Hong Kong S Health System

This book provides a significant contribution to the discussions about the future of the system.The evidence-driven content draws from the deep expertise and experience of a wide spectrum of contributors, who represent virtually all relevant areas of the health system.

The book covers the period from British colonisation of Hong Kong in 1841 through to the present day. It looks at the way in which the health sector developed, the structural arrangements that resulted, and the manner in which the health system functions today.

This book focuses on a seldom discussed topic despite its immeasurable impact on the health of the citizens and public health in Hong Kong—the development of outpatient medical services and their contributions. In the early 20th century, Chinese elite organized and operated a number of Chinese Public Dispensaries in Hong Kong and Kowloon, initially to reduce the prevalence of “dump bodies” on the streets during epidemics of smallpox or plague, and to determine the cause of death of these bodies. Later other services including domiciliary deliveries by trained midwives were added. The government founded similar clinics in the New Territories. After WWII, the government took over all the Chinese Public Dispensaries and operated them as general outpatient clinics. Over the years, more general clinics and special clinics were developed. These clinics helped improve the health indices of the population to those of the Western countries by the 1970s. Endorsement Modern-day medicine increasingly emphasises patient management on an outpatient basis. We are indebted to Professor Moira M. W. Chan-Yeung for her tireless efforts in researching the history of medical outpatient services in Hong Kong. Through this book, readers will gain insights into how outpatient medicine in the past has shaped the city’s modern day healthcare system, and have a glimpse into its future development. —Professor Lau Chak-sing, Head of Department of Medicine, LKS Faculty of Medicine, The University of Hong Kong An exemplary piece of scholarship that interprets the past and illuminates our future paths. Seldom has history, so dear and near, been told with such prides and hopes, for maestros and ordinary folks. —Professor Gilberto K. K. Leung, Clinical Professor and Associate Dean (Teaching & Learning), LKS Faculty of Medicine, The University of Hong Kong

In Hong Kong the responsibility for building and operating hospitals used to be shared by the Government of Hong Kong and a number of charities, including religious orders, some with traditions dating back to the earliest times. Unfortunately this dual system of government and subvented hospitals was not integrated, leading to problems of coordination and management and resulting in gaps and duplication in services, inefficient and ineffective use of resources, as well as low staff morale. The problems persisted against a background of significant population growth, rising community expectations, and technological advancement. Fundamental and radical solutions were needed. Overseas experts were invited by the Hong Kong Government to study the situation in the mid-1980s. Finally the Government adopted their proposal and set up an autonomous body, the Hospital Authority, to tackle this crucial problem. The development of this local health care system since the 1980s, the setting up of the Hospital Authority and its work in the past few years form the subject of this book.

First published in 1999, this book constitutes a unique account of the development and reform of health care in Hong Kong. Its main focus is on policy developments since 1945. Victor Wong demonstrates the development of a two-tier health system in both a capitalist and Chinese context. His work is one of both health policy and political economy. Wong utilises the latter perspective to show the state’s role in the interests of capital, the public demand for health care and the power of the medical profession. Alongside this, Wong brings in the role of Chinese and family medicine and the role of the family in cost containment and minimising the hospitalisation of elderly, frail and chronically ill patients. The volume is the most comprehensive analysis available for health policy in Hong Kong.

This book provides a timely review on what has been accomplished, and what remains amiss, following the World Health Organization’s 1978 ‘Health for All’ campaign, by identifying enduring gaps in health care within a global context. The WHO declaration of "Health for All by the Year 2000" mapped out a road towards primary health care for all people and demarcated it as essential for human progress in terms of economic development and social justice. However, 45 years have gone by, and most societies and countries have yet achieved 'health for all’, despite so much having changed in technology, disease patterns, and population demographics. In promoting community health and improving service delivery, the book advocates the development and implementation of “All For Health” strategies to steer stakeholders in the right direction towards universal health care. The book covers the gaps and actions in health improvements, the ‘All For Health’ strategies, and the Health in All Policies (HiAP), reviewing and discussing issues through both Asian and international examples. Contributors include both academics and practitioners from diverse professional backgrounds including medicine, nursing, pharmacy, allied health, dietetics, social sciences, life sciences, education, business, administration, law, and public policy. Essential to scholars in public health and related disciplines, this book is also useful to policymakers, community and public health practitioners, and health care executives and interns.