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3.3 PUBLIC PRIVATE PARTNERSHIPS TO

IMPROVE PRIMARY CARE ACCESSIBILITY

With less than 30% of total health expenditure spent on PHC of which close to 70% of Hong
Kong’s PHC spending is in the private sector (with a significant portion from OOP household
payments) that remains unaffordable to the lower income population, Hong Kong needs to
consider how to make primary care more accessible in progressing towards a primary care-
led health system. This entails either “making” (creating services strategically in the public
sector) more affordable primary care services accessible in the public sector, or otherwise
“purchasing” primary care services in the private sector using public funds and making such
services available at a lower price. In addition to planning for increasing primary care service
provision in our already overburdened public healthcare sector that dedicates much of its
capacity to secondary and tertiary levels of care, as discussed in previous health financing
reform documents (Table 3.2), ways to better leverage the capacity of the private sector
should be considered. To achieve this, the Government should consider
evaluating and adjusting the allocation of existing resources and
purchasing and payment mechanisms for improved accessibility to
affordable primary care so that the population particularly those with chronic diseases
are provided with need services.

As discussed in section 3.1, the government’s recent health reform policies, including various
PPPs, have concentrated on promoting primary care services through engaging the private
sector. Table 3.6 lists primary care services funded by the Government in 2019/20. The
expenditure breakdown by services reveal that a large proportion of financial resources have
been recently directed towards “purchasing” services in the GOPC-PPP Programme and
Elderly Health Care Voucher Scheme (EHCVS), which currently accounts for about 17.2% of
the total public expenditure on primary care.

Table 3.6

Primary care services funded by the Government, 2019/20

Service Providers Service Scopes 2019–20 actual Total Share
expenditures (%) [1]
(HKD million)
Hospital Authority General Outpatient 3,256.8 21.1 (87.2)
Attendance
Family Medicine Specialist 393.8 2.6% (10.6)
Clinic Attendance
GOPC-PPP 82.5 0.5 (2.2)
Department of Health Disease Prevention 7,180.7 46.6 (61.7)

Health Promotion 415.2 2.7 (3.6)
Curative Care 1,134.3 7.4 (9.8)
Rehabilitation 150.9 1.0 (1.3)
Elderly Health Care 2,569.7 16.7 (22.1)
Voucher Scheme (PPP)
Vaccination Reimbursement 181.1 1.2 (1.6)
Food and Health Bureau District Health Centre 43.6 0.3 (100)
Total public expenditure on primary care 15,408.5 100

Note: [1] Figures in bracket represent the share within the same service providers
Sources: PricewaterhouseCoopers, 2020; HKSARG, 2021a

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