C-Mer group founder Dennis Lam attends the Straight Talk show on TVB, April 25, 2023. (PROVIDED TO CHINA DAILY)
Reputed eye doctor and C-Mer group founder Dennis Lam is on the show this week. Dr Lam says Hong Kong's medical system needs to act to attract and retain doctors amid a brain drain. And he also suggests pushing for medical tourism in order to catch up with Thailand and Singapore.
Check out the full transcript of TVB’s Straight Talk host Dr Eugene Chan’s interview with Dr Dennis Lam:
Chan: Good evening! Thank you for joining us on Straight Talk. Our guest this evening is Dr Dennis Lam, a key leader in ophthalmology in the Asia Pacific region.
Dr Lam established the Hong Kong C-MER international eye care group in 2012, which is listed on the Hong Kong stock exchange and runs eye centers in Hong Kong, Beijing and throughout China. At the Chinese University of Hong Kong, he was the chairman of the department of ophthalmology and visual sciences for 13 years. He has also been the Hong Kong deputy of the National People's Congress since 2008, and is a current member of the Hong Kong Legislative Council. This evening, we will be debating the question “Are Hong Kong doctors still first class?” Welcome, Dennis!
Chan: Dennis, you have a very accomplished CV, you were at the university for a long time. You were a professor. Then, you left university and came to practice. And you have actually established an eye care group, which is now listed on the stock exchange, running eye hospital centers in the Chinese mainland. You're also a Hong Kong's deputy of the NPC as well as a Hong Kong legislative councilor. So, you have been in education, business, politics, and a true community leader. We want to ask you, before we ask “Are Hong Kong doctors still first class?”, what made you want to become a doctor in the first place?
Lam: Well, a very good question. I think a doctor belongs to the profession that helps people. And I believe, you know, if you're in a position to understand yourself, and then you are able to help people when they are in need, physically, and actually also, spiritually, if we're talking about psychological or psychiatric diseases. So, I think the feeling of the opportunity to help others is something always at the core of me being a doctor. And throughout the years, I have been actually doing quite a lot of charity work, for example, going to a lot of the poverty-stricken places in the mainland to teach local people to you know, do surgeries, so we … not give them the fish, but help them to fish themselves so that they can take care of themselves. So, I think we should have the spirit that the medical profession is a caring profession. If you have that mindset and heart, then you will be enjoying your work. Although it's extremely busy, you know, day in and day out taking care of patients and their medical advancement is so quick. So, you have to keep abreast of the latest development. Only when you have the heart for your patients, then will you be able to do a good job and enjoy your work.
Chan: Right, Dennis. We all thank you for not only working on the patient, but also teaching people in the mainland, teaching them how to do surgery as many people know about that. But what is actually the current state of Hong Kong medical professionals? I mean, you've been to education, you're in business, you're now actually in the mainland. Are Hong Kong doctors still first class? That's the title of the show. What will be your simple answer to that?
Lam: A definite yes. We can look at it from different angles. For example, our two medical schools – the HKU (University of Hong Kong) and Chinese University – have been providing world class education and our hospital authorities are providing first class training. So, look at the rankings of our two universities, 31st and 32nd worldwide for medical school ranking respectively. So, you can be reassured that we are very good, you know, at this level; on the other hand, you will look from the patient's angle. It is because of COVID, otherwise before COVID Hong Kong was a major Asian referral center for medical care. So, you know, not just from the Chinese mainland, but from a lot of Asian countries. So, I think all of this speaks for the standard of what we are having.
Chan: So, what are the challenges do you think the Hong Kong medical professionals are facing? Which will be the most imminent issue that you can identify?
Lam: I think number one is the shortage of manpower. You know, our public services. In Hong Kong, we are having a dual system – public and private. In the United Kingdom, or in Canada, they are more or less a national healthcare systems, in America it's basically private-led. So, the free system Hong Kong and Singapore, we are having two arms, private and public, and we are good examples. Why? Because our standards are good. And also, we use a lesser GDP – Singapore and Hong Kong is about 6 percent. But in the United Kingdom, about 10 percent, and then in America it is 18 percent. So, I think this dual system has its advantages as well as limitations.
Chan: Right, Dennis, just go back to manpower issues you just mentioned, we realised that according to the Health Bureau, the public hospitals lost about 1,247 doctors between April 2020, to the end of 2022. And the most alarming issue is that out of that only 15 percent, they left because of retirement. Why do you think that's the case? And has the same picture been seen in the private sector as well, or just only the public?
Lam: I think, in Hong Kong, the loss of manpower, basically, one is actually to the private sector. The other is emigration to other places. I think, as a matter of fact, in the past few years, because of the period of upheavals in the political situations. So, we do have a little bit of brain drain. So, I think we have to address the issues from number one: can we produce more medical doctors from our two universities? The government is applying for funding to increase the teaching facilities so that currently we have 530 graduates per year from the two medical schools. In the future, we are targeting about 800.
Chan: Would it be an oversupply?
Lam: I think we have to look at a bigger picture. If we are just talking about serving 7.3 million local populations, that is one story. But if you want to become the Asia medical hub, not just the Greater Bay Area or the mainland, you're talking about other Asian countries, then the calculation would be different.
Chan: Right. You know, just now you talked about the manpower issue, the government has launched various programmes, you know, the Hospital Authority chairman, Mr Henry Fan actually welcome 70 nurses and three doctors from Guangdong, who will be in Hong Kong for one year, under the Greater Bay Area Healthcare Talent Exchange Program. And following a recruitment drive to the UK we have signed another 20 plus medical professionals to Hong Kong and there'll be a plan going to Australia soon. So, do you think we have to keep on doing that? Or how can we attract more doctors to come? Because if you look at the amount of work we put in, we are attracting only just under 100 doctors so far, it is not a high number. What can we do to make Hong Kong more attractive so that they'd be more professionals to come to Hong Kong? Before we can produce our own doctors in time?
Lam: I think manpower planning is always a big challenge. Yes because you're not talking about today you're talking about mid and longer term. We need, you know, five years medical education plus internship and then specialist training and so on and so forth. So, as I just mentioned, we have to look at the greater picture. For example, I can sort of envisage that in future there may be quite a number of Hong Kong doctors serving in the Greater Bay Area, home base is still Hong Kong, but they may be running around or they may be doing jobs on say a period in Hong Kong, and other period may be in China. So, the calculation, we have to really sit down and take all factors into consideration. But by and large, I think we need to have a good balance. Wisdom is a matter of good balance, we do not want to have an undersupply of doctors or oversupply. So, currently, we do have a severe shortage of manpower in the public sectors. So, can we do something about public-private partnership? So, that our sort of capacity in the private sector, which has not been fully utilized can also be used up. There are actually programs from the Hospital Authority to utilize the resources in the private sector. So, this is one. And you mentioned the visitors program.
Chan: Yes.
Lam: And I think this is good for Hospital Authority as well as the university. And then recently, we also have this special exemption scheme. So, now we have 75 medical institutes on the list. So, it's only the beginning, I believe, with Hong Kong, you know, Hong Kong is an Asian world city. And then our prospect is good, because if you look at the world economy, Hong Kong is so much linked to China and the Greater Bay Area. And also the medical standard in Hong Kong is good. And then we are an active member of the international medical community. So, I believe with you know, with more effort we should be able to recruit more talents from overseas and we also have these licensure examinations. So, there have been comments that the examination time is too limited, quota too limited, and so on and so forth. So, I think from producing more doctors locally to recruit, good standard, good quality doctors from outside Hong Kong are all on the agenda. And we have to face the issue you just mentioned, if you have done all these beautifully, we will be having too many doctors, which is something that we do not want.
Chan: Right, Dennis, let's take a break now and viewers do stay with us, we will be right back!
Straight Talk presenter Eugene Chan (left) interviews C-Mer group founder Dennis Lam attends the Straight Talk show on TVB, April 25, 2023. (PROVIDED TO CHINA DAILY)
Chan: Thank you for staying with us. We have been talking with Dr Dennis Lam. He has been updating us on the current state of our healthcare system, the shortage of manpower we face and the standard of care here in Hong Kong. Our question to him this evening is: “are Hong Kong doctors still first class?” So, Dennis, obviously your answer to my question is yes. You're quite convincing to say that. And also with all the work that we're trying to do, you think the manpower shortage issue should be solved? One part I want to just follow up on what you've said, Hong Kong now we spend like 6 percent of our GDP on healthcare, whereas you look at the United States has spent nearly 18 percent as some claim. Do you think this is the root cause of the problem? Or should our doctors in the public system be paid more, so that there'll be all… I mean everyone want to stay in the public system and entice one from the private sector to go back to the public system? Do you think that will be the quick and short answer?
Lam: Monetary return is only one of the factors in the doctors' minds, so we treasure the opportunity to serve patients as well as to build our medical career. So, I believe you know, Hong Kong has a very good deal system, if you are having only the public health or public medical system, then people will stay there almost until they retire. So, the juniors are having problems shouldering more responsibilities, for example, learning the more difficult surgeries. If you are not in that ranking or positions, you will be having less chances. So, I think we have to be reasonable. We have to be reasonable in terms of the salary, in terms of working environment, promotional aspect, as well as the chance to learn, the chance to interact with the international medical community.
Chan: Right Dennis, another area that I'm sure people going to ask over the television, you can say, of course you are being a very esteemed member of the medical profession, of course, you can say we are first class, but if you look at some objective figures, I just done some homework, the United Nation estimated Hong Kong now we have the second highest life expectancy we used to be highest, just recently overtaken by Morocco. And our average life expectancy for females is 88 years old, for males 83. We have the lowest infant mortality in the world. Also we have the highest quality childcare as well.
So, with all that, will you say that Hong Kong doctors… is it just doctors doing well or the system? What has contributed to such great success stories?
Lam: I think its nature and nurture. The genetic component is important. The environment is very important, the system is also very important. For example nowadays we stress a lot on primary health care, prevention is the best cure. And also, you want to take care of the disease at the earliest stage. So, it will be much more cost effective. So, I think it's a really a joint effort to make us such a high standard or level, we have strong fundamentals, and we have strong foundation, the two medical schools, and then the medical profession at large. So, I believe that despite the economy, or there may be some brain drain at a certain period of time, as long as we are vigilant about our own situations, so that we can plan forward, including manpower planning, failed to plan is plan to fail.
Chan: Right, Dennis, you know that in Hong Kong, we all… in this show, we often compare ourselves to Singapore, because we've got COVID with what has happened, all the neighboring cities, they're doing very well and Hong Kong is always the center to be… as a benchmark. So, where do our Hong Kong doctors stand amongst the Asia Pacific region? Do you have any rankings you can share with us?
Lam: Well, we have these 100 most influential eye doctors in the Asia Pacific region recently held, and Hong Kong is not bad. For example, out of the 100, 12 are from Hong Kong, right. And then for the top 10, we have two doctors; one is ranked number one, one is ranked number five. So, the first and the fifth among the top 10. So, this represents not just the standard, but the leadership. We have been playing a very active role in terms of ophthalmology or eye services, we want to promote, and to elevate the standard of the eyecare, not just in Hong Kong, but in the whole region. So, I think Hong Kong has been playing a very active leadership role.
Chan: You also mentioned just now, that Hong Kong before COVID, we used to be one of the hubs for major referral from the rest of the world. But we hardly hear of that in the news, because they often say Hong Kong… Let’s say Singapore, they have like half a million medical tourists last year. And according to Medical Tourism Association, they’re ranked second for the world for medical tourism. So, now you're being in the Hong Kong Legislative Council and also the Hong Kong deputy to the NPC, would you do something about that? Because Hong Kong obviously has a lot of room and ability to be really up there, if not the best.
Lam: Well, I cannot agree more. Medical tourism is very important for the whole society, because you bring in a lot of new revenues, from tourism or from the medical work, and also it's a great contribution to the growth of the medical community. I think, if you look around, Singapore is one example. Another very good example is Thailand. If you're comparing the standard, you can look at those rankings. But they are doing extremely good in medical tourism. So, I think the government as well as the medical community have to join hands to make it happen. We have the quality, we have the standard, we have the ability to provide top notch services, but how come that we are not in a very good or leading position? So, we are talking about the system. For example, how can we promote this medical tourism as an industry”? And also, you have to facilitate people from coming over from visa issuing or other how to promote ourself in other countries or territories. So, I think there are a lot of things to do. And this is one of the areas that I'm very interested to make a push.
Chan: Right, Dennis, one question, I think, it could be a little embarrassing, but I have to ask you that, I mean, we're now really integrated with the mainland now. One work that we have to do is to integrate medical services between Hong Kong and the Greater Bay Area. How would you rank the mainland doctors' standards in terms of Asia Pacific, let's not just compare to Hong Kong? Where would they stand? A lot of people are not as confident as they come to see your doctors in Hong Kong.
Lam: We just mentioned the top 100 most influential eye doctors in the Asia Pacific region. So, China has 20 candidates successfully included in this top 100 list. I will say that in China, there are really institutes, that are world class, international standard. On the other hand, China is so big and then we have urban and suburban areas. So, the gap is big. So, I think in the Greater Bay Area, certainly Hong Kong is in the leading positions, and I believe we have a special role to play. We can help take the lead, and then integrate the whole Greater Bay Area and try to elevate the standard to the international benchmark or level. And I do believe that, you know, it takes time, but won't be too sort of distant from now that we will be having really integrated medical standards or services in the Greater Bay Area. Give you an example, the policy is very important, the government has given this special exemption so that drugs or devices that have been used in Hong Kong can get exemptions to be used in the Greater Bay Area. So, they have identified 19 hospitals in China, in the Greater Bay Area or in Guangdong Province, so that the drug usage is the same. So, overnight, the standard of drug use is the same between Hong Kong and the Greater Bay Area cities. So, just look at the impact of this policy is really far… sort of far reaching. So I believe with the ground infrastructures, and also the internet in the sky, artificial intelligence, big data, so on and so forth, we can really move forward very quickly, to such an extent that maybe in five to 10 years, the medical standard, over the Greater Bay Area at large, will be international.
Chan: Right Dennis, also wants to bring you some local news. I mean, in the last couple of weeks, we realized there's a reported death of a woman who has waited 12 hours for treatment at the public hospital. And Uncle Ray, one of our past DJ's families want to make a complaint about the treatment they have received at Queen Elizabeth's hospital. Just two little examples. All that doesn't help to build the image of the Hong Kong medical system. So, what you are saying to that, especially now you're in the Legislative Council?
Lam: I think it's a tragedy that should not have happened. So, nevertheless, there is always room for improvement, we have to be vigilant about our shortcomings, about our limitations, and then we have to use, you know, modern technologies, for example, the AI, the eHealth, so on and so forth, so that we can sort of fill the gaps. On the other hand, we also have to be accommodating. Why? Because all over the world, there are three major sorts of medical systems. One is mostly private, one, it's mostly public, the other is a dual system. None of the systems is perfect. Each of the territories or countries have to face their own problem, and then make appropriate adjustments so that they can serve their patients better.
Chan: Right. One final question about the integration of the Greater Bay Area. Some people were worrying that because if we have more travel between the rest of GBA and Hong Kong, even now already a hard-pressed service, it will be under even more pressure. Are you worried?
Lam: This is an issue that we have to face, but I believe we can have solutions.
Chan: Right. Okay. Right. Thank you, Dennis, for sharing your perspective on medical doctors in Hong Kong. I think you have assured our viewers that we still have world-class, well-trained doctors that will continue to serve the community. Thank you for watching and see you next time!