After our Financial Secretary announced the 2018-19 Budget, there
was much criticism from law-makers and citizens alike. His pro-government allies even openly asked
him to redo his major piece of homework. However, he was decent enough to spare his
valuable time and energy to raise public concern on the issue of medical
protectionism. Again, he suggested that
we should allow overseas doctors to practice in Hong Kong. I assumed that he understood our medical
system and knew that there is already the Licensing Examination as a route for a
non-locally graduated doctor to get a license and practice in Hong Kong. So, I took it that he was referring to
by-passing the Licensing Examination.
This is a highly controversial suggestion. It involves a fundamental change to the
Medical Registration Ordinance and there are numerous practical issues. The Hong Kong Medical Association has been too
dutiful and too diligent in directly tackling this problem with the aim of
protecting the public and the profession. However, the result was that parties taking
the suggestion seriously were repeatedly labelled “protectionism”. While we were talking about up-holding
standards, official responses were that profits of private doctors would not be
jeopardized. Seemingly, blaming doctors
serves as a good excuse to the apparent shortage of manpower in the public
sector. It was not us who did the
obviously below standard manpower planning. It was not us who raun
the Hospital Authority and failed to tackle even a less-serious-than-average
influenza surge. And then, officials got
indulged in this scapegoating game. Whenever
they mess up, they chant “protectionism” and pray to divert public attention at
no cost.
On the same day when our Financial Secretary smiled sheepishly and
did his chanting, a group of construction workers went for a demonstration
against the slow flow of funding from the government. Not long ago, the same group of workers
demonstrated to fight against importing foreign workers despite outcries from
developers. This was not labelled
“protectionism”. Actually, the
government is practicing protectionism in various aspects without admitting it.
The government is adopting a tolerating,
if not encouraging, stance towards minimally trained “cosmetic workers”. There had been numerous blunders. The medical profession had voiced out
repeatedly. The Consumer Council had
openly advised on tightening controls. Instead
of protecting the public, the government chose to protect the income of these
workers.
I am not sure whether not importing workers to do dish-washing is
protectionism. But having mechanism in
place for overseas doctors to take examination and get a license is surely
not protectionism. Some chanters
commented that the passing rates of the Licensing Examination were too low. Apart from reviewing the contents of the
Examination, we might also need to consider whether Hong Kong can attract
high-caliber overseas doctors. We speak
Cantonese dialect. Most of us can only
afford to dwell in ashamedly tiny cubicles. We save every dime and send our kids to study
abroad before their puberties. Doctors
are not allowed to advertise. The dire
working conditions of public hospitals hit newspaper headlines now and then. Some of us fly regularly to Japan or Australia
just to remind ourselves how a blue sky should look. I do not think Hong Kong is the dream land for
the cream of the cream, especially those married and with kids.
Keeping the standard is important. Examination is the most commonly recognized,
though not perfect, way. If exemptions
from the Licensing Examination are granted, how are we going to maintain the
standard? Laymen’s matter-of-fact
referral to “well-recognized” universities is but topics in WhatsApp group
chats or amateur views from newspaper columnists. To write it in the Medical Registration Ordinance,
we need specific details that are reasonable and can stand from challenges. Are we going to exempt all graduates from all
universities from the United Kingdom? Or
just some selected universities? How
about graduates from other European countries? How about those from the United States? Or those from Mainland?
Does exempting an overseas doctor from the Licensing Examination
mean exempting him from the internship? In such case, we have practically surrender
all controls on the entrance requirements. Should the exempted doctors be allowed to
practice under the employment of the Hospital Authority only? The recent program of granting limited
registrations to non-local doctors “to relieve manpower pressure and alleviate
the workload pressure of frontline doctors” has stretched the Medical
Registration Ordinance to a dangerous level. Working posts with no training and no
promotion prospect are provided to junior non-local doctors. I doubt how job-satisfied those candidates
will be.
Working is but one aspect of life. Will qualified doctors become Hong Kong
citizens? Or will they be hailed back
to their home countries if our Hospital Authority decides to end their
contracts for one reason or another? If
non-local doctors who are exempted and granted licenses can stay in Hong Kong
by starting their own private practice, it would create a loop-hole for some to
just register their business and never practice medicine. Hong Kong becomes a region with no border to
medical graduates.
I have had enough. I
reiterate that I object to the talking-in-a-vacuum allowing foreign doctors to
practice in Hong Kong without formal standard assessment. I am not going to change my stance. However, pragmatism might be a strategy
against dogmatism. I would like to urge
the finger-pointers to forward a formal proposal to enlighten the profession
and the public how they are going to solve the above problems.
I have all my dogmatic labels ready to throw at whoever speaks up.
