Financial tsunami and surgery

Abstract

Recently, according to a report titled State of the World's Cities 2008/2009 – Harmonious Cities released by UN-Habitat, the United Nations Human Settlements Programme,1 Hong Kong has the highest Gini coefficient among Asian countries. Gini coefficient is a commonly used index to measure the income gap among citizens of a city. While the government has always encouraged those who can afford it to seek private healthcare, there are no mechanisms to prevent such individuals from using the public system. Obviously, those who truly cannot afford it will remain in the public system, particularly those with surgical conditions who will have to remain on the waiting list. However, for surgical diseases, it is not uncommon for patients to queue up three times: first to see a surgical specialist, then to have investigations done and, finally, for the surgical procedures to be carried out. Although the creation of long queues should not be the means to push patients towards private healthcare providers, this is the painful reality that we are seeing, particularly true for non-malignant surgical conditions. At the time of writing, the financial tsunami has been having a series of effects in Hong Kong as well as worldwide. Hong Kong is experiencing yet another downfall in the economy since 2003 when SARS hit our community hard. Whether the behavior of patients seeking surgical care will be affected by the financial crisis remains to be seen, but there are signs that more patients are flooding back to the public system, as noted by residents at the accident and emergency departments. Recently, emergency theatres in many of the public hospitals are treating patients around the clock. Managing the possible increasing number of surgical patients will become a big task for the public system. Coupled with other competing requests for healthcare resources, this particular huge task looks more daunting than ever. Preventing preventable errors from occurring should be second nature for surgeons. Last year, the WHO's World Alliance for Patient Safety launched a flagship programme focusing on safe surgery. During 2007 and 2008, some pilot sites have initiated and trialled the ‘WHO Surgical Safety Checklist’ and there are plans to have the programme rolled out to the rest of the world. It will certainly come to Hong Kong in the future. Interested readers could look for more information at http://www.who.int/patientsafety/challenge/second_gpsc/en/index.html