

of 310 per day in 1978. which is the issuing authority of OWP’s. The authority reduced the limit to 75 per day in 1983 while it increased to 105 in 1993 to facilitate the admission of a large number of long-separated spouses and children born to Hong Kong citizens. which was almost 250% of the figure in 1977.25 Entry to Hong Kong for Visit The restrictions over Mainland visitors were strict in colonial era. Pp. Mainlanders who wish to make private visit to Hong Kong had to apply for a Two-way permit (TWP) 25 CHAN. Hong Kong : Sweet & Maxwell Asia (2004). ‘The Evolution of Immigration Law and Policies : 1842-2003 and Beyond’ in CHAN J. J.495 legal immigrants from Mainland China Although the in one single year. the Mainland authority. 15-16. A compromise would be that the Director of Immigration always gave permission to land to whoever was issued an OWP. the quota was not strictly enforced. still changed the daily limit over time. Rwezaura. Indeed.. British and Chinese governments reached an agreement on the daily limit of the number of legal immigrant to 150 per day in 1980. the number of legal migrants who It reached a peak came to Hong Kong by way of an OWP varied from time to time. Since then the daily limit remained unchanged. In 1995. 18 . Therefore. the quota increased to 150 per day.constitute a tacit recognition on the part of the Chinese government that Hong Kong was not part of China. It resulted in 67. B. (eds) Immigration Law in Hong Kong : An Interdisciplinary Study.

visitors had to join tours organized by one of the three recognized and approved Mainland tour operators. or more. Shanbo (2002).27 Mainland people coming to Hong Kong for visits before 1997 were not as free as Hong Kong people going to Mainland China for visits were. there were only two types of endorsements.3 persons for the whole of Mainland China. For Group Visit. TWP scheme was Before 1997. Pp 6-9.from Mainland Public Security Bureau offices before entry. though this was still inadequate to cope with the demand.142 in 1998. They must arrive and There was also daily quota imposed on the Group visit endorsement. 27 SHAO. spouse. Endorsement would only be issued to those who had relatives residing in Hong Kong. 26 Before 1997. Each had strict ‘Tanqing’ (Relative visit) and ‘Tuandui Luyou’ (Group visit). the definition of ‘close relative’ confined to parents. 內地人士非移民簽證來港的政策檢討及建議. Relative Visit endorsement was issued for those who went to Hong Kong for managing properties or business or visiting close relatives who were Hong Kong permanent residents. certificate of marriage. 一國兩制研究中心. The applicant must produce proof of business and properties in Hong Kong or proof of close relatives26 living in Hong Kong. depart together as a group. spouse’s parents and siblings. requirements upon application. upon application. It was hard to believe that the average daily quota for Group visit was 8. The daily limit increased to 1. including copies of Hong Kong Identity Card. implemented in 1950. 19 .

The ‘One Country. 28 SHAO. all these Asian currencies depreciated with Traveling to other Asian countries became much respect to the Hong Kong dollar. reason was that the China Government did not want chaos at the time of handover and sought stability. a number of Asian currencies had depreciated substantially with respect to the US dollar. political stability faded away as the issue of concern as the economy became the major focus. either for settlement or for visit. remained steady at 7. Pp 20. 一國兩制研究中心.29 million in 1996 to 2.75. The 150 daily quotas for OWP still Number of Mainland visitors to The major applied and the issue of TWP was not released. Two Systems’ arrangement went off to an auspicious start. Hong Kong decreased from 2. after the changeover of sovereignty in July 1997. Quite unexpectedly. the outbreak of the Asian Until the financial crisis began with the depreciation of the Thai baht in July 1997.26 million in 1997. What many Hong Kong people and international observers feared about intervention by Chinese authorities did not happen. 內地人士非移民簽證來港的政策檢討及建議.Immigration Policy on Mainlanders after 1997 Immediately after the change of sovereign. it As a result. end of January 1998. Shanbo (2002). 20 . Since Hong Kong dollar was linked to the US dollar. there was no significant influx of Mainlanders.28 It was ironic that.

Pp. The Asian Financial Crisis and After Problems and Challenges for the Hong Kong Economy. Mainland China was less affected by the Financial Crisis. Liang.. Hong Kong government agreed to have the restrictions on the issue of TWP relaxed. Alan & WONG. China was less affected by the financial crisis. The requirements for Relative 29 LIU. 31 With all of its foreign investment took the form of factories on the ground instead of securities. Pak-wai (1998). RMB's non-convertibility protected its value from currency speculators. (2004) Pp. ‘The Impact of SARS on Greater China Economies’ in Wong. which insulated the country from rapid out flowing of assets and money and sharp drop in the exchange rate after the financial crisis. Singapore : World Scientific Publishing Company. China insulated itself from rapid capital flight. S.8% in 1997 and 7. China Government introduced ‘Shangwu’ (Business visit) endorsement.29 Domestic consumption shrank and the economy contracted. 21 . which allowed visitors on business trip.32 To revive the economy. 13. Hong Kong Institute of Asia-Pacific Studies. who previously were required to obtain a visa upon arrival at Hong Kong. J (eds). 18 30 SIU.30 When compared with Hong Kong. 62-83.31 The Chinese economy was hardly affected by the financial crisis as it continued to grow at 8. SARS Epidemic. Chan.cheaper than to Hong Kong after their currency depreciation. Unlike other Asian countries. Hong Kong’s unemployment rate hit record levels exceeding 7% by the end of 2002. In the first half of 1998. Economic Impact of SARS : The case of Hong Kong.8% in 1998. In 1998. pp. Asian Economic Papers 3:1 (Winter 2004). most of the China’s investment took the form of factories on the ground rather than securities. Richard.. the number of visitor arrivals declined sharply by 21% as compared to the first half of 1997. RMB’s non-convertibility protected its value from currency speculators. J. R. 32 Wong.

The number of tour operators in Mainland China.1% in the fourth quarter of 2002. pp. Richard.Visit endorsement were released in 2000.82 million in 2002. All tour operators were monitored by the China Tourism Association. also increased from 3 before 1997 to 63 in 2002. which undertook the application of Group visit endorsement. which allowed Mainlanders to visit their relatives who lived. HKSAR Government. A professor from Guangdong came to Hong Kong for a relative’s wedding.142 in 1997 to 1. 22 . The relaxation in TWP permit requirements greatly attracted tourists from Mainland China. He sought medical treatment in Hong Kong and was admitted Not soon after. The daily quota for Group visit endorsement increased from 1. 33 At present.500 in 2000. and studied in Hong Kong. 34 35 Tourism Development Board. Economic Impact of SARS : The case of Hong Kong. Asian Economic Papers 3:1 (Winter 2004). there are in total 99 tour operators in Mainland China that can apply Group Visit TWP.34 Revenue from tourism-related activities increased from 142 millions in 1998 to 287 million in 2002.4% in the third quarter of 2002 and at 5. 內地人士非移民簽證來港的政策檢討及建議. Alan & WONG. 36 Real GDP in Hong Kong grew at 3. 一國兩制研究中心. Sources : SIU. 2003. Hong Kong experienced another crisis –Severe Acute Respiratory Syndrome (SARS). Pp. 8. 62-83.67 million in 1998 to 6. 33 SHAO. Ibid. worked. He stayed in a hotel in Kowloon for one night in February. The number of Mainland visitors to Hong Kong increased from 2. his brother-in-law to Kwong Wah Hospital on February 13.35 When economy started to recover again 36 . Shanbo (2002).

23 . 38 Hong Kong Tourism Board Annual Report 2003-2004. Eleven healthcare staff of PWH working in Ward 8A left on sick leave on March 10. and those of May by almost 68%. 2003. with Hong Kong’s April arrivals dropping by almost 65% compared with 2002. HK Government http://www. total 1755 people were infected with SARS. who stayed in the same hotel with the professor.info. The SARS epidemic reached its peak on March 30.hk/english/reports/reports/reports_fullrpt. were admitted.htm. Department of Health.38 By the end of the epidemic. On February 22. Hong Kong people refrained from many consumption activities outside their 37 SARS Expert Committee Report : From Experience to Action. 1451 were discharged while 304 died of the disease. 2003. the Guangdong professor was certified death and was later confirmed to have died of SARS. Department of Health. 39 SARS.and 16 other people. 2003 when the government issued an order to isolate Block E of Amoy Garden after 213 residents of Amoy Garden were admitted to hospital for suspected and confirmed SARS with half of the cases were from block E. The number of medical staff who had infected with SARS through contact with this patient increased to 139.sars-expertcom. admitted to Ward 8A of Prince of Wales Hospital (PWH) and brought the index case for Hong Kong’s first outbreak in PWH. Another patient. On April 2. the World Health organization (WHO) issued an advisory against non-essential travel to Hong Kong and Guangdong Province. http://www. 2003.gov. who visited an acquaintance staying on the same floor of the hotel during the critical day in February.hk/info/sars/e_sars2003.39 Fearing the disease might spread to the community at large.37 Visitor numbers fell throughout the Asia-Pacific region. HKSAR Government.html.gov.

Individual visitors from the Mainland were permitted to remain in Hong Kong for a period of not more than 7 days upon each entry. it was opened only to residents of Dongguan.40 To bring the Hong Kong economy back to life. 40 Unemployment rate increased from 7. The number of visitors from Mainland China from 1997 to 2006 is shown in Annexure E. the Chinese Government further released the issue of TWP and implemented the Individual Visit Scheme. Hong Kong SAR Government. In the past three and a half years. and Foshan in Guangdong Province.234 million in 2003 to 91. Jiangmen. Zhongshan.5 million in 2003 to 12. the scheme extended progressively.homes. The drop in demand put further pressure on the price level and worsened the unemployment problem.5% in March 2003 to the highest point of 8. Source : Census and Statistics Department. Mainlanders might go to Hong Kong as individual visitors. The Individual Visit Scheme has brought a significant increase in the number of Mainland visitors to Hong Kong from 8. and now covers Guangdong province and 28 other cities (Refer to Map at Annexure D). HKSAR Government. 24 . When this scheme was introduced in July 2003.41 The Individual Visit Scheme was successful in reviving Hong Kong economy while it also paved way for Mainland pregnant women to come to Hong Kong for giving birth.2 million in 2004 which brought an increase in inbound tourism revenue from 70.849 million in 2004. 41 Tourism Board Highlights 2004.7% in July 2003.

a child born in Hong Kong acquired the status of a British Dependent Territories (Hong Kong) 42 43 The Basic Law of The Hong Kong Special Administrative Region of The People’s Republic of China. Two Systems". The British Nationality Act 1981 was an Act of Parliament passed by the British Parliament concerning British nationality.42 Immigration Ordinance The definition of ‘Hong Kong citizen’ was stipulated in Immigration Ordinance Cap.Contradiction between Basic Law and Immigration Ordinance The Sino-British Joint Declaration on the Question of Hong Kong (The Joint Declaration) was signed between the Chinese and British Governments on 19 December 1984. the implementation of the British Nationality Act 198143. Country. The Act reclassified Citizenship of the United Kingdom and Colonies into three categories relating to the right of abode in United Kingdom : British citizens who had the right of abode in the UK. The Basic Law of the Hong Kong Special Administrative Region (The Basic Law) was adopted on 4 April 1990 by the Seventh National People's Congress (NPC) of the PRC. The Joint Declaration provides that these basic policies shall be stipulated in a Basic Law of the HKSAR. Most of the Hong Kong people fell largely into the category of British Dependent Territories Citizens. 115. the socialist system and policies shall not be practiced in the Hong Kong Special Administrative Region (HKSAR) and Hong Kong's previous capitalist system and life-style shall remain unchanged for 50 years. It came into effect on 1 July 1997. Before 1997. The Joint Declaration sets out the basic policies of the People's Under the principle of "One Republic of China (PRC) regarding Hong Kong. British Dependent Territories Citizens who enjoyed a right of abode in the Dependent Territories and British Overseas Citizens who enjoy right of abode nowhere in the whole. 25 .

(c) not to have a deportation order made against him and (d) not to have a removal order made against him. While its meaning remained the same which required that for a Chinese citizen born in Hong Kong to be a permanent resident. Article 24 of Basic Law states that the following categories of people shall have the right of abode in Hong Kong and shall be qualified to obtain. and any condition of stay that is imposed shall have no effect. 26 44 . in accordance with the laws of the Region. and he is not subject to any limit of stay in Hong Kong. 115 was slightly amended upon the change of sovereign in 1997. 115. a Hong Kong permanent resident enjoys the right of abode in Hong Kong which are the right to (a) land in Hong Kong. 115. For the purpose of reunification. (b) not to have imposed upon him any condition of stay in Hong Kong. this qualifying requirement sated in paragraph 2(a) of Schedule 1 of Immigration Ordinance does not exist in Article 24 of Basic Law. Basic Law However. Schedule 1 of Immigration Ordinance Cap. This provision was stated clearly in Schedule 1 of Immigration Ordinance Cap.citizen if one of his or her parents had the same status or was settled in the city at the time of their birth. It was the common understanding of the Chinese and British experts under the Sino-British Joint Liaison Group that similar arrangement would apply after 1997 and no formal agreement was made before the reunification. 45 According to s. permanent identity cards which state their right of abode – The term ‘settled’ is defined by Para. one of his parents must have been settled44 or had the right of abode45 in Hong Kong at the time of his birth or at any later time. 1(5) of Schedule 1 of Immigration Ordinance Cap. 115 as ‘A person is settled in Hong Kong if he is ordinarily resident in Hong Kong. 2A of Immigration Ordinance Cap.

who. iii) Persons of Chinese nationality born outside Hong Kong of those residents listed in categories (1) and (2). 27 . ii) Chinese citizens who have ordinarily resided in Hong Kong for a continuous period of not less than seven years before or after the establishment of the Hong Kong Special Administrative Region.i) Chinese citizens born in Hong Kong before or after the establishment of the Hong Kong Special Administrative Region. and vi) Persons other than those residents listed in categories (1) to (5). before the establishment of the Hong Kong Special Administrative Region. had the right of abode in Hong Kong only. v) Persons under 21 years of age born in Hong Kong of those residents listed in category (4) before or after the establishment of the Hong Kong Special Administrative Region. iv) Persons not of Chinese nationality who have entered Hong Kong with valid travel documents. have ordinarily resided in Hong Kong for a continuous period of not less than seven years and have taken Hong Kong as their place of permanent residence before or after the establishment of the Hong Kong Special Administrative Region.

and did not accept that he 28 . CHONG Fung-yuen case was a classic case arguing the legal provision on the residency of Hong Kong born child to Mainland parents. They were not residents of Hong Kong. Shortly after the parents arrived in Hong Kong. The authority of Immigration Ordinance was seriously challenged. CHONG Fung-yuen v. Article 11 of Basic Law provides that no law enacted by the legislature of the Hong Kong Special Administrative Region shall contravene the Basic Law. The Director did not accept CHONG Fung-yuen as permanent resident of Hong Kong. They were arrested and repatriated while CHONG Fung-yuen stayed in Hong Kong with his grandfather who was a Hong Kong citizen. permanent or otherwise.More importantly. Chong’s grandfather lodged a claim about Chong's status with the Director of Immigration. CHONG Fung-yuen’s parents were Mainlanders who came to Hong Kong with two-way permits on a visit in early September 1997. the Director of Immigration The Contradictions between Basic Law and the qualifying requirements provided in the Immigration Ordinance brought a numbers of judicial reviews where decisions and authority of the Director of Immigration Department were challenged. That was in November 1997. the mother gave birth to CHONG Fung-yuen on 29 September 1997.

HACL 69/1999 29 .46 46 CHONG FUNG-YUEN v. The Court of First Instance ruled that the wordings in Article 24(2) (1) of the Basic Law are clear and self-explanatory enough to confer the status of permanent residents on Chinese citizens who have been born in Hong Kong. and contravene art.24(2)(1) of the Basic Law. Chong’s grandfather applied for a judicial review against the Director’s decision in 1999. They have therefore no effect to limit the right of abode of those Chinese citizens born within Hong Kong. The judged state that – the words in paragraph 2(a) of Schedule 1 to the Immigration (Amendment) Ordinance enacted on 1 July 1997 : ‘if his father and mother was settled or had the right of abode in Hong Kong at the time of the birth of the person or at any later time’ were in my judgment incompatible with.has the right of abode in Hong Kong by referring to the provision stated in Para 2(a) of Schedule 1 of Immigration Ordinance. the Director of Immigration.

there were totally 1991 Chinese citizens born in Hong Kong whose parents neither had the right of abode in Hong Kong nor Hong Kong residents. 2001. Once the floodgate was open. Hong Kong medical and health care and social welfare services became the big pull for Mainland mothers. South China Morning Post. a 13-fold increase. Director of Immigration lodged an appeal to the Court of Appeal and Court of Final Appeal and were both dismissed. Following the Court’s judgment. The lack of foresight of our judges brought about today’s plight. (2006-12-04) 30 . 1997 to January 31.Besides. 62 of 2000. the number of such births in Hong Kong has risen from 709 in 2000 to 9273 in 2005. the judges of the case had reviewed the numbers of children born in Hong Kong between July 1.) 48 ‘The Hordes at our gate’ by Regina Ip. whose parents neither had the right of abode nor lived in Hong Kong at the time of birth. 47 Between July 1. the Director of Immigration.47 Based on the survey of 43 months. 1997 and January 31. The decision of Court of Final Appeal has tremendous implication on Hong Kong population policy. they concluded that such judgment posed no ‘significant risk’ to the city and decided that anyone born in Hong Kong is Hong Kong resident regardless of his or her parents’ residency48. (CHONG Fung-yuen v. 2001. CACV No.

problems of collective action and problem of externalities can be used to explain the service-seeking behaviour of Mainland pregnant women. The content and effectiveness of government reactions in 2005 will be analyzed through Pigou’s theorem of government intervention as a solution to the problem of externality. For goods which is very difficult. if not impossible. does the good or service remain available for subsequent consumption or use by someone else. By referring to the public obstetric service as a common-pool resource. is it possible to restrict someone’s access to that good or service and the second. we basically ask two questions : firstly. Common Pool Resources When categorizing a good or service. the insufficient public obstetric service for local women will be diagnosed from an economic perspective. once access is gained and consumption or use occurs. we can 31 . to restrict someone’s access to the resources and becomes unavailable for subsequent consumption once it is open for access.CHAPTER THREE DIAGNOSIS OF THE PROBLEM FROM AN ECNONOMIC APPROACH Introduction In this chapter.

pp.. 50 Brickers. Governing the Commons : the evolution of institutions for collective action. 5 51 Ostrom. hardly at all of common interest. Cambridge: Cambridge University Press. K.N. In Garrett Hardin’s ‘Tragedy of the Commons’. pastures. The most typical examples of common-pool resources are forests. every herder can gain access to the same piece of land. Boston . These resources are so large Furthermore. resources are exhaustible. (1990).51 49 Ostrom. 32 . E. The individual is likely to neglect the impact of overgrazing as everyone thinks chiefly of his own. E. Pp 2. people do things to advance their own goals and objectives50. he used behaviour of As human beings are rational and If rational herders to illustrate the phenomena. Problem of Collective Actions Standard analysis in modern resource economics concludes that when common-pool resources are open to people for consumption. they tend to add more and more animals as they receive the direct benefit of their own animals and bear only a share of the costs resulting from overgrazing. Pp 30. these that it is impossible or too costly to restrict someone’s access. Governing the Commons : The evolution of institutions for collective action. (2001). Public policy analysis : a political economy approach. (1990). self-interested.categorize it as common-pool resource. Cambridge: Cambridge University Press. the problem of collective action is common. and fishery grounds49. New York : Houghton Mifflin. there will be one day when the resources be used up if open for consumption without proper management or control.

Another scholar Robert Axelrod suggested that the ‘Tragedy of Commons’ could be avoided by repeated interactions and cooperation among individuals. The rationale

behind this is that individual will cooperate if they believe that gains from cooperation over time outweigh the loss in short-term benefits of not doing so. However, due to

individuals’ inability to trust one another, they fail to cooperate and end up competing with each other. This theory is called prisoner’s dilemma, which is a common

representation of the failure of self-interested individuals to cooperate due to lack of trust.

Mancur Olson in The Logic of Collective Action also suggested those human beings are rational and self-interested. Unless the number of individuals is small, or unless

there is coercion or some other special device to make individuals act towards their common interest, rational, self-interested individuals will not act to achieve their common or group interest.52 best interest. Instead, they will behave in a way that brings them the

52

Ostrom, E, ‘Policy Analysis of collective Action and Self-Governance’ in Dunn W.N. & Kelly, R.M (eds) Advances in Policy Studies Since 1950, New Brunswick (USA) and London (UK) : Transaction Publics (1992), Pp 89-90. 33

The above three theories are closely related. At the heart of each of these models is the free rider problem. Whenever one person cannot be excluded from the benefits

that others provide, each person is motivated not to contribute to the joint effort and to obtain benefit without paying. Since individuals are rational and self-interested, they tend to allow others to pay for the goods so that they may ‘free ride’. participants choose to free ride, the collective benefit is not produced. If all

On the other

hand, some may provide while others free ride, leading to a less than optimal level of provision of collective benefit. The temptation to free ride, however, may dominate

the decision process and thus all end up where no one wanted to be. These models are extremely useful for explaining how perfectly rational individuals can produced, under some circumstances, outcomes that are not ‘rational’ when viewed form the perspective of all of those involved.53

Externalities The irrational outcome usually appears in the form of inefficiency due to negative externalities. Figure 154 shows the effects of a negative externality. The marginal

benefit curve showing the maximum value that one is willing to pay for successive

53

Ostrom, E, ‘Policy Analysis of collective Action and Self-Governance’ in Dunn W.N. & Kelly, R.M (eds) Advances in Policy Studies Since 1950, New Brunswick (USA) and London (UK) : Transaction Publics (1992), Pp 90. 54 Dahlman. C.J., ‘The Problem of Externality’ in Cowen T. (eds) The Theory of Market Failure, Virginia : George Mason University Press (1988). Pp 209-234. 34

units of goods while the marginal social cost curve representing the maximum values that one is willing to forgo for the production of successive unit of goods. In a

perfectly competitive market, the efficient equilibrium is at the point of intersection of the supply and demand curves, where marginal social cost equals to marginal social benefit. The latter reflects the idea that the marginal social benefits should equal the marginal social cost, that is the production or consumption should be increased only when the marginal social benefit exceeds the marginal social cost.

However, there are situations where individual decisions are not based upon full account of true costs and true benefits. If the consumers or producers only take into

account their own private cost, they will end up at price Pp and quantity QP, instead of the more efficient price Ps and Qs. The result is that a free market is inefficient since

at the quantity Qp, the social benefit is less than the social cost, so society as a whole would be better off if the goods between Qp and Qs had not been produced or consumed. The problem is that people are buying and consuming excessively. The most typical example of externality is the problem of pollution. Producers only see

their private costs of production such as input of materials, labour cost, rent of factory, while fail to appreciate the real cost or the social cost to others such as pollutions arisen from their production and the impact of others’ health. As the producers

35

55 55 Ostrom. Pp. E. they tend to produce more than market optimum and induce loss to the society as a whole. Modern resource economics analysis also concludes that where number of users have access to a common-pool resource.N. 86 36 . New Brunswick (USA) and London (UK) : Transaction Publics (1992). ‘Policy Analysis of collective Action and Self-Governance’ in Dunn W. & Kelly.neglect these externalities.M (eds) Advances in Policy Studies Since 1950. total resource units withdrawn from the resource will be greater than the optimal economic level of withdrawal. R.

(Figure 2 refers56) 56 Dahlman. the real cost is internalized to the producers or consumers so as to resume the market optimum. Pp 209-234. Virginia : George Mason University Press (1988). (eds) The Theory of Market Failure. He stated that it is desirable to make the producers or consumers take By imposing charges or tax for every unit of responsibility for the externalities. which was suggested by Pigou in Economics of Welfare in 1921. 37 . C. ‘The Problem of Externality’ in Cowen T.One of the most frequently cited solutions to externality is government intervention by way of user charges or tax.J.. goods or services consumed or produced.

it is in reality impossible to restrict one’s access to medical care. all externalities would be eliminated.J. He criticized that government is not capable of gathering perfect information to set an optimal level of charge or tax to bring marginal private cost equal to marginal social cost. ‘The Problem of Externality’ in Cowen T. it is the Hospital Authority’s principle not to deny medical care due to 57 Dahlman. (eds) The Theory of Market Failure. In Hong Kong. which makes medical service a private good.Pigouvian theorem ‘The Pigouvian Tax’ was criticized by Ronald Coase to be inefficient in solving public problem. Virginia : George Mason University Press (1988). medical services that are provided by public hospitals can be categorized as common-pool resources that are non-excludable and subtractive..57 Public Obstetric Service in Hong Kong In Hong Kong. Pp 209-234. 38 . He further suggested that when there are no costs of transacting. C. the transaction costs for formulating regulation. However. imposition of tax and monitoring are too high. Additionally. Some may argue that user charge excludes those who cannot afford the payment from accessing the medical services. as costless transaction opportunities will allow suitable modification of translations behaviour so that all undesirable side effects are properly internalized. Non-excludable means that it is impossible to prevent relevant people from using the resources and subtractive means that consumption by a person will impose cost on others.

as human lives are paramount. 59 In 2005/2006 financial year. Hong Kong public medical services are funded mainly by the government59 through revenue from taxes and sale of land. bed. Obstetric service before September 2005 calculated on the number of day of hospitalization. The ethical concern makes public medical service non-excludable in nature. The government A pregnant woman about to give birth was turned away from three hospitals and a clinic in Kunming because she only had 900 yuan. medical services will be provided to any person in Hong Kong who is in need regardless of their ability to pay. thereby imposing costs on other patients. 39 . medical attention from doctors and nurse. 60 In 2005/2006 financial year. who now received less attention from nurse and doctors and less space in the same ward. Unlike Mainland China58. South China Morning Post. who do not manage to reserve a place in public hospital or who want to have better medical care. are forced to pay more and give birth in private hospitals when the limit in public hospitals is reached.60 Patients seeking medical service only have to pay at a rate. 58 Non-Hong Kong residents paid HK$3. ‘Hospitals slam door on pregnant woman’. among the HK$300 million revenue of Hospital Authority. ward. which is highly subsidized by government. 90% i. HK$263 million was from government subvention.e. Additionally Mainland mother are patients requiring addition drugs. Hong Kong residents only had to pay HK$100 per day for admission to public hospital for giving birth. Pregnant women. over 70% of the total government revenue was from tax.lack of means. 2007-04-03.300 per day. Public medical resource is common-pool resource because it is also subtractive.

000 to HK$14. Cost of giving birth in Hong Kong When deciding whether to give birth in Hong Kong or in Mainland.61 Alternative to public medical service is private medical service provided by seven private hospitals in Hong Kong. 2004. a more comfortable stay.pdf) 40 .legco. They focus on their private costs and benefits while neglecting the costs for the Hong Kong society by consumption of medical care. Mainland women evaluate the costs and benefits based on their knowledge.subsidized 97% and 75% respectively as the cost of delivery for each pregnant woman is estimated to be HK$12.000 (Service Those who can afford the higher charges of seven private hospitals at Annexure F). The charge for obstetric services in private It ranges from HK$15.000. service charges will choose private hospitals that provide better medical treatment. As utility maximizers.hk/yr04-05/english/counmtg/hansard/cm1110ti-translate-e.gov. Mainland mothers choose the option that benefits them most.000 to over HK$100. and better postnatal care. hospitals is much higher. in private or in public hospital. 61 Legislative Council Meeting on November 10. (http://www.

Source : Website of Division of Exit and Entry Administration Department of Public Security of Guangdong Province. The transportation cost is rather limited.htm 41 . Many of these Mainland mothers-to-be come to Hong Kong with two-way permit under Individual Visit Scheme.300 before September 2005. Hukou system was implemented by Mainland China government in 1955 as a measure to guard big cities 62 63 ‘特首:需要新醫院 便建新醫院 與公安部研究孕婦來港產子問題’. Mainland pregnant women come from Guongdong province.62 They come to Hong Kong mainly by train. The cost of lodging ranges from hundreds to thousands. (2006-12-29) Application fee fro a two-way permit cost RMB120 for a single entry while cost RMB140 for double entries. II) Long-term costs Giving birth in Hong Kong is not without long-term cost. http://www. Mingpao. they have to pay lodging.I) Short-term costs Giving birth in Hong Kong involves short-term costs and long-term costs to Mainlanders.e. i. For those who have no relative in Hong Kong. Short-term costs include obstetric service charges. The most important one would be forgoing ‘hukou’.com/wlgat/gdgry/index. citizenship.63 However. in Mainland China. Majority of It depends on the type of accommodation chosen by the Mainlanders.gdcrj. which were only HK$3. The application fee for a TWP together with a single entry endorsement costs RMB120. travel during pregnancy involves risk to the mothers and babies that should also be counted as costs.

marry. or shelter. Hukou registration provides the principal basis for establishing identity. China’s urban population increased from 10.6 million. there are still differentiations. Within both urban and rural spheres. every Mainland China citizen is required to register to a Public Security Bureau. Without registration. obtain employment.against influx of rural population. 42 . eligibility for the above benefits in Mainland is not standardized across the country. go to school. or enlist in the army. their counterparts in countryside. clothing. Tiejun Cheng and Mark Selden. for example in the allocation of social services by job status. 65 Deborah Davis (1989) Chinese Social Welfare : Policies and Outcomes. with a net gain of 34. one cannot establish eligibility for food. The China Quarterly.64 Under Hukou system.6% in 1956. Unlike Hong Kong. (1994) The Origins and Social Consequences of China’s Hukou System. The China Quarterly.6% of the total population in 1949 to 14. citizenship. Children of state official and military officers attend elite schools with small classes while those of workers in urban area go to neighborhood schools and the parents pay 5% of their income for tuition plus a range of miscellaneous fees. and proof of official status.65 64 Rapid economic development in Mainland China brought significant rural-urban migration. The state reserves its resources disproportionately for those Benefits allocated to urban areas are privileged over classified as urban population.

Gabe T. pointed out that strict adherence to population control policies was the only way out of poverty.. In 1978. Vt. the Chinese leader at that time. Four modernization included modernization of agriculture. (1999). It was also the first time that family planning was confirmed legally and became one of the fundamental duties of all citizens. 43 . industry. the Health Ministry issued instruction to all government organizations to provide guidance to people on the concept of birth control. In 1954 when the first census survey in China revealed that China’s population was over 600 million and was growing by 2 percent yearly. Aldershot . Deng Xiaoping. With the implementation of economic reform in late 1970s. the Fifth National Peoples’ Congress ratified the new constitution. and to realize the four modernizations66. majority of these Mainland pregnant women regard hukou as a push instead of a pull of coming to Hong Kong for giving birth because they can flee from paying one-child policy penalty by having baby in Hong Kong. Thoughts and Policies. Brookfield. Central Government officials started doubting their traditional beliefs that having large family was a good thing. As a result. which explicitly stipulated that the state advocated family planning.Benefits of giving birth in Hong Kong I) Fleeing from One-child Policy Penalty However. 87-94. 67 WANG. Pp. : Ashgate. national defence and science and technology.67 66 ‘Four modernizations’ was fundamental part of Deng Xiaoping’s economic reform in China in late 1970s. China’s Populations : Problems.

There The penalty varies from city to city. and resolutely prevent the third child.68 Under the one-child policy. It explains why so many 68 WANG. a family in Guangdong who has their second child will be fined for around RMB80. Mainland and paying the penalty will not guarantee social services especially for those live in rural area and /or without state employment. Mainlanders can evade from making the penalty of RMB80. Generally speaking. Vt.which advocates that each couple has only one child. every Mainland couple is only entitled to have one child.300 to give birth in Hong Kong.. : Ashgate. to make people think clearly before having children and second. By paying just HK$3. China’s Populations : Problems. Mainlanders come to Hong Kong for giving birth. Gabe T.The population Control Policy in late-1970s included four parts. Pp. The Family Planning Office claims that the rationales behind is first. entitlement to social services Having a Hukou in depends largely on the type of Hukou and social status.000. Aldershot . Brookfield. as a financial support for the government to provide education and other welfares for their children. will be a fine for having an extra child. (1999). However. from household to household. Thoughts and Policies. One is to reduce the number of children-. 44 . it must strictly control the second birth. 95.000 to the government.

They are attracted by the nine-year free education. Mainlanders. While in Hong Kong. medical services are provided only They follow strictly to this rule. III) Hong Kong Residency However. Especially after the landmark Chong Fung-yuen case in 2001. the service seeker can easily avoid paying deposit or can make off without payment by approaching A&E ward and seeking service in the last minute. when full payment is made upon admission. Many Mainland mothers cherish the better living environment and welfare for their children and thus try every mean to give birth in Hong Kong. Furthermore. Reports on denying medical treatment due to lack of means is common in Mainland China. public housing 45 . it became clear that everyone born in Hong Kong would be Hong Kong citizen. as they know that they can obtain better medical service without paying a penny in Hong Kong. the major drive for Mainlanders giving birth in Hong Kong is the permanent residency for their children born in Hong Kong. medical care and technology in Hong Kong is much more advanced than that in Mainland China.II) Advanced Medical Care Further. in Mainland. This is also the method used by many Mainland women to flee from The whole system attracts making payment in Hong Kong public hospitals.

The cost of delivery ranges from HK$12.000 to HK$14. consumption by one would impose cost to another. With only limited cost. The negative externalities associated are not incorporated in the cost function of these Mainland mothers.benefits. their children can enjoy disproportionately greater benefits provided by the Hong Kong government. the large influx of Mainlanders has placed significant pressure on the Hong Kong medical resources. medical resources are subtractive in nature. Externalities What these Mainland mothers cannot see are costs imposed on the society upon their consumption of medical care in Hong Kong. different sorts of allowances such as Comprehensive Social Assistance Allowance and more recently the Pre-primary Education Voucher Scheme. Besides. That makes Hong Kong quite attractive to Mainlanders. As mentioned before.000. The difference between the charge level and the cost are borne by Hong Kong taxpayers. Those managing to get a place in public hospitals are forced to stay in a 46 . Saturation of public hospitals forced local expecting mothers to give birth in private hospitals. The service-seeking behaviour of Mainlanders has reduced the frequency and quality of prenatal and postnatal checks entitled to all local mothers-to-be. public medical care. but appears as costs to others in the society.

shouldered by Hong Kong taxpayers. Furthermore. This discrepancy between the marginal private costs and marginal social costs of seeking obstetric services by Mainland mothers induces a loss in the overall benefit of such consumption for the whole society. whose husbands are also Mainlanders. Hong Kong people show anxiety over this situation as they feel that their contributions to the society are subsidizing children whose parents have done nothing to contribute to the economic prosperity of Hong Kong. irrational behaviour. providing education. coming to Hong Kong for the purpose of giving birth. The costs are. They feel that these children free ride on the effort of Hong Kong taxpayers. nevertheless. and welfare to these Hong Kong born children to Mainland parents are not without cost. 47 .crowded ward and give birth with another woman in the same delivery room at the same time. government has taken measure to internalize the costs to the Mainlanders and tackle the problem of externality. Not all of these costs were recognized by the Mainlanders. there was an upsurge in Mainland pregnant women. Individual rational decision becomes collective In order to resume market equilibrium. Especially after 2005. medical care.

as the public hospitals had no vacancy left.Policy before September 2005 After Hong Kong Court of Final Appeal confirmed the status of Hong Kong born child to Mainland parents in 2001. the charge for obstetric service in Hong Kong for non-Hong Kong residents was just HK$3. Policy after September 2005 Hong Kong government noted the problem and tried to regulate the situation by imposing a negative incentive. extra charge. delivery room. pressure on medical staff and affected the quality of service provided to local pregnant women. 300 for one-day hospitalization in public ward. Some local mothers-to-be were forced to pay extra to get a place in private hospitals. Together with the long-term benefits to their children and the relaxation of Two Way Permit (TWP) requirements. The sudden increase in the number of Mainland pregnant women induced congestions in public ward. The private cost for Mainlander was far below the social cost of giving birth in Hong Kong. thousands and thousands of Mainlanders came to Hong Kong for giving birth. for non-Hong Kong resident seeking 48 . The number of Mainland women giving birth in Hong Kong in 2005 increased almost 3-fold over that in 2001. with delivery service included. there was an upsurge in the Mainland mothers coming to Hong Kong for giving birth. At that time.

in September 2005. required all Mainland pregnant women to pay HK$19. the cost of giving birth in Hong Kong was internalized to Mainlanders seeking the service. A HK$20. they might simply remain in China.800 deposit upon admission to hospital in order to avoid defaulted payment.000 by fleeing from one-child policy penalty. The major reason It is was that the charge was not effectively set to bring the market back to optimum. For those could not This Pigouvian tax adopted by the government proved to be ineffective in solving the problem. afford HK$20. In 2006. quite ironic to set the charge at HK$20. Another purpose was to bring the charge level of public obstetric service closer to that of private hospital. The rational behind was that by increasing the price level. one year after the implementation of increased charge for the obstetric package.000. the number of Mainland women gave birth in Hong Kong increased 30% from 19538 in 2005 to 20577 in the first ten months of 2006. the marginal private cost after the 49 . so that Mainlanders who could afford the charge might rationally decide to give birth in private hospitals in order to get better medical treatment and service in return.000 when one can save HK$80. Besides.obstetric service in public hospital.000 obstetric package was introduced The package included delivery and care fees in a public ward It also came along with a deposit system that for the first three days in the hospital.

the obstetric package did not come along with new initiatives in preventing and collecting defaulted payments as many of the defaulted payments ended up as bad-debt. Source : ‘Hospital Authority : management of outstanding medical fees’.implementation of new charge was still far below the marginal social cost. Audit Commission. there existed a loophole that allowed Mainland women to obtain obstetric service without making deposit.69 As Mainlanders can easily escape from making payment. Another reason why the package could not reduce the number of Mainland pregnant women coming to Hong Kong was that the cost could not successfully be internalized to the consumers.pdf 50 . Although the Authority required every non-Hong Kong resident to make deposit upon admission for giving birth.aud. It coincides with the criticism over Pigouvian’s theorem that the government is incapable of setting an optimal level of charge or tax to attain market equilibrium. the cost of delivery could not be internalized to them and could not bring the market to optimum. Furthermore.gov. HKSAR Government.800 million in 2005/06 financial year. They knew that Hong Kong hospitals would not deny service due to lack of means. they then sought last-minute hospital admission before delivery through the A&E ward. http://www.hk/pdf_e/e47ch05. 69 The bad debts of Hospital Authority amounted to HK$2.

A group of 30 local mothers-to-be marched to Central Government Office to air their grievances over the situation in November 2006.CHAPTER FOUR NEW POLICY IN FEBRUARY 2007 Introduction The ever-increasing number of Mainland mothers coming to Hong Kong for giving birth has reached an unsustainable level. The action by these groups of pregnant women had tremendous effect. Legislative Council members and the public have urged the government to face the problem. Some suggested having the Basic Law amended or reinterpreted while 51 . Speculations on the possible solutions and development over the issue can be seen on the headline of the newspaper almost everyday. Public hospitals are overcrowded. quality of service delivery has declined significantly. duration of stay after delivery and number of postnatal checks entitled by every baby and mother have been reduced. Different pressure groups. existing medical staff manpower can no long cater for the increasing workload. They urged the government for solution to ensure sufficient public obstetric service is reserved for local pregnant women.

and strengthening of immigration control. The New Policy Increase in Charge Effective from February 1. The official objective of the new measures is to ensure sufficient public obstetric service is available to local pregnant women. was tailor-made solely for Mainland women. The authority’s explanation was that the number of pregnant women from other countries seeking obstetric service in Hong Kong was not common.000. and Food Bureau finally came up with a package of new measures to tackle the problem.000 is the minimum rate that covers the charges for the delivery (vaginal or operative) and the first three days of hospitalization in general wards for the 52 . HK$39.some suggested withholding the baby’s birth certificate until the parents have settled their hospital charge. The measures include increasing the charge. The policy Pregnant women of other nationalities were not bounded by these rules. All were rejected by the government. a centralized booking system. Welfare.000 to HK$39. After months of meetings with Mainland authorities. 2007 when the new measures were implemented. Health. the charge for delivery in public hospital increased from HK$20.

concerned delivery. private hospitals. Authority will defer submission of birth data to Birth Registry for Mainlanders until outstanding fees are paid up to 42 days. To effectively internalize the costs to the Mainland mothers. and medical staffs. the Mainland mother-to-be is required to produce proof of address. encourages the Mainland pregnant women to have prenatal checks before their delivery in order to reduce the risks to the mothers.000 additional charge was to deter It also Mainland pregnant women from seeking obstetric service in the last minute. An additional HK$9. their babies. Those. The major aim of doubling the service charge was again to make it closer to or even over the price level set by private hospitals. who have outstanding fee will only be provided with 53 . So that the Mainland mothers will shift to The imposition of HK$9. the Hospital Authority implemented several measures for collecting outstanding medical fees. the Additionally. without an effective defaulted payment system. Defaulted Payment Prevention Mechanism As mentioned in last chapter. Upon registration. the consumers will never see the real costs of their consumption.000 will be charged for those who have not made a prior confirmed booking for their delivery and / or have not undergone the antenatal checkup provided by the Hospital Authority during the pregnancy. including both Hong Kong residents and non-Hong Kong residents.

‘Authority cashes in on pregnancy policy’. People in Mainland China are getting wealthier. Furthermore. the government implemented other supporting measures to ensure sufficient obstetric service is available to local pregnant women.000 worthy as they can flee from one child policy penalty and their children can enjoy Hong Kong social welfare benefits. 54 . Mainland people might still find HK$39. Every Mainland woman must make prior booking in person and settle the Priority is reserved for local women and only when extra In any case. the number of full payment in advance. the government knows clearly that the problem cannot be solved solely by increasing the service charge.000 for giving birth to a baby are countless. Centralized Registration System The Bureau developed a centralized booking system for both private and public hospitals. payments. 70 Discussion Paper on ‘Impact of the use of Obstetric Services by Mainland Women on Public Hospital Resources’ by Legislative Council Panel on Health Services.71 Besides.emergency services. People who can afford HK$39. CB (2) 761/06-07(03). 71 On the first day of the implementation of this new measures. (2007-02-02).6 million revenue to Hong Kong Government within in single day. the Authority is also exploring the possibility of hiring international debt collection agency for pursuing Mainland bad debts. (8 January 2007). quotas are left will be allocated to Mainland women. Therefore. administrative charge will be imposed for late Finally. LC Paper No.70 Having learnt from previous lessons. South China Morning Post. totally 734 Mainland pregnant women made registration through the Hospital Authority centralized booking system and brought HK$28.

The new policy was put forward in January 2007 and was fully implemented in February. In spite of the rush. Every Mainland mother-to-be is required to produce such certificate to Entry of those Mainland women at immigration officer upon entry to Hong Kong. the authority has defined ‘advanced stage of pregnancy’ as being pregnant for more than 7 months i. pressure groups or politician at the time it was implemented. Body check facilities and medical officers were stationed in all checkpoints to provide advice on the physical conditions of the non-local pregnant women. 72 To avoid dispute. the advanced stage of pregnancy72 who have no booking would be denied.000 per year. a booking certificate will be issued to them. The public generally welcomed the policy which had considerably released their anxiety over the situation. After the Mainland women have made the reservation. 55 . Tightened Immigration Control The Bureau also anticipated that those who have not made reservation nor had no money might try to get through the immigration control points by concealing or disguising their pregnancy. 28 weeks.quota for Mainland mothers would not exceed HK$12.e. there was no big opposition or objection from the public. Those who were found to be pregnant for more than 28 weeks and without booking certificate will be denied entry.

1. the number of Mainland pregnant woman giving birth in Hong Kong public hospitals dropped significantly after the implementation of the new measures in February 2007.000’ SCMP (2007-04-17) and ‘內地孕婦來港分娩個案降 4%’ Singtao Daily. although the total number of Mainland women coming to Hong Kong only dropped by 4%. 2007. 371 of them sought last-minute obstetric service from emergency wards. When compared with the figure of the same period last year. Besides. Mainland pregnant women seeking emergency delivery service even dropped by 75%. it seems that the new measures have successfully shifted the Mainland mothers-to-be from public to private hospitals.CHAPTER FIVE EVALUATION OF THE NEW POLICY Introduction According to the figure released by the Health. In the first nine weeks of the new policy until April 4.190 of them gave birth in public hospitals. the number seeking services from public hospitals dropped significantly by 35%. and Food Bureau. the implementation of centralized booking system together with immigration control has 73 ‘Birth fee drop for wives . (2007-04-16) 56 .800 Mainland women gave birth in Hong Kong. totally 3. Welfare.73 By looking at the figure. charge for cross-border couples could fall to HK$20.

(1987) ‘Instruments and strategy in public policy’. Carrots. Certain instruments fit certain problems and objective better than other instruments. Rist R. Richard F. 41. Pp. this chapter will be the evaluation of the new policy with focus on its design and implementation. Sticks and Sermons. it is good to know something about the potential effects of different policy instruments before one chooses among them.F. Bemelmans-Videc M. Different policy instruments have different operating characteristics. these responses are called instruments. while the instrument choice is real and will have immediate consequence75. the duration is too short to see the real effectiveness of the policy. Policy Studies Review. The study of policy instruments then can be useful in strengthening the predictive capacity of policy analysis that would be helpful in policy design. Elmore stated that certain types of problems predictably bring into play certain responses from policy makers. Policy Instruments and their Evaluation. R. However. USSA New Brunswish : Transaction Publishers. Therefore.C. and implementation problems. (1998). strengths. Therefore. 57 .74 As a broad policy objective is to be achieved far in the future. this chapter will evaluate the new policy by referring to the choice and design of the policy instruments. 74 75 Elmore. since the new policy has been implemented for just two and a half months.deterred people from seeking last-minute service from the emergency wards. instead of focusing on the output of the policy. Vedung E.

Rist R. the values of good governance include effectiveness. Vedung E. no matter ‘output evaluation’ or ‘process evaluation’.C. 77 Bemelmans-Videc M. design. democracy. which is generally referred as ‘output / outcome evaluation’. Policy Instruments and their Evaluation. policy outcome. and H. When evaluating a policy. Evaluation : A Systematic Approach. there should be some criteria by which to judge the adequacy of the policy the criteria of ‘good governance’ – the central values of which government actions is appraised. and legitimacy77. Carrots.E. 76 Rossi. According to Marie-Louise Benelmans-Videc. 1993. 58 .H. 41. legality.76 Evaluation of a policy cannot do away with figures and data on the In fact. all phases of the policy process. 5. implementation and utility of social intervention programmes. Sticks and Sermons. (1998). Pp. from problem analysis through monitoring implementation to the appraisal of the actual result of the policy can be evaluated. Apart from ‘output / outcome evaluation’. Pp. USSA New Brunswish : Transaction Publishers. P. Newbury Park. CA : Sage. Freeman. efficiency.What is Evaluation? Evaluation is the systematic application of social research procedure for assessing the conceptualization. there is also ‘process evaluation’ where the evaluation focuses on the process of designing and implementing of policy or programme.

Pp.78 78 Bemelmans-Videc M. Sticks and Sermons. USSA New Brunswish : Transaction Publishers. The final value is legitimacy. instrument. Therefore. Vedung E. which is the degree to which government choices are perceived as just and lawful in the eyes of the involved actions.g. policy instruments that score high on the democracy criterion often have a price tag in terms of their efficiency.C. (1998). Carrots. It includes both positive and negative effects brought by the policy Efficiency refers to the input-output ratio of the policy instrument. 6-9 59 . These central criteria of good governance need to be combined. It includes the problems of implementation of the policy instrument through devised means. the choice of policy instrument instruments is a search for optimum solution. and a balancing act. Rist R. Policy Instruments and their Evaluation. e. Legality means the degree of correspondence of administrative action in designing and implementing policies with the relevant formal rules as well as with the principles of proper process. a prioritizing process. while at the same time they compete or conflict.Effectiveness is the degree of goal-realization due to the use of certain policy instrument. Democracy is the degree to which administrative action in designing and implementing policies correspond with accepted norms as to government-citizen relationships in a democratic political order.

Classification of Policy Instruments Nowhere in the international literature on policy analysis and public administration is to be found a uniform. Pp. Sticks and Sermons. Pp. Carrots. economic means. Vedung E. Regulations often associated with threats of negative sanctions such as fines. 81 Bemelmans-Videc M. Rist R.C. generally embraced classification of policy instrument. Rist R. Carrots. policy instruments can be categorized in many ways. Policy Instruments and their Evaluation. Vedung E. 31. policy instruments are categorized by the degree of authoritative force or degree of constraints involved in the government effort. (1998). Sticks and Sermons. Pp. 60 . and other type of punishment. By such.79 Regulatory Instrument Regulations are measures undertaken by government to influence people by means of formulated rules and directives that mandate receivers to act in accordance with what is ordered in these rules and directives. (1998). 59. Policy Instruments and their Evaluation.80 Regulation is often chosen by the governments as a policy tool because it appears to be more certain and effective as regulatory instruments define the norms. The In this paper. policy instruments can be defined as regulation. USSA New Brunswish : Transaction Publishers. and information.C. 59. USSA New Brunswish : Transaction Publishers.81 79 Bemelmans-Videc M. 80 Ibid. acceptable behaviour or to limit activities in a society. imprisonment.

What makes economic policy instruments different from regulations is that the addressees are not obligated to take the measures involved. Pp. (1998). Policy Instruments and their Evaluation.Regulatory instruments are not without weakness. Rist R. Additionally. The effectiveness of a regulatory instrument is associated with its legitimacy. 83 Bemelmans-Videc M. either positive or negative.83 Taking cigarette consumption in Hong Kong as an 82 Bemelmans-Videc M. Carrots. which also determines the capacity of the government organization to ensure compliance. Rist R. (1998).82 An illegitimate regulation might lead to non-compliance and the cost of non-compliance might even greater that the cost of the problem itself. Vedung E. Economic Instrument Economic policy instruments involve either handing out or the taking away of material resources from the addressees to make it cheaper or more expensive in terms of money. effectiveness also greatly depends on the nature of the policy context. because they hesitate to take the measures required to get it. Carrots. USSA New Brunswish : Transaction Publishers.71. effort. They may decide not to make use of the government incentive. It is argued that regulations are ineffective in changing behaviour if there no social consensus around the government policy underlying the regulatory instruments. and other valuables to pursue certain actions. time. Policy Instruments 61 . Sticks and Sermons.C. Sticks and Sermons. Vedung E.C.

as the addressee has no obligation to follow the regulation. Pp. the government imposes heavy tax on it and makes the smokers’ habit more expensive. Instead of formulating rule to totally ban the purchasing of cigarette in the market. the addressee might already have decided to behave in the desired way. The addressees have the right to choose. communication of reasoned argument and persuasion. the effectiveness of economic instrument must rely heavily on the relationship between the economic incentive and the policy goals. 32-33. 84 Through advertisement. in which case economic incentive or disincentive has been unnecessary. How the and their Evaluation.example. 62 . USSA New Brunswish : Transaction Publishers. since cigarette smoking is hazardous to health. 84 Ibid. 33. Economic policy instrument is flexible and usually has higher legitimacy when compared with regulatory instruments. education. Sometimes. citizens are informed of what is right or wrong. amassing and packaging etc. Information The third type of instrument is information which influences people through the transfer of knowledge. good or bad. However. the government fells the need to do something to discourage people consuming cigarette. Pp. diffusion of printed material.

Pp.000 to HK$39. 63 . USSA New Brunswish : Transaction Publishers. and availability of other policy instruments. regulatory. USSA New Brunswish : Transaction Publishers. Policy Instruments and their Evaluation. Vedung E. Policy Instruments and their Evaluation.000.85 The former refers to information as a policy instrument while the latter refers as information on policy instrument. Sticks and Sermons.86 85 Bemelmans-Videc M. and informative policy instruments. 86 Bemelmans-Videc M. Vedung E. It increased the public obstetric service charge for Mainland women from HK$20. Rist R. Mainlanders are not obligated to pay the adjusted service charge. Carrots.people should act and behave and what people are allowed to do.C. 48. Pp 79. (1998). Sticks and Sermons. They can choose not to come to Hong Kong for giving birth if they hesitated to give the amount of money or they can seek service from private hospitals in Hong Kong. meaning.C. It is worth highlighting that information can be either a policy instrument in its own right or a metapolicy instrument in the sense that it is used to disseminate knowledge of the existence. The financial disincentive increased the cost of action and prompted the addressees to undertake activities that will achieve the goals of the government. (1998). Carrots. Rist R. Evaluation of 2007 Policy Policy Instruments The policy implemented in 2007 is a combination of economic.

Many new policies in Hong Kong in recent years like to use information either as a tool or as a package.000. since the target of this policy is Mainland women. There is also yearly quota that set the upper limit of vacancy allocated to Mainland women to ensure sufficient obstetric service is available to local women. there are advertisement. policy formulation is the art of choice making. body check facilities are put in place in border checkpoints to ascertain the health condition of pregnant Mainland women. However. we do not see large-scale promotion or publicity on this policy in Hong Kong. and consultation papers to raise people attention on the subject. There are two factors which shape the choice of policy makers : the first one is the 64 . Those seeking obstetric service without registration will be penalized for HK$10. it imposed regulations requiring all Mainland obstetric service seekers make prior registration and settle full payment before delivery. To avoid non-compliance.To avoid defaulted payment and enhanced the effectiveness of the policy. Choice of instruments From policy instrument perspective. Well before the policy is put forward. press release. Those Mainland women at their advanced stage of pregnancy without booking certificate would be denied entry.

There were suggestions to request Mainland pregnant women to pay deposit upon entry at border checkpoints and withhold the issue of birth certificate to their children if they fail to settle the hospital bill. the political and fiscal costs of selecting a particular instrument. Pp 144. Some even suggested amending Basic Law to redefine the residential status of children born in Hong Kong with Mainland parents. 65 .problem identification and the second is the resources and constraints faced by policy makers. Educational Evaluation and Policy Analysis. the government announced its plan in tackling the service seeking behaviour of Mainland pregnant women while no extremely authoritative measures as 87 McDonnell. different people had different focuses on the issue that led to different proposals on the solutions. and the different constituent pressures faced by the policy maker. ‘Getting the Job done : Alternative Policy Instruments’. 151.M. (1998). USSA New Brunswish : Transaction Publishers. 2.. 9. R. In January 2007. Sticks and Sermons. Pp. Policy Instruments and their Evaluation. L. 88 Bemelmans-Videc M. No. Vedung E. Carrots. Summer 1987. Elmore. the capabilities of implementing institution.F.87 The decision making process is an exercise of give and take which involves the trade-offs of effectiveness and efficiency. some focused on the residency of the children while some focused on the quality and availability of obstetric service in public hospitals. Some focused on the problem of defaulted payment.88 In late 2006 when the issue received the hottest debate.C. Rist R. Vol.

66 . there is no need to totally deny service to non-local women. FACV No. it can reduce the possibility of defaulted payment. Two System’. Instead of implementing absolute prohibition. Ka-ling case89 in 2002. 14 of 1998. the prior registration requirement allow the authority better control the number of Mainland pregnant women seeking public obstetric service. the level of legitimacy would induce difficulties in implementation. Although these measures will surely bring effectiveness and efficiency due to their degree of coerciveness. The possibility of seeking reinterpretation was ruled out by the Secretary for Security on the first day it was proposed. The political cost and the After NG cost of non-compliance are so high that the government cannot afford. reinterpretation of Basic Law became a taboo of Hong Kong government which was condemned to have ruined the autonomy of Hong Kong under ‘One Country.listed above could be seen in the proposal. Hong Kong government chose conditional prohibition. which granted permission to Mainland women to come to Hong Kong if they have fully settled the obstetric service charge in advance. On the other hand. More importantly. On one hand. As the policy objective is to ensure sufficient obstetric service to local pregnant women. the children born in Hong Kong might become our future workforce. which will relieve the problem of 89 NG Ka-ling and others v. the Director of Immigration.

67 . which is the goal of the policy. In the meantime. the policy doubled the service charge to make the charging level of obstetric service in public hospital more inline with that in private hospitals. Census and Statistics Department. it is estimated that by 2030. The economic mean has changed people’s behaviour and successfully shifted the service seekers from public hospitals to private hospitals. The government then put in place series of measures to avoid non-compliance. HKSAR Government. Apart from prior registration system to prevent defaulted payment. Finally.90 Allowing Mainland mothers to give birth in Hong Kong is one of the methods in ensuring the sustainability of Hong Kong population growth. there are still intermittent reports on Mainland women gained entry to Hong Kong by 90 2006 Population By-census. the authority also set up body check facilities in border checkpoint to ascertain the pregnant women’s medical condition. the imposition of yearly quota ensured sufficient obstetric service is available to local pregnant women.the ageing population faced by the society. However. With the consistently low birth rate. 27% of the total population will be aged 65 and above. Regulation seldom results in uniform compliance. There is always individuals resist compliance if by doing so they can reap positive benefits.

Other illegal acts such as illegal smuggling of pregnant women from Mainland China to Hong Kong and overstaying in Hong Kong waiting for delivery are common. they only have to pay HK$20. Design of Policy However. They would not be any barrier from entering Hong Kong solely on the ground of pregnancy. it also has its downsides. Government’s explanation was that non-local pregnant women from places other than China are a clear minority and would not pose threat to the Hong Kong public medical service just does not sound convincing. Firstly. it is not a perfect policy. UK. It only applies to Mainland women. In fact. Japan. The way the policy is designed is unexpectedly insensitive which made it subjected to challenges. If the policy goal is to protect the welfare of Hong Kong pregnant 68 . and Thailand etc are not required to make prior registration for giving in Hong Kong. a Mainland woman crossed the border with a forged registration certificate that was issued by a medical practitioner in Hong Kong. Sri Lanka. the policy is discriminatory in nature. Women from all other countries are not covered by the new policy.disguise or forgery. What more. which means pregnant women from USA. what the government can do is to reduce the variation of behaviour to a tolerable level because the enforcement cost for uniform compliance is prohibitively high. 000 for giving birth in Hong Kong. Recently.

000 even if they have money as they found it unfair to be treated differently. feasibility. Among the 20. Their grievance over the policy is understandable. They found it unfair as they are required to pay extra for service and welfare entitled by every Hong Kong people. Conclusion The choice of policy instrument appears to have stricken a balance between effectiveness. the new service charge should apply to all obstetric service seekers from all over the world. 2007 and May 13. Fifty Hong Kong males who have wives in Mainland China marched to Central Government Officer on April 1. instead of just targeting Mainland pregnant women. The figure in the first three months after the implementation of policy has initially approved the policy’s effectiveness in reducing Mainland women’s demand over public obstetric service. These Mainland women expressed that they will not pay HK$39.women. and legitimacy. The legitimacy of the new policy is doubtful. After the 69 . 2007 to demonstrate against the new policy.577 Mainland women coming to Hong Kong for giving birth in the first 10 months of 2006. Moreover. 39% of them are married to Hong Kong males. the policy was criticized for failing to take care of the real need of Hong Kong people.

registration system and immigration control have deterred people from taking free lunch. the successfully shifted the demand from public to private hospitals. 1. It dropped by 35% when The new pricing system has Besides.implementation of the new policy.190 of them gave birth in public hospitals. there is a significant reduction in the number of Mainland pregnant women giving birth in public hospitals. among the 3. 70 . compared with the figure of the same period last year.800 Mainland women gave birth in Hong Kong. According to the figure released in early-April 2007.

The primary worry is the implication of Mainland children's In the first nine weeks after the implementation inclusion in our society in the end.170 registrations for obstetric 71 .CHAPTER SIX THE WAY FORWARD Introduction Judging from some key indicators of policy outcome such as the number of Mainland women giving birth in public hospitals. In the three months after the implementation. the goal of relieving the pressure of public obstetric service has been achieved by shifting Mainland pregnant women from public hospitals to private hospitals. Hospital Authority received 10. The number of Mainland pregnant women seeking obstetric service between February and April this year dropped by 37% when compared with the figure of the same period in 2006. is the Does it mark an end to Hong Kong people’s anxiety about the influx of Mainland immigrants? Long Term Implication Government knows that Hong Kong people's concern is not just the availability of obstetric service. the implementation of the policy has been a success. problem really solved? However. of the new policy.

Source : Social Welfare Department.000’ SCMP (2007-04-17) and ‘內地孕婦來港分娩個案降 4%’. there were signs of deepened social disintegration after the issue became the center of discussion last year. and other welfare services of Hong Kong. married with Mainland wives. Otherwise. 72 . Based on this figure. we will commit the same mistake as committed by our judges in CHONG Fung-yuen case in 2001. They are all entitled to the education. In fact. the demand of From welfare services from these newborn babies has surfaced progressively. implication for Hong Kong resources will be significant. medical The services. Hong Kong residents. 91 ‘Birth fee drop for wives . Singtao Daily. Social Disintegration The uncertainties faced by Hong Kong people made them worry and anxious. from Mainland women91. in both private and public hospitals. there were 102 children born to Mainland parents applied for Comprehensive Social Security Assistance (CSSA)92. August 2006 to March 2007. (2007-04-16) 92 The applicants’ ages ranged from two months old to 17 years old. charge for cross-border couples could fall to HK$20. Besides. it is estimated that the number of registration will reach twenty or even thirty thousand by the end of 2007. However. The figure might seem trivial when compared with the total number of children born to Mainland parents every year. its implication cannot be overlooked.services. housing facilities.

the government can show its care and support to all families in Hong 73 .complained that they are discriminated and are not provided with the same rights and benefits enjoyed by other Hong Kong residents. The best and simplest way in achieving this is by standardizing the service charge for all Hong Kong families. the government should focus its effort on the long term planning in order to balance the population and the resources. Other Hong Kong people argued that allowing Mainland women married to Hong Kong males to give birth in Hong Kong at normal rate would expose our medical resources to exploitation. Instead of protecting the benefit of local pregnant women. By doing so. With the short-term problem being solved. the objective of the policy has to be re-oriented to meet the real need of Hong Kong people. Restructure of obstetric service policy Reorienting Policy Target First. That means Mainland women married to Hong Kong residents only have to pay HK$100 per night for giving birth in public hospitals. the policy should aim at protecting the right and benefit of Hong Kong residents as a whole. The welfare of those Hong Kong residents with Mainland wives should be cared for equally. This can be achieved by restructuring the current policy on obstetric services and better management of welfare resources.

Increasing Charge for Couples who are Both non-Hong Kong Residents Thirdly. the quota system should extend to cover the registration in private hospitals. Extending Quota Coverage Secondly. the above-suggested policy would gain support that is more public. Mainland women giving birth in private hospitals might pose unbearable pressure on the resources of Hong Kong at a later date. Without proper control.170 Mainland women registered for obstetric services in Hong Kong. Under current policy. for those couples who are both non-Hong Kong residents wishing to give birth in Hong Kong. Mingpao (2007-04-13) 74 . and seeking medical 93 “內地婦急症室產子減 75% 四成不付款”.Kong without differentiation which would definitely be beneficial to restore social harmony. the quota system is not applicable to private hospitals. there were 10. As most of the opposition of the current policy was from Mainland women married to Hong Kong residents. From February to April. as their children might be educated. 3756. living. to better manage the number of Mainland women giving birth in Hong Kong. around 36% of them sought service from public hospitals 93 .

000.and welfare of all kinds in Hong Kong. it is very likely that people will try every possible mean to come to Hong Kong illegally. Those seeking obstetric services in Hong Kong would be willing and capable in paying the services. they are required to pay extra as compensation to the Hong Kong government. It can be achieved by strengthening of Immigration control and implementing a defaulted payment prevention system. The payment is expected to be in line with the amount of the one-child policy penalty i. which can reduce the possibility of defaulted payment. I) Immigration Control An experienced Immigration officer served in Lok Ma Chau border-crossing point revealed that in the past few months after the implementation of the new policy. Series of measures have to be put in place to avoid non-compliance. the increase in charge has the effect in screening incoming pregnant women.e. around HK$100. The aim is not to raise public revenue. Apart from protecting Hong Kong people’s benefits. Mainland pregnant women without registration certificate tried different means to 75 . The whole purpose is to reduce their incentive to give birth in Hong Kong to the minimum. Supportive Measure As the charge is so high.

Immigration officers had After medical They even no choice but to send these Mainlanders to the nearest hospitals. The possibility of non-compliance can be minimized by strengthening the communication with Mainland and solving the problem by working in partnership. Apart from the most commonly used tricks that was disguising as non-pregnant woman. treatment. the officer should not allow the pregnant woman to leave China unless the woman can produce a valid registration certificate. They should establish a cross-border system that cover two issues.come to Hong Kong. these Mainland women refused to leave the hospital. and the Mainland public security officer at clearance counter reasonably believes that she is at her advanced stage of pregnancy. First. Second. if a Mainland woman leaves Mainland China to Hong Kong. there were also Mainland mothers claimed feeling unwell and sought medical treatment at the border crossing points. Mainland women claim feeling unwell and seek medical service from Hong Kong border-crossing points should be handed over to the Mainland public security officers 76 . Some Mainlanders waited in the area between China and Hong Kong clearance counters and sought obstetric service from the border crossing point when they were ready for delivery. Few falsified registration certificates while others became nasty when being denied entry. threatened to commit suicide if repatriated.

who will either render medical treatment on the spot or send the women to the nearest hospitals for treatment. China government should realize that such service-seeking behaviour of Mainland women is not simply a Hong Kong problem. policy of Mainland China. The system is expected to reduce the possibility of abusing medical service due to policy loophole. it is a cross-border problem. The training will better equip the officers and make them more confident and competent in carrying out their duties. it needs the active participation of Mainland China. 77 . especially those serving in border checkpoints. The behavior poses significant impact on the population As those babies born in Hong Kong will not be counted as China population. Immigration Department should invest more resources in training their staffs. it requires cohesive communication and cooperation between Mainland and Hong Kong authorities. However. the communication skills and the negotiation technique. As the whole obstetric service policy lies heavily on the effectiveness of the immigration control. the one-child policy will be less effective in controlling the number of population in China. Training should focus on the authority empowered to Immigration officers under the new policy. More importantly.

who have overstayed in Hong Kong after the expiration of their TWP. They should be portrayed as the pillar of our society. In these cases. Some are illegal immigrants while some are two-way permit holders. Mainland mothers can still enter Hong Kong illegally. Those who fail to settle full service charge before they leave the hospitals will be wanted and denied egress from Hong Kong. 78 . these babies born to Mainland women were discriminated by other Hong Kong people that resulted in serious social segregation.II) Defaulted Payment Prevention System Even under strict immigration control. Civil Education Due to excessive negative reports by the media. The purpose is to reduce people’s incentive to come to Hong Kong for giving birth illegally. The government should exert greater effort in promotion the positive image of these newborn babies by publicizing the benefits and advantages brought by them. the government should take actions to show her intolerance to these immigration offences and the determination in collecting full payment by criminalizing non-payment of hospital fee and charging all illegal immigrants and overstaying pregnant women with heavier penalty to deter illegal acts. which will be the solution to our aging population problem in the future.

Education These children may seek education.000 in 1980 to 67. medical service. 79 .censtatd. The government should monitor the trend of the service-seeking behaviour of Mainland women and project the demand on education.gov.hk/showtableexcel2. Due to the ever-declining birth rate94.700 in 1990 and to 48.200 in 2001. and welfare of all kinds in Hong Kong. Besides. Medical Service and Other Welfare Policies In 2006. Housing. accommodation. there was growing proportion of these newborn babies whose parents are not Hong Kong residents. All policies have to be reviewed to meet the need of our next generation. housing facilities. These schools are either demolished or left idle. social assistance.Vision in Education. 94 The number of birth in Hong Kong dropped from 85. The most imperative one would be our education policy. Many teachers lost their jobs and many students are forced to transfer to other primary schools. http://www.jsp?tableID=004. totally 127 primary schools closed down between 2001 and 2006 due to the low enrollment rate. and medical care in the coming decade. Census and Statistic Department. 63% of the newborn babies were born to mothers from Mainland China and became the major source of population growth in Hong Kong. The government should recognize the implication of the growing number of these newborn babies and their family profile to our existing and future social policies.

If these children seek education in Hong Kong. They successfully brought our population back to 1990 level. This means the whole society’s demand on education will increase in the coming decade. or the government can provide the services by herself so that the quality of education and living environment can be assured. it would take considerable time for them to travel to school. On the other hand. the demand on boarding schools was low which made the number of boarding schools limited.000 in 2006. with our geographical layout. it is very likely that they will not live with their parents. 80 . we might be able to avoid unnecessary chaos as such.However. with children born to Mainland mothers formed the major part of the population increase. the demand on boarding schools might increase. since 2001. if they remain residents in Mainland China. The government should consider either encouraging private sector to run boarding schools. If the government has insight and takes a proactive role in forecasting our demand on education in the future.200 in 2001 to 65. The number of birth rose from 48. With the increase proportional of newborn children whose parents are not Hong Kong residents. which provide all in one services to these children so that their education. accommodation and catering are being taken care. Hong Kong's population has rebounded. In the past.

to ensure the assistance goes directly to the applicant. the existing social welfare system needed to be reviewed. requirements are exempted for those who are under 16 years old. any person who has been Hong Kong resident for 7 years or more and has resided in Hong Kong for at least one year is eligible for applying CSSA. Furthermore.955 per month if can pass the Social Welfare Department should develop a system with Mainland China to collect reliable information on the applicant’s financial situation to avoid deception of the social assistance programs. financial test95. Under current policy. These two That means those children born to Mainland parents are all eligible for applying CSSA on the day they are born in Hong Kong. 81 . Besides. 95 To be eligible for CSSA. the applicant’s capital asset should not be more than HK$34. government should reduce the amount of cash assistance and explore the feasibility of using voucher or direct subsidies to service providers to avoid assistance being misused. as the assistance is provided to the Hong Kong born children only.000 for ‘single person’ application. the amount and the mode of assistance also needs to be reviewed.Social Welfare Assistance To better protect Hong Kong people’s welfare and avoid social resources being abused. These children can get HK$1.

The government should look into far too many issues. and medical service in Hong Kong while they also have the obligation to contribute to the community. education. Conclusion These newborn babies are Hong Kong residents. However. Whether they will become the pillar or the burden of the society depends on the government’s attitude and determination in nurturing them and builds their sense of belonging towards Hong Kong that makes them recognize Hong Kong as their home. which is an irrebuttable truth. They have the right to enjoy the welfare. 82 . it is not the purpose of this paper to list out all policies the government has to review. The objective of this section is to highlight that the government should note the significant implication brought by these newborn babies to our society. The government should extend its focus from the availability of public obstetric service to the long-term planning of social policies to ensure sustainable development of Hong Kong society as a whole.

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Annex A Birth Statistics Total Number of Birth in Hong Kong Number of babies born to Mainland women in HK (% to the total number of births) 7810 (16%) 8506 (17. (8 January 2007).9% 14.1% 47.5% 61.6%) 10128 (21.5%) 19538 (34%) 20577 (39. of babies Number of babies % to the total number born to Mainland born to Mainland of babies born to women women in HK Mainland women 7810 8506 10128 13209 19538 20577 620 1250 2070 4102 9273 12678 7. 87 .6%) 13209 (26. CB (2) 761/06-07(03).4% 31.7% 20. LC Paper No.6% Year 2001 2002 2003 2004 2005 2006 (first 10 months) Source : Discussion Paper on ‘Impact of the use of Obstetric Services by Mainland Women on Public Hospital Resources’ by Legislative Council Panel on Health Services.3%) Year 2001 2002 2003 2004 2005 2006 (first 10 months) Number of Births in HK 48219 48209 46965 49796 57098 52265 Family Profile of babies born to Mainland mothers Total No.

Abolition of ‘reach based’ policy China and British governments finally reached an agreement on the daily quote of One Way Permit. Mainland China increased the OWP quota from 75 to 105 per day 1950 1950 1950 1966 1974 1980 1980 1983 1984 1993 88 . Outbreak of Cultural Revolution in Mainland China Introduction of ‘reach based’ policy.Annex B Chronology of Major Events affecting Hong Kong Immigration Policy on Mainlanders 1841 1940 1941 1949 Hong Kong became British colony Immigration Control Ordinance introduced Second World War Immigration Control Ordinance stipulated that no person may enter into the Colony without an entry permit. which brought Hong Kong entrepot trade to a standstill. Hong Kong Government introduced a quota system to balance the numbers of those entering into and those leaving the Colony. Outbreak of Korean War The United States imposed an almost complete embargo on Chinese trade. Mainland China reduced the OWP quota from 150 to 75 per day Signing of Sino-British Joint Declaration. Maximum 150 legal immigrants were allowed to enter Hong Kong for settlement per day. natives of Guangdong province were exempted.

Relaxation of ‘Tanqing’ (Relative visit) endorsement requirements. Court of Final Appeal ruled that any person born in Hong Kong is Hong Kong residents in CHONG Fung-yuen case SARS Outbreak Introduction of Individual Visit Scheme 2001 2003 2003 89 .1995 1997 1997 1998 1998 The daily quota for OWP further increased to 150 per day Change of sovereignty Hong Kong hit by Asian Financial Crisis Unemployment rate of Hong Kong reached 7% Introduction of ‘Shangwu’ (Business visit) endorsement for Two-way Permit.

J. 90 . (eds) Immigration Law in Hong Kong : An Interdisciplinary Study.. HKSAR Government. ‘The Evolution of Immigration Law and Policies : 1842-2003 and Beyond’ in CHAN J. B.Annex C Growth of Population in Hong Kong (1841 – 2006) 8000 7000 6000 5000 4000 3000 2000 1000 0 1841 1851 1861 1871 1881 1891 1901 1911 1921 1931 1941 1951 1961 1966 1971 1976 1981 1986 1991 1986 2001 2006 Thousand(s) Year Source : The figure from 1841 – 2001 were taken from CHAN. Hong Kong : Sweet & Maxwell Asia (2004) The figure for 2006 was drawn from Census and Statistics Department. Rwezaura.

Annex D Map of Cities covered by Individual Visit Scheme in 2007 Changchun Shenyang Beijing Shijiazhuang Dalian Tianjin Jinan Wuxi Suzhou Wuhan Shanghai Chengdu Nanjing Hangzhou Chongqing Ningbo Changsha Taizhou Fuzhou Nanchang Guiyang Quanzhou Xiamen Nanning Kunming Zhengzhou Hefei Haikou 91 .

of Mainlanders Visited Hong Kong (1997 – 2006) Million(s) 14 12 10 8 6 4 2 0 8. Source : Tourism Board 92 .46 m * 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 Year * Individual Visit Scheme implemented in Mainland China in July 2003.Annex E No.

100 – HK$16.800 – Same as charges for Hong (港安醫院) Hong HK$41.280 HK$28.200 – HK$42.800 – Same as charges for Hong Administration HK$32.000 – HK$24.000 HK$100.000 ward) HK$100.000 – HK15.000 Baptist Hospital (香港浸信會醫院) St. HK$10.800 – HK$25.000 HK$15.000 93 . Hospital (聖德肋撒醫院) Union Hospital (仁安醫院) Teresa’s HK$13.600 – Same as charges for Hong Administration HK$51.000 – HK$28.000 – HK$27.500 – HK$15. Fee Kong HK$13.180 – HK$30.000 – HK$52.800 – HK$17.000 – Additional Administrative (聖保羅醫院) Canossa Hospital (嘉諾撒醫院) HK$25.500 Kong residents.00 Charge – HK$1.000 HK$45.680 – HK$15. charge Caesarean Delivery for Special Women Arrangements Mainland mother for Mainland Pregnant Kong HK$13.000 ward) (private (general St.800 Normal Delivery Kong residents.800 HK$488.000 – HK$35.880 HK$37.800 HK$85.000 – HK$25.880 – HK$18.000 Fee HK$13.100 Kong residents.Annex F Obstetric Service Charges in Hong Kong Private Hospitals Service charge for Hong Service Hospital Kong residents Normal Delivery Hong Sanatorium Hospital (養和醫院) and HK$32.260 HK$34.000 Adventist Hospital HK$15.000 HK$33.800 – Same as charges for Hong Deposit for Mainlanders HK$50.700 HK$94.000 Caesarean Delivery HK$43.780 Kong residents.000 HK$26. Paul Hospital HK$12.500 HK$80. HK$15.880 HK$42.

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