Blueprint

HIGHLIGHT

WELCOME MESSAGE - PREFACE BY THE SECRETARY OF HEALTH

Hong Kong has an effective and efficient public and private healthcare system of very high professional standard that delivers multi-level healthcare services. Nonetheless, facing major challenges brought about by a rapidly ageing population and increasing prevalence of chronic diseases, the overloaded situation of the public healthcare services resulting in long waiting time will only be further aggravated without fundamental reform.

Over the past three years, the Coronavirus Disease (COVID-19) pandemic has further demonstrated the critical importance of a strong primary healthcare infrastructure and workforce within the community. At the same time, it has also exposed and exacerbated the financial burden on our healthcare system and the social costs of chronic diseases. A robust primary healthcare system will be an important line of defence against a wide range of potential public health crises.

It has been well said that ‘an ounce of prevention is worth a pound of cure’. The Government is committed to enhancing district-based primary healthcare services in a bid to shift the emphasis of the present healthcare system and changing people’s mindset from treatment-oriented to prevention-oriented. We are delighted that the establishment of District Health Centres (DHCs) in all districts in Hong Kong has progressively materialised.

The Government is determined to tackle the health challenges brought about by an ageing population and increasing chronic disease prevalence. This Blueprint aims to address the software and systemic aspect of our healthcare system, in terms of service delivery, governance, resources, manpower and technology. It also aims to map out the next steps towards establishing a primary healthcare system that can improve the overall health of the public and enhance their quality of life.

We strongly believe that the recommendations set out in this Blueprint will guide the direction of the development of our healthcare system that will enable us to support a sustainable and healthy system that backs up each and every citizen in Hong Kong in the decades to come. We look forward to joining hands with you towards building Hong Kong as an even healthier society.

Taking this opportunity, I would like to express my heartfelt gratitude to members of the Steering Committee on Primary Healthcare Development for their comprehensive analysis of the structural situation of our primary healthcare system and their constructive and invaluable recommendations to the Government. Their continued contribution is of paramount significance in the formulation of this Blueprint.

Secretary for HealthProfessor Chung-mau LO, BBS, JP

WHAT IS PRIMARY HEALTHCARE?

Primary healthcare (PHC) is the first point of contact for individuals and families in a continuous healthcare process in the living and working community, which entails the provision of accessible, comprehensive, continuing, co-ordinated and person-centred care. A well-established and overarching PHC system routinely manages, maintains and enhances the health of the population at the community level, forms the foundation and portal of the pyramid of healthcare services, and serves as a gateway to specialised secondary and tertiary healthcare in hospital and institution settings. It is recognised as the most essential component in a well-functioning healthcare system.

MILESTONES OF

OUR PRIMARY HEALTHCARE

PHC development in Hong Kong could be traced back to the document “Health for All, the Way Ahead: Report of the Working Party on Primary Health Care” in 1990. The Report affirms the importance of PHC and provided a list of 102 recommendations toward its development. The Report has guided the development of the later policy and many of its recommendations are still being adopted today. In the subsequent years, a number of consultation documents released by the Government, including the “Your Health, Your Life Consultation Document on Healthcare Reform” in 2008 and the “Our Partner for Better Health – Primary Care Development in Hong Kong: Strategy Document” in 2010.

Throughout the successive healthcare reform consultations, enhancement of PHC has been a common theme and key consensus. In particular, there is a consistent emphasis on the urgency and importance to foster PHC amidst a rapidly ageing population, as potential solutions for the increasing demand of healthcare services and the overstretched public sector; and that a more strategic and effective use of private healthcare services through increasing scope of collaboration between public and private sectors should be adopted in healthcare service delivery especially for PHC.

2019

Primary Healthcare Office and the first District Health Centre established

2017-18

Steering Committee on Primary Healthcare Development established

2010

Strategic document: Our Partner for Better Health

2008-09

Working Group on Primary Care established

2008

Consultation paper: Your Health, Your Life

2005

Discussion paper: Building a Healthy Tomorrow

2000

Consultation paper: Liffelong Investment in Health

1990

Report Health for All, the Way Ahead

THE STEERING COMMITTEE ON PRIMARY HEALTHCARE DEVELOPMENT

To take forward PHC reform, the Steering Committee on Primary Healthcare Development (SCPHD) was set up in November 2017 to develop a blueprint for the sustainable development of primary healthcare services for Hong Kong (the Blueprint). Comprising PHC experts from the public and private sectors, SCPHD has provided advice on primary healthcare development from different aspects, namely manpower and infrastructure planning, collaboration model, community engagement, planning and evaluation framework and strategy formulation, with a view to formulating the Blueprint. With the progressive expansion of DHC’s services to 18 districts in Hong Kong, SCPHD has explored the development and service collaboration of a district-based primary healthcare system.

Chairperson

Secretary for Health

Non-official members (Surname in alphabetical order)

Professor CHAN Wing-kwong (from 1 December 2020)
Mr Philip CHIU Kwok-leung
Mr CHUA Hoi-wai
Dr LAM Ching-choi
Professor Cindy LAM Lo-kuen
Professor Gabriel Matthew LEUNG
Dr Donald LI Kwok-tung
Mr SHUM Ho-kit
Professor Hector TSANG Wing-hong
Professor Frances WONG Kam-yuet
Professor Samuel WONG Yeung-shan
Dr ZHU En (from 1 December 2017 to 30 November 2020)

Ex-officio members

Permanent Secretary for Health
Permanent Secretary for Labour and Welfare (or representative)
Director of Health (or representative)
Director of Home Affairs (or representative)
Commissioner for Primary Healthcare, Health Bureau (or representative) Chief Executive, Hospital Authority (or representative)
Chief Manager (Nursing), Hospital Authority (or representative)

Terms of reference

To develop a blueprint for the sustainable development of primary healthcare services for Hong Kong, the Steering Committee would deliberate on the following -

Manpower and infrastructure planning - review the software and hardware provision for the delivery of primary healthcare, with a view to achieving better efficiency and effectiveness, and identifying scope for enhancement;
Collaboration model - develop primary healthcare service models which can enhance medical-social collaboration and public-private partnership and facilitate interfacing with other levels in the healthcare system;
Community engagement - develop strategies and incentives to raise the health awareness of the community, and promote health management and patient empowerment;
Planning and evaluation framework - exploit the use of big data to plan and devise strategies that best fit the needs of the community. Develop the framework for monitoring and evaluating initiatives or pilot projects, including the development of performance indicators and clinical and health outcomes, such as the reduction in avoidable use of accident and emergency and inpatient services in the public system; and
Strategy formulation – having regard to Tasks 1–4 above, formulate strategies for enhancing primary, secondary and tertiary prevention in the community.