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In response to the release of the Investigation Report on Medical Fee Waiver System by the Office of The Ombudsman today (April 6), a spokesman for the Hospital Authority (HA) issued the following statement:
The HA always welcomes opportunities for enhancements in administrative procedures, and has worked closely with The Ombudsman over many years in this regard. In this spirit, the HA generally accepted the recommendations of The Ombudsman for further improvement in the system, as part of the processes of continuous quality improvements.
With regard to this particular Report, continuous efforts have been made over the past year to tighten safeguards, including incorporating a counter-checking mechanism for all high risk cases, such as those approved on non-financial grounds, introduction of an E-waiving System and ensuring that officers in-charge select a sample of approved cases for regular checking and quality assurance purposes.
There are established guidelines and procedures in public hospitals to administer the medical fee waiver system. The system is under constant review, both to meet the evolving needs of patients and their families, as well as to ensure the integrity of the system. There is also the need to ensure that needy patients are not deterred from seeking necessary treatment by over-stringent administrative procedures.
The HA considers that the risk of abuse in the medical fee waiver system is reduced significantly by a number of factors, including the fact that the people must first be in need of medical services; the applicant does not gain any actual monetary reward; the often relatively low monetary value of the waiver involved and the assessment is made by a professional social worker.
The HA would also like to outline the following key issues which may better balance the perspectives raised in the Report:
*CSSA Waivers
Some 83% of all waivers go to Comprehensive Social Security Assistance (CSSA) cases. However, these waivers are not administered by Medical Social Workers (MSW). As the Report focuses solely on MSW administration of non-CSSA cases, inclusion of statistics of CSSA cases is misleading.
*Waiver on Non-Financial Grounds
There are detailed guidelines governing the consideration of non-financial grounds, which are carefully exercised by professionals in social work. Waivers will be granted on non-financial grounds for patients with special difficulties on a case-by-case basis. The value of cases granted on non-financial grounds represents only 1.6% of all waivers, or just 6.8% of all non-CSSA medical fee waivers. This reinforces that waivers granted on non-financial grounds are not granted 䩕casually蒅.
*Verification of Information provided by Applicant in Non-CSSA cases
The verification process must be cost-effective, as the emphasis on documentation review by MSW to verify the information provided by the applicant in their application reflects the high number of applications and the relatively low monetary value involved, especially for Specialist Outpatient Clinic, General Outpatient Clinic and Accident & Emergency cases.
*Management Information
As part of its continuous efforts to improve the medical fee waiver system, HA has in 2004 introduced the E-waiving System which both improves application processing and now provides additional management information for enhanced monitoring and control purposes.
*Prevention of potential abuse by Applicants
During the assessment process, MSW will read out an abuse warning contained in the form to the applicant. This stresses the legal consequences for knowingly providing false information. Nevertheless, follow-up checks/investigations for a limited number of cases, as a further assurance measure, are being considered.
The spokesman reiterated that HA, as an accountable public organisation, would continue to manage available public resources in a responsible manner, while upholding the Government﷿s policy that no one should be denied adequate medical care due to lack of means.
Ends/Thursday, April 6, 2006
Issued at HKT 12:00
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