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2) Hybrid purchasing model drawing upon experience
from existing PPP programmes and the strategic
purchasing ideals

The recommendations provided for the design and implementation considerations of the
Scheme are based on lessons drawn from existing primary care PPP programmes such as
the EHCVS and the GOPC-PPP. They are also based on strategic purchasing criteria, which
seeks to address many factors that affect the successful application thereof to Hong Kong’s
unique health system from the level of governance to benefit package design, considering
the need for adequate incentivisation and coverage of co-morbid conditions. There are
currently no PPP programmes designed as a hybrid of supply-side and demand-side
instruments, each best suited for the two components of the proposal for a screening
voucher and chronic disease management to change and optimise healthcare utilisation
patterns. To that effect, the Scheme provides a visionary approach to tackling holistic and
continuity in the provision of care. The Scheme also advocates that co-morbidities be
managed and subsidised within the scope of its service provision, and highlights key design
considerations that i) the purchaser should reduce potential dual utilisation of public and
private sectors among the Scheme’s voucher users through regulation and ii) ensure the
ease of access to affordable primary care services for underserved and disadvantaged
populations. Further studies need to be undertaken to explore varying scenarios of costs,
their sources, and payment mechanisms to optimise financial sustainability of the system.
Key stakeholders including patients should be engaged throughout the finalisation of the
design of the proposed Scheme that should be piloted and evaluated when considered for
scaling up.

3) In line with latest Government policy agenda and
initiatives in primary healthcare development

It would be important for the Government to consider how the introduction of the said
Scheme will complement the existing programmes, particularly existing primary care
initiatives, PPPs and the District Health Centres (DHC), to examine how they may be
synchronised and integrated to avoid duplication of resources which create health system
inefficiency. As an example, at of the time of writing, two District Health Centres have
commenced services. The Scheme will maximise its population impact through disease
detection and downstream continuous management services, in conjunction with DHCs’
positioning for the provision of upstream HDH prevention across all districts. DHCs could
also serve as a hub for coordination of the programme.

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