Hong Kong’s Secretary for Health, Lo Chung-mau, has raised alarm over a growing trend of young doctors in their 30s shifting from public hospitals to the private sector immediately after obtaining their specialist qualifications. This switch from the public sector is not only decreasing the availability of skilled doctors in public hospitals but could also lead to a worrying cycle that further depletes the public sector of much-needed expertise.
Recent Surge in Shifts
According to the health minister, “The recent pattern is that young doctors, rather than waiting, exit right after obtaining their specialty qualifications.” During a radio discussion, Lo noted an emerging sentiment among young doctors that it appears “inane” if they don’t set up their private clinics. This mindset, combined with the current trend, could eventually initiate a negative loop wherein increasing departures lead to even more exits.
Data from the Hospital Authority has shown that from May 2022 to April 2023, 7.1% of its full-time doctors left their positions. This equated to 449 departures, against 528 new hires during the 2022-2023 financial year – a slender net increase of 79. More alarmingly, the sector recorded a net loss of 450 nurses during the same period.
In March, the Health Bureau shared with lawmakers that during the 2021-2022 period, 125 doctors with 11 to 16 years of experience left the public sector. This number, representing the largest group based on experience, showcased an astounding rise of 165% from the previous year. The second largest group of departures included doctors with 1-6 years of experience, totaling 114, while those with 6-11 years had 73 exits.
Interestingly, Lo highlighted that while a significant 90% of Hong Kong residents rely on the city’s public health services, almost half the doctors are now employed in the private domain.
The Financial Gap
A striking revelation by the Secretary was that the Hospital Authority, responsible for all public hospitals in Hong Kong, finds it increasingly challenging to match private sector salaries. This is in spite of the government significantly upping its grants by nearly 48% over the past five years, allocating HK$90.9 billion (US$11.6 billion) for the fiscal year 2023-24.
Tim Pang Hung-cheong, a spokesperson for the Society for Community Organisation, pointed out that many doctors prefer private practice as it provides them more control over their schedules and better remuneration. He suggests, “The Hospital Authority should strategize ways to reduce doctors’ workload, enabling them to achieve a better equilibrium between their professional and personal lives.”
Backing these observations, Dr. David Lam Tzit-yuen, representing the medical and health services sector, highlighted the importance of work-life balance, especially for the younger generation of doctors. He proposed an innovative “half-time” system where public sector doctors can reduce their working hours, thus allowing them time for other pursuits. Lam stressed, “Simply attributing this shift to monetary benefits would be a naive oversimplification.”
Retentive Measures
Recognizing the gravity of the situation, the Hospital Authority is endeavoring to offer enticing incentives to retain its workforce. One such initiative is the Enhanced Home Loan Interest Subsidy Scheme. Launched in late 2022, it offers full-time employees on permanent contracts with a minimum of three years of service, a loan up to HK$6 million with subsidized interest for housing purposes. This scheme alone attracted over 1,100 applications.
Simultaneously, in an effort to combat the diminishing numbers, the government has initiated several overseas recruitment campaigns to attract international doctors to the city. Recent efforts have shown that after conducting over 100 interviews in the UK and Australia in June, the first batch of recruits will begin work in September. Furthermore, the chairman of the authority, Henry Fan Hung-ling, shared that 145 candidates from these countries have received conditional offers, with 59 doctors from the UK having accepted the proposal. These international doctors are expected to serve public hospitals for a duration of up to two years, receiving comparable compensation to their local counterparts.
Moreover, under the Greater Bay Area Medical Talent Exchange Programme, 10 doctors and 70 nurses have been hired this year, sourced from mainland China. They will serve in public hospitals for approximately a year.
With all these efforts, Health Minister Lo Chung-mau remains hopeful, concluding, “I hope we can transition from this vicious cycle to a more positive and sustainable one.”
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