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  • Tony Kwok

How would Lee Kuan Yew have solved Hong Kong’s housing and health care problems?


Not that many years ago, Singapore was well behind Hong Kong when it came to most areas of the economy and living standards. At that time, according to a Singaporean friend who has worked in the government, prime minister Lee Kuan Yew instructed every minister in his cabinet to set the Hong Kong standard as their target for policy goals. Now, of course, Singapore has surpassed Hong Kong in nearly all areas.

So, it’s time for a role reversal. The most pragmatic way to improve Hong Kong's governance is for Chief Executive Carrie Lam Cheng Yuet-ngor to instruct all policy secretaries to aim for the Singapore standard

Under such a scenario, how could Hong Kong look to Singapore for ideas to solve two of its most serious problems, housing and medical care?

Singapore has had similar difficulties in housing its population – limited land resources, high population density and fast-growing demand. But currently, Singapore provides public housing for 80 percent of its population, while Hong Kong public estates house around 45 percent of the population. The waiting time for public housing is 2.5 years in Singapore and 5.5 years in Hong Kong.

Meanwhile, average living space per person stands at 270 sq ft in Singapore, and in Hong Kong, just 170 sq ft – only a little more than a standard parking space. According to a recent survey by one real estate firm, the average price of a home in Hong Kong is HK$9.6 million, way above the HK$6.8 million in Singapore. Perhaps these comparative figures should become the key performance indicators for our secretary for housing in the coming years.

The Singapore solution to the housing problem has been simple: land reclamation. The Singapore government has increased the land mass by about 22 per cent since independence in 1965 and plans to add around 8 per cent by 2030. This would mean a total reclamation area of roughly 2½ Hong Kong Islands.

Hongkongers should learn from the success story of Singapore and support the Hong Kong government’s Lantau Tomorrow Vision, which will solve our housing problem once and for all by providing 400,000 homes, 70 per cent of which will be public housing.

The other pressing issue in Hong Kong is medical care, which we all know comes down to insufficient doctors in the public health sector. In 2008, Hong Kong and Singapore had similarly low ratios of around 1.7 doctors per 1,000 people. Today, Singapore has 2.4 doctors per 1,000 people, while Hong Kong has 1.9. This is a miserable figure, given that the Organisation for Economic Cooperation and Development recommends a ratio of 3.4.

Singapore encourages foreign-trained doctors to work in the city state. As a result, its doctor population has grown over the past decade and there is no longer a shortage. In Singapore, the median waiting time for a first appointment with an orthopaedic specialist is four weeks. In Hong Kong, it’s 60 weeks. Quite clearly, the problem lies with the Medical Council, which has thus far allowed less than 1 per cent of doctors in Hong Kong to come from overseas.

The Hong Kong government should use the following figures as targets: Hong Kong would need about 3,000 more doctors to catch up with Singapore, or more than 10,000 to meet the OECD standard.

Singapore has increased the number of doctors by accepting graduates of the world’s top 158 medical schools. A recent proposal put forward by Our Hong Kong Foundation is to follow Singapore's example, but to trim the list to the top 50. This should be a welcome compromise to ensure the quality of incoming foreign-trained doctors.

In the face of an acute shortage of doctors, the Hong Kong public health system is evidently at breaking point. Yet, the Medical Council recently provoked outrage by

voting down four proposals to recruit foreign-trained doctors to work in public hospitals. In so doing, the council has lost public respect and trust.

The Hong Kong government should not be afraid to antagonise the powerful medical sector. It should take matters into its own hands – revamp the medical system with a new law and directly govern the recruitment of foreign-trained doctors. In the interests of patients, who are the ones who suffer most, and of the growing elderly population, there is no room for procrastination or lack of courage.

Courtesy : South China Morning Post

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