Professor E.K. Yeoh and International Experts Share Views in Leveraging Health Financing Levers to Propel Primary Care Development in Hong Kong’s Segmented Health System

Population ageing and the growing burden of chronic diseases in Hong Kong will foreseeably contribute to increasing healthcare demands, costs and ultimately, questionable health system financing sustainability. Providing accessible, affordable and well-integrated primary care that is person-centred and community-based remain ongoing challenges. The local supply of healthcare services is characterised by a stark segregation of the public and private sectors in terms of service provision and underlying financing mechanisms. The current demand-supply arrangements heavily contribute towards over-reliance on public-funded hospital care that lead to health system inefficiencies and unmet population healthcare needs.

In light of this, Our Hong Kong Foundation, in collaboration with the Centre for Health Systems and Policy Research, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, today organised a roundtable ‘Health Financing in the 21st Century: The Public-Private Lever in Strategic Purchasing’. Prominent speakers included:

• Professor Sophia Chan, Secretary for Food and Health, the HKSAR Government; 

• Professor Eng-kiong Yeoh, Professor of Public Health, Director, Centre for Health Systems and Policy Research, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong; 

• Professor Soonman Kwon, Professor and Former Dean of the School of Public Health, Seoul National University, South Korea, and Adjunct Professor at the China Center for Health and Development, Peking University, Beijing; 

• Professor Chiu-wan Ng, Professor of Public Health, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Malaysia; 

• Mr Henry Fan Hung-ling, Chairman, Hospital Authority, Hong Kong;  

• Dr Donald Li, President, World Organization of Family Doctors (WONCA)

The international expert discussion touched upon the challenges and opportunities unique to financing healthcare in the 21st century. Drawing upon experiences from South Korea and Malaysia, the panel discussed the best practices of implementing health financing levers that enhance primary care accessibility and promote universal health coverage in systems with different health financing structures, setting forth important lessons to be had. Perspectives on the role of key players of health systems, including the Hospital Authority of Hong Kong, were also put forward.

In today’s roundtable, Professor Yeoh highlighted the need for Hong Kong to review the functions of health system financing in moving towards a visionary primary care-led health system in a sustainable manner. In evaluating the system’s health-related revenue collection together with the pooling and allocation of resources, Professor Yeoh called for the need to reassess the role of government funding by either expanding and providing primary care to meet the demand in our overloaded public sector, or alternately, purchasing relevant services using supply- and demand-side instruments from the private sector. 

Acknowledging existing efforts and citing the Elderly Health Care Voucher Scheme as an example, Professor Yeoh emphasised the need to better design such well-intended purchasing mechanisms, which has as yet failed to significantly boost preventive care uptake and chronic disease management, which are necessary to reduce the burden of chronic disease. Furthermore, he stressed that we need not necessarily look to significantly expanding the existing healthcare budget but instead, should look to effectively leverage on existing resources, so that funding will be aligned with service delivery goals. 

Specifically, Professor Yeoh pointed to the critical need to consider strategic purchasing, a financing mechanism that transforms the government’s role in healthcare resource allocation, making it an active purchaser that prioritises funding to better meet health system goals.  He also stressed on the need to further evaluate the role of public-private partnership in our currently pluralistic public-private financial structure in meeting emerging healthcare needs.

Mrs Eva Cheng, Executive Director of the Our Hong Kong Foundation remarked that: ‘Our upcoming policy report on health financing extends the Foundation’s ongoing efforts in calling for a health system transformation in Hong Kong.’ She added: ‘This research is an important continuation of ideas presented in our health policy report Fit for Purpose: A Health System for the 21st Century, which was named “2019 Best Policy Study/Report Produced by a Think Tank” along with 162 selected research reports worldwide in the “2019 Global Go To Think Tank Index” by University of Pennsylvania.’

Professor Eng-kiong Yeoh, Professor of Public Health, Director of the Centre for Health Systems and Policy Research at the JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, said: ‘The way our health system is currently financed is unsustainable—we must acknowledge the significance of strategic purchasing for public-private partnership in our system to enable universal health coverage and health-related Sustainable Development Goals delineated by the United Nations.’

Dr Pamela Tin, Head of Healthcare and Social Development of Public Policy Institute of the Our Hong Kong Foundation, highlighted that: ‘In discussing enhancements that must be made to our health system, our upcoming policy report will examine health financing levers for propelling primary care development and will conclude with policy recommendations on strategic purchasing for public-private partnership aimed at better health equity in Hong Kong.’

‘Health Financing in the 21st Century: The Public-Private Lever in Strategic Purchasing’:
Full live webinar: https://youtu.be/kzLWGHmQeh8?t=168