How Hong Kong’s Health System Favors Outward Medical Tourism

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Walking through the passageways at the North District Hospital in Hong Kong, it may be difficult to ignore one sign on the notice board. The sign stares at all who care to read and lists all the services available in the hospital and the wait times before a patient could receive each of them: A 29-month wait for an ultrasound scan, a 29-month wait for a mammogram, and a 23-month wait for an MRI.

These alarmingly long wait times are typical for almost all public hospitals in Hong Kong, as the increased demand for healthcare in the city exceeds the capacity of medical manpower available.

If a woman has to wait two-to-three years to screen for breast cancer with a mammogram or have a pelvic ultrasound to diagnose a pelvic disease, it means the early stages of such diseases will be missed, giving room for progression of the disease as treatment is delayed, increasing the risk of disease complications and deaths.

Similar to or, in some cases, worse than the wait times for these radiological investigations is the average wait time for specialized care. According to the Hospital Authority, Hongkongers seeking specialized medical care may have to wait up to 166 weeks, nearly three-and-a-half years for their first appointment with a specialist.

This has led to a rapidly growing number of Hongkongers going to Taiwan and other nearby countries on medical tourism trips to receive similar health care services, which are much faster and affordable.

The reasons for this drawback in delivering healthcare in Hong Kong cannot be far-fetched: The surging demand for healthcare services far exceeds the number of healthcare professionals available and the rate at which more doctors and other healthcare providers join the workforce.

With a doctor-to-patient ratio in Hong Kong standing at 1:519, this issue is further worsened by the low pay of doctors, the surging increase in the population of Hongkongers, and the high cost of treatment at private hospitals.

Last year, the President of the College of Physicians of Hong Kong, Professor Philip Li Kam-tao, decried a shortage of internal medicine specialists to provide care amid the growing demand for medical care, particularly in the peak flu season.

Li noted that while the number of patients visiting physician clinics has increased by 20 percent between 2011 and 2015, the number of physicians had only increased by 15 percent, putting a strain on the medical personnel and causing them to reduce consultation time for each patient.

Another area of specialized medical care facing this challenge is mental health services. Official statistics revealed that the number of patients needing mental healthcare services grew by 20 percent within a 5-year review period, while the number of doctors and mental health professionals only grew by 3 percent.

In addition, only two psychiatric nurses have been added to the workforce over the last five years to provide care for over 48,000 people diagnosed with severe mental illness.

Patients in stable conditions may wait up to 159 weeks – more than three years – for their first visit with a specialist and each patient is only allowed six to eight minutes in a doctor’s office before their time is up.

These long queue times do not only affect these non-emergency care services, but Hongkongers also have to wait for a long time before receiving care in the ER, for the same reason.

Two months ago, a 72-year-old man died of cerebral haemorrhage after being delayed for about two hours in the ER of Prince of Wales Hospital before receiving a diagnosis, by which time the patient had significantly deteriorated.

This hitch attenuates the merits of the average public hospital in Hong Kong: low cost of healthcare services and high quality of its medical personnel, compared to other cities in China’s Greater Bay Area.

Doctors in Hong Kong’s hospitals also write referrals to private clinics to circumvent the long wait times for some cases, but this comes at a huge cost. While private healthcare in Hong Kong is among the best in the world, patients would have to pay a very huge price to receive treatment in private clinics.

For example, a low- or moderate-income earner in Hongkong who earns roughly HK$15,000 a month would have to give off a full month’s salary to pay for an MRI scan in a private hospital, which costs around HK$3,000 to HK$15,000.

This leaves the average Hongkonger with the option of medical travel. Many of these patients avoid this delay by travelling to Taiwan, Malaysia, Singaprore, and Thailand to receive high quality of care, at an affordable price. In Thailand, for instance, an MRI scan costs about HK$2,300, with minimal wait times.

Hongkongers also fear that as China strengthens links among the Bay Area cities, it may overburden the medical resources and infrastructure in the city, as more people from the Bay Area will travel freely to Hong Kong to receive medical care, which is the best in the area. This will see only see more Hongkongers seek cheaper and better healthcare in countries around.

The cost, quality, and speed of treatment are major drivers of medical tourism around the world and the need for these is potentiating medical travel among residents of Hong Kong. With the current low doctor-to-patient ratio, very long wait times, and growing population in the city, outward medical tourism will be inevitable in Hong Kong.