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a. Patient data could be linked to payment mechanisms while ensuring
that sufficient rights are offered to private sector practitioners to access and
update patient data.

b. Policies should be in place to ensure patient privacy, data protection
and integrity, safeguarding data against manipulation.

2. Hong Kong must engage in rigorous monitoring and assessment of its current
investment in primary healthcare to ensure that the purchasing of services is strategic
and cost-effective. To integrate data into purchasing decisions, we suggest that the
Government systematise and regularise the tracking of Hong Kong’s primary
healthcare expenditure using international measurement standards.
This could be done by fully adopting the System of Health Accounts
(SHA), a joint classification proposed by the OECD, the European Union, and the
WHO.

a. This will allow a better estimate of primary healthcare spending in accordance to
the 2019 WHO PHC spending definition that considers: i) general outpatient and
home-based consultations; ii) preventive care; iii) parts of medical goods provided
outside health care services; and iv) parts of health system administration and
governance costs (see Box 3.5 in Chapter 3) (WHO, 2019a). The SHA segregates
health spending by source of financing, financing schemes, types of health care
goods, services consumed, and the health care providers who deliver the
services. This tracking methodology will allow for timely internal evaluation against
external references to ensure local developments are aligned with both global
trends, namely with WHO’s suggested primary healthcare spending, and local
aims (outlined in Chapter 3). Furthermore, systematic tracking will aid in strategic,
evidence-based policymaking by helping to achieve budgetary flexibility according
to population health needs.

Element 2:
Citizen empowerment, as indicated by transparent benefit packages

Citizens and participants of the Scheme are best served when they are aware of the different
benefits and pricing available to them through the Scheme and if they are provided with
recourse for holding both purchasers and providers accountable for full provision of services.
As demonstrated by the telephone polling exercise described in Chapter 4.2, citizen
empowerment must involve the voices of all beneficiaries, including those who are least likely
to be fully served by the current range of health services available.

The set up and recurrent costs of the proposed Scheme will be substantial and will need to
be secured. Against this background, since screening programmes are more likely to be
successful if no co-payment mechanism is involved, the purchaser of the Scheme is
recommended to fully pay for screening services. We put forth suggestions for the pricing
mechanism for chronic disease management services that includes consideration for
medications in the private sector to ensure that users are financially
empowered to access the Scheme.

1. Depending on users’ willingness-to-pay, the Government may consider fully
subsidising further consultations for the management of HDH in the
private sector. Alternatively, the Government can consider the
implementation of a co-payment scheme to lessen the Government’s
financial burden toward the Scheme while also ensuring financial affordability for
financially vulnerable populations.

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