LCQ15: Measures to facilitate cross-boundary medical consultations for members of the public
Question by the Hon Chan Chun-ying :
Following the implementation of the Pilot Scheme for Supporting Patients of the Hospital Authority in the Guangdong-Hong Kong-Macao Greater Bay Area (“the Pilot Scheme”), eligible Hong Kong elderly persons may use the Elderly Health Care Vouchers to pay for dental treatment at the designated medical institutions in the Mainland cities of the Guangdong-Hong Kong-Macao Greater Bay Area (“GBA”). On the other hand, Hong Kong people employed in the Mainland are required to join the basic medical insurance for employees, while retired Hong Kong people living in the Mainland may take out the basic medical insurance for urban and rural residents. It is learnt that both plans are entitled to the same social insurance protection as Mainland residents. In addition, it has been reported that some Hong Kong insurance companies have partnered with Mainland medical institutions to provide simpler and faster direct claims settlement services for Hong Kong people who receive medical consultations and medical treatment in the Mainland under the “direct billing without paying upfront” approach. Regarding the measures to facilitate cross-boundary medical consultations for Hong Kong people, will the Government inform this Council:
(1)whether it has compiled statistics on the current respective numbers of people who have used the Elderly Health Care Vouchers to go north for dental treatment and those who have participated in the Pilot Scheme; if so, whether both numbers meet the expectations;
(2)whether it has compiled statistics on the current respective numbers of Hong Kong people who have joined the mandatory and the voluntary medical insurance schemes in the Mainland; if not, of the reasons for that;
(3)whether it has plans to study and promote with the Mainland authorities the possibility of allowing Hong Kong residents holding the Mainland Travel Permits for Hong Kong and Macao Residents to take out the basic medical insurance for urban and rural residents in the Mainland; if so, of the details; if not, the reasons for that; and
(4)whether it will introduce policies to encourage more Hong Kong insurance companies and “Grade 3A” hospitals in GBA to provide direct billing services to Hong Kong people who receive cross-boundary medical consultations; if so, of the details; if not, the reasons for that?
Reply by the Secretary for Health , Professor Lo Chung Mau
The Hong Kong Special Administrative Region (HKSAR) Government has been following the principles of complementarity and mutual benefits to enhance the healthcare-related cooperation with various Mainland cities of the Guangdong-Hong Kong-Macao Greater Bay Area (GBA), on the premise of benefitting the development of the healthcare systems of Hong Kong and the Mainland, so as to provide convenience to Hong Kong residents who choose to develop and reside in the Mainland. In particular, the Government supports the healthcare needs of these Hong Kong residents through collaboration with suitable healthcare organisations in the Mainland cities of the GBA. Examples include the Elderly Health Care Voucher Greater Bay Area Pilot Scheme, the Pilot Scheme for Supporting Patients of the Hospital Authority in the Guangdong-Hong Kong-Macao Greater Bay Area, as well as the proposed new function under the five-year plan of eHealth+ to allow members of the public to keep and use their personal medical records from within and outside Hong Kong.
As the HKSAR is a member of the GBA, the HKSAR Government, in formulating cross-boundary healthcare measures, would not only focus on meeting the needs of Hong Kong citizens, but would also consider the potential impact of the policies on the social resources and livelihood of people in the Mainland. The healthcare needs, relevant laws and regulations, and regulatory regimes for healthcare professions are different in Hong Kong and the Mainland. The HKSAR Government, with the important role of protecting the health of the Hong Kong citizens, will continue to provide quality healthcare services to Hong Kong citizens. The Government would also explore cross-boundary healthcare measures under the premise that these measures are feasible and mutually beneficial, with a view to providing additional and convenient access to and choices of healthcare services for Hong Kong citizens who choose to develop and reside in the Mainland.
In consultation with the Financial Services and the Treasury Bureau (FSTB), the consolidated reply to the questions raised by the Hon Chan Chun-ying is as follows:
(1)Under the Scheme at the University of Hong Kong Shenzhen Hospital (HKU-SZH), eligible elderly may currently use the voucher to pay for services provided by HKU-SZH and its Huawei Li Zhi Yuan Community Health Service Center (Huawei CHC), including dental services. The number of voucher recipients using Elderly Health Care Vouchers (EHCVs) for paying services received at the dental clinic of HKU-SZH in the past five years are tabulated as follows:
Note: Eligible elderly person may also receive different kinds of outpatient services, including Family Medicine, Chinese Medicine, Dental Services and Physiotherapy etc., at the Huawei CHC set up by the HKU-SZH. The Department of Health only keeps data on total claims for the Huawei CHC. Thus, the figures as provided above do not include the number of voucher recipients receiving dental services at the Huawei CHC.
“The Chief Executive’s 2023 Policy Address” announced the rolling out of the EHCV GBA Pilot Scheme (Pilot Scheme) to extend the coverage of EHCVs to five medical institutions providing integrated services (all with dental services) in the GBA and two dental institutions in Shenzhen. At present, the coverage of the EHCVs has been extended to the First Affiliated Hospital, Sun Yat-sen University (FAH-SYSU) and Zhongshan Chen Xinghai Hospital of Integrated Traditional Chinese and Western Medicine (ZSCXH) since 28 June and 18 July this year respectively. The Pilot Scheme is expected to expand to the remaining pilot institutions in the third quarter of this year. Since the Pilot Scheme has just started being implemented at the pilot institutions, we currently do not have the data on the number of participants. The HKSAR Government will review the utilisation of EHCVs at the pilot institutions in due course.
The policy parameters for the HKSAR Government to enhancing the Elderly Health Care Voucher Scheme (EHVS) are enabling elderly persons to use primary healthcare services appropriately so as to ensure the optimal use of resources for the EHVS and better use of their vouchers for primary healthcare services for disease prevention and health management. Our policy of allowing EHCVs to be used in the GBA similarly aims at providing more convenience for Hong Kong elderly persons residing in Mainland cities in the GBA by providing more service point options for them to use their EHCVs to meet their primary healthcare needs, and to allow Hong Kong elderly persons to use their EHCVs for receiving dental services across the boundary at medical institutions in Shenzhen and even other Mainland cities in the GBA, with a view to addressing the pressing demand of Hong Kong elderly persons in seeking dental services.
The Government also launched the “Pilot Scheme for Supporting Patients of the Hospital Authority (HA) in the Greater Bay Area (GBA)” (Pilot Scheme for Supporting Patients of the HA in GBA) on 10 May last year making reference to the experience from the Special Support Scheme during the COVID-19 epidemic, so that patients with scheduled follow-up appointments at designated Specialist Out-patient Clinics (SOPCs) or General Out-patient Clinics (GOPCs) of the HA (eligible patients) can receive subsidised consultations at the HKU-SZH. Having considered the effectiveness of the Pilot Scheme for Supporting Patients of the HA in GBA in meeting the needs of relevant patients for frequent follow-up consultations, the HKSAR Government has extended the Pilot Scheme for Supporting Patients of the HA in GBA for one year to 31 March 2025. Since the launch of the Pilot Scheme for Supporting Patients of the HA in GBA in May last year, more than 4 400 patients have participated in the Scheme with total attendances of over 12 300 as at end of June 2024. According to a patient questionnaire survey conducted by the HKU-SZH, over 90 per cent of the participating patients agreed that the Pilot Scheme for Supporting Patients of the HA in GBA allowed them to enjoy the convenience of attending follow-up consultations on the Mainland that had spared them the tiring journeys between the Mainland and Hong Kong.
Since the Scheme at the HKU-SZH, EHCV GBA Pilot Scheme and Pilot Scheme for Supporting Patients of the HA in GBA all aim to provide convenience to Hong Kong citizens residing in or travelling frequently among GBA cities, we do not set a target for the number of beneficiaries of the schemes.
(2) and (3)In considering healthcare policies, governments of different places would normally need to take into account key factors such as the overall social resources and policy objectives. As regards health insurance in the Mainland, the Ministry of Human Resources and Social Security (MOHRSS) and the National Healthcare Security Administration (NHSA) promulgated the “Interim Measures for Participation in Social Insurance by Hong Kong, Macao and Taiwan Residents in the Mainland (the Interim Measures)” in 2019, which allows eligible Hong Kong residents to participate in the national health insurance scheme in the Mainland. The health insurance arrangements for Hong Kong residents in the Mainland fall within the scope of responsibilities and authority of the relevant ministries and commissions of the healthcare security administrations of various provinces and municipalities, and there are certain differences in the arrangements for health insurance schemes among various cities in the GBA. At present, the relevant bureaux and departments of the HKSAR Government do not keep the statistics of Hong Kong residents participating in the health insurance scheme in the Mainland. The HKSAR will continue to monitor the implementation arrangement of the Interim Measures.
(4)With the changes in Hong Kong residents’ behaviour towards cross-border healthcare service utlisation, individual Hong Kong insurance companies have, taking into account their commercial decisions and considerations, collaborated with relevant Mainland healthcare institutions to provide various types of streamlined administrative arrangements (e.g. pre-approval of medical expenses and direct claim settlement services) for the convenience of the insured persons.
The Government introduced the Voluntary Health Insurance Scheme (VHIS) in 2019 to regulate individual indemnity hospital insurance products and improve market transparency, providing consumers with greater confidence in purchasing health insurance. Moreover, the VHIS provides tax deduction to encourage members of the public to purchase VHIS products. As per the basic protection of the VHIS Standard Plan, insurance companies are required to provide global coverage, such that the fees of hospitalisation, day case surgical procedures, and prescribed diagnostic imaging tests in and outside Hong Kong (including Mainland cities in the GBA) are covered (except for psychiatric treatment, which is limited to hospitalisation in Hong Kong). The VHIS does not restrict the claims measures of insurance companies, which may make arrangements based on market needs.