• jeremiahbull

Havoc in the hospitals

In Hong Kong (HK) people rightly put their trust in medical doctors and nurses, in their integrity and expertise. This is no different from what happens in other countries. It is often said that the field of medicine is one of the noblest of professions. Those who join the profession enter into a benevolent contract with society. They agree to put the interests of patients above their own, to establish and maintain standards of competence and integrity as they provide their service to society. Given this, it is deeply disturbing to see the stature and work of medical professionals working in HK's public hospitals being undermined by those in authority. The health system in HK already has a raft of problems!

As the CCP's use of "soft power" has evolved into "sharp power" there is stronger evidence than ever before of coercion taking place in HK hospitals. [See our BLOG on CCP coercion impacting HK]

On 17th June, 2019 news broke that the police could freely access the Hospital Authority’s (HA) computer system to check details of injured protesters. The HA denied sharing information with police, though at least five protesters were arrested whilst seeking help at hospitals. Barely a week later a petition was issued to Police asking them to stop harassing and arresting patients in hospitals.

By the end of the month (29th June, 2019) the first signs of tensions in hospitals were evident when frontline medical staff clashed with officers of the Police force stationed at Accident and Emergency Departments in two different hospitals. In response the Hospital Authority (HA) and Police met with one another to improve communications and discuss operational issues.

On 13th August, 2019 medical staff from at least seven public hospitals staged silent protests over what they said was the excessive use of force by the HK police force (HKPF) in clashes with demonstrators. Protesting what they considered a moral issue, it came after mass-casualty events in Yuen Long and in Tsim Sha Tsui. After each violent clash between protesters and police, hospital emergency rooms routinely received a similar set of patients with injuries resulting from blunt trauma, dislocated joints, or respiratory symptoms such as coughing and breathing difficulties. A statement prepared by organisers said “As health care professionals bound to advocate for the best interest of our patients and the human race, we cannot stay silent in the face of such police brutality and social injustice. Regardless of any political views we may hold, it is our duty to uphold the basic moral standards fundamental to any civilised society.” Blame for the climate of fear that now pervades public hospitals was laid squarely on the HK government and HKPF.

Reacting to large-scale rallies by public sector employees, the HA on 15th August reminded its doctors of the “importance of public expectations and perceptions towards public hospitals.” While doctors are allowed to express opinions in a personal capacity, the HA said that medical staff should provide “equitable care” to all patients.

Contrasting the support for protesters given by most medical staff of public hospitals, a different group of medical professionals opted to express their support for the work of the HKPF in an open letter published on 16th September, 2019. About 500 doctors, mostly older and more experienced, came out in support of police and their handling of Hong Kong protests. This shows clearly that, just like in wider society, there is a split in the medical profession between older and younger staff.

It must be noted that among the signatories in the open letter was Dr Donald Li Kwok-tung, a HK member to China’s top political advisory body, the Chinese People’s Political Consultative Conference, and a family medicine specialist in private practice. He was joined by Dr Dennis Lam Shun-chiu, a HK deputy to the country’s top legislature the National People’s Congress and the city’s richest ophthalmologist; and leading HK liver expert Professor Lo Chung-mau, head of the University of Hong Kong-Shenzhen Hospital.

On 5th October, 2019 the relationship between the HA and the HKPF was again strained after armed and armoured officers of the HKPF entered Tuen Mun Hospital ostensibly to communicate with a teenager who had been shot in overnight clashes. It's not clear from news reports why HKPF did not come to the hospital wearing their regular Police uniform.

On 14th October medical workers at Tseung Kwan O Hospital staged a rally in support of a doctor arrested at a shopping mall protest the day before. The doctor was apparently detained by police after taking photographs of officers raiding the mall and making arrests there. Although it was claimed that there was no obstruction of the police, the doctor suffered injuries to his head, hands and legs when he was arrested and at the time of the protest was still being treated in hospital.

The staff oTuen Mun Hospital staged a sit-in on 18 October, 2019 to protest that male Police officers were being allowed to enter the hospital's maternity ward; armed riot police had also intruded in the hospital, disrupting its operations and scaring patients and staff. As police had been conducting hospital arrests, protesters were now reluctant to go to public hospitals for treatment.

In response to the risk of arrest if protesters went to a public hospital, underground mobile clinics were established by medics. These, operating out of borrowed cars, which many patients attended, were often staffed by junior doctors who wished to remain anonymous, fearing arrest or repercussions from their employers. It's not right that in order to fulfill their Hippocratic oath physicians have to put themselves or their career in jeopardy.

Henry Fan Hung-ling took up office as new head of the HA in December, 2019. In making public comments about the difficulty in recruiting overseas doctor for vacancies in public hospitals he sided with the HK Chief Executive (CE) and her government's plan to form a committee to look into the underlying causes of the protests. While stating that it would be wrong for the HA to show any political stance, he suggested that such a committee of inquiry ought to have the statutory power to call witnesses.

Putting further pressure on HK's medical professionals were comments made by the dean of Chinese University's medical school (in HK), Francis Chan, on 4th January 2020. His position seemed to imply that medical professionals' care for patients would somehow be compromised by a doctor's politics and trying to achieve greater aspirations for society.

Capping off these various instances of coercion, Dr Kuen Lam of the HA Workers General Union took the unusual step of writing a letter to the HA which was published in South China Morning Post (SCMP) on 7th of January 2020. The letter, bemoaned what it called "a bullying epidemic" that was deeply effecting staff morale. It listed four main problems:

1. The HA denies the bullying phenomenon and always dismisses complaints against supervisors as 'miscommunication' 2. There are no formal disciplinary actions for bullying 3. The formal complaint procedure lacks transparency and reliability, as the HA does not let labour union representatives accompany staff to hearings 4. The composition of the Staff Appeals Committee is not representative. That the Union, representing some 80,000 workers, has resorted to taking its disagreement with the HA to the public via SCMP suggests things are really bad. While some medical staff have become patients suffering from depression and anxiety, others have chosen to quit the public healthcare system.

The sooner the HK government resolves the current civil unrest, the sooner it can focus on improving its provision of medical care - something that is in the best interests of every citizen of the SAR. Hospitals should be places of healing, not havoc or horror! Ignoring the protesters' 5 clear demands, as the CE has done and repeatedly claiming they are unrealistic, or impossible is not constructive. A political solution is needed, not the violence and repression that is being delivered by the HKPF that is just putting more people in hospital. Wethepeopleofhk again suggests that a public referendum for all HK citizens would invigorate dialogue and provide a new opportunity for authorities in Beijing and HK to rebuild trust. Ballots are better than bullets! Showing no willingness to compromise and instead offering coercion might please the CCP, but it creates an atmosphere of 'white terror' that is counterproductive.

May HK enjoy freedom from fear, and freedom from coercion in its many forms.

Jeremiah B.

[For information about the Mental Health crisis in Hong Kong follow this link.]

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