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“I make these lengthy, arduous journeys throughout the border to get life-saving treatment I can not afford in Hong Kong,” 59-year-old Liu mentioned.
Single and dwelling alone, she stop her job in social companies after she was recognized with lung most cancers greater than two years in the past.
Then the most cancers unfold to her mind. She was instructed she wanted a focused drug which might price greater than HK$30,000 (US$3,800) a month in Hong Kong.
Unable to afford it, she went to mainland China, the place the identical drugs price about 5,000 yuan (US$687) a month, lower than a fifth of that in Hong Kong.
She mentioned she had been making her month-to-month journeys throughout the border since final September.
Liu is amongst 1000’s of Hong Kong residents searching for medical care on the mainland, the place ready occasions are shorter and consultations and medicines price a lot much less.
The development has picked up because the reopening of the border final 12 months after the Covid-19 pandemic, and consists of not solely low-income residents and the aged, however more comfortable Hong Kong residents too.
Consultants mentioned the development was largely market-driven, but in addition mirrored the state of Hong Kong’s overwhelmed public medical system, with its notoriously lengthy ready occasions, whereas personal care was past the attain of most individuals.
“It’s an irreversible development, pushed by the combination of the Higher Bay Space and the enhancing medical companies throughout the border,” mentioned Dr Lam Ching-choi, a member of the town’s key decision-making Govt Council.
“The development has created new alternatives for cooperation between Hong Kong and the mainland in medical care, and has additionally prompted us to think about how we are able to clear up our personal issues.”
Agony of ready for an appointment
Hong Kong’s quickly ageing inhabitants has put growing stress on the general public medical system. Hospital Authority information additionally exhibits that ready occasions may even stretch into years.
A comparability of median ready occasions throughout specialist outpatient clinics confirmed {that a} “steady case” eye affected person reserving a primary appointment should wait between 42 and 85 weeks, as of the top of March. The longest wait of 180 weeks was recorded in Kowloon West.
These thought of pressing or semi-urgent instances needed to wait much less.
The median ready time for ear, nostril and throat appointments ranged between 14 and 70 weeks throughout clinics, and for orthopaedic and trauma instances, between 20 and 59 weeks.
Safety guard Tan Chun, 70, went to a public hospital in February for power again ache brought on by the narrowing of her spinal canal. She was instructed to attend three months for her subsequent session, in Could.
In March, the ache in her decrease again was so extreme that she might barely stroll. She tried therapeutic massage and acupuncture, however stopped when she couldn’t afford to pay HK$500 to HK$600 every time.
A mainlander married to a Hongkonger, she made a five-hour journey by high-speed prepare to her hometown, Guangxi, for remedy at hospitals there.
She mentioned she was attended to right away and over a number of weeks, obtained remedy together with drug infusions, therapeutic massage, acupuncture and conventional Chinese language drugs.
“The ready time in Hong Kong’s public hospitals is simply too lengthy to bear the ache,” she mentioned.
Excursions supply sightseeing and a check-up
Linda Tsang Chi-man, govt director of the Hong Kong Federation of Commerce Unions Higher Bay Space Social Providers, mentioned the quantity heading to the mainland, particularly aged folks, had began surging from the second half of final 12 months.
Many sought dental and eye care and bodily check-ups in Shenzhen and Zhuhai, close to the border.
Some have been attracted by the mainland establishments’ elevated promoting in Hong Kong, whereas others have been inspired by good suggestions from buddies or kinfolk in regards to the high quality, care and value.
Tsang’s organisation determined to start out guided excursions taking aged Hongkongers for well being screenings and sightseeing throughout the border.
Sufferers’ rights advocate Tim Pang Hung-cheong, of the Society for Neighborhood Organisation, mentioned that earlier than the pandemic, most of these going throughout the border for medical companies have been low-income residents and new arrivals from the mainland.
Now, extra middle-class sufferers are going too, together with most cancers sufferers who paid solely 1 / 4 to a 3rd of Hong Kong costs for therapies corresponding to chemotherapy, radiotherapy and focused remedy medication.
Most selected hospitals in Shenzhen, though some travelled additional to Zhuhai, Zhongshan or Huizhou, additionally in Guangdong.
Pang mentioned he anticipated the quantity to continue to grow.
Extra mainland hospitals entice sufferers
The College of Hong Kong–Shenzhen Hospital, which opened in 2012, is a best choice for a lot of Hongkongers as a result of it bears the model of the town’s prime college.
Till this 12 months, the general public hospital and its neighborhood well being centre have been the one mainland establishments the place eligible aged Hongkongers might use a healthcare voucher.
Since 2009, eligible residents aged 65 and above have obtained an annual voucher of HK$2,000 per individual, with the quantity allowed to build up as much as HK$8,000.
The worth of vouchers used on the hospital tripled from about HK$4 million in 2019 to about HK$11.9 million final 12 months, in keeping with official information. Within the first half of this 12 months, vouchers price about HK$9.2 million have been used.
In February, the Hong Kong authorities introduced that the vouchers is also used at seven extra medical establishments in mainland cities within the bay space this 12 months. 5 supply built-in medical companies and two present dental care.
Different medical establishments on the mainland, together with these focusing on better-off sufferers, have additionally gained growing reputation.
Retired development foreman Kwong Yuk-lam, 72, mentioned he and his spouse accompanied their accountant daughter to the Shenzhen New Frontier United Household Hospital in Futian to take away her uterine fibroids.
All the things was completed in simply three days, he mentioned.
His daughter, in her 40s, checked in on Could 30 and had a check-up earlier than present process the process the following day. She was discharged the day after that.
“The surroundings was good and extra importantly, the association of the companies was quick,” Kwong mentioned.
The entire price? About 40,000 yuan.
Kwong mentioned if his daughter had chosen to be handled in Hong Kong, she would have needed to wait half a 12 months for a follow-up go to at a public hospital. Going to a non-public clinic would have price about HK$130,000 – thrice greater than she paid in Shenzhen.
Brian Siu Ngai-fong, govt director of New Frontier, which runs the personal hospital in Shenzhen, mentioned that till final August, it noticed solely about 20 Hong Kong sufferers a month.
Anticipating the arrival of extra Hong Kong sufferers after the pandemic, the hospital elevated its promoting on social media and in sufferers’ teams final summer time.
“The variety of Hong Kong sufferers began rising final September and the momentum has stayed,” he mentioned.
Concentrating on middle- and high-income sufferers, it now has about 1,000 sufferers a month from Hong Kong, accounting for a fifth of its complete.
Many have been aged, and probably the most sought-after companies included well being screenings, dental cleansing and gastroscopy.
Bodily check-ups price between about 3,000 yuan and eight,000 yuan, and a gastroscopy price between 7,000 yuan and eight,000 yuan, each roughly half the value in Hong Kong.
The hospital now runs a daily shuttle bus service from the Futian border, and has skilled its medical employees to talk Cantonese and arrange a devoted hotline for Hong Kong and Macau sufferers.
Siu mentioned the hospital would open a brand new rehabilitation centre in Hong Kong this 12 months, so sufferers getting back from Shenzhen might obtain follow-up companies.
‘Heading north is the one method out’
Hongkonger Golan Kwok Che-lun began a volunteer service final 12 months to accompany most cancers sufferers to the College of Hong Kong–Shenzhen Hospital.
The previous IT skilled, now 60 and retired, was recognized with lung most cancers three years in the past whereas working in Shanghai. That was when he realised how a lot much less focused remedy medication price there.
For instance, he mentioned, a selected hormone remedy drug for prostate most cancers prices about HK$35,000 a month at Hong Kong’s public hospitals however solely 500 yuan on the mainland – lower than 2 per cent of the value in Hong Kong.
“For a lot of, heading north isn’t another however their solely method out,” he mentioned.
Kwok and his group of six volunteers, all present or recovered most cancers sufferers, have helped greater than 100 sufferers up to now. Some had impaired mobility or have been unfamiliar with procedures on the mainland.
The group now makes a weekly journey, taking three to eight sufferers throughout the border. Though the method was principally smooth-going, the lengthy journey could possibly be agonising for some aged sufferers.
Generally, when their digital medical data weren’t accessible throughout the border, they ended up having to repeat checks there.
Kwok hoped to coach extra volunteers to fulfill rising demand.
Tsang Kin-ping, chairman of affected person group Uncommon Illness Hong Kong mentioned these searching for cheaper remedy on the mainland included folks with uncommon illnesses.
About eight sufferers with spinal muscular atrophy – a degenerative genetic situation that weakens the muscle mass progressively, inflicting mobility issues – started making common journeys to the College of Hong Kong–Shenzhen Hospital final 12 months.
Tsang mentioned every of them wanted medicines that price greater than HK$2 million a 12 months in Hong Kong with out authorities subsidies. In Shenzhen, it price 95 per cent much less, 100,000 yuan a 12 months, he added.
Kwok and Tsang urged Hong Kong authorities to do extra to carry down the value of the medication within the metropolis.
Others mentioned Hong Kong sufferers additionally confronted difficulties accessing their digital medical data when on the mainland, and a few didn’t know tips on how to deal with medical disputes there.
Some urged increasing the healthcare voucher scheme additional to incorporate extra Grade 3A hospitals, the highest tier of hospitals on the mainland, in Guangdong cities.
It will additionally assist if the federal government subsidised sufferers to purchase the mainland’s medical insurance coverage to cowl inpatient service bills, they mentioned.
‘Work with mainland to chop drug costs’
Lawmaker David Lam Tzit-yuen, who represents the medical and well being companies sector, mentioned that when it got here to drug costs, the mainland had sturdy bargaining energy with pharmaceutical firms.
He urged that the Hong Kong authorities work with the central authorities to purchase expensive medication for uncommon illnesses and cancers to carry down the costs within the metropolis.
He mentioned the authorities had acted to chop the lengthy ready time on the metropolis’s public hospitals.
Neighborhood screening for earlier detection of power situations had helped scale back the variety of critical instances, whereas steady instances have been moved to the first healthcare system.
“We have to improve the manpower on the one hand, and likewise scale back the variety of sufferers with critical illnesses on the opposite, in addition to hand some steady instances over to the neighborhood,” he mentioned.
The federal government had set a sequence of targets to chop ready occasions, together with lowering the look ahead to steady new case bookings for the specialty of inside drugs by 20 per cent in 2023-24. That meant going from 122 weeks to 97 weeks.
Based on the Hospital Authority’s report on final 12 months’s efficiency, the goal had been reached, with the ready time right down to 92 weeks.
The authorities have been additionally working to fulfill new targets to trim the ready time for steady new case bookings for ear, nostril and throat, and orthopaedics and trauma sufferers.
Exco member Lam Ching-choi mentioned the development of Hongkongers heading north mirrored the town’s polarised medical system which left many sandwiched between reasonably priced public care and high-priced personal care.
He mentioned cooperation between the town and the mainland might supply an answer, with sufferers doing low-risk checks on the mainland at a decrease price earlier than returning to Hong Kong to seek the advice of native medical doctors.
Additional cross-border healthcare integration would see extra Hong Kong medical doctors searching for alternatives within the bay space, and completely different well being situations could possibly be handled at varied locations within the area to maximise advantages to sufferers, he added.
Lau Siu-kai, a guide for the Chinese language Affiliation of Hong Kong and Macau Research, a semi-official assume tank, mentioned the development of Hongkongers searching for medical care on the mainland might make up for the shortcomings of the town’s medical companies and likewise immediate native medical doctors to decrease costs.
However he cautioned {that a} steady inflow of sufferers might trigger mainlanders to complain that Hongkongers have been swamping their medical assets.
He mentioned it will assist if extra Hong Kong companies arrange medical services throughout the border, growing the general provide of companies for each Hongkongers and mainlanders.
He additionally urged the authorities on either side to make sure cross-border medical disputes have been dealt with correctly and step up schooling on affected person rights.
“This may promote the event of our healthcare trade and can also be according to the broader cross-border healthcare integration,” he mentioned.
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