FEATURE: 'Dream hospital' comes of age

HONG KONG (China Daily/ANN) - Pilot HK-Shenzhen medical project is hailed as a breakthrough in cross-boundary medical collaboration.

The University of Hong Kong-Shenzhen Hospital (HKU-Shenzhen Hospital) — a ground-breaking pilot project run by the University of Hong Kong (HKU) and the Shenzhen municipal government — represents a testing ground for operating a hospital with two different medical systems, and its development in the past five years has been successful, says Hospital Chief Executive Lo Chung-mau.

The institution, which drew much public attention when it opened in July 2012, is also a splendid example of how cross-boundary medical collaboration can bring mutual benefits to Hong Kong and the Chinese mainland, Lo tells China Daily in an interview.

“One plus one can be more than two,” says Lo, who also heads the Liver Transplant Centre at the Queen Mary Hospital in Pok Fu Lam, Hong Kong, and teaches at the HKU.

The HKU-Shenzhen Hospital, which serves as a public hospital in Shenzhen but sticks to a Hong Kong management model and hospital culture, currently has 250 Hong Kong doctors, who are licensed to practice on the mainland and make up about half of the hospital’s total pool of doctors employed.

The difference between the medical systems of Hong Kong and Shenzhen is stark. One major difference is the way public hospitals finance themselves. In Hong Kong, public hospitals are financed mainly by the government, while hospitals on the mainland are responsible for their own profits or losses.

Mainland public hospitals are, thus, often criticized for over-charging patients for unnecessary medications like antibiotics and intravenous injections, as well as dispensable examinations using expensive medical devices.

“We need to respect the mainland system, but that doesn’t mean we can’t improve on it. After all, hospitals are geared to patients, not profit-oriented,” stresses Lo.

The HKU-Shenzhen Hospital has launched reforms in various aspects, including pricing. It pioneered a package pricing system for its outpatient clinic, inpatient departments, as well as surgical procedures. Patients need to pay a fixed, one-off fee covering standard check-ups, medication, surgery and consultation.

“Package pricing prevents doctors from prescribing unnecessary medications and using expensive medical devices in treating patients. Therefore, it plays an effective role in cutting down patients’ medical bills,” says Lo. 

Citing gall bladder removal surgery, he says the normal rate charged by other Shenzhen public hospitals is close to 20,000 yuan (HK$22,748). At the HKU-Shenzhen Hospital, it’s just 11,000 yuan. “The system is reassuring for patients. They need not worry about being subject to unnecessary treatment or having to shoulder excessive medical bills. It contributes to better doctor-patient relations and, eventually, attracts more patients.”  

Another highlight of the pricing reform is raising the consultation fee as part of the package. Doctors in mainland hospitals generally charge patients no more than 10 yuan for consultation. While specialists would charge more, it’s still less than 20 yuan. At the HKU-Shenzhen Hospital, the consultation fee is set at 100 yuan.

“The self-financing system on the mainland also leads to another problem — people believe medicines are more important than doctors as they pay more for medicines than doctors’ professional advice. We need to correct this wrong concept. Doctors should be rewarded for their expertise, not the medicines they prescribe,” says Lo.

The HKU-Shenzhen Hospital is also striving to improve mainland medical system by introducing a new appointment setup — a common practice in Hong Kong but rarely seen in mainland public hospitals.

“The booking system offers multiple benefits. It maintains order in hospitals, guarantees the time doctors are assigned to every patient and protects patients’ privacy,” Lo explains.   

But, to his surprise, the practice wasn’t well received when it was launched. Despite being repeatedly reminded about the procedure, patients still queued up at the hospital as early as 6 am.

“I was confused at first, but later found out it was because the patients did not trust the system. They would rather believe in themselves rather than in the hospital treating every patient fairly,” says Lo. The cold response, however, did not force the hospital to scrap the procedure and it has managed to win back the trust of patients. According to Lo, about 3 million patients had been treated at the HKU-Shenzhen Hospital in the past five years based on the new booking system.

“We hope the Hong Kong-style management would help ease some of the headaches the mainland faces in the medical field, and this would have a positive influence on people’s health,” adds Lo.

A splendid training ground for SAR’s medical staff

Besides helping to lift medical development on the Chinese mainland, the University of Hong Kong-Shenzhen Hospital (HKU-Shenzhen Hospital) serves as a great lab and training ground for Hong Kong’s future medical staff. 

Hospital Chief Executive Lo Chung-mau recalls the first time he visited the hospital, located near Shenzhen Bay, in 2012, saying he was overwhelmed by its spaciousness and advanced supporting equipment. He calls the institution a “dream hospital”.

The hospital has 2,000 ward beds, with 1,200 occupied, and the total number of beds is expected to reach 3,000 by 2020. Hong Kong’s largest public hospital, the Queen Elizabeth Hospital, has more than 1,800 ward beds. 

“The spacious structure means the hospital is capable of housing more patients. It helps medical students to learn by studying under varying conditions. Medical knowledge can be gained not only from textbooks, but also real-life experience,” says Lo.

The University of Hong Kong will send its medical students to HKU-Shenzhen Hospital for brief study stints. Lo says the arrangement will enrich students’ knowledge and broaden their horizons as they’ll be exposed to cases that are seldom seen or treated in Hong Kong.

The hospital has been running an annual program offering free diagnosis and treatment to children with cleft lips and palates since last year. In this year’s program launched in May, some 40 children from across the mainland went under the knife for cleft lips and palates free of charge. 

“Cleft lip and palate surgery is rarely practiced in Hong Kong, with only about 10 cases a year. The number is not enough to give proper training for specialists in plastic and reconstructive surgery in the city,” Lo says.
The HKU-Shenzhen Hospital is also helping to better implement the Hong Kong government’s policy in care services for the elderly.

With Hong Kong facing a rapidly graying population, it’s projected that one in three Hong Kong residents would be aged 65 or above by 2040, a trend that could plunge the SAR into crisis arising from chronic diseases.

“The HKU-Shenzhen Hospital could help alleviate Hong Kong’s pressure in providing timely medical services for the elderly,” says Lo.

In October 2015, the hospital became the first on the mainland to accept healthcare vouchers provided by the Hong Kong government to elderly people. This facilitates Hong Kong’s senior residents living in or near Shenzhen to get medical services.

Government data show that some 1,230 elderly people had used the vouchers at the hospital by January.

“With the launch of the Guangdong-Hong Kong-Macao Greater Bay Area project, cross-boundary exchanges would be more frequent and larger in scale. With these increased exchanges, more senior citizens would choose to live in lower-cost mainland cities, where medical attention is a major factor for consideration,” Lo says.

“We started from zero and we’re now seeing the results. We’ve made Hong Kong’s once closed medical system more open to change in relation to the mainland,” he says, adding that such exchanges should be taken to the next level by the incoming new Hong Kong administration. 

With the support of the Shenzhen government, plus the openness and willingness to cooperate as shown by doctors and medical staff from across the boundary, Lo is confident the institution will continue to thrive in future, exerting a significant influence on the country’s medical development.