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The Hong Kong Medical Association and Hong Kong Public Doctor’s Association response to the latest proposed amendments to the Medical Registration Ordinance

香港醫學會及香港公共醫療醫生協會對《醫生註冊條例》最新修訂建議的回應

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 香港醫學會及香港公共醫療醫生協會對《醫生註冊條例》最新修訂建議的回應

 

香港醫學會及香港公共醫療醫生協會就食物及衛生局(食衛局)於8月31日公布《醫生註冊條例》的最新修訂建議作出以下回應:

 

  1. 政府提出的最新修訂容許持有認可醫學資格,為香港永久性居民的非本地培訓醫科畢業生,即使未進行實習亦可參加執業資格試(執業試),日後並可透過特別註冊途徑在本港正式註冊。本港醫科生的實習及培訓資源並不充裕,我們憂慮此舉將進一步減少本地醫科生的實習及培訓機會,尤其是公立醫院工作量大,令負責培訓及督導的醫生壓力倍加。事實上,非本地醫科學院有責任提供實習資源,本港並不應以有限的醫療培訓資源補貼其他地區。香港醫學會及香港公共醫療醫生協會促請政府盡快闡釋具體措施,以確保本地醫科生的實習、培訓,甚至就業前景不受是次修例影響。

 

  1. 對於政府建議為具備專科資格的有限度註冊醫生提供銜接安排,以加入特別註冊制度,在一定程度上需依賴僱主(即各公營醫療機構)及香港醫學專科學院(醫專)監管。以上機構作為把關角色,必須有既定公平機制去確保受聘醫生的質素達標,否則極有可能成為漏洞,反危及本港醫療水平。修訂中非本地培訓專科醫生,不須如早前建議畢業於指定認可名單上的醫學院,只須要曾在醫療機構任職便可,標準又如何拿捏?對此,政府須馬上聯同上述機構,向公眾、醫學界解說聘用非本地培訓醫生或認可海外專科資格的機制及門檻,保證受聘醫生達既定標準。

 

  1. 現時特別註冊委員會的組成缺乏前線公營醫生的參與,而決定認可醫學院名單的條件、過程、機制亦不受業界監察,專業性及透明度成疑。香港醫學會及香港公共醫療醫生協會重申,特別註冊委員會需要有前線醫生的參與,才能反映公營醫生聲音。對於今次港府修訂建議,香港醫學會及香港公共醫療醫生協會事前並未獲諮詢,我們對此表達相當失望。

 

  1. 本港公營醫療服務的問題複雜,非單靠增加醫生數目即可解決,現時建議並未觸及改善公院軟硬件配套的問題,如增加床位、手術室及護士等輔助人手。若政府及醫管局不改善以上種種,即使引入海外醫生,也沒有設施、人手、機制配合,結果也只是藥石亂投,未能真正讓病人受惠。

 

  1. 是次修例對改善公院服務的成效未明,政府必須制定檢討機制,例如成立專責小組,於修例後每兩年檢視透過新註冊途徑來港執業的醫生數字、受訓背景;及對公院服務輪候期、服務指標等影響的資料,以檢討修例對改善香港醫療的真正效用。政府並應與各個公營醫療機構、醫專設立三方平台,定期審視新註冊途徑對香港醫療人手、水平的長遠影響,並需訂定熔斷機制,以防日後出現醫療人手失衡甚至過盛的問題。  
  2. 次修訂涉及香港醫療水平及市民福祉,不應草率推行,政府必須對以上幾點作出回應,以釋公眾及醫學界的疑慮。香港醫學會及香港公共醫療醫生協會強調,要真正提升香港公營醫療服務,單靠增加醫生無疑只是緣木求魚。政府必須增加對醫護人手及相關設施的撥款,減少人才流失;同時需改善公私營醫療協作機制,分流公院病人到私營機構,方能減輕現時公營醫療體系的負擔。

 

二零二一年九月一日

 

 

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 1 September 2021

The Hong Kong Medical Association and Hong Kong Public Doctor’s Association

response to the latest proposed amendments to the Medical Registration Ordinance

 

The Hong Kong Medical Association (HKMA) and Hong Kong Public Doctor’s Association (HKPDA) make the following response to the latest proposed amendments to the Medical Registration Ordinance announced by the Food and Health Bureau (FHB) on 31 August 2021:

 

  1. The latest amendment proposed by the Government allows non-locally trained medical graduates who hold recognized medical qualifications and Hong Kong permanent resident status to take the Licensing Examination (LE), irrespective of whether an internship is inclusive in their medical training. Such individuals can later gain full registration through the Special Registration Pathway. However, internship and training resources for local medical students have long been limited. The HKMA & HKPDA worry that this measure will further reduce the internship and training opportunities for local medical students. Workload on public doctors is already heavy, additional supervision responsibilities over non-locally trained medical graduates will further increase their job pressure and stress.  As a matter of fact, it should be the responsibility of those non-local medical schools to provide internship to their own students and Hong Kong should not shoulder the cost.  We urge the Government to expound on specific measures to guarantee that internship, training, and even employment prospect of the local medical students will not be affected by this amendment.

 

  1. For the Government's proposal to provide bridging arrangement for the limited registration doctors to migrate to Special Registration regime, such policy will heavily rely on the supervision of employers (public medical institutions) and the Hong Kong Academy of Medicine (HKAM). The above-mentioned institutions which are given the role of gatekeepers, must establish a fair and reliable mechanism to ensure that the quality of all doctors employed meets the necessary requirements; otherwise, it may result in a loophole and put the overall medical standards of Hong Kong at risk.  The new amendments are proposing to allow specialists previously worked in any non-local medical institutes to come to Hong Kong.  Is there a set of criteria to assess the standard of those institutes? In this regard, the Government needs to immediately work with the relevant institutions to explain to the public and the medical sector the mechanism and thresholds for hiring non-locally trained doctors or accrediting overseas specialist qualifications that guaranteed all employed doctors are up to par.

 

  1. The current composition of the Special Registration Committee (SRC) lacks the participation of front-line public doctors, and the criteria, process, and mechanism for determining the list of approved medical schools are not subject to industry scrutiny; hence, professionalism and transparency remain questionable. The HKMA & HKPDA reiterate that it is essential to have the representation of front-line doctors in the SRC to reflect the voice of the public medical sector.  We are disappointed for not being consulted by the FHB before the announcement of the amendments.

 

  1. The problems of public medical services in Hong Kong are complex and cannot be solved by solely increasing the number of doctors. The current amendments have touched on neither improving the hardware nor software of public hospitals, such as increasing the number of beds, operating rooms, nurses and other allied health staff. If the Government and the Hospital Authority (HA) do not improve the overall provision, import of doctors alone cannot do much due to the limitation in facilities and supporting staff.  Ultimately, the public will not gain from the change.

 

  1. The success of this amendment to improve public hospital services is yet to be assessed, to which the Government must establish a review mechanism to evaluate its efficacy in enhancing Hong Kong's medical services. The Government should set up a task force to periodically examine data such as the number of doctors who register under the new registration pathway and their training backgrounds, as well as its effects on service indicators such as the waiting time for public hospitals. The Government should also establish a tripartite platform with frontline doctors, relevant public medical institutions and HKAM to regularly review the long-term impact the policy may bring to Hong Kong's medical manpower and medical standard. A fuse mechanism is also necessary to prevent imbalance or even excessive surplus of medical staff in the future.

 

The new amendment will dramatically affect Hong Kong's medical standards and public welfare; therefore, it should not be implemented hastily. The Government must respond to the above to clarify the concerns of the public and the medical sector. The HKMA & HKPDA reiterate that it is a lot more than just increasing the number of doctors to improve Hong Kong's public medical services fundamentally. The Government must inject more funding for health staff and related facilities to reduce brain drain. At the same time, the Government needs to improve the public-private partnership (PPP) to divert patients from public hospitals to private institutions in order to reduce the burden of the current public medical system. Only with a multiple-pronged strategy, our healthcare system can genuinely be improved.

 


編輯備忘:香港醫學會成立於一九二零年,旨在聯繫政府、各公立醫療機構、大學及私人執業的醫務工作者,交流意見,團結一心。醫學會致力將最新的醫療資訊及醫務發展傳遞與會員,提倡會員遵行專業操守,進而服務社會,維護民康。

 

Notes to editors: The Hong Kong Medical Association, founded in 1920, aims to bring together Hong Kong's government, institutional, university and private medical practitioners for an effective exchange of views and co-ordination of efforts.  The foremost objective of the Association is to safeguard and promote public health.  The Association speaks collectively for its members and aims to keep its members abreast of medical ethics, issues and advances around the world.  In fulfilling these goals, the association hopes to better serve the people of Hong Kong.

 

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