Lin Min

    THE snail-paced medical reform on the Chinese mainland may be given new inspiration when Shenzhen Binhai Hospital opens later this year.

    The hospital, named University of Hong Kong (HKU) Shenzhen Hospital by Hong Kong media, will be HKU’s second teaching hospital. Built and funded by the Shenzhen government, it will be a showcase for health care reform on the mainland.

    According to South China Morning Post, HKU has identified five key areas to be developed at the Shenzhen hospital — liver transplants, spinal surgery, assisted human reproduction, cardiology and oncology.

    While it would be good news for Shenzhen patients that HKU surgeons will pass on their widely acclaimed expertise in liver transplants, in-vitro fertilization and spine operations to their colleagues across the border, the significance of the groundbreaking project, however, will lie in how it can provide an example in reshaping public hospital services on the mainland.

    China initiated its much-anticipated medical care reform in 2009 to make health care more accessible and affordable for the country’s 1.3 billion people. The reform is aimed at providing all citizens with basic health care as a public service, with the Central and local governments pumping in billions of yuan each year to broaden medical insurance coverage and improve medical services.

    However, public hospital reform has been slow. Despite being funded by taxpayer money, public hospitals are profit-motivated, with doctors prescribing unnecessary, expensive medicines and tests to get higher pay, and a bloated, poorly regulated drug distribution and procurement system leading to excessive markups on drug prices. It is one of China’s worst-kept secrets that many doctors receive kickbacks from suppliers.

    Poor medical service, as manifested by difficult access to quality treatment and mistrust between doctors and patients, has also been blamed on the outdated management of public hospitals that are run by red-tape-obsessed bureaucrats.

    Hong Kong hospitals have a good reputation not only for their world-class expertise in some disciplines, but also for their advanced management. The prominent task for HKU should be to make Binhai Hospital a model in reform for public hospitals in Shenzhen and other parts of the mainland.

    It is reported that Binhai Hospital’s opening has been delayed from August to November because the Shenzhen city government and HKU have not been able to agree on a management model for the hospital and who will be in charge.

    Shenzhen should understand that if the hospital is to become a meaningful showcase for reform, the Hong Kong side should be given full autonomy in management.

    The latest twist in the education reform saga concerning the South University of Science and Technology of China, in which the first 45 students recently boycotted a requirement by the Ministry of Education for them to sit the National College Entrance Examinations, shows reforms of any kind are likely to meet stumbling blocks posed by existing rules and customs. Granting a reform project as much autonomy as possible before it starts will improve the chances of smooth sailing for the reform.

    It is an encouraging sign that HKU vice chancellor Tsui Lap-chee has said the Shenzhen hospital would be “run in an HKU way.” HKU has pledged to introduce clinical audits and other quality assurance plans at the new hospital. A clinical audit — a quality improvement process that seeks to improve patient care and outcomes through systematic reviews — appears to be new to most mainland hospitals.

    A Hong Kong-run hospital, however, may give rise to worries that medical services would be more expensive at Binhai Hospital than in other public hospitals in Shenzhen, given that the pay for Hong Kong doctors would be much higher than their mainland peers.

    Hopefully, the new hospital will demonstrate how it can reduce costs for patients by prescribing cost-effective medicines and tests that are done only when necessary, and by adopting a transparent procurement system that prevents doctors and procurement staff from receiving kickbacks from suppliers.

    Given the good reputation of Hong Kong’s medical service and HKU’s first teaching hospital, Queen Mary Hospital, hopes are high on the reform at Binhai Hospital. But Shenzhen should make sure that HKU is given a free hand.

    (The author is editor of the Shenzhen Daily News Desk.)

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