Policy development in primary healthcare in Hong Kong — Building an effective district health system

Abstract

In 1988, the Hong Kong Government established a Working Party on Primary Care to make recommendations on the future development of primary healthcare in Hong Kong. Hospital Authority was established in 1991 and primary healthcare has been mentioned over 3 decades with no concrete action plan until the 2017 Policy Speech called for the establishment of District Health Centre. However, primary healthcare does NOT simply mean healthcare in community. It implies the identification of persons at high risk for medical intervention for early intervention and appropriate service providers to meet the health needs of patients. Patients with multi-morbidity require more than an ‘assess-and advise’ model of care. Comprehensive and holistic care with good co-ordination is essential to help patients navigate the complexity, which is at the heart of primary care. Patient-centred care is needed to support patients adopting behaviours across a wide range of lifestyle factors for the management of their underlying conditions but there is little guidance as to how to achieve these recommendations. Hong Kong lacks an infrastructure of quality primary care to provide comprehensive, whole person and continuing care. This chapter will discuss building up an effective district health system to meet the health needs of the community.