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
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, 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.
the Director of Immigration 28
Diagnosis of the Problem from an Economic Approach Introduction Common Pool Resources Problem of Collective Actions Externalities
31 31 32 34
.Table of Content
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
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.
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
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
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
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
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
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.
‘醫管局擬五招防病人走數’. Some did not
receive the same amount of prenatal checks as they used to have. Apple Daily (2006-12-07) 2
. The privacy of these mothers-to-be was not
respected. (2006-12-8) “港婦：被迫開刀分娩 確保有牀位”.3
Undesirable Phenomena There were intermittent reports on the plight of local pregnant women. Apple daily. Worse still. 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. some pregnant women deliberately chose to deliver their babies by surgery instead of natural labour just to secure a stay in the hospital.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. 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.
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.
Before the imposition of the HK$20. HKSAR Government.2 billion in 2006 which was around 13% of the overall government expenditure.000 obstetric package in September 2005. 90% was government subvention. Sources : Census and Statistics Department.Local pregnant women showed concern about deteriorating standards of care and were resentful of outsiders coming in. jumping queues. 2006. 3
Hong Kong public medical care is funded mainly by the HKSAR government. prior to this.300
Public money spent on medical service amounting to $32. and getting services they had not wholly paid for. 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. 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. which was believed to be the major factor that triggered the implementation of new measures in February 2007. the charge for obstetric services was calculated based solely on the number of days of hospitalization. Approximately HK$300 million revenue of Hospital Authority in 2006.
some of these Mainland women did not settle the bill before they left the hospitals.000. 8 In 2006.
Legislative Council Meeting on November 10. especially when the pregnant woman has Viral Hepatitis Type B or Acquired Immune Deficiency Syndrome.
more. and the babies because illness.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. hospital staff. as the service seekers’ medical
history and the health condition of their babies are all unknown to the hospitals.000 to $14. the
bad debts of Hospital Authority amounted to $2. LC Paper No.800 million in 2005/06. (2006-12-07). there were almost 20. CB (2) 761/06-07(03).8 It posed considerable risks to both the mothers-to-be. (8 January 2007).per day for non-Hong Kong residents while the average cost of delivery for a pregnant woman was $12.legco. More than 70% of them did not receive antenatal examination. Together with the inefficient default payment collecting mechanism. (2006-12-07) & ‘內地婦港產嬰 5 年升 16 倍’.
(http://www. Source : ‘內地婦來港產子要做產前檢查’. 4
. this also brought risk to the hospital staffs and other pregnant women staying in the same hospital.hk/yr04-05/english/counmtg/hansard/cm1110ti-translate-e.
other patients. 2004. Mingpao.000 Mainland women gave birth in Prince of Wales Hospital. Besides.gov. Singtao Daily. defects and other possible problems could not be detected before delivery.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.6 The influx of Mainland women seeking obstetric What is
services imposed significant financial burden to our health care system.
The purpose was to control the number of influx of Mainland China to
avoid unbearable pressure on the resources of Hong Kong. Hong Kong experienced an economic downturn due to Asian Financial Crisis. The restrictions on Mainland visitors were further relaxed by the
Immigration Department Annual Reports 96-97. the Severe Acute
Respiratory Syndrome (SARS) outbreak seriously hit Hong Kong retail.27 million in 1997 to 4. The number of Mainland visitors increased from 2. its economic development.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. job opportunities. Before 1997. Hong Kong government
enacted Immigration Ordinance and imposed strict control over Mainland migrants and visitors.9 When Hong Kong economy rebounded in 2003. It is the result of political. 03-04. Hong Kong government agreed to increase the
Two-way Permit quota three folds to encourage Mainland visitors traveling Hong Kong. when Hong Kong
was still a British colony. To revive the economy. 5
. economic. political stability attracted immigrants from Mainland China. and social changes after the handover of sovereignty in 1997.86 million in 2001.
After 1997. tourism. and catering industries.
Legal Ambiguity Before 1997. 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. 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. without being part of a tour group) for a maximum of seven days. 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. With
the introduction of Basic Law in 1997. when the people moving in and out from Hong Kong were governed by Immigration Ordinance Chapter 115 (Cap.e.introduction of Individual Visit Scheme in 2003 that allowed Mainlanders to visit Hong Kong in their own capacity (i. 115). 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.
which is also the main reason for Mainland women coming to Hong Kong for giving birth. as
Hong Kong citizens.
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. welfare. Health care services in Hong Kong are distributive in nature. Fees and charges for different medical services are standardized across all public hospitals at a highly subsidized rate. Requests from any person. Although
either hypothesis is anticipation.The decision of Court of Final Appeal gave all babies born to Mainland women in Hong Kong. and education. They know that their babies. housing benefit and social welfare. the number of babies born to Mainland women is large enough to have implication on Hong Kong’s planning and policy on population. 7
. residency in Hong Kong. regardless of their citizenship and financial condition. would be contemplated.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. healthcare. 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. will have free education. (2007-02-02). South China Morning Post. The same fee
‘Authority cashes in on pregnancy policy’.
payment is made before they left. This policy was
adopted by Mainland China since late-1970s as a measure to control its population.
September 2005. Mainland parents could avoid the penalty for having more than one child under One-child policy.300 for one-day hospitalization in a public general ward. It stipulates that each couple is only entitled to have one child. This charge has already included
The charge was so low that it could not even cover the
cost of delivery. there is no policy or system in place to ensure full The ineffective default payment mechanism For Mainland women.
Despite the low medical charge. obstetric service for Mainland women only costed HK$3. the baby delivery service. In addition. by giving birth in Hong Kong.
obstetric services in Hong Kong have everything to gain.structures applied to Hong Kong and non-Hong Kong residents alike.
further encouraged such free-riding behaviour. nothing to lose. Every extra child will cost the couple around RMB80.000 as penalty. many Mainland women did not settle the bill before leaving the hospitals. 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. Since children born in Hong Kong
What is more.
requests from local and Mainland pregnant women were handled in the same manner.
bring the market to optimum. the Hospital Authority introduced a new charging system as a rational basis for the allocation of resource in September 2005. their parents would not be fined.are Hong Kong citizens and will not have Mainland Hukou.000. 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. Each
non-Hong Kong pregnant woman giving birth in Hong Kong will be provided with a minimum obstetric package.
Government Actions The ever-increasing number of Mainland mothers giving birth in Hong Kong made the government realize the problem.
. The whole package charges each service
seeker HK$20. As
services were provided based on medical need regardless of the patients’ or service seekers’ citizenship. citizenship. 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. causing market disequilibrium.
the Bureau came up with some measures to tackle with the problem. 10
. as many Mainland pregnant women know that they would not be
denied medical service due to lack of means. the defaulted payment arisen from obstetric services by Mainland women amounted to HK$1.200 million. Source : ‘Hospital Authority : management of outstanding medical fees’. There were intermittent reports that babies died due to inadequate postnatal care as the babies’ mothers left hospitals for avoiding payment. Ambrose Lee.aud.hk/pdf_e/e47ch05. After several meetings among the Secretary for Health. Welfare. http://www.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. and Mainland China Authorities on the issue.gov. (2006-12-27). Wenweipo. they avoided paying deposit by seeking service from accident and emergency (A&E) ward when they approached to deliver.800 upon admission at a public hospital. Aims of the
measures are to ensure that local pregnant women would be provided with proper and
In 2004/2005 financial year. HKSAR Government. The minimum obstetric service package required all
non-Hong Kong residents to pay a deposit of $19. Audit Commission. These acts pose significant risks to both the mothers and babies. and Food Bureau Dr. Secretary for Security Mr. York Chow.pdf 12 ‘4 日男嬰 離奇猝死’. However. the Mainland mothers left with their babies prematurely to evade payment.The alarming figure of bad debt11 also pushed the authority to introduce measures to avoid defaulted payment. After delivery.
(eds).gov. Governing the Commons.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. Advanced in Policy Studies since 1950. Va. The following are the major presumptions in the framework14 – i) Public obstetric service is common-pool resources that are
non-excludable and subtractive.. 2007. R. 11
.hk.M. Cambridge : NewYork. : George Mason University Press and DUNN.13
Framework of Study This paper will employ market theories to explain the problem of insufficient public obstetric service in Hong Kong. KELLY. they only see the cost imposed on them and neglect the cost imposed on the society as a whole. problem of ‘free-riders’. www. (eds). Cambridge University Press. New Brunswick and London : Transaction Publishers (1992). T.. The problem of externalities resulted in market inequilibrium and inefficiency.. ii)
Its nature inevitably results in the
As human beings are rational and self-interested. (1990). E. Fairfax.info. The Theory of Market Failure : A critical Examination. 14 The presumptions are the summary of reference drawn from OSTROM. Press Release. COWen. W..
The problem of externalities can be solved by internalizing the social cost to individual through Pigouvian tax so that the consumer can see
‘New measures on obstetric services and immigration control’ on January 16.
. 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’. literature will be conducted on these theories. 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.the real cost of their consumption. useful information will
be collected from newspaper. journals and reports and meeting records of Legislative Council.
Research Questions In this dissertation. 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. Extensive research on academic
Additionally. magazines. and websites. ‘externalities’ and ‘Pigouvian tax’ to illustrate the problem of insufficient public obstetric service in Hong Kong in recent years.
five by applying Policy Instrument theory. 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.
Dissertation Plan The whole dissertation comprises six chapters.
answering the failure of 2005 policy. representatives of enforcement agencies and professionals such as doctors and nurses to seek their views on the feasibility and effectiveness of the new policy. In Chapter 2. 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.
this chapter will analyze the policy effectiveness and legitimacy by referring to the choice of policy tools and the design of policy.
.Interviews will be conducted with representatives of interest groups. Chapter 4 is the detailed description of the new policy implemented in February 2007. Chapter 3 will explain the Mainland women’s service-seeking behaviour from This chapter will apply the Pigouvian theorem in
economic point of view. This policy will be evaluated in Chapter Instead of evaluating the policy outcome.
Evolution of Hong Kong immigration policy on Mainlanders since 1842 is outlined in Annexure B.CHAPTER TWO HONG KONG’S IMMIGRATION POLICY ON MAINLANDERS
Introduction Hong Kong has long been an immigration city. more than half of Hong Kong population is immigrants from Mainland China.. Some treasure political stability while some cherish rapid economic development. ‘The Evolution of Immigration Law and Policies : 1842-2003 and Beyond’ in CHAN J. Rwezaura.15 People from Mainland China come to Hong Kong for different reasons.
Immigration Policy on Mainlanders in Colonial Era Hong Kong had no immigration control measures on Mainlanders until 1938 when the
CHAN. Since the British occupation of the
territory in 1842. 14
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. Pp. Hong Kong has been a favorite sanctuary for those looking for a better life. B. 1. J. At present. 16 Ibid. to now.16 From 1842 when Hong Kong became a British colony. (eds) Immigration Law in Hong Kong : An Interdisciplinary Study. Hong Kong : Sweet & Maxwell Asia (2004).
. Details at Annexure C.000. social. the Hong Kong Government realized that the society could not cope with the influx of people from Mainland China in terms of physical. B. How an illegal immigrant was
to be dealt with was decided by the prevailing executive policies and not by the law..population grew from 878.
Notwithstanding the introduction of the Immigration Control Ordinance.17 At the time. 18 Natives of Guangdong Province were exempted from this Ordinance. Instead of
being repatriated to Mainland. and economic infrastructure. (eds) Immigration Law in Hong Kong : An Interdisciplinary Study. the immigration authority adopted an ‘open door’ policy. One of
the reasons was that Hong Kong economy suffered badly in the fifties after the outbreak of the Korean War in June 1950. every illegal immigrant could obtain entry permit by reporting to the immigration authorities so that their stay could be regulated. visas or entry permit. Pp. J. Rwezaura. Immigration officers could exercise their discretions in granting permits. Source : CHAN. Hong Kong : Sweet & Maxwell Asia (2004). 1. with or without conditions.500. frontier passes or certificates of residence issued under the Ordinance were illegal immigrants and would not be permitted to land.947 in 1931 to over 1. to allow an illegal immigrant to stay in Hong Kong. ‘The Evolution of Immigration Law and Policies : 1842-2003 and Beyond’ in CHAN J. The
Immigration Control Ordinance of 1949 was enacted which provided that any person not in possession of relevant travel documents. enter or remain in Hong Kong18. The United Nation and the United States
Growth of Population in Hong Kong 1841-2006.
and industrious labour. However. 6-9. 20 When comparing with the total population of 4. 21 Hong Kong Population Projection 1971-1991. political uncertainties pushed refugees
from Mainland China who brought to Hong Kong capital and industrial expertise as well as a pool of skilled. 16
.000 illegal immigrants arrived from the Mainland. 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. entered the urban areas and subsequently gained a home with relatives or otherwise found proper
CHAN. in 1974. Census and Statistics Department.19
Under this ‘open door’ policy. J. about 60..imposed embargoes on Mainland China and Hong Kong. Hong Kong : Sweet & Maxwell Asia (2004). intelligent.203.700 in 197321. B. At the same time. the figure was quite alarming. (eds) Immigration Law in Hong Kong : An Interdisciplinary Study. Pp. ‘The Evolution of Immigration Law and Policies : 1842-2003 and Beyond’ in CHAN J. 56. in 1973 alone. 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. but all others who evaded immediate capture.000 Chinese persons entered Hong Kong illegally between 1962 and 1972 and were subsequently permitted to stay. Trading of Hong Kong almost came to a standstill. HKSAR Government. Rwezaura. It pushed the Hong Kong Government to impose a ‘reached-base’ policy Under this policy. 20 Ibid.
700. 23 Illegal immigrants from Mainland who successfully evaded capture and remained in Hong Kong increased from 6.24 All illegal immigrants from Mainland China were to be
Entry to Hong Kong for Settlement Since the abolishment of the ‘reach-base’ policy in 1980.700 (1979). J. removed. the first year of the abolishment of ‘reach-based’ policy. the number of Mainlander arrested on arrival and repatriated was 89. 24 The number of legal immigrants from Mainland China dropped from 107. 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.23 This ‘reached-base’ policy was thus abolished in 1980.600 (1977) to 28.accommodation would be given permission to stay in Hong Kong. It
was also a sensitive political matter to have an agreement on the quota. 17
. Hong Kong : Sweet & Maxwell Asia (2004). Some condemned that this policy positively
encouraged illegal immigrants from Mainland and led to an influx of illegal immigrants who arrived and reached base. (eds) Immigration Law in Hong Kong : An Interdisciplinary Study. 12-13. 12.700 in 1979 to 69. B.22
In 1979. the introduction of quota was opposed by the Mainland authority as ‘unreasonable and unfriendly act towards the PRC and its people’. However. five
years after the implementation of ‘reach-base’ policy.100 (1978) to 107. as this might
CHAN.900 while those evaded capture and remained in Hong Kong was 107..500 in 1980. Pp. Rwezaura. the only legal way for people from Mainland China to come to Hong Kong for settlement was entry under One-way Permit (OWP) scheme. ‘The Evolution of Immigration Law and Policies : 1842-2003 and Beyond’ in CHAN J. Ibid Pp.
‘The Evolution of Immigration Law and Policies : 1842-2003 and Beyond’ in CHAN J. 15-16. Rwezaura. In 1995. the quota was not strictly enforced..495 legal immigrants from Mainland China Although the
in one single year. 18
. J. the quota increased to 150 per day. of 310 per day in 1978. which was almost 250% of the figure in 1977. (eds) Immigration Law in Hong Kong : An Interdisciplinary Study. which is the issuing authority of OWP’s.25
Entry to Hong Kong for Visit The restrictions over Mainland visitors were strict in colonial era.
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. A
compromise would be that the Director of Immigration always gave permission to land to whoever was issued an OWP. Therefore. Mainlanders who wish to make private visit to Hong Kong had to apply for a Two-way permit (TWP)
CHAN.constitute a tacit recognition on the part of the Chinese government that Hong Kong was not part of China. Hong Kong : Sweet & Maxwell Asia (2004). Indeed. still changed the daily limit over time. the Mainland authority. Pp.
It resulted in 67. Since then the daily
limit remained unchanged. 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. B.
The daily limit increased to 1. though this was still inadequate to cope with the demand. It was hard to believe that the average daily quota for Group visit was 8. The applicant must produce proof of business and properties in Hong Kong or proof of close relatives26 living in Hong Kong. there were only two types of endorsements. Shanbo (2002). They must arrive and
There was also daily quota imposed on the Group visit
endorsement. For Group Visit. spouse. spouse’s parents and siblings. Each had strict
‘Tanqing’ (Relative visit) and ‘Tuandui Luyou’ (Group visit). including copies of Hong Kong Identity Card. the definition of ‘close relative’ confined to parents. implemented in 1950. upon application.
Before 1997. 27 SHAO. certificate of marriage. 一國兩制研究中心. Pp 6-9. requirements upon application. 內地人士非移民簽證來港的政策檢討及建議.142 in
. visitors had to join tours organized by one of the three recognized and approved Mainland tour operators.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. or more.3 persons for the whole of Mainland China. depart together as a group.
TWP scheme was
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. Endorsement would only be issued to those who had relatives residing in Hong Kong.from Mainland Public Security Bureau offices before entry.
political stability faded away as the issue of concern as the economy became the major focus. The 150 daily quotas for OWP still Number of Mainland visitors to The major
applied and the issue of TWP was not released. Since Hong Kong dollar was linked to the US dollar. The ‘One Country. Pp 20. 一國兩制研究中心. the outbreak of the Asian Until the
financial crisis began with the depreciation of the Thai baht in July 1997. What
many Hong Kong people and international observers feared about intervention by Chinese authorities did not happen.Immigration Policy on Mainlanders after 1997 Immediately after the change of sovereign. remained steady at 7. all these Asian currencies depreciated with Traveling to other Asian countries became much
respect to the Hong Kong dollar. Shanbo (2002). it As a result. there was no significant influx of Mainlanders.29 million in 1996 to 2. 內地人士非移民簽證來港的政策檢討及建議.75.
Hong Kong decreased from 2. Quite unexpectedly.
reason was that the China Government did not want chaos at the time of handover and sought stability. Two Systems’ arrangement went off to an auspicious start.26 million in 1997. a number of Asian currencies had depreciated substantially with respect to the US dollar. after the changeover of sovereignty in July 1997. either for settlement or for visit.
end of January 1998.
It was ironic that. 20
J (eds). which allowed visitors on business trip..8% in 1997 and 7. China was less affected by the financial crisis. pp. 62-83. In 1998. R.
Unlike other Asian countries. Hong Kong government agreed to have the restrictions on the issue of TWP relaxed.31 The Chinese economy was hardly affected by the financial crisis as it continued to grow at 8. Mainland China was less affected by the Financial Crisis. 18 30 SIU. 21
. (2004) Pp. S. Asian Economic Papers 3:1 (Winter 2004). Richard. Singapore : World Scientific Publishing Company. Economic Impact of SARS : The case of Hong Kong. SARS Epidemic. RMB's non-convertibility protected its value from currency speculators. 32 Wong. the number of visitor arrivals declined sharply by 21% as compared to the first half of 1997. which insulated the country from rapid out flowing of assets and money and sharp drop in the exchange rate after the financial crisis.29 Domestic consumption shrank and the economy contracted.cheaper than to Hong Kong after their currency depreciation. ‘The Impact of SARS on Greater China Economies’ in Wong.. who previously were required to obtain a visa upon arrival at Hong Kong. 13.32
To revive the economy.30 When compared with Hong Kong. The Asian Financial Crisis and After Problems and Challenges for the Hong Kong Economy. Hong
Kong’s unemployment rate hit record levels exceeding 7% by the end of 2002. Pp. Pak-wai (1998). China insulated itself from rapid capital flight. Liang.
In the first half of
1998. 31 With all of its foreign investment took the form of factories on the ground instead of securities. Chan. China Government introduced ‘Shangwu’ (Business visit) endorsement.8% in 1998. most of the China’s investment took the form of factories on the ground rather than securities. Alan & WONG. Hong Kong Institute of Asia-Pacific Studies. The requirements for Relative
LIU. J. RMB’s non-convertibility protected its value from currency speculators.
The relaxation in TWP permit requirements greatly attracted tourists from Mainland China. Alan & WONG. Sources : SIU. The daily quota for Group visit endorsement increased from 1. pp. Pp. there are in total 99 tour operators in Mainland China that can apply Group Visit TWP. The
number of Mainland visitors to Hong Kong increased from 2. Ibid. and studied in Hong Kong.
SHAO. Shanbo (2002). Economic Impact of SARS : The case of Hong Kong. Richard.142 in 1997 to 1.82 million in 2002. also increased from 3 before 1997 to 63 in 2002. 一國兩制研究中心. 62-83. 22
. 33 At present. Hong Kong experienced another crisis –Severe Acute Respiratory Syndrome (SARS). his brother-in-law
to Kwong Wah Hospital on February 13. All
tour operators were monitored by the China Tourism Association.34 Revenue from tourism-related activities increased from 142 millions in 1998 to 287 million in 2002. which allowed Mainlanders to visit their relatives who lived. which undertook the application of Group visit endorsement. A professor from Guangdong
came to Hong Kong for a relative’s wedding.
8. 36 Real GDP in Hong Kong grew at 3. HKSAR Government.4% in the third quarter of 2002 and at 5. Asian Economic Papers 3:1 (Winter 2004).67 million in 1998 to 6. 內地人士非移民簽證來港的政策檢討及建議. worked.Visit endorsement were released in 2000.1% in the fourth quarter of 2002.35
When economy started to recover again 36 .
Tourism Development Board. 2003. The number of
tour operators in Mainland China.500 in 2000. He sought medical treatment in Hong Kong and was admitted Not soon after. He stayed in a hotel in Kowloon for one night in February.
hk/info/sars/e_sars2003. HK Government http://www.gov. On February 22.38 By the end of the epidemic. the World Health organization (WHO) issued an advisory against non-essential travel to Hong Kong and Guangdong Province.sars-expertcom.gov. Another patient.info. The SARS epidemic
reached its peak on March 30. total 1755 people were infected with SARS. who stayed in the same hotel with the professor. The number of medical staff who had infected with SARS through contact with this patient increased to 139.html. Eleven healthcare staff of PWH working in Ward 8A
left on sick leave on March 10. were admitted. 2003. Department of Health.37 Visitor numbers fell throughout the Asia-Pacific region. 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. HKSAR Government. 38 Hong Kong Tourism Board Annual Report 2003-2004. and those of May by almost 68%. with Hong Kong’s April arrivals dropping by almost 65% compared with 2002. Department of Health. 1451 were discharged
while 304 died of the disease. Hong Kong people refrained from many consumption activities outside their
SARS Expert Committee Report : From Experience to Action.htm. 39 SARS. On April 2.39 Fearing the disease might spread to the community at large. 23
. who visited an acquaintance
staying on the same floor of the hotel during the critical day in February. the Guangdong professor was certified death and was later confirmed to have died of SARS. http://www.hk/english/reports/reports/reports_fullrpt. admitted to Ward 8A of Prince of Wales Hospital (PWH) and brought the index case for Hong Kong’s first outbreak in PWH. 2003. 2003.and 16 other people.
Unemployment rate increased from 7. it was opened
only to residents of Dongguan. The number of visitors from Mainland China from
1997 to 2006 is shown in Annexure E.40
To bring the Hong Kong economy back to life.234 million in 2003 to 91.homes. The Individual Visit Scheme has brought a significant increase in the number of Mainland visitors to Hong Kong from 8.849 million in 2004. and Foshan in Guangdong Province. 41 Tourism Board Highlights 2004. and
now covers Guangdong province and 28 other cities (Refer to Map at Annexure D).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. The drop in demand put further pressure on the price level and worsened the unemployment problem. Zhongshan. Jiangmen. Hong Kong SAR Government. Individual visitors from
the Mainland were permitted to remain in Hong Kong for a period of not more than 7 days upon each entry. When this scheme was introduced in July 2003. HKSAR Government. the Chinese Government further released the issue of TWP and implemented the Individual Visit Scheme.5% in March 2003 to the highest point of 8. 24
.5 million in 2003 to 12. Source : Census and Statistics Department.2 million in 2004 which brought an increase in inbound tourism revenue from 70. Mainlanders might go to Hong Kong as individual visitors. In the past three and a half years. the scheme extended progressively.7% in July 2003.
Declaration provides that these basic policies shall be stipulated in a Basic Law of the HKSAR.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. 115. It came into effect on 1 July 1997. 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.42
Immigration Ordinance The definition of ‘Hong Kong citizen’ was stipulated in Immigration Ordinance Cap.
Country. the implementation of the British Nationality Act 198143. 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 British Nationality Act 1981 was an Act of Parliament passed by the British Parliament concerning British nationality. 25
. a child born in Hong Kong acquired the status of a British Dependent Territories (Hong Kong)
The Basic Law of The Hong Kong Special Administrative Region of The People’s Republic of China. Most of the Hong Kong people fell largely into the category of British Dependent Territories Citizens. 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. 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. Two Systems". The Joint Declaration sets out the basic policies of the People's Under the principle of "One
Republic of China (PRC) regarding Hong Kong. Before 1997.
115. 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. (b) not to have imposed upon him any condition of stay in Hong Kong. (c) not to have a deportation order made against him and (d) not to have a removal order made against him.
Basic Law However. in accordance with the laws of the Region. and any condition of stay that is imposed shall have no effect. and he is not subject to any limit of stay in Hong Kong. 45 According to s. permanent identity cards which state their right of abode –
The term ‘settled’ is defined by Para. a Hong Kong permanent resident enjoys the right of abode in Hong Kong which are the right to (a) land in Hong Kong. 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. 1(5) of Schedule 1 of Immigration Ordinance Cap. 115. this qualifying requirement sated in paragraph 2(a) of Schedule 1 of Immigration Ordinance does not exist in Article 24 of Basic Law. While its meaning
remained the same which required that for a Chinese citizen born in Hong Kong to be a permanent resident. 115 was slightly amended upon the change of sovereign in 1997. 26
. This provision was stated clearly in Schedule 1 of Immigration
Ordinance Cap. 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. For
the purpose of reunification.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.
had the right of abode in Hong Kong only. who.
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. before the establishment of the Hong Kong Special Administrative Region. and
Persons other than those residents listed in categories (1) to (5).
Persons of Chinese nationality born outside Hong Kong of those residents listed in categories (1) and (2).
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.
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.
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. permanent or otherwise. Chong’s grandfather lodged a claim about Chong's status with the Director of Immigration.More importantly. That was in November 1997.
Shortly after the parents arrived in Hong Kong. CHONG Fung-yuen’s parents were
Mainlanders who came to Hong Kong with two-way permits on a visit in early September 1997. the mother gave birth to CHONG Fung-yuen on 29 September 1997. They were not residents of Hong Kong. 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. They were arrested and repatriated while
CHONG Fung-yuen stayed in Hong Kong with his grandfather who was a Hong Kong citizen. CHONG
Fung-yuen case was a classic case arguing the legal provision on the residency of Hong Kong born child to Mainland parents. The authority of Immigration Ordinance was seriously challenged. and did not accept that he
CHONG Fung-yuen v. The Director did not accept
CHONG Fung-yuen as permanent resident of 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. and contravene art.46
CHONG FUNG-YUEN v. They have therefore no effect to limit the
right of abode of those Chinese citizens born within Hong Kong. HACL 69/1999 29
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. the Director of Immigration. Chong’s grandfather applied for a judicial review against the Director’s decision in 1999.24(2)(1) of the Basic Law.
47 Based on the survey of 43
months. 1997 to January 31. the Director of Immigration. 62 of 2000. Following the Court’s judgment. 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. CACV No. 2001.) 48 ‘The Hordes at our gate’ by Regina Ip. Director of Immigration lodged an appeal to the Court of
Appeal and Court of Final Appeal and were both dismissed. the number of such births in Hong Kong has risen from 709 in 2000 to 9273 in 2005. South China Morning Post.
Between July 1. 1997 and January 31. the judges of the case had reviewed the numbers of children born in Hong Kong between July 1. 2001. Hong Kong medical and health care and social welfare services became the big pull for Mainland mothers. The lack of foresight of our judges brought about today’s plight.Besides. a 13-fold increase. (2006-12-04) 30
. Once the floodgate was open. (CHONG Fung-yuen v. 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.
The decision of Court of Final Appeal has tremendous implication on Hong Kong population policy. whose parents neither had the right of abode nor lived in Hong Kong at the time of birth.
By referring to the public obstetric service as a common-pool resource. the insufficient public obstetric service for local women will be diagnosed from an economic perspective.CHAPTER THREE DIAGNOSIS OF THE PROBLEM FROM AN ECNONOMIC APPROACH
Introduction In this chapter. we basically ask two questions : firstly. does the good or service remain available for subsequent consumption or use by someone else. if not impossible. 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. problems of collective action and problem of externalities can be used to explain the service-seeking behaviour of Mainland pregnant women. For goods which is very difficult. is it possible to restrict someone’s access to that good or service and the second. once access is gained and consumption or use occurs.
Common Pool Resources When categorizing a good or service. we can
. to restrict someone’s access to the resources and becomes unavailable for subsequent consumption once it is open for access.
Governing the Commons : The evolution of institutions for collective action. 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. E. 5 51 Ostrom. Cambridge: Cambridge University Press. he used behaviour of As human beings are rational and If
rational herders to illustrate the phenomena. 50 Brickers. there will be one day when the resources be used up if open for consumption without proper management or control. New York : Houghton Mifflin. (2001). these
that it is impossible or too costly to restrict someone’s access.
resources are exhaustible. 32
.categorize it as common-pool resource. K. hardly at all of common interest. Cambridge: Cambridge University Press. Boston . Public policy analysis : a political economy approach. Governing the Commons : the evolution of institutions for collective action. (1990). The individual is likely to neglect the impact of overgrazing as everyone thinks chiefly of his own.
every herder can gain access to the same piece of land. people do things to advance their own goals and objectives50.N. These resources are so large Furthermore. In Garrett Hardin’s ‘Tragedy of the Commons’. and fishery grounds49.
Problem of Collective Actions Standard analysis in modern resource economics concludes that when common-pool resources are open to people for consumption. Pp 30. the problem of collective action is common. (1990). pp. Pp 2. E. pastures.. The most typical examples of common-pool resources are forests.
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
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
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
Modern resource economics analysis also concludes that where number of users have access to a common-pool resource.M (eds) Advances in Policy Studies Since 1950. ‘Policy Analysis of collective Action and Self-Governance’ in Dunn W.neglect these externalities. total resource units withdrawn from the resource will be greater than the optimal economic level of withdrawal.55
Ostrom. 86 36
. they tend to produce more than market optimum and induce loss to the society as a whole.N. R. New Brunswick (USA) and London (UK) : Transaction Publics (1992). E. & Kelly. Pp.
One of the most frequently cited solutions to externality is government intervention by way of user charges or tax. 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. 37
. which was suggested by Pigou in Economics of Welfare in 1921. C.. Virginia : George Mason University Press (1988). ‘The Problem of Externality’ in Cowen T. Pp 209-234. (Figure 2 refers56)
Dahlman. (eds) The Theory of Market Failure.J. the real cost is internalized to the producers or consumers so as to resume the market optimum.
goods or services consumed or produced.
imposition of tax and monitoring are too high. 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. ‘The Problem of Externality’ in Cowen T. as costless transaction opportunities will allow suitable modification of translations behaviour so that all undesirable side effects are properly internalized. He further suggested that when there are no costs of transacting. Virginia : George Mason University Press (1988)..J. Pp 209-234. C. the transaction costs for formulating regulation. Additionally.Pigouvian theorem ‘The Pigouvian Tax’ was criticized by Ronald Coase to be inefficient in solving public problem. it is in reality impossible to restrict one’s access to medical care. 38
. Some may argue that user charge excludes those who cannot afford the payment from accessing the medical services.57
Public Obstetric Service in Hong Kong In Hong Kong. which makes medical service a private good. it is the Hospital Authority’s principle not to deny medical care due to
Dahlman. all externalities would be eliminated. However. 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. medical services that are provided by public hospitals can be categorized as common-pool resources that are non-excludable and subtractive. (eds) The Theory of Market Failure. In Hong Kong.
Public medical resource is common-pool resource because it is also
subtractive. are forced to pay more and give birth in private hospitals when the limit in public hospitals is reached.
A pregnant woman about to give birth was turned away from three hospitals and a clinic in Kunming because she only had 900 yuan. 59 In 2005/2006 financial year. The ethical concern makes public medical service non-excludable in nature. medical attention from doctors and nurse. over 70% of the total government revenue was from tax. Additionally Mainland mother are patients requiring addition drugs. ‘Hospitals slam door on pregnant woman’. HK$263 million was from government subvention.
Hong Kong public medical services are funded mainly by the government59 through revenue from taxes and sale of land.60 Patients seeking medical service only have to pay at a rate. who now received less attention from nurse and doctors and less space in the same ward. thereby imposing costs on other patients. medical services will be provided to any person in Hong Kong who is in need regardless of their ability to pay.lack of means.e. bed. among the HK$300 million revenue of Hospital Authority. 2007-04-03. 39
. Pregnant women. South China Morning Post. Obstetric service before September 2005 calculated on the number of day of hospitalization. 90% i. as human lives are paramount. who do not manage to reserve a place in public hospital or who want to have better medical care. ward. 60 In 2005/2006 financial year. Hong Kong
residents only had to pay HK$100 per day for admission to public hospital for giving birth.
Non-Hong Kong residents paid HK$3.300 per day. Unlike Mainland China58. which is highly subsidized by government.
hospitals is much higher. Mainland mothers choose the option that benefits them most.legco. Mainland women evaluate the costs and benefits based on their knowledge. 2004.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). and better postnatal care.
service charges will choose private hospitals that provide better medical treatment. They focus on their private costs and benefits while neglecting the costs
for the Hong Kong society by consumption of medical care.hk/yr04-05/english/counmtg/hansard/cm1110ti-translate-e.
Cost of giving birth in Hong Kong When deciding whether to give birth in Hong Kong or in Mainland. The charge for obstetric services in private
It ranges from HK$15. in private or in public hospital. As utility maximizers.
Legislative Council Meeting on November 10. a more comfortable stay.000 to over HK$100.
Alternative to public medical service is private medical service provided by seven private hospitals in Hong Kong.000 to HK$14.pdf)
For those who have no relative in Hong Kong.63 However.I) Short-term costs Giving birth in Hong Kong involves short-term costs and long-term costs to Mainlanders.htm 41
. which were only HK$3.300 before September 2005.
Mainland pregnant women come from Guongdong province. Hukou system was
implemented by Mainland China government in 1955 as a measure to guard big cities
‘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’. The application fee for a TWP together with a single entry
endorsement costs RMB120.com/wlgat/gdgry/index. Short-term costs include obstetric service charges. Many of these
Mainland mothers-to-be come to Hong Kong with two-way permit under Individual Visit Scheme.
II) Long-term costs Giving birth in Hong Kong is not without long-term cost.gdcrj.62 They come to Hong Kong mainly by train. The most important one would be forgoing ‘hukou’. http://www. Source : Website of Division of Exit and Entry Administration Department of Public Security of Guangdong Province. Mingpao. Majority of
It depends on the type of accommodation chosen by the Mainlanders.
The cost of lodging ranges from hundreds to thousands. i. (2006-12-29) Application fee fro a two-way permit cost RMB120 for a single entry while cost RMB140 for double entries. The transportation cost is rather limited.e. in Mainland China. travel during pregnancy involves risk to the mothers and babies that should also be counted as costs. they have to pay lodging. citizenship.
for example in the allocation of social services by job status. and proof of official status.against influx of rural population. The China Quarterly. obtain employment. marry. 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. with a net gain of 34. The China Quarterly.
their counterparts in countryside. Hukou registration
provides the principal basis for establishing identity. 42
. citizenship. China’s urban population increased from 10. (1994) The Origins and Social Consequences of China’s Hukou System.6 million.6% in 1956. Without registration.6% of the total population in 1949 to 14. go to school.64 Under Hukou system. there are still differentiations. Within both urban and rural spheres. The state reserves its resources disproportionately for those Benefits allocated to urban areas are privileged over
classified as urban population. every Mainland China citizen is required to register to a Public Security Bureau. or enlist in the army. 65 Deborah Davis (1989) Chinese Social Welfare : Policies and Outcomes. clothing.65
Rapid economic development in Mainland China brought significant rural-urban migration. eligibility for the above benefits in Mainland is not standardized across the country.
Unlike Hong Kong. one cannot establish eligibility for food. Tiejun Cheng and Mark Selden. or
national defence and science and technology. In 1978. China’s Populations : Problems. With the implementation of economic reform in late 1970s. the Fifth National
Peoples’ Congress ratified the new constitution. Pp. and to realize the four modernizations66. Deng Xiaoping. industry. Vt. Brookfield. Thoughts and Policies.67
‘Four modernizations’ was fundamental part of Deng Xiaoping’s economic reform in China in late 1970s. (1999). Four modernization included modernization of agriculture. 43
. It was also the first time that family planning was
confirmed legally and became one of the fundamental duties of all citizens.Benefits of giving birth in Hong Kong I) Fleeing from One-child Policy Penalty However. Aldershot . Gabe T. the Chinese leader at that time. : Ashgate. 67 WANG.. pointed out that strict adherence to population control policies was the only way out of poverty.
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. 87-94. 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. Central Government officials started doubting their traditional beliefs that having large family was a good thing. the Health Ministry issued instruction to all government organizations to provide guidance to people on the concept of birth control. which explicitly stipulated that the state advocated family planning. As a result.
It explains why so many
WANG.300 to give birth in Hong Kong. One is to reduce the number of children-. 95. The Family Planning Office
claims that the rationales behind is first. it must strictly control the second birth.
Mainland and paying the penalty will not guarantee social services especially for those live in rural area and /or without state employment. (1999). There
The penalty varies from city to city.The population Control Policy in late-1970s included four parts.which advocates that each couple has only one child.
By paying just HK$3. Mainlanders can evade from making the penalty of RMB80. Generally speaking. Brookfield. will be a fine for having an extra child. Mainlanders come to Hong Kong for giving birth. a family in Guangdong who has their second child will be fined for around RMB80. every Mainland couple is only entitled to have one child. : Ashgate. as a financial support for the government to provide education and other welfares for their children.000 to the government. Pp. Gabe T. to make people think clearly before having children and second. However.000. entitlement to social services Having a Hukou in
depends largely on the type of Hukou and social status. Vt. from
household to household. Thoughts and Policies. 44
. China’s Populations : Problems. and resolutely prevent the third child..68 Under the one-child policy. Aldershot .
III) Hong Kong Residency However. They are attracted by the nine-year free education. While in Hong Kong. Especially after the landmark Chong Fung-yuen case in 2001.II) Advanced Medical Care Further.
when full payment is made upon admission. This is also the method used by many Mainland women to flee from The whole system attracts
making payment in Hong Kong public hospitals. Furthermore.
Reports on denying medical treatment due to lack of means is common in Mainland China. the major drive for Mainlanders giving birth in Hong Kong is the permanent residency for their children born in Hong Kong. it became clear that everyone born in Hong Kong would be Hong Kong citizen. 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. in Mainland. medical services are provided only They follow strictly to this rule.
Mainlanders. Many Mainland mothers cherish the better
living environment and welfare for their children and thus try every mean to give birth in Hong Kong. as they know that they can obtain better medical service without paying a penny in Hong Kong. public housing
. medical care and technology in Hong Kong is much more advanced than that in Mainland China.
HK$14. The cost of delivery ranges from HK$12.
Externalities What these Mainland mothers cannot see are costs imposed on the society upon their consumption of medical care in Hong Kong. With only limited cost. consumption by one would impose cost to another. but appears as costs to others in the society. the large influx of Mainlanders has placed
significant pressure on the Hong Kong medical resources. The difference between the charge level and the cost are borne by Hong Kong taxpayers. their children can enjoy disproportionately greater benefits provided by the Hong Kong government. The negative externalities associated
are not incorporated in the cost function of these Mainland mothers. medical resources are subtractive in nature. Besides. That makes Hong Kong quite attractive to Mainlanders. As mentioned before. 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.benefits.000. different sorts of allowances such as Comprehensive Social Assistance Allowance and more recently the Pre-primary Education Voucher Scheme. public medical care. Those managing to get a place in public hospitals are forced to stay in a
whose husbands are also Mainlanders.
Not all of these costs were recognized by the Mainlanders. there was an upsurge in Mainland pregnant women. and welfare to these Hong Kong born children to Mainland parents are not without cost.
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. The costs are. shouldered by Hong Kong taxpayers.crowded ward and give birth with another woman in the same delivery room at the same time. They feel that these children free ride on the effort of Hong Kong taxpayers. coming to Hong Kong for the purpose of giving birth. 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. providing education.
Furthermore. irrational behaviour. Especially after 2005. medical care. Individual rational decision becomes collective
In order to resume market equilibrium. nevertheless.
. government has taken
measure to internalize the costs to the Mainlanders and tackle the problem of externality.
thousands and thousands of Mainlanders came to Hong Kong for giving birth. as the public hospitals had no vacancy left. 300 for one-day hospitalization in public ward. At that time. The private cost for Mainlander was far below the social cost of giving birth in Hong Kong. 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. for non-Hong Kong resident seeking
. Some local mothers-to-be were forced to pay extra to get a place in private hospitals. The number of Mainland women giving
birth in Hong Kong in 2005 increased almost 3-fold over that in 2001.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 sudden increase in the number of Mainland
pregnant women induced congestions in public ward. with delivery service included. Together with the long-term benefits to their children and the relaxation of Two Way Permit (TWP) requirements. there was an upsurge in the Mainland mothers coming to Hong Kong for giving birth. delivery room. pressure on medical staff and affected the quality of service provided to local pregnant women. extra charge.
000 when one can save HK$80. The rational behind was that by
increasing the price level. in September 2005.
required all Mainland pregnant women to pay HK$19. Another purpose was to bring the charge level of public obstetric service closer to that of private hospital. 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. The major reason It is
was that the charge was not effectively set to bring the market back to optimum. one year after the implementation of increased charge for the
obstetric package. the cost of giving birth in Hong Kong was internalized to Mainlanders seeking the service. In 2006. Besides. For those could not
This Pigouvian tax adopted by the government proved to be ineffective in solving the problem.800 deposit upon admission to hospital in order to avoid defaulted payment. 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.
A HK$20.obstetric service in public hospital.000. afford HK$20.000 by fleeing from one-child policy penalty.
quite ironic to set the charge at HK$20. the marginal private cost after the
.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. they might simply remain in China.
. 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. They knew
that Hong Kong hospitals would not deny service due to lack of means.hk/pdf_e/e47ch05. the cost of delivery could not be internalized to them and could not bring the market to optimum. Source : ‘Hospital Authority : management of outstanding medical fees’. HKSAR Government. http://www. they then sought last-minute hospital admission before delivery through the A&E ward.aud.
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.69 As Mainlanders can easily escape from making payment.800 million in 2005/06 financial year. there existed a loophole that allowed Mainland women to obtain obstetric service without making deposit. Audit Commission.
The bad debts of Hospital Authority amounted to HK$2. Although the Authority required every non-Hong Kong resident to make deposit upon admission for giving birth.
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. Furthermore.implementation of new charge was still far below the marginal social cost.
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. 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. Public hospitals are overcrowded. Some suggested having the Basic Law amended or reinterpreted while
. Legislative Council members and the public have urged the government to face the problem. Speculations on the possible solutions and
development over the issue can be seen on the headline of the newspaper almost everyday. quality of service delivery has declined significantly. They urged the government for
solution to ensure sufficient public obstetric service is reserved for local pregnant women.
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
. a centralized booking system. The
official objective of the new measures is to ensure sufficient public obstetric service is available to local pregnant women. The policy
Pregnant women of other nationalities
were not bounded by these rules. All were rejected by the government. The measures include increasing the charge. and Food Bureau finally came up with a package of new measures to tackle the problem.
After months of meetings with Mainland authorities. Welfare. HK$39. the charge for delivery in public hospital increased from HK$20. The authority’s explanation was that the number of pregnant women from other countries seeking obstetric service in Hong Kong was not common. was tailor-made solely for Mainland women. Health.000. and strengthening of immigration control.
The New Policy Increase in Charge Effective from February 1.some suggested withholding the baby’s birth certificate until the parents have settled their hospital charge. 2007 when the new measures were implemented.000 to HK$39.
000 additional charge was to deter It also
Mainland pregnant women from seeking obstetric service in the last minute. the Hospital Authority implemented several measures for collecting outstanding medical fees. To effectively
internalize the costs to the Mainland mothers. private hospitals. the Additionally. So that the Mainland mothers will shift to
The imposition of HK$9. who have outstanding fee will only be provided with
.concerned delivery. their babies.
encourages the Mainland pregnant women to have prenatal checks before their delivery in order to reduce the risks to the mothers. Upon registration. the
Mainland mother-to-be is required to produce proof of address. 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. and medical staffs. An additional HK$9. without an effective defaulted payment system.
Defaulted Payment Prevention Mechanism As mentioned in last chapter. including both Hong Kong residents
and non-Hong Kong residents.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. the consumers will never see the real costs of their consumption.
Authority will defer submission of birth data to Birth Registry for Mainlanders until outstanding fees are paid up to 42 days. Those.
Mainland people might still find HK$39.71 Besides. ‘Authority cashes in on pregnancy policy’. People who can afford HK$39. CB (2) 761/06-07(03). (8 January 2007). (2007-02-02). 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.000 worthy as they can flee from one child policy penalty and their children can enjoy Hong Kong social welfare benefits. the government implemented other supporting measures to ensure sufficient obstetric service is available to local pregnant women. People in Mainland China are getting wealthier.000 for giving birth to a baby are countless.emergency services.6 million revenue to Hong Kong Government within in single day. administrative charge will be imposed for late
Finally. the government knows clearly that the problem cannot be solved solely by increasing the service charge. the Authority is also exploring the possibility of hiring
international debt collection agency for pursuing Mainland bad debts.
Centralized Registration System The Bureau developed a centralized booking system for both private and public hospitals. South China Morning Post.70
Having learnt from previous lessons. 71 On the first day of the implementation of this new measures. Therefore.
Discussion Paper on ‘Impact of the use of Obstetric Services by Mainland Women on Public Hospital Resources’ by Legislative Council Panel on Health Services. totally 734 Mainland pregnant women made registration through the Hospital Authority centralized booking system and brought HK$28. LC Paper No.
quotas are left will be allocated to Mainland women. payments. 54
quota for Mainland mothers would not exceed HK$12.000 per year. the authority has defined ‘advanced stage of pregnancy’ as being pregnant for more than 7 months i.
To avoid dispute. 55
. pressure groups or politician at the time it was implemented. In spite of the rush.
The new policy was put forward in January 2007 and was fully implemented in February.
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.
the advanced stage of pregnancy72 who have no booking would be denied. 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.e. a booking certificate will be issued to them. there was no big opposition or objection from the public. 28 weeks. The public generally welcomed the policy which had considerably released their anxiety over the situation. Body check facilities and medical officers were
stationed in all checkpoints to provide advice on the physical conditions of the non-local pregnant women. Those who were found to be pregnant for more than 28
weeks and without booking certificate will be denied entry.
Mainland women have made the reservation.
first nine weeks of the new policy until April 4. charge for cross-border couples could fall to HK$20. the number of Mainland pregnant woman giving birth in Hong Kong public hospitals dropped significantly after the implementation of the new measures in February 2007.800 Mainland women gave birth in Hong Kong. the
implementation of centralized booking system together with immigration control has
‘Birth fee drop for wives .CHAPTER FIVE EVALUATION OF THE NEW POLICY
Introduction According to the figure released by the Health. 371 of them sought last-minute obstetric service from emergency wards.000’ SCMP (2007-04-17) and ‘內地孕婦來港分娩個案降 4%’ Singtao Daily.190 of them gave birth in public hospitals. 2007. 1. (2007-04-16) 56
. it seems that the new measures have successfully shifted the Mainland mothers-to-be from public to private hospitals. totally 3. and Food Bureau. When compared
with the figure of the same period last year. although the total number of Mainland women coming to Hong Kong only dropped by 4%. the number seeking services from public hospitals dropped significantly by 35%. Mainland pregnant women seeking
emergency delivery service even dropped by 75%. Besides.73
By looking at the figure. Welfare.
while the instrument choice is real and will have immediate consequence75. The study of policy instruments then can be useful in strengthening the predictive capacity of policy analysis that would be helpful in policy design.
Richard F. Policy Studies Review. this chapter will be the evaluation of the new policy with focus on its design and implementation. these responses are called instruments. instead
of focusing on the output of the policy. Certain instruments fit certain problems and objective better than other instruments. R. 57
. it is good to know something about the
potential effects of different policy instruments before one chooses among them. Therefore. the duration is too short to see the real effectiveness of the policy. Therefore. Vedung E. and implementation problems. Policy Instruments and their Evaluation. Different policy instruments have different operating characteristics. Bemelmans-Videc M. Elmore stated that certain types of problems predictably bring into play certain responses from policy makers. Pp. USSA New Brunswish : Transaction Publishers.74
As a broad policy objective is to be achieved far in the future. Rist R. (1987) ‘Instruments and strategy in public policy’.
Elmore.C. 41.F. since the new policy has been implemented for just two and a half months. strengths. However. this chapter will evaluate the new policy by referring to the choice and design of the policy instruments. Carrots.deterred people from seeking last-minute service from the emergency wards. Sticks and Sermons. (1998).
. and H. According to Marie-Louise Benelmans-Videc. 5.C.76 Evaluation of a policy cannot do away with figures and data on the In fact. Policy Instruments and their Evaluation. Freeman. 41. Evaluation : A Systematic Approach. efficiency. legality.H. 77 Bemelmans-Videc M. Sticks and Sermons. Pp. there is also ‘process evaluation’ where the evaluation focuses on the process of designing and implementing of policy or programme.What is Evaluation? Evaluation is the systematic application of social research procedure for assessing the conceptualization. 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.
all phases of the policy process. P. 1993. Apart from ‘output / outcome evaluation’. design. no matter ‘output evaluation’ or ‘process evaluation’. Rist R. and legitimacy77. Carrots. CA : Sage. Vedung E. USSA New Brunswish : Transaction Publishers.
When evaluating a policy. (1998). from problem analysis through monitoring implementation to the appraisal of the actual result of the policy can be evaluated. Pp. implementation and utility of social intervention programmes.E.
policy outcome. the values of good governance include effectiveness. which is generally referred as ‘output / outcome evaluation’. Newbury Park. democracy.
Pp. the choice of policy instrument instruments is a search for optimum solution. Policy Instruments and their Evaluation. while at the same time they compete or conflict. The final value is legitimacy. USSA New Brunswish : Transaction Publishers. Vedung E.Effectiveness is the degree of goal-realization due to the use of certain policy instrument. instrument.C. These central criteria of good governance
need to be combined. 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. 6-9 59
. Rist R. policy instruments that score high on the democracy criterion often have a price tag in terms of their efficiency. and a balancing act. It
includes the problems of implementation of the policy instrument through devised means. e. 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.g. It includes both positive and negative effects brought by the policy Efficiency refers to the input-output ratio of the policy instrument. (1998). Carrots. Sticks and Sermons.78
Bemelmans-Videc M. Therefore. which is the degree to which government choices are perceived as just and lawful in the eyes of the involved actions.
Rist R. 59. The
In this paper. 31. economic means. 80 Ibid. Vedung E. generally embraced classification of policy instrument. acceptable behaviour or to limit activities in a society. Pp. Policy Instruments and their Evaluation. policy instruments can be categorized in many ways.Classification of Policy Instruments Nowhere in the international literature on policy analysis and public administration is to be found a uniform.81
Bemelmans-Videc M. (1998). 59. Pp. Policy Instruments and their Evaluation. Regulations often associated with threats of
negative sanctions such as fines. Sticks and Sermons.C. By such. (1998). policy
instruments are categorized by the degree of authoritative force or degree of constraints involved in the government effort. Carrots. and information. Vedung E. Carrots. USSA New Brunswish : Transaction Publishers. imprisonment. USSA New Brunswish : Transaction Publishers. policy instruments can be
defined as regulation. and other type of punishment. 60
. Pp. Sticks and Sermons. 81 Bemelmans-Videc M.C.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.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. Rist R.
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. because they hesitate to take the measures required to get it. and other valuables to pursue certain actions. which also determines the capacity of the government organization to ensure compliance.C. effort.C. (1998). Policy Instruments 61
. They may decide not to make use of the
government incentive. Pp. effectiveness also greatly depends on the nature of the policy context. Sticks and Sermons.Regulatory instruments are not without weakness. USSA New Brunswish : Transaction Publishers. time. (1998). 83 Bemelmans-Videc M. Carrots. Additionally. Vedung E. Rist R.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. Sticks and Sermons.83 Taking cigarette consumption in Hong Kong as an
Bemelmans-Videc M. Policy Instruments and their Evaluation. Rist R.
It is argued that regulations are
ineffective in changing behaviour if there no social consensus around the government policy underlying the regulatory instruments. The effectiveness of a regulatory
instrument is associated with its legitimacy.71. Carrots. What makes economic policy instruments different from regulations is that the addressees are not obligated to take the measures involved. Vedung E. either positive or negative.
diffusion of printed material. the addressee might
already have decided to behave in the desired way.
Information The third type of instrument is information which influences people through the transfer of knowledge. USSA New Brunswish : Transaction Publishers. How the
and their Evaluation. good or bad. amassing and packaging etc. communication of reasoned argument and persuasion. Instead of formulating
rule to totally ban the purchasing of cigarette in the market. the
effectiveness of economic instrument must rely heavily on the relationship between the economic incentive and the policy goals. the government fells the need to do something to discourage people consuming cigarette. in which case economic incentive or disincentive has been unnecessary. 32-33. The addressees have the right to choose. Pp. 62
. Sometimes.example. 84 Ibid. citizens are informed of what is right or wrong. Pp.
Economic policy instrument is flexible and usually has higher legitimacy when compared with regulatory instruments. 84 Through advertisement. 33. since cigarette smoking is hazardous to health. the government imposes heavy tax on it and makes the smokers’ habit more expensive. However. as the addressee has no obligation to follow the regulation. education.
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. Policy Instruments and their Evaluation. Vedung E. regulatory. and availability of other policy instruments. Rist R.
Evaluation of 2007 Policy Policy Instruments The policy implemented in 2007 is a combination of economic. Pp. Sticks and Sermons.
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. meaning. 48.people should act and behave and what people are allowed to do. USSA New Brunswish : Transaction Publishers. It increased the public obstetric service charge for
Mainland women from HK$20.C. Policy Instruments and their Evaluation. The financial disincentive increased the cost of action and prompted the addressees to undertake activities that will achieve the goals of the government.000 to HK$39. Mainlanders are not obligated to pay the adjusted service charge.C. (1998). 63
. (1998).000. USSA New Brunswish : Transaction Publishers. 86 Bemelmans-Videc M. Sticks and Sermons. Vedung E. Rist R. Carrots. Pp 79.85 The former refers
to information as a policy instrument while the latter refers as information on policy instrument. and informative policy instruments.86
Bemelmans-Videc M. Carrots.
However. press release. 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. it imposed regulations requiring all Mainland obstetric service seekers make prior registration and settle full payment before delivery. Well before the policy is put forward. Those
seeking obstetric service without registration will be penalized for HK$10. Those Mainland women at their advanced stage of pregnancy without booking certificate would be denied entry. since the target of this policy is Mainland women.
Choice of instruments From policy instrument perspective. 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. there are advertisement.To avoid defaulted payment and enhanced the effectiveness of the policy.000. There are two factors which shape the choice of policy makers : the first one is the
Many new policies in Hong Kong in recent years like to use information either as a tool or as a package. To avoid non-compliance. and consultation papers to raise people attention on the subject. we do not see large-scale promotion or publicity on this policy in Hong Kong.
No. the capabilities of implementing institution. Sticks and Sermons. 2. 65
.C. L. 9. Pp 144.87 The decision making process is an exercise of give and take which involves the trade-offs of effectiveness and efficiency. 88 Bemelmans-Videc M. Rist R. the government announced its plan in tackling the service seeking behaviour of Mainland pregnant women while no extremely authoritative measures as
McDonnell. Pp. different people had different focuses on the issue that led to different proposals on the solutions. Some even suggested amending Basic Law to redefine the residential status of children born in Hong Kong with Mainland parents. USSA New Brunswish : Transaction Publishers. (1998). Some focused on the problem of defaulted payment.
In January 2007. and the different constituent pressures faced by the policy maker. Elmore. Carrots.M. ‘Getting the Job done : Alternative Policy Instruments’. Vedung E. some focused on the residency of the children while some focused on the quality and availability of obstetric service in public hospitals. Policy Instruments and their Evaluation. 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.F. 151. Summer 1987. Educational Evaluation and Policy Analysis. R. the political and fiscal costs of selecting a particular instrument.88
In late 2006 when the issue received the hottest debate..problem identification and the second is the resources and constraints faced by policy makers. Vol.
implementing absolute prohibition. On one hand. the children born
in Hong Kong might become our future workforce. there is no need to totally deny service to non-local women. More importantly. 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. On the other hand. the level of legitimacy would induce difficulties in implementation. which will relieve the problem of
NG Ka-ling and others v.
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. it can reduce the possibility of defaulted payment. 14 of 1998.
Ka-ling case89 in 2002. 66
. Two System’. the prior registration requirement allow the authority better control the number of Mainland pregnant women seeking public obstetric service. the Director of Immigration. 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. FACV No.
As the policy objective is to ensure sufficient obstetric service to local pregnant women. The political cost and the After NG
cost of non-compliance are so high that the government cannot afford.listed above could be seen in the proposal.
Census and Statistics Department. The government then put in place series of measures to avoid non-compliance.
Regulation seldom results in uniform compliance. it is estimated that by 2030.
there are still intermittent reports on Mainland women gained entry to Hong Kong by
2006 Population By-census. the imposition of yearly quota ensured sufficient obstetric service is available to local pregnant women.90 Allowing Mainland mothers to give birth in Hong Kong is one of the methods in ensuring the sustainability of Hong Kong population growth. 67
. 27% of the total population will be aged 65 and above. Finally. the authority also set up body check facilities in border checkpoint to ascertain the pregnant women’s medical condition.
There is always individuals resist
compliance if by doing so they can reap positive benefits. However.
In the meantime. With the consistently low birth rate. HKSAR Government. which is the goal of the policy.the ageing population faced by the society. The
economic mean has changed people’s behaviour and successfully shifted the service seekers from public hospitals to private hospitals. Apart from prior registration system to prevent defaulted payment. the policy doubled the service charge to make the charging level of obstetric service in public hospital more inline with that in private hospitals.
disguise or forgery. If the policy goal is to protect the welfare of Hong Kong pregnant
. What more. In
Recently. they only have to pay HK$20. Women
from all other countries are not covered by the new policy. Japan. which means pregnant women from USA. the policy is discriminatory in nature. Firstly.
Design of Policy However. a Mainland woman crossed the border with a forged
registration certificate that was issued by a medical practitioner in Hong Kong. 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. 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.
It only applies to Mainland women. The way the policy is designed is unexpectedly insensitive which made it subjected to challenges. 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. and Thailand etc are not required to make prior registration for giving in Hong Kong. They would not be any barrier from entering Hong Kong solely on the ground of pregnancy. it also has its downsides. Sri Lanka. 000 for giving birth in Hong Kong. it is not a perfect policy.
Their grievance over the policy is understandable. and legitimacy.577 Mainland women coming to Hong Kong for giving
birth in the first 10 months of 2006.
Moreover. 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. 2007 and May 13. the new service charge should apply to all obstetric service seekers from all over the world. instead of just targeting Mainland pregnant women. the policy was criticized for failing to take care of the real need of Hong Kong people. The legitimacy of the new policy is doubtful. 2007 to demonstrate against the new policy. feasibility. After the
. Among the 20. These Mainland women expressed that they will not pay HK$39. They found it unfair as they are required to pay extra for service and welfare entitled by every Hong Kong people.women.
Conclusion The choice of policy instrument appears to have stricken a balance between effectiveness. Fifty Hong Kong males who have wives in Mainland China marched to Central Government Officer on April 1. 39% of them are married to Hong Kong males. 000 even if they have money as they found it unfair to be treated differently.
there is a significant reduction in the number of Mainland pregnant women giving birth in public hospitals. According to the figure
released in early-April 2007.800 Mainland women gave birth in Hong Kong.
registration system and immigration control have deterred people from taking free lunch. among the 3. 1.
. compared with the figure of the same period last year.implementation of the new policy. It dropped by 35% when The new pricing system has Besides. the
successfully shifted the demand from public to private hospitals.190 of them gave birth in public hospitals.
the goal of relieving the
pressure of public obstetric service has been achieved by shifting Mainland pregnant women from public hospitals to private hospitals. 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.
of the new policy.170 registrations for obstetric
. 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. problem really solved? However. the implementation of the policy has been a success. 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.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. Hospital Authority received 10.
will commit the same mistake as committed by our judges in CHONG Fung-yuen case in 2001. However.
August 2006 to March 2007. charge for cross-border couples could fall to HK$20. its implication cannot be overlooked. Hong Kong residents.
this figure. there were signs of deepened social disintegration after the issue became the center of discussion last year. from Mainland women91. (2007-04-16) 92 The applicants’ ages ranged from two months old to 17 years old. the demand of From
welfare services from these newborn babies has surfaced progressively. in both private and public hospitals. there were 102 children born to Mainland parents applied for Comprehensive Social Security Assistance (CSSA)92. housing facilities. medical The
services. married with Mainland wives. Otherwise. Source : Social Welfare Department. and other welfare services of Hong Kong.
‘Birth fee drop for wives .000’ SCMP (2007-04-17) and ‘內地孕婦來港分娩個案降 4%’. Singtao Daily. Besides. They are all entitled to the education.services.
Social Disintegration The uncertainties faced by Hong Kong people made them worry and anxious. it is estimated that the number of registration will reach twenty or even thirty thousand by the end of 2007. The figure might
seem trivial when compared with the total number of children born to Mainland parents every year. 72
. implication for Hong Kong resources will be significant.
The best and simplest way in achieving this is by standardizing the service charge for all Hong Kong families. 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. That means Mainland women married to Hong
Kong residents only have to pay HK$100 per night for giving birth in public hospitals.
Restructure of obstetric service policy Reorienting Policy Target First. the government should focus its effort on the long term planning in order to balance the population and the resources. The welfare of those Hong Kong residents with Mainland wives should be cared for equally. the government can show its care and support to all families in Hong
.complained that they are discriminated and are not provided with the same rights and benefits enjoyed by other Hong Kong residents.
With the short-term problem being solved. Instead of protecting the benefit of local pregnant women. This
can be achieved by restructuring the current policy on obstetric services and better management of welfare resources. the objective of the policy has to be re-oriented to meet the real need of Hong Kong people. the policy
should aim at protecting the right and benefit of Hong Kong residents as a whole. By doing so.
February to April. around 36% of them sought service from public hospitals 93 . Mainland women giving birth in private
hospitals might pose unbearable pressure on the resources of Hong Kong at a later date. the quota system should extend to cover the registration in private hospitals. to better manage the number of Mainland women giving birth in Hong Kong. the above-suggested policy would gain support that is more public. As most of the opposition of the current policy was from Mainland
women married to Hong Kong residents. as their children might be educated. Without proper control. there were 10. the quota system is not applicable to private hospitals. for those couples who are both non-Hong Kong residents wishing to give birth in Hong Kong.Kong without differentiation which would definitely be beneficial to restore social harmony.170 Mainland women registered for obstetric services in Hong Kong. Mingpao (2007-04-13) 74
Increasing Charge for Couples who are Both non-Hong Kong Residents Thirdly. and seeking medical
Extending Quota Coverage Secondly. Under current policy.
Those seeking obstetric services in Hong Kong would be willing and capable in paying the services. Apart from protecting Hong Kong people’s benefits. Series of measures have to be put in place to avoid non-compliance.
Supportive Measure As the charge is so high.e. It can be achieved by strengthening of Immigration control and
implementing a defaulted payment prevention system. The aim is not to raise public revenue.000. they are required to pay extra as compensation to the Hong Kong government. Mainland pregnant women without registration certificate tried different means to
. 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.and welfare of all kinds in Hong Kong. around HK$100. The whole purpose is to reduce their incentive to give birth in Hong Kong to the minimum.
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.
the increase in charge has the effect in screening incoming pregnant women. it is very likely that people will try every possible mean to come to Hong Kong illegally.
these Mainland women refused to leave the hospital. Immigration officers had After medical They even
no choice but to send these Mainlanders to the nearest hospitals. They should establish a cross-border system that cover two issues. Few falsified
registration certificates while others became nasty when being denied entry.come to Hong Kong. Second. there were also Mainland mothers claimed feeling unwell and sought medical treatment at the border crossing points. the officer should not allow the pregnant woman to leave China unless the woman can produce a valid registration certificate. and the Mainland public security officer at clearance counter reasonably believes that she is at her advanced stage of pregnancy. if a
Mainland woman leaves Mainland China to Hong Kong. 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
. treatment. First.
threatened to commit suicide if repatriated. 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. Apart from the most commonly used tricks that was disguising as non-pregnant woman.
The possibility of non-compliance can be minimized by strengthening the communication with Mainland and solving the problem by working in partnership.
the one-child policy will be less effective in controlling the number of population in China. it needs the active participation of Mainland China. China government should realize that such
service-seeking behaviour of Mainland women is not simply a Hong Kong problem.who will either render medical treatment on the spot or send the women to the nearest hospitals for treatment.
The system is expected to reduce the possibility of abusing medical service due to policy loophole. More importantly. However.
As the whole obstetric service policy lies heavily on the effectiveness of the immigration control. policy of Mainland China. 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. especially those serving in border checkpoints. the communication skills and the negotiation technique. Immigration Department should invest more resources in training their staffs. it requires cohesive communication and cooperation
between Mainland and Hong Kong authorities. Training should
focus on the authority empowered to Immigration officers under the new policy. The behavior poses significant impact on the population As those babies born in Hong Kong will not be counted
as China population.
Mainland mothers can still enter Hong Kong illegally. In these cases.II) Defaulted Payment Prevention System Even under strict immigration control. The purpose is to reduce people’s incentive to come to Hong Kong for giving birth illegally. these babies born to Mainland women were discriminated by other Hong Kong people that resulted in serious social segregation. which will be the
solution to our aging population problem in the future. who have overstayed in Hong Kong after the expiration of their TWP. The government should exert greater effort in promotion the positive image of these newborn babies by publicizing the benefits and advantages brought by them. They should be portrayed as the pillar of our society. 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.
. Some are illegal immigrants while some are two-way permit holders. Those who fail to settle full service charge before they leave the hospitals will be wanted and denied egress from Hong Kong.
Civil Education Due to excessive negative reports by the media.
accommodation. social assistance.
Education These children may seek education. Due to the ever-declining birth rate94.700 in 1990 and to 48. and medical care in the coming decade.censtatd. These schools are either demolished or left idle. Housing. medical service. 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.jsp?tableID=004. 63% of the newborn babies were born to mothers from Mainland China and became the major source of population growth in Hong Kong. All policies have to be reviewed to meet the need of our next generation.Vision in Education. Medical Service and Other Welfare Policies In 2006. The government should monitor the trend of the
service-seeking behaviour of Mainland women and project the demand on education.200 in 2001.000 in 1980 to 67. and welfare of all kinds in Hong Kong. http://www. there was growing proportion of these newborn babies whose parents are not Hong Kong residents.
The number of birth in Hong Kong dropped from 85. housing facilities. totally 127 primary schools closed down between 2001 and 2006 due to the low enrollment rate.gov. Census and Statistic Department. 79
. 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.hk/showtableexcel2. Besides.
The number of birth rose from 48. This means the whole society’s demand on education will increase in the coming decade. if they remain residents in Mainland China. The government should consider either encouraging private sector to run boarding schools. since 2001. Hong Kong's population has rebounded. which provide all in one services to these children so that their education. accommodation and catering are being taken care. They successfully brought our population back to 1990 level. On the other hand. the demand on boarding schools was low which made the number of boarding schools limited. with children born to Mainland mothers formed the major part of the population increase.
In the past.However. If these children seek education in Hong Kong. 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. the demand on boarding schools might increase.
. With the increase proportional of newborn children whose parents are not Hong Kong residents. we might be able to avoid unnecessary chaos as such. If the government has insight and takes a
proactive role in forecasting our demand on education in the future.000 in 2006. with our geographical layout. it
is very likely that they will not live with their parents.200 in 2001 to 65.
financial test95. the amount and the mode of assistance also needs to be reviewed. requirements are exempted for those who are under 16 years old. 81
. 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. to ensure the assistance goes directly to the applicant.Social Welfare Assistance To better protect Hong Kong people’s welfare and avoid social resources being abused. as the assistance is provided to
the Hong Kong born children only. Besides. the existing social welfare system needed to be reviewed.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. Under current
policy. the applicant’s capital asset should not be more than HK$34. These children can get HK$1.
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.
To be eligible for CSSA. 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.000 for ‘single person’ application.
it is not the purpose of this paper to list out all policies the government has to review.
Conclusion These newborn babies are Hong Kong residents. 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. and medical service in Hong Kong while they also have the obligation to contribute to the community.
. 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.The government should look into far too many issues. education. The objective of this section is to highlight that the government should note the significant implication brought by these newborn babies to our society. They
have the right to enjoy the welfare.
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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 (17.6%) 13209 (26.
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. (8 January 2007).4% 31.5% 61.5%) 19538 (34%) 20577 (39.1% 47.7% 20. CB (2) 761/06-07(03).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.9% 14. 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 7.6%) 10128 (21. LC Paper No.
natives of Guangdong province were exempted. Abolition of ‘reach based’ policy China and British governments finally reached an agreement on the daily quote of One Way Permit. 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. Mainland China increased the OWP quota from 75 to 105 per day
1966 1974 1980 1980
1983 1984 1993
. Maximum 150 legal immigrants were allowed to enter Hong Kong for settlement per day. Mainland China reduced the OWP quota from 150 to 75 per day Signing of Sino-British Joint Declaration. Hong Kong Government introduced a quota system to balance the numbers of those entering into and those leaving the Colony. which brought Hong Kong entrepot trade to a standstill. Outbreak of Korean War The United States imposed an almost complete embargo on Chinese trade.
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
. Relaxation of ‘Tanqing’ (Relative visit) endorsement requirements.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.
HKSAR Government..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
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.
. ‘The Evolution of Immigration Law and Policies : 1842-2003 and Beyond’ in CHAN J. B. J. (eds) Immigration Law in Hong Kong : An Interdisciplinary Study.
Map of Cities covered by Individual Visit Scheme in 2007
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
46 m *
1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
* Individual Visit Scheme implemented in Mainland China in July 2003.
Source : Tourism Board
No. of Mainlanders Visited Hong Kong (1997 – 2006)
14 12 10 8 6 4 2 0
800 HK$488.000 HK$33.000 HK$100.000
Baptist Hospital (香港浸信會醫院) St.100 Kong residents.000 – HK15.000 Fee
HK$13.180 – HK$30.000
HK$15.800 – Same as charges for Hong Administration HK$32.800 – HK$25.000 – HK$24.800 Normal Delivery Kong residents.000 – HK$27.000 ward) HK$100.000 – HK$25.280 HK$28.500 Kong residents. Fee
Kong HK$13. Hospital (聖德肋撒醫院) Union Hospital (仁安醫院)
Teresa’s HK$13.800 – Same as charges for Hong Deposit for Mainlanders HK$50.000 – HK$35.000 ward) (private (general
St.200 – HK$42.800 HK$85.780 Kong residents.500 HK$80.000
Adventist Hospital HK$15.000 HK$45.600 – Same as charges for Hong Administration HK$51.800 – Same as charges for Hong (港安醫院) Hong HK$41.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. charge Caesarean Delivery for Special Women Arrangements
for Mainland Pregnant
Kong HK$13. Paul Hospital HK$12.000 – Additional Administrative (聖保羅醫院) Canossa Hospital (嘉諾撒醫院) HK$25.880 HK$42.500 – HK$15.680 – HK$15.800 – HK$17.000 – HK$52. HK$10.700 HK$94.00 Charge – HK$1.000 Caesarean Delivery HK$43.880 – HK$18.100 – HK$16.260 HK$34.880 HK$37.000 – HK$28. HK$15.000 HK$26.