Public Doctors losing faith in Hospital Authority

Public Doctors losing faith in Hospital Authority

and Government

By Dr Leong Che-hung,

Member of the Legislative Council

The recent uproar of the Hospital Authority (HA) doctors has seen their biggest rally since 1988.

In 1988, the then Government doctors were up in arms. They lamented the poor working environment, lacking of proper professional career and frustrations of being unable to serve patients well.

Today, HA doctors are frustrated with the ever increase in workload, daily bombardment by patients and the media often times uncalled for, the bureaucracy and the seemingly non-delivery of promise of the HA Head Office, and the absence of sympathy and concern of the Government and the HA Board. Worse, in these days of lean economy, the private market is not conducive for them to set up their own practice.

In 1990, when the HA was set up, it was asked by Government to design a remuneration package that was conducive to attract, retain and motivate staff. The first HA package formulated was all to the approval of Government's hawk eyes. Yet, as soon as most staff had switched over from civil service to HA terms, Government moved in step by step for the kill. Spouses working together in HA have a big chunk of their encashed benefits slashed off under the disguise of non-compliance to the 𡞫ouble benefit” rule.

Under the blessing of the Director of Audit's concern that HA staff budget will be much higher than that of civil service in some 20 years, Government launched its second strike. HA was forced to take a reduced staff on-cost budget. Regrettably, under pressure, the HA Board foolishly complied. A second much-reduced HA package was thus offered to new staff since 1998. Existing staff then were promised that they would not be affected, even when they are promoted, as they are protected by contractual obligations of their employer.

However, overnight, under the disguise of a two-tier service obligation reform, the HA Head Office pushed out a third HA package with much reduced encashed fringe benefits. It is not just for new recruits, even existing staff are expected to bridge over, or else they can kiss promotion "god bye”.

To many, such amount not only to a possible substantial cut in their salary and benefit, but also to a complete loss of faith in their employer. What is to be expected next?

Yet, the accusing fingers should not be pointed at the HA alone. Much is the result of Government's nonchalant doings.

Yes, in these days of economic lean, Government should contain its expenditure by demanding for enhanced efficiency. This it has done by rigidly proclaiming a 5% cut in spending in three years across the board. Regrettably, it has not considered the possible lowering of service standard, albeit staff efforts, in certain departments which face ever surging service need.

The public health care service is a very good example. It has seen an exponential increase in public utilisation in the last few years. To wit, from 1992 to 1998, there is an average annual increase of 9.1% in casualty attendance and 6.8% in hospital admission, bringing the figures to over 2.1 million and 985,000 respectively. Furthermore, with poor economy, the utilisation of heavily subsidised public service will certainly increase. On top of this, HA has on its own, since its establishment, achieved productivity saving of some 11%.

The new staff package is thus seen as a means to achieve such an unreasonable further saving at the expenses of staff benefit and even service standards.

In these economic times, it is the duty of each and everyone to do their share. Yet diligent staff must be reasonably compensated, and a good employer should never be unceasingly moving its goal post.

(27 NOV 1999 Hongkong Standard)

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Longer version

The recent uproar of the Hospital Authority (HA) doctors has seen their biggest rally since 1988. is more than a storm in the tea cup. Some 1,000 doctors gathered in the hall of a public hospital to vent their frustration, the biggest rally since 1988. Why should these, usually self contained, dedicated to serve, contented with saving lives professionals took out such radical action?

In 1988, the then Government doctors were up in arms. They lamented the poor working environment, lacking of proper professional career and frustrations of being unable to serve patients well. Some 16% of Government doctors left the public service on an annual basis then for greener pasture. But these were the good times when Hong Kong's economy is on the boom.

Today, 10 years down the line, HA doctors are frustrated with the ever increase in workload, daily bombardment by patients and the media often times uncalled for, the bureaucracy and the seemingly non-delivery of promise of the HA Head Office, and the absence of sympathy and concern of the Government and the HA Board. Worse, in these days of lean economy, the private market is not conducive for them to set up their own practice.

Let us examine some of their frustration. In 1990, when the HA was set up, it was asked by Government to design a remuneration package that was conducive to attract, retain and motivate staff. The first HA package formulated was all to the approval of Government's hawk eyes. Yet, as soon as most staff had switched over from civil service to HA terms, Government moved in step by step for the kill. Spouses working together in HA have a big chunk of their encashed benefits slashed off under the disguise of non-compliance to the "double benefit” rule.

Under the blessing of the Director of Audit's concern that HA staff budget will be much higher than that of civil service in some 20 years, Government grabbed the opportunity and launch its second strike. HA was forced to take a reduced staff on-cost budget. Regrettably, under pressure, the HA Board foolishly complied. A second much-reduced HA package was thus offered to new staff since 1998. Existing staff then were promised that they would not be affected, even when they are promoted, as they are protected by contractual obligations of their employer. Furthermore, they were told in no uncertain term that their original contractual benefit would continue irrespective of their promotion -- or so it seems.

To many, such amount not only to a possible substantial cut in their salary and benefit, but also to a complete loss of faith in their employer. What is to be expected next? To them, it is sans faith, sans hope and sans everything!

Yet, the accusing fingers should not be pointed at the HA alone. Much is the result of Government's nonchalant doings.

Yes, in these days of economic lean, when Government's income is difficult to maintain and that no one would like to see our reserve continuously eroded with no end in sight. Government should contain its expenditure by demanding for enhanced productivity efficiency. This it has done by rigidly proclaiming a 5% cut in spending in three years across the board. Regrettably, it has not considered the possible lowering of service standard, albiet staff efforts, in certain departments which face ever surging service need.

The public health care service is a very good example. It has seen an exponential increase in public utilisation in the last few years. To wit, in 1992/93, the attendance at HA casualty departments was over 1.4 million and total hospital admissions over 710,000. During the ensuing years up to 1997/98, From 1992 to 1998, there is an average annual increase of 9.1% in casualty attendance and 6.8% in hospital admission, bringing the figures to over 2.1 million and 985,000 respectively. Furthermore, with poor economy, the utilisation of heavily subsidised public service will certainly increase. On top of this, HA has on its own, since its establishment, achieved productivity saving of some 11%.

The new staff package is thus seen as a means to achieve such an unreasonable further saving at the expenses of staff benefit and even service standards.