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Nonetheless, stakeholders cautioned that the successful implementation of the Scheme
would be contingent on buy-in from both private sector providers and the general public,
thereby requiring sufficient incentives for both parties to join. Furthermore, stakeholders
elaborated on the need for health system planners and the purchaser to enable the
sustainability of the Scheme through overcoming existing barriers present in the health
system. Specifically, the untransparent pricing of services, limited regulation, and concerns
over inconsistent service quality across the public and private sectors must be addressed.

Stakeholders further highlighted that a PPP-oriented Scheme would require the collaboration
and input of various sectors and industries, particularly in the design and implementation of
the Scheme. Notably, stakeholders suggested that the purchaser should engage with the
insurance and pharmaceutical industries to better plan health financing mechanisms to
improve access to health services.

Findings are detailed in Chapter 4.1.

The voices of the general public

Using a telephone survey, we assessed the likely public reception of the Scheme upon
implementation and identified design considerations to ensure successful implementation.
To understand the ways in which the Scheme’s design can best facilitate progression
towards UHC, we applied WHO’s core concept of universal access in analysis that considers
the key dimensions of physical accessibility, financial affordability, and acceptability.

Key findings demonstrate a mismatch between respondents’ preference in service sector
(public/private) for seeking care and actual utilisation patterns. A majority of respondents
reported utilisation of public sector services to obtain preventive and disease management
services. Nonetheless, respondents generally did not indicate a strong preference for
continuing their use of public sector services; on the contrary, the majority of respondents
indicated either a preference for the private sector or no preference at all. This suggests the
feasibility of promoting private sector usage through the Scheme.

Additionally, survey results indicated that a variety of socio-economic factors impacted
respondents’ past health-seeking behaviours when i) choosing whether to engage in preventive
services, ii) deciding between the public and private sectors for care, and iii) expressing their
willingness-to-pay (WTP) range for the Scheme. In particular, three factors associated with
past health-seeking behaviour were identified: monthly household income, medical insurance
coverage, and perceptions of financial preparedness. Most respondents reported their WTP
range for chronic disease management as HKD 51–200. We also found that monthly
household income was positively associated with respondents’ WTP range, with lower monthly
income being correlated with a lower willingness-to-pay range. Similarly, individuals without
insurance coverage were more likely to choose public sector services over private sector
care, thus highlighting the importance of considering the financial barriers of this group in the
payment structure of the Scheme. These factors should be taken into consideration in ensuring
that all residents, irrespective of financial status are empowered to access the Scheme.

Finally, survey findings suggested that the Scheme should remove barriers to accessibility of
screening services, ranging from issues of geographical convenience, flexibility in attaining
services (targeting busyness), and limited health literacy (targeting non-urgency). Findings
also suggested that health literacy is a promising target for intervention in order to increase
the willingness to participate in preventive behaviours. Respondents welcomed the advice of
medical professionals and indicated willingness to change their stance toward being willing
to take up screening and management if they have received advice in favour of doing so. To
that end, the role of primary care providers can be enhanced to improve population health
literacy and ultimately increase the public’s participation in preventive behaviours.

Findings are detailed in Chapter 4.2.
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