Some thoughts in Black September

The two pieces of breaking news in September were the collapse of Lehman Brothers and the melamine-tainted milk scandal in China.

On September 15, Wall Street bank Lehman Brothers filed for bankruptcy protection.  Then Merrill Lynch sought refuge by selling itself to Bank of America.  Subsequently, insurance giant AIG called for emergency funding from the Federal Reserve Bank of New York.  On September 28, European bank giant Fortis was partially nationalized.   This was followed by the nationalization of the mortgage lender Bradford & Bingley in Britain the next day.

These stunning series of global financial turmoil had great influence on us.  Apart from the “free-fall” in the stock market, thousands of retail investors, many of whom were ordinary citizens, were at the edge of losing their lifelong savings through holding the so-called low risk “mini-bonds” issued by Lehman Brothers.  Another event showing the shaky emotion of Hong Kong citizens was the bank run on September 24 after rumor was spread via Internet and mobile phone messages about the financial stability of a local bank.

Some citizens had query on the fundamental philosophy of saving and investment.   There was growing mistrust in banks and insurance companies.  Could fund managers or investment banks look after our wealth better than we did while investment banks like Lehman Brothers could go bankrupt?  How did “wealth managers” in local banks be ensured to discharge their fiduciary duties when they lived on commissions from selling “mini-bonds”?  What would people who joined the bank run do with their lumps of cash?  Could anyone say that he was wiser to invest in “mini-bonds” than the conservatives who put their cash or gold bars in moon-cake tins in the old days?  Should citizens be forced to invest through Mandatory Provident Fund Schemes?  Should our newer generations be allowed to keep money notes inside cookie tins?  What would be the impacts on the forthcoming Supplementary Healthcare Financing?

On September 11, Mainland’s Sanlu brand of infant formula was found to be contaminated with melamine.  Chinese babies across the country developed urinary problems, mainly stones in the urinary tracts after consuming tainted milk powder.  Screening reviewed over thousands of babies being affected.  There were young victims with renal stones after consuming tainted milk powder for as short as two months.  Then, many other brands of milk powder and products with milk-derived ingredients were detected to contain melamine.  Melamine is an industrial chemical used for the production of melamine resins.  It was postulated that melamine was added illegally to the milk products so as to past the quality test for protein content after the milk was diluted with water to increase profit.  In this issue, we have reports from the Association’s delegates who visited Guangzhou and Jiangmen to study the conditions and the management of children suffering from renal stones.

In Hong Kong, the Centre for Food Safety (CFS) was closely monitoring the situation.   Batches of dairy product samples had been collected for melamine tests throughout the weeks.  Dreadfully, unsatisfactory samples of dairy products (frozen confections, chocolates, milk beverages, cakes etc) had been announced one after the other.   Apart from condemning the malpractice in China, this incident was an illustration of the importance of food hygiene and food safety.  Suddenly, a wild thought came across my mind.  Would it be advisable for the Food and Health Bureau to consider providing hygienic and healthy food to the public at minimal cost with heavy subsidies from the government?  Would this better guarantee the quality of food supplied to citizens?  Should public canteens be built to serve guaranteed and nutritious breakfast, lunch, snacks and dinners to all Hong Kong citizens at perhaps two dollars per meal?  No one would then be deprived of the availability of quality and hygienic food.

Readers might immediately disagree with this suggestion, as foreseeable harms would much outweigh foreseeable benefits.  A large bureaucratic body needs to be created.  There would be high administration costs for running this specific governing body.  The operation costs, together with the subsidy for food and running costs, would place heavy burdens on taxpayers.  There may also be an increase in wastage by users due to the perceived minimal cost.  Moreover, unfair competition may lead to a gradual decline in the number of private restaurants.  The most essential point is the fact that the government’s public canteens will still encounter the same problem of quality control and food safety as before.  Hence, the only outcome is to replace free market by a distorted monopolized market.

Then what do you think about a hospital authority that insists on looking after nearly all kinds of health problems of the public at minimal cost?  You can read about the thoughts of Dr. CHOI Kin, Dr. SHEA Tat Ming and Dr. SHIH Tai Cho on this problem from the interviews in this issue: The 3 Ex.

(Source: HKMA News October 2008)

From the Editor

For the past few months, over hundred nominated candidates vigorously fought for 60 seats in the Legislative Council for a four-year term of office from 2008.  After copious numbers of election campaigns and canvassing efforts over a long period of time, the battle finally came to an end on 7 September 2008.  Dr. LEUNG Ka Lau won his seat in the Medical Functional Constituency.  He received 2,217 votes for approximately 33%.  (Dr. HO Pak Leung - 2,138 votes; Dr. KWOK Ka Ki - 1,869 votes & Dr. YEUNG Chiu Fat - 580 votes).  For other doctors taking part in the election, Dr. PAN Pey Chyou was elected uncontested in one of the three seats of the Labour Functional Constituency.  Dr. SHIH Tai Cho and Dr. LO Wing Lok, two nominated candidates from Hong Kong Island geographical constituency, did not succeed in the election.

As the new Editor, I mentioned in the last issue that I would like to add some new elements into the HKMA News.  Here, I am going to get started with a special feature: “Interview with Dr. LEUNG Ka Lau”.  Based on the new insight about the functions of a bridge, I intend to provide readers a chance to view Dr. LEUNG from a different angle.  I invited Dr. LEUNG for an interview straight after the Legco election.  Preparation time was very short (3 days).  My original plan was to allow interviewees to choose the restaurant and food they felt affection for, as I believe in the old saying “You are what you eat”.  However, the prior arrangement of this interview was so tight.  I then decided to dine with Dr. LEUNG in the Association (Wanchai) Club House.  This was surely a good choice, as it provided an opportunity to promote our Club House.  Arranged by Mrs. Yvonne LEUNG, our Secretariat CE, a special menu was designed for Dr. LEUNG so as to feature Chef WONG’s signature dishes.  A special note of thanks should also be given to Dr. Amy PANG, an award-winning professional photographer, to take photographs for us.  

Initially, I planned to give my “signature bear” to Dr. LEUNG as a souvenir.  My bear’s hands were tied by a stethoscope, signifying the constraints faced by family doctors in the practice of medicine in HK.  After the interview, I changed my mind.  I took away the stethoscope and wished that Dr. Leung’s hands would not be tied in the coming four years.  And a bear with the wordings “More Than Words” on its foot was chosen to reflect our wishes.

Another observation after the interview was that there was much room for communication between Dr. LEUNG and family doctors, and we should put more effort in this aspect.  It was clearly brought up in Food and Health Bureau healthcare reform consultation document “Your Life Your Health” that Family Medicine should be promoted.  However, we have great uncertainties about what will be done.  Concerning this matter, the HKMA CME Committee is working on a new task.  We are restructuring our “Continual Medical Education Programme for practising doctors who are not taking Continue Medical Education programme for specialists”, the official name that I hate to refer to.  Let’s refer to it as CME for family doctors.  Core module with seminars and workshops on family medicine would be provided.  Participants are encouraged to take all the seminars and workshops in the core module in a three year cycle.  Together with other activities concerning different specialties attended, these CME records are kept in a portfolio provided by the HKMA.  This serves as evidence of CME activities and some basic training in family medicine.  

At the end of August, the Beijing Olympics 2008 ended with massive viewership.   China’s Olympic tally (51 Gold; 21 Silver; 28 Bronze; 100 Total) solidified its status as a sports powerhouse.  In this issue, we have several articles talking about the Beijing Olympics.  Our Past President, Dr. CHOI Kin presented his unique view on the closing, while our Council Member, Dr. LI Sum Wo reported on the opening.  Dr. CHAN Man Kam, also our Council Member, shared with us his feelings on the Olympics in poems, joining the increasing number of poem-writers in the News. 

(Source: HKMA News September 2008) 

From the New Editor

It is my pleasure to be appointed Editor of the HKMA News for two years.  Interestingly, the first batch of things that come across my mind are the Emergency Council Meeting and another midnight meeting in a hotel lounge to discuss the threat of suing the Editor for defamation, and reprimanding the Editor for disclosing confidential information by the Medical Council respectively.  I can reassure readers that it is just coincidence to find both the new Editor and Deputy Editor law degree holders.

The next things I think about are the functions of the HKMA News, which directly relate to my role as the Editor.  I always think that the HKMA News serves as a bridge between the Council and our members.  A bridge is basically a structure spanning and providing passage over a gap or barrier.  It might not be the shortest or fastest route, as internet can now serve this purpose better.  But it is one of the convenient routes which can provide large flow of important information.  The bilingual Message from the President contains unique viewpoints from our president on important issues, and usually stirs up echoes and heated debates.  Council Section reports news from the Council, which includes activities attended by Council Members (Busy Month) and questions answered by our Duty Council Members.  Committee News always features beautiful pictures and reports from our various committees.  Upcoming events and activities of other medical organizations are found in Notice.  Members Section updates the status of our membership.  Much information is also provided by the Classified Advertisement and Membership Reminders.  Forum is the section looked for by most members when they receive the News.  It contains viewpoints contributed by our members, some of which you have never thought of.  Leisure Corner is relatively new.  It contains articles, photos, drawings, etc from members which are not as serious as those in the Forum.  Three other relatively news sections are Special Feature from JSM writing on medical legal issues (I love this section!), Legislative Councilor’s Monthly Report from our diligent Legco Member, Dr. Kwok Ka Ki, and the HA Section, which only shows up sporadically.

But that’s now all for bridges.  During my visit to RCGP in UK, I came across many bridges, both in London and in Newcastle Upon Tyne. One of them gave me new insight into bridges.  This was the Kew's Rhizotron and Xstrata Treetop Walkway in the Royal Botanic Gardens, Kew, London.  It is 18-meter high in the sky, among the trees, to provide visitors chances to get a closer look at the treetops.  Thus a bridge can serve another function of providing a chance to look at things from a different angle.  I am thinking about to develop a new section in the coming issues featuring interviews.  I am sure it can provide readers an objective way to look at people familiar to them from another angle.

Moreover, bridges are seldom unidirectional.  A more convenient way of communication from readers to the Editorial Board is now in place.  You can e-mail to us at editor@hkma.org for any comment on any section of, or any issue concerning, the News.  I shall try my best to look into them or to publish some of them in the following issue.

Finally, one cannot leave without talking about the upcoming 2008 Legislative Council Election (while our President and Immediate Past President both write on this topic).  What directly relates to us would be the one member returned from the Medical Functional Constituency.  There are four candidates and 10606 registered electors.  No matter who is elected, I foresee than he will have a hard job.  Apart from facing the difficult (and eternal) issues of imbalance between HA and the private sector, the healthcare system reform, HMOs, the increased number of medical students…., he needs to work very hard because he has got a very good precedent.  In the past four years, Dr. Kwok Ka Ki has been very diligent and doing very well as our Legco Member.  Please remember to vote on September 7, to give KK another chance to continue his performance, or to give a hard job to the one you choose to represent us. 

(Source: HKMA News August 2008)