Hong Kong Hospitals Forsake International Standards Amidst CCP Encroachment

Apart from demonstrating political loyalty [to the CCP], I see no reason for the necessity to collaborate with the Greater Bay Area.”

Patients lie on hospital beds at a temporary holding area outside Caritas Medical Centre in Hong Kong on Feb. 16, 2022. Sung Pi-Lung/The Epoch Times

Hong Kong Chief Executive John Lee announced in his October policy address that the Hospital Authority of Hong Kong will restart its hospital accreditation program, forsaking international standards in favor of standards set by mainland China. Analysts believe this move could negatively impact Hong Kong’s medical sector, further eroding its once-leading position and moving it away from international benchmarks.

Lo Chung-mau, the Secretary of Health, responded on Nov. 29 to legislator Chan Hok-fung’s question in the council, confirming that the Hospital Authority will adopt the “International Hospital Accreditation Standards (China) 2021 Edition,” abandoning the international standards previously followed.

The Shenzhen Health Hospital Evaluation Research Center was established in December 2020 under the guidance of the Shenzhen Municipal Health Commission. Stating to follow principles set by the International Society for Quality in Health Care and blending them with China’s national tertiary hospital evaluation standards, the Center formulated a set of “International Hospital Accreditation Standards (China) 2021 Edition.” The Legislative Council reported that these standards have been successfully accredited by the International Society for Quality in Health Care.

Hong Kong Hospitals Adopt Chinese Standards from 2023

Mr. Lo stated that to align with the Policy Address’s directives to restart the hospital accreditation program, the Hospital Authority will adopt the “Chinese version of the accreditation standards” in the Eastern District’s Pamela Youde Nethersole Eastern Hospital and Prince of Wales Hospital from 2023 to 2024. The objective is to “homogenize hospital evaluations and healthcare quality and safety in the Greater Bay Area and align with the national healthcare system.”

Mr. Lo revealed that a working group has been established to guide public hospitals in implementing the “Chinese version of the accreditation standards.” Some private hospitals have also expressed interest in adopting these standards for their accreditation reviews.

In September 2022, the Shenzhen Health and Hospital Evaluation Research Center finalized the “Chinese version of the accreditation standards.” Since March 30, 13 hospitals from Beijing, Guangzhou, Shenzhen, Zhuhai, and Hong Kong have participated in this accreditation, including Prince of Wales Hospital, Pamela Youde Nethersole Eastern Hospital, Gleneagles Hospital, and the CUHK Medical Centre.

To date, medical staff from both public and private health care institutions in Hong Kong have begun participating in assessor training conducted by the Shenzhen Health and Hospital Evaluation Research Center.

Patient Data Transferred to Mainland China

As part of the “cross-border medical collaboration” outlined in the Policy Address, the authorities plan to launch a pilot program for the Elderly Healthcare Voucher Scheme in the Greater Bay Area in 2024. The authorities also stated that medical facilities in the area, especially the University of Hong Kong-Shenzhen Hospital, should be used to “help reduce waiting times for Hong Kong residents.”

In May, after the “Support for Guangdong-Hong Kong-Macao Greater Bay Area Hospital Authority Patient Pilot Program” was launched, eligible Hong Kong residents can receive subsidized diagnostic services at the University of Hong Kong-Shenzhen Hospital. The authorities plan to expand cross-border medical services. They are exploring “deepening the mechanism for cross-border electronic medical record transmission” to achieve “data interoperability between the north and south.”

Sun Dong, Secretary for Innovation, Technology, and Industry, also recently told party media Wen Wei Po that there might be possibilities for cross-border medical record sharing between mainland China and Hong Kong.

Chinese Personnel & Pharmaceuticals Enters Hong Kong

In recent years, Hong Kong’s public hospitals have started introducing pharmaceuticals from mainland China, including antibiotics for intravenous injection, antifungal drugs, and medications for controlling rapid heartbeats.

A former public hospital nurse told The Epoch Times that the quality of drugs from mainland China tends to be less stable. For instance, some antibiotics contain impurities, leading to inconsistencies in dissolution times.

In 2022, several public hospitals were found prescribing medicines sourced from mainland China, such as “paracetamol,” which is not on the Department of Health’s list of registered pharmaceutical products. According to the Hospital Authority, “Central Support for Hong Kong” medicines from mainland China have been exempted from registration.

Additionally, Mr. Lo revealed in June that Hong Kong plans to establish its own drug approval agency. In the future, “there will be no need to wait for foreign permissions for drug approval, speeding up the process.”

The Policy Address also proposed establishing a new “1+” mechanism for approving medicines to treat severe or rare diseases. Since Nov. 1, medicines registered with the first approval agency and meeting local clinical data requirements and expert approval can be used in Hong Kong.

Patients in hospital beds wait in a temporary holding area outside Caritas Medical Centre in Hong Kong on March 2, 2022. Kin Cheung/AP Photo

Regarding manpower, the authorities will strengthen two-way training and exchanges of medical talent between Hong Kong and other regions and cities in mainland China beyond the Greater Bay Area.

Under the “Greater Bay Area Medical Talent Exchange Program,” the first batch of 83 medical professionals from mainland China arrived in Hong Kong in early 2023. Among them, 70 nurses were evenly distributed across seven hospital networks for 10.5 months, while the doctors were exchanged for a year across Kowloon Central, Kowloon West, and New Territories West. The Hospital Authority said it hopes to make this exchange program a permanent fixture.

International Standards Helped HK Hospitals Improve

Hospital evaluations internationally are usually based on standards set by the Australian Council on Healthcare Standards (ACHS) and the Joint Commission International (JCI) of the United States.

Since 2009, the Hospital Authority has collaborated with Australia’s ACHS to implement the hospital accreditation program. According to the Legislative Council press release, by 2017, 20 hospitals under the Hospital Authority had successfully achieved accreditation. During the accreditation process, each hospital made continuous improvements in various areas and services, such as enhancing management and review systems, standardizing services and workflows, and reducing redundant work.

In 2017, the marginal benefits of continuing the program were deemed to be diminishing and not cost-effective, leading the Hospital Authority to officially terminate its collaboration with the ACHS in 2019.

Beijing also stated that it would seek international certification standards. As of 2019, 100 hospitals in China had passed the JCI accreditation, including the University of Hong Kong-Shenzhen Hospital, which passed ACHS accreditation in 2015.

However, after over 20 years of collaboration with Chinese health care institutions, the JCI decided to close its operations in China in 2023, citing the complex regulatory environment in China over the past few years as the main reason.

Analysis: Political Loyalty to CCP Sole Purpose

Chung Kim-wah, former assistant professor at Hong Kong Polytechnic University and deputy chief executive of Hong Kong’s Public Opinion Research Institute, expressed concerns over Hong Kong’s increasing adoption of mainland Chinese medical personnel and the exemption of Chinese drugs from rigorous scrutiny.

“The medical system in mainland China involves many bureaucratic operations and a lot of non-standard behavior, which often fails to meet the standards commonly used in the West,” he said.

“The medical field involves various professional standards and norms. Each aspect, including doctors, nurses, pharmacists, physical therapists, and radiologists, must have independent yet cooperative procedures. Therefore, how these standards correspond to each other is crucial.

“In many instances, mainland China’s official-centric approach overrides everything. The highest leaders want to control everything. All other semi-medical or auxiliary medical standards and operations have to give way and align with this so-called major policy.

“Therefore, in many minor aspects, there could be inconsistencies with the management principles commonly used in the West. This is also reflected in other certification standards, like ISO.”

The picture shows Prof. Chung, a former assistant professor at Hong Kong Polytechnic University. (Song Bilong/The Epoch Times).

Professor Chung does not endorse Hong Kong’s shift away from international standards, believing that the “One Country, Two Systems” policy itself affirms Hong Kong’s autonomy. Thus, the healthcare system could continue operating under its existing framework.

“Apart from demonstrating political loyalty [to the CCP], I see no reason for the necessity to collaborate with the Greater Bay Area,” he said.

HK’s Leading Medical Standards Further Eroded

Similarly, political commentator Ji Da believes that Hong Kong’s medical system, which was once at the forefront globally, has always adhered to international standards with exceptional management and world-class universal healthcare, a level mainland China struggles to match.

“Mainland China’s medical standards are far from international requirements. Adopting mainland evaluation standards and allowing mainland personnel to work in Hong Kong moves away from internationalization. This represents a significant decline for Hong Kong,” she said.

“It can be said that Hong Kong has been totally eroded by the Mainland, which is chilling.”