President’s
Jottings
After
a much protracted “labour”, for reasons undisclosed, the Consultation
Document on Health Care Reform was finally “delivered”.
However, the Document leaves many queries unanswered and other areas
untouched.
For the purpose of the medical profession, the long-awaited document
certainly does not fulfill our expectations and anticipation.
Many lament that it is a “skeleton with no muscle”, while others
consider it as the Government’s measure to quiet the public.
Irrespective of the Government’s goal, it is a consultative health care
policy paper since the last one published 26 years ago.
Despite
its shortcomings this is a comprehensive document that covers many areas of
health care that need reform of our system, control of standards and financing.
Thus, it is imperative that the medical profession responds actively to
this document in a positive manner – giving constructive criticisms and
suggestions.
As
a College, to drive our expectations home, there are at least two areas we must
respond to - the training of specialists and the assurance of standard of the
medical profession.
The
training of Primary Health Care Physicians has been heavily addressed in this
“Green Paper”. Few would
dispute that there is a great shortage of Family Physicians and that they are
important as gatekeepers for hospital care.
Unfortunately, areas on training of other specialties – including the
manpower required and the funding provision – have not been substantively
examined in the document.
With
the Hospital Authority freezing trainer posts and reducing trainee numbers to
accommodate productivity gains, specialist training is set to suffer.
It is imperative that the College and the Academy work together to
produce a realistic manpower survey and thus, to demand from the Government the
necessary financial requirement. Moreover,
it is important that the College and the Academy should be assured of a role in
the Hospital Authority posting of trainees.
It is ironic that whilst the Academy and its Colleges define the training
programme for each trainee, they are not given the opportunity to perform the
matching role in the Hospital Authority posting exercise.
The
Academy has also called for a review of training policy – do all specialties
need a six-year training programme? What
proportion of “general” specialists versus “supra” specialists do we
need in each specialty? These are
the areas that your College will respond with vigilance and I will be bringing
to the Council and the membership for final consultation.
“Life
long learning” is to many professions and trades a norm rather than an
exception. It is for this reason,
and to assure the public that all Academy Fellows are always up to date in our
pursuit of medical advances, that adequate continuing medical and dental
education (CME) is a prerequisite of specialist registration and
re-registration. It only stands to
reason too that a structured CME, in the course of time, be mandatory for
registration to practice medicine and dentistry if our professions are to remain
in the trust of the public at large.
As
a corollary of CME is, of course, quality assurance – a task that your College
and the Academy must take an active step to promulgate and take responsibility.
Finally,
there are other areas that the Council of the Academy has deliberated and
proposed for initial response. I
would urge all Fellows to study them with care and instigate constructive
criticisms. Your College awaits
eagerly your opinion and wisdom!
27
January 2001