LCQ6: Attracting non-locally trained doctors to practise in Hong Kong

     Following is a question by Dr the Hon Chiang Lai-wan and a reply by the Secretary for Food and Health, Professor Sophia Chan, in the Legislative Council today (June 17):
 
Question:
 
     To attract non-locally trained doctors to practise in Hong Kong so as to alleviate the manpower shortage of doctors in public hospitals, I and fellow members of the party to which I belong proposed in the middle of last year to amend the Medical Registration Ordinance to the effect that non-locally trained doctors who had been in employment with the Hospital Authority (HA) under limited registration for not less than five years and with satisfactory work performance would be qualified to apply for full registration as a registered doctor, without having to go through the required examination. The Government responded that as the proposal was controversial, it was not an "opportune time" to amend the Ordinance without full consultation of the stakeholders. In this connection, will the Government inform this Council:
 
(1) whether it has assessed at what time, and upon what conditions having been met, it will be an opportune time to implement the aforesaid proposal; whether it has consulted HA and other stakeholders on the proposal; if it has consulted, of the details of the views collected, including the ratio between those views for the proposal and those against and the justifications therefor; whether and when it will consult members of the public on the proposal;
 
(2) whether it knows the current situation of the manpower shortage of doctors in public hospitals, and the impacts of such situation on the quality of public healthcare services; and
 
(3) given that as at the end of March this year, there were only 24 non-locally trained doctors employed by HA under limited registration, whether it has reviewed the effectiveness of the efforts in attracting such doctors to practise in Hong Kong; if it has reviewed and the outcome is that the efforts are unsatisfactory, whether the Government will consider providing more incentives for such doctors to practise in Hong Kong, e.g. by implementing the aforesaid proposal; if so, of the timetable; if not, the reasons for that?
 
Reply:
 
President,
 
     The Government has taken a multi-pronged approach to tackle the severe shortage of doctors in the public healthcare system by, inter alia, increasing the number of healthcare training places, providing funding for universities to upgrade and increase their healthcare training capacities, as well as supporting the manpower initiatives of the Hospital Authority (HA). The Government will also continue to actively promote and publicise for the limited registration arrangement overseas, and conduct recruitment exercises to attract qualified non-locally trained healthcare professionals to practise in Hong Kong.
 
     My reply to the question raised by Dr the Hon Chiang Lai-wan is as follows:
 
(1) The Food and Health Bureau set up a multi-party platform in March last year, engaging representatives from the Medical Council of Hong Kong (MCHK), the Hong Kong Academy of Medicine (HKAM), the Hong Kong Medical Association, the HA, the two medical schools in Hong Kong and the Department of Health to discuss feasible options for increasing the supply of doctors.
 
     In the past year or so, a number of measures to increase the supply of doctors have been implemented. For instance, for non-locally trained specialist doctors who have passed the Licensing Examination and have worked full-time in the public healthcare sector for three years, the MCHK has, since last August, shortened their period of assessment from six months to two days. Besides, four colleges of the HKAM (namely Emergency Medicine, Family Medicine, Internal Medicine and Paediatrics) have agreed to admit non-locally trained doctors with qualifications at the pre-intermediate level for continuation of their specialist training in Hong Kong on the premise that the specialist training opportunities for locally trained doctors will not be compromised. The HA has updated the recruitment requirements for non-locally trained doctors with limited registration in these specialties since April this year. We expect that these measures will attract more eligible non-locally trained doctors, particularly those who are the children of Hong Kong people, to serve in our public healthcare sector through limited registration, thus alleviating the manpower shortage problem.
 
     The Government will consider the effectiveness of the above measures as well as the views of relevant institutions and stakeholders in the healthcare sector before deciding on the way forward.
 
(2) In 2019-20, there was a cumulative shortfall of around 260 doctors, and an attrition rate of 5.4%, or 322 full-time doctors in equivalent, in the HA. 
 
     The HA is very concerned about the manpower of doctors in public hospitals, and will continue to undertake measures to increase and retain manpower. In addition to increasing the number of Resident Trainee posts, the HA will strive to recruit more full-time and part-time doctors, increase promotion opportunities and enhance training, and continue to recruit non-locally trained doctors to serve in public hospitals under limited registration, so as to relieve the work pressure on frontline doctors and improve the working environment. Besides, the HA will continue with the Special Retired and Rehire Scheme to rehire suitable serving doctors upon their retirement at normal retirement age or leaving the service upon completion of contract.
 
(3) With the commencement of the Medical Registration (Amendment) Ordinance 2018, the validity period and the renewal period of limited registration have been extended from not exceeding one year to not exceeding three years. The HA has taken this opportunity to review and enhance the Limited Registration Scheme (the Scheme) in different aspects with the aim to attracting more non-locally trained doctors to practise in Hong Kong. Relevant measures include extending the Scheme from April 2019 to cover all specialties at the rank of Resident and recruiting non-locally trained specialists at the rank of Associate Consultant in specialties where shortage of specialists is more serious. Moreover, in order to increase the promotion opportunities for non-locally trained doctors, those at the rank of Resident with five or more years of post-specialist qualification clinical experience in public hospitals will have the chance to be promoted to the rank of Associate Consultant.

     With the implementation of the enhancement measures, the number of non-locally trained doctors recruited by the HA has increased. As at May this year, there are 25 non-locally trained doctors working in HA public hospitals under limited registration.

     Job applications from non-locally trained doctors are still received under the Scheme. As usual, the HA will assess the qualification and experience of the applicants in accordance with the mechanism and arrange interviews for suitable candidates. For those who are eligible and considered suitable for appointment, the HA will submit their limited registration applications to the MCHK in batches according to their intended dates of reporting for duty in Hong Kong. Four non-locally trained doctors whose applications for limited registration were earlier approved by the MCHK will report for duty within this year. The HA has submitted another three applications from non-locally trained doctors to the MCHK in May this year.

     The HA will continue to recruit non-locally trained doctors by way of limited registration and keep reviewing and monitoring its overall manpower situation.