family doctor are healthier, undertake more preventive care such as exercise and regular cancer screening, are less likely to attend emergency departments or get admitted to hospital, and are more likely to report they feel better after consultation with their doctor. ‘Primary healthcare starts with self-care and each person looking after themselves. The next step is primary medical care but the two are related because healthcare professionals in primary care also help educate people on looking after themselves,’ she said. Moreover, almost everyone will have visited a doctor for primary care, versus about less than half seeing a specialist and maybe less than one-tenth experiencing hospital care in a year. Despite these benefits, Hong Kong has since the 1950s devoted resources to the end of the pipe – hospitals – and let the private sector look after primary care, as well as develop private hospitals. This dual-track system ensures no one is deprived of urgent and expensive hospital services for financial reasons and gives people a choice. But today, Hong Kong has a much older population and a greater prevalence of chronic diseases that require long-term management and costly medication. As a result, about 80 per cent of chronic patients seek affordable care in the public sector, which is buckling under the pressure. The government has long been aware of the need to improve primary care. In 1990, the Working Party on Primary Health Care, chaired by Professor Rosie Young Tse-tse, published Health for All – The Way Ahead that encouraged more efforts on primary care. Other consultation documents were also published over the years, but while there was awareness, comprehensive and specific implementation seemed far away. In 2017, the government decided to develop a more concrete plan of action. The resulting Blueprint offers a clear direction and a holistic framework. ‘The Blueprint is very special because unlike previous documents on primary healthcare, which stayed very much at the idea level, this is a plan for implementation,’ Professor Lam said. The goal is for everyone in Hong Kong to have access to a family doctor who can offer quality primary care that is personcentred, continuing and comprehensive, covering everything from prevention to acute/chronic disease management to mental health. Actions have been recommended for five key areas: primary healthcare governance, infrastructure, funding resources, information management and training. On governance, a Primary Healthcare Commission is being →Professor Cindy Lam Lo-kuen, Clinical Professor of the Department of Family Medicine and Primary Care, SClinMed 臨床醫學學院家庭醫學 及基層醫療學系臨床 教授林露娟教授 about80% of chronic patients seek affordable care in the public sector 27 HKUMed News Summer 2023
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