OFFICIAL RECORD OF PROCEEDINGS Thursday, 18 July ...

LEGISLATIVE COUNCIL ─ 18 July 2013

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OFFICIAL RECORD OF PROCEEDINGS

Thursday, 18 July 2013

The Council continued to meet at Nine o'clock

MEMBERS PRESENT: THE PRESIDENT THE HONOURABLE JASPER TSANG YOK-SING, G.B.S., J.P. THE HONOURABLE ALBERT HO CHUN-YAN THE HONOURABLE LEE CHEUK-YAN THE HONOURABLE JAMES TO KUN-SUN THE HONOURABLE CHAN KAM-LAM, S.B.S., J.P. THE HONOURABLE EMILY LAU WAI-HING, J.P. THE HONOURABLE TAM YIU-CHUNG, G.B.S., J.P. THE HONOURABLE TOMMY CHEUNG YU-YAN, S.B.S., J.P. THE HONOURABLE FREDERICK FUNG KIN-KEE, S.B.S., J.P. THE HONOURABLE VINCENT FANG KANG, S.B.S., J.P. THE HONOURABLE WONG KWOK-HING, B.B.S., M.H. DR THE HONOURABLE JOSEPH LEE KOK-LONG, S.B.S., J.P. THE HONOURABLE WONG TING-KWONG, S.B.S., J.P. THE HONOURABLE RONNY TONG KA-WAH, S.C.

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THE HONOURABLE CYD HO SAU-LAN THE HONOURABLE STARRY LEE WAI-KING, J.P. DR THE HONOURABLE LAM TAI-FAI, S.B.S., J.P. THE HONOURABLE CHAN HAK-KAN, J.P. THE HONOURABLE CHAN KIN-POR, B.B.S., J.P. DR THE HONOURABLE LEUNG KA-LAU THE HONOURABLE CHEUNG KWOK-CHE THE HONOURABLE WONG KWOK-KIN, B.B.S. THE HONOURABLE IP KWOK-HIM, G.B.S., J.P. THE HONOURABLE MRS REGINA IP LAU SUK-YEE, G.B.S., J.P. THE HONOURABLE PAUL TSE WAI-CHUN, J.P. THE HONOURABLE ALAN LEONG KAH-KIT, S.C. THE HONOURABLE LEUNG KWOK-HUNG THE HONOURABLE ALBERT CHAN WAI-YIP THE HONOURABLE WONG YUK-MAN THE HONOURABLE CLAUDIA MO THE HONOURABLE MICHAEL TIEN PUK-SUN, B.B.S., J.P. THE HONOURABLE JAMES TIEN PEI-CHUN, G.B.S., J.P. THE HONOURABLE NG LEUNG-SING, S.B.S., J.P. THE HONOURABLE STEVEN HO CHUN-YIN


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THE HONOURABLE FRANKIE YICK CHI-MING THE HONOURABLE WU CHI-WAI, M.H. THE HONOURABLE YIU SI-WING THE HONOURABLE GARY FAN KWOK-WAI THE HONOURABLE MA FUNG-KWOK, S.B.S., J.P. THE HONOURABLE CHARLES PETER MOK THE HONOURABLE CHAN CHI-CHUEN THE HONOURABLE CHAN HAN-PAN DR THE HONOURABLE KENNETH CHAN KA-LOK THE HONOURABLE CHAN YUEN-HAN, S.B.S., J.P. THE HONOURABLE LEUNG CHE-CHEUNG, B.B.S., M.H., J.P. THE HONOURABLE KENNETH LEUNG THE HONOURABLE ALICE MAK MEI-KUEN, J.P. THE HONOURABLE KWOK WAI-KEUNG THE HONOURABLE DENNIS KWOK THE HONOURABLE CHRISTOPHER CHEUNG WAH-FUNG, J.P. DR THE HONOURABLE FERNANDO CHEUNG CHIU-HUNG THE HONOURABLE SIN CHUNG-KAI, S.B.S., J.P. DR THE HONOURABLE HELENA WONG PIK-WAN


THE HONOURABLE IP KIN-YUEN DR THE HONOURABLE ELIZABETH QUAT, J.P. THE HONOURABLE MARTIN LIAO CHEUNG-KONG, J.P. THE HONOURABLE POON SIU-PING, B.B.S., M.H. THE HONOURABLE TANG KA-PIU DR THE HONOURABLE CHIANG LAI-WAN, J.P. IR DR THE HONOURABLE LO WAI-KWOK, B.B.S., M.H., J.P. THE HONOURABLE CHRISTOPHER CHUNG SHU-KUN, B.B.S., M.H., J.P. THE HONOURABLE TONY TSE WAI-CHUEN MEMBERS ABSENT: THE HONOURABLE LEUNG YIU-CHUNG DR THE HONOURABLE LAU WONG-FAT, G.B.M., G.B.S., J.P. THE HONOURABLE ABRAHAM SHEK LAI-HIM, G.B.S., J.P. THE HONOURABLE JEFFREY LAM KIN-FUNG, G.B.S., J.P. THE HONOURABLE ANDREW LEUNG KWAN-YUEN, G.B.S., J.P. DR THE HONOURABLE PRISCILLA LEUNG MEI-FUN, S.B.S., J.P. DR THE HONOURABLE KWOK KA-KI THE HONOURABLE CHUNG KWOK-PAN


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PUBLIC OFFICERS ATTENDING: THE HONOURABLE LAI TUNG-KWOK, S.B.S., I.D.S.M., J.P. SECRETARY FOR SECURITY DR THE HONOURABLE KO WING-MAN, B.B.S., J.P. SECRETARY FOR FOOD AND HEALTH CLERKS IN ATTENDANCE: MISS FLORA TAI YIN-PING, ASSISTANT SECRETARY GENERAL MISS ODELIA LEUNG HING-YEE, ASSISTANT SECRETARY GENERAL MRS PERCY MA, ASSISTANT SECRETARY GENERAL


MEMBERS' MOTIONS PRESIDENT (in Cantonese): Good morning. Council will now continue with the debate on the motion "Dissolving the Hospital Authority". DISSOLVING THE HOSPITAL AUTHORITY Continuation of debate on motion which was moved on 17 July 2013 MR VINCENT FANG (in Cantonese): President, good morning. The Liberal Party opposes Dr LEUNG Ka-lau's motion on "Dissolving the Hospital Authority". Before we propose to eliminate any existing and operating framework, should we first study whether there are any better and more constructive proposals, rather than thinking that since the existing framework is not so good, we must dissolve it first even before we start to explore whether there are any better replacements? I think this is a rather irresponsible approach. Despite its inadequacies, the Hospital Authority (HA) has still succeeded in making Hong Kong one of the best few providers of public healthcare services in the world. I am not defending the Government. Such behaviour is not consistent with my usual style either. However, I was a member of the HA and the Chairman of the Hospital Governing Committees of the Princess Margaret Hospital and Kwai Chung Hospital for many years. I have therefore witnessed the gradual upgrading of Hong Kong's public healthcare system since the days of the Medical and Health Department. Today, the resources invested in healthcare services account for only 5% of Hong Kong's GDP, far lower than the corresponding rates in the United States, where a health insurance system is in place and the United Kingdom, which sees the separation of the buying and selling of healthcare services. Although the resources invested are shared equally between public-sector and private-sector healthcare markets, the former is responsible for providing more than 90% of the hospitalization services in Hong Kong, especially in the case of serious diseases. The original motion proposes to dissolve the HA and replace it with the principle of "money follows patient", under which the Government directly purchases services from public and private healthcare institutions, and allows patients to choose hospitals for their treatment. In other words, private


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healthcare institutions are to share the heavy burden of public healthcare institutions. I strongly support and welcome such a move. However, my support is premised on whether public and private healthcare institutions are going to charge the same levels of fees. With the same amount of money, can a patient receive the same level of service in private healthcare institutions as in healthcare organizations? In particular, can critically ill patients and those who need long-term treatment and community support services also receive the same level of care in private healthcare institutions? We cannot possibly say that simple illnesses or cases of labour and delivery are to be handled by private healthcare institutions, while complicated illnesses, critical illnesses and cases that need long-term treatment are to be taken up by public healthcare institutions. If this is really the case, the burden of public healthcare institutions will be even heavier than before, right? The second problem is about monitoring. If the proposal of the original motion is to be realized, the private healthcare system must disclose information about its operation, facilities, number of healthcare workers and even the most important issue of charges, and it must also accept the monitoring of the relevant authorities. This means that the resource utilization and allocation of the private healthcare system must then be subject to the monitoring of the Legislative Council. Are private healthcare institutions willing to do so? If patients are allowed to choose hospitals for treatment, all hospitals will find it difficult to forecast the sizes and composition of their clientele. In that case, how can hospitals plan their equipment upgrading and manpower deployment? Of course, since the HA is such a mammoth organization responsible for providing adequate and quality healthcare services to a population of 7 million, I admit that it is necessary to regularly review its operation, with particular emphasis on the services, cost-effectiveness, and service standards of the various hospital clusters, so as to explore the possibility of further efficiency enhancement under the framework of existing resources. The historical factor of urban development have resulted in the allocation of more resources to certain hospital clusters covering districts developed earlier, and less resources to those covering newly developed areas. One of the amendments proposes to expand the Drug Formulary, and put in place a discretionary mechanism. I support this proposal. But the point is that the inclusion of all drugs in the Drug Formulary as General Drugs and Special


Drugs is something which cannot be done even in those countries universally recognized as excelling in medical welfare. Thus, it is better for us to consider how best to prevent the indiscriminate prescription of drugs in the public healthcare system, so that resources can be used on patients with genuine needs. The effect of doing so may be better. President, finally, I would like to raise an old issue. When "doubly non-permanent resident pregnant women" flocked to Hong Kong to give birth, there was a surge of business for the maternity wards in private hospitals. However, this also resulted in a substantial increase in the demand for infant intensive care services in public hospitals. This was because the facilities and experience of public hospitals in handling critical illnesses and intensive care are stronger, so when parents found anything wrong with their babies, they switched to public hospitals for help instead. Consequently, this added greatly to the pressure and burden of the public healthcare system. As I said just now, I totally support the strengthening of public-private co-operation to enable patients to receive expeditious, timely, and effective treatment and care, one example being the referral of elderly persons to private medical practitioners for cataract surgeries. But such co-operation can never be achieved simply by dissolving the HA. Instead, both sectors must complement each other and narrow the gap between their fees. I so submit. Thank you, President. MR TANG KA-PIU (in Cantonese): President, the Hong Kong Federation of Trade Unions has not proposed any amendments to Dr LEUNG Ka-lau's motion on "Dissolving the Hospital Authority", because proposing an amendment will imply our support for the motion. However, this motion simply does not and can hardly deserve any support and is totally beyond understanding. The justification put forth by Mr Vincent FANG of the Liberal Party, an advocate of the free market, already suffices to convince the public that this proposal is neither feasible nor justifiable. The latest annual report of the Hospital Authority (HA) shows that last year, the SAR Government allocated a recurrent government subvention and a capital government subvention totalling $37.6 billion to the HA. If this $37.6 billion is divided by 7 million people, each person will have a share of $5,300. In the case of my family of three, for example, we can get $15,000 a year. This amount sounds very big because we are healthy, and we seldom use


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any out-patient service. Even if we use the service 10 times a year, we will still have a lot of money left. But chronic patients, unfortunate accident victims in need of frequent medical treatment, elderly persons and persons with disabilities will all get the same amount of $5,300. The original motion proposes to dissolve the HA, but the option it proposes as a replacement is "money follows patient". However, we do not quite believe that this idea is feasible. Under the operation of a free market, as Mr Vincent FANG has pointed out clearly just now, the private-sector market will only go for profitable business. Members all know very clearly what has happened to the four sites originally earmarked for inviting tenders for constructing private hospitals following the introduction of the "zero quota" policy for "doubly non-permanent resident pregnant women". Only one site has been successfully tendered out, probably only because of its location in Wong Chuk Hang of Hong Kong Island, a location of relative importance. The remaining three sites have been withdrawn due to unsatisfactory response. This can clearly illustrate market response. This is how the market works. Thus, we do not quite believe that the proposal of the motion is feasible. Are there any inadequacies with the HA? The answer is absolutely yes. There are problems in all such areas as primary healthcare services, out-patient services, and waiting time for specialist services. And, we even agree that the allegation of "fattening the top and thinning the bottom" is partially substantiated. But as a representative of the labour sector, I must say that from the perspective of the sector, the HA should deserve commendation on one measure, the measure of implementing our advocacy of standard working hours as from 1 May and allowing its staff to work 44 hours a week. In this connection, I hope the Secretary can seek to resolve one remaining problem. And, I believe that other Members may also talk about this later. There are still some 500 HA staff members who used to be the staff of the Department of Health, and who decided to stay behind in the HA without giving up their civil servant status and pay. They are not eligible for a 44-hour week and must still work 45 hours per week. At the same time, they cannot enjoy any "paid meal break" neither. The HA has taken the lead to set a good example. I hope that the Secretary can proactively seek to resolve the issue after listening to this. Moreover, with respect to manpower development, I have met with a group of physiotherapists recently. They have lots of grievances. As we all know,


with the exception of those returning from their overseas studies, all local physiotherapists are trained by one tertiary institution in Hong Kong. About 30% to 40% of the graduates every year will join the HA. This may also be their goal anyway, but the HA has never formulated a blueprint of manpower demand in this regard. Actually, people's demand for healthcare services is quite independent of the ups and downs of the economy (with the exception of psychiatric services, of course). However, physiotherapists are unable to foresee the dimensions of society's demand for their service in the next 10 years. They only know from past experience that in times of economic downturn, some physiotherapists may need to switch to the insurance and pharmaceutical sectors. They are all professionals, so this will mean a waste of talents in society, and also a waste of the resources spent by the tertiary institution on the publicly-funded programmes. Thus, the HA should have a unique mission here, meaning that apart from providing healthcare services, it must play a leading role in providing healthcare-related manpower support. It must formulate certain standards, and it must also work with the Food and Health Bureau, and even the Education Bureau and various relevant departments to make planning for manpower training, both in terms of quality and quantity. Many paramedical professionals have also indicated that when the overall economy is in poor shape, they will suddenly lose employment opportunities. They say that even when social demand and healthcare demand are clearly consistent, they still cannot find a job, and even the HA will not actively recruit manpower. That is why they find it hard to understand all this. They hope that the HA can look at things from the perspective of social development, and realize that with such a huge annual subvention of $30-odd billion from the SAR Government and a market share of 90% in Hong Kong's healthcare services, it should play a certain role in this regard. We hope that the HA will do more than performing the function of manpower recruitment. Based on the world acclaim won by the ethics of Hong Kong's healthcare system, the HA should take the lead in establishing and promoting to the world a set of professional standards and criteria for various paramedical professionals, with a view to enhancing the morale of the healthcare sector. Apart from the HA, I do not know which entity is capable of taking up this task. Furthermore, no other entity will be capable of leading various


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professionals or sectors in carrying out this task. Thus, based on the circumstances mentioned above, we have reservation about the motion topic. Finally, I want to point out that no hospitals in any countries, China not excepted, will treat patients without any money regardless of how strong they are. The medical charges are beyond any estimation. In the United States, people with no insurance coverage are likewise unable to receive any medical treatment. The one valuable and rare merit of Hong Kong's healthcare system is that it will not watch anyone die with folded arms. Such is the professional ethics and moral integrity of Hong Kong healthcare personnel, which we all treasure and respect. I am afraid that if we make any drastic changes to the existing mechanism, such moral integrity and professional ethics will simply vanish. Although both China and the United States are strong, their healthcare systems are marked by many defects. Hong Kong should adhere to the very system we have all been proud of and seek to enhance it, instead of talking rashly about making any changes. I so submit. Thank you. MISS ALICE MAK (in Cantonese): President, as the "safety net" provider in primary healthcare services, the Hospital Authority (HA) is allocated a funding of $45 billion in 2013-2014, the highest over the years. However, as Dr LEUNG Ka-lau have said, despite the increasing resources for the HA, there has been no improvement in the quality of public healthcare services. The waiting time for specialist out-patient services in public hospitals has remained very long, showing no notable improvement. I agree to the wording of Dr LEUNG's motion, in the sense that the various hospital clusters are given too much power of personnel appointment, thus making it difficult for the HA to shuffle manpower and resources among the clusters. In a bid to compete for resources, all clusters seek to develop some unique services of their own. It is basically a good thing for different clusters to compete with one another in order to strive for greater resource allocation. However, such a situation has led to a variation of service standards among different clusters.


Time and again, we have heard how medical practitioners of various clusters boast of themselves in this way: "This service of ours is unique in all the seven hospital clusters, and our services are the best among the seven hospital clusters." These words can show the sense of satisfaction felt by medical practitioners amidst such "benign competition". But they also reflect that the system of seven hospital clusters under the HA has failed to provide people uniformly with good and new services. As a result, the various clusters have sought to roll out their unique services as a means of competing with other clusters. Euphemistically, this can be described benign competition. To put it crudely, every cluster is just putting up a fierce fight, trying to become the "local lord" and expand itself continuously. Our greatest concern now is why the Kowloon Central Cluster should be given the greatest allocation of resources. Many doctors or senior doctors of other clusters also query why their respective clusters are allocated less resources. Healthcare personnel in the New Territories West Cluster and the New Territories East Cluster, for example, often complain that they have to travel long distances to work, and that it is more convenient to go to work in Kowloon Central. They also query why most of the newly recruited manpower is deployed to the Kowloon Central Cluster. The reasons why hospitals of the New Territories West Cluster often complain of difficulties in recruiting staff are precisely insufficient resources and the inconvenience of working there. Actually, while doctors complain about insufficient resources, objective statistics also reveal that in the HA's resource allocation in 2012 or 2013, the per-capita funding (that is, the funding available to each person) allocated to the Kowloon Central Cluster is double that of the Kowloon East Cluster despite the fact that the former cluster has a smaller population than the latter cluster ― many Members have already mentioned this, so I am very brief on this point. Moreover, there is also a high variation in the waiting time for specialist out-patient services among the clusters. Let us look at the New Territories West Cluster as an example. The waiting time for orthopaedics and traumatology services which I am most concerned about is 58 weeks. But the waiting time in the Hong Kong East Cluster is nine weeks only. There is a vast difference between the two. The waiting time for paediatric and adolescent medicine services at the specialist out-patient clinics in the New Territories West Cluster is


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14 weeks, several times longer than the waiting time of four weeks in the Kowloon West Cluster. Let me once again refer to the number of general hospital beds in the New Territories West Cluster, my constituency. In the Kowloon Central Cluster, the number of general hospital beds per 1 000 people aged 65 or above is more than two times the corresponding number in the Hong Kong East Cluster, and there is even a decline in the overall ratio. The New Territories West Cluster lacks the support of private hospitals, but the number of its general hospital beds ranks the lowest. In 2012-2013, the number of general hospital beds in the New Territories West Cluster ranks the sixth among the seven clusters, but the population of the New Territories West Cluster is the third highest among the clusters. Moreover, the number of general hospital beds per 1 000 people in the New Territories West Cluster ranks last among the seven clusters, with only two beds. The resource allocation figures given by Dr LEUNG just now have also been mentioned by a number of other Members. What do those figures reflect? Uneven resource allocation. This may be due to the competition and fierce fight among the various clusters and also their attempts to become the "local lord". As a result, they all try to develop their services endlessly. Another reason is that the HA does not allocate resources on the basis of the population size each individual cluster serves. The HA has provided some special reference materials to us today, but its intention is mainly to tell us that the performance of the HA is not that poor. The paper makes it a point to say that in resource allocation, the HA adopts a computation based on "patient benchmarking". However, regardless of whether "patient benchmarking" or population distribution is adopted as the computation method, the authorities still cannot convince us why such huge resource discrepancies should exist among the clusters. Manpower shortage is another problem of the HA. All of us can see that the wastage rate of front-line doctors has all along remained high. If we read the newspapers in recent years, particularly a certain newspaper, we will read about the turnover rate of specialist doctors in a certain hospital every several months. What is the implication of the relevant figures to us? The implication is that


despite the annual increase of resources allocated by the Government to the HA, the HA is unable to retain its staff; instead, there is an increasing number of staff quitting their jobs. The HA is a public organization with enormous resources. We also consider the benefits the HA provides to its staff excellent. Then why do employees refuse to stay but choose to leave? Thus, after the announcement of the Budget, when I visited local communities and attended residents' meetings, I often joked about the HA getting billions of funding in the following year. We do not mind the HA getting more resources, but we think that if the funding can be used for employing front-line doctors or purchasing drugs much needed by patients, the difficulties faced by front-line doctors in the course of diagnoses can at least be alleviated, and patients will benefit in turn. So, the question is: how is the additional funding spent? As Members mentioned just now, the existing problem is the uneven resource allocation among clusters. We need to resolve the problem of clusters engaging in a fierce fight to become the "local lord". Thus, we should not let our emotions take over us and talk about dissolving the HA. We agree to the majority of proposals put forth in the amendments of Dr Fernando CHEUNG and Mr Albert HO, and in particular, the proposal of Dr Fernando CHEUNG on the Drug Formulary (The buzzer sounded) …… MR CHEUNG KWOK-CHE (in Cantonese): President, when we talk about reforming the Hospital Authority (HA), we must first look at the difficulties faced by the grassroots in seeking medical services. In this connection, it makes sense to refer to the Drug Formulary over and over again. If patients' drug expense problem is not solved and if they must often muster several hundred thousand dollars or even over $1 million for drug purchase, I really fear that the problem of illness causing poverty will become increasingly serious. The first proposal put forth by Dr Fernando CHEUNG in his amendment is "to promote democratization of the management of public hospitals and clinics, and encourage more local and civic organizations to participate in such management". I think this is a very important task. As we have always


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pointed out, the reason why the existing Drug Formulary fails to meet patients' needs is that while the Government follows the wrong direction of strictly controlling social service expenditure, patients are denied any participation in the policy formulation mechanism, with the result that the Government is unable to grasp the difficulties and expectations of patients. Our request for the inclusion of representatives of patient organizations and patients' family member groups is meant to enable the Government to listen directly to the voices of service users. This issue was put before the Legislative Council for discussion in May this year. The main demands set out in the motion were passed. I hope that the Government will not turn a deaf ear to it. Last month, the Panel on Health Services of the Legislative Council discussed the waiting time for HA's specialist out-patient services. The overly long waiting time for specialist out-patient services is not a problem that has started only today. According to the figures released by the HA at the end of last month, the waiting time for first appointments at specialist out-patient departments is very long in most cases. The waiting times at departments of medicine and psychiatry are respectively 68 weeks and 70 weeks; in the case of departments of surgery, the waiting time is even longer ― 110 weeks. In other words, new patients must wait at least two years before they can see a doctor. Mr LEUNG Pak-yin, Chief Executive of the HA, has explained that this is due to Hong Kong's population ageing, the lower ages of chronic patients, and the lack of sufficient doctors and healthcare workers to meet demand. Elderly Health Centres, which provide a community-based preventive primary care service, could have been developed into a health protection model similar to the family medicine system. However, the Government has never attached any importance to this service over the years, nor has it provided any substantial increase of resources. So, no progress has been made. In 2012, for example, the total number of Elderly Health Centres in Hong Kong remained at 18. Despite the ageing population, the Government has not yet formulated any plans for the expansion of this service. Consequently, in Hong Kong as a whole, only 38 500 places a year can be provided. Viewed against the 1 million elderly people in Hong Kong now, this number is just a drop in the ocean. And, the average waiting time for first appointment is thus as long as 11 months.


Faced with the shortage of healthcare workers, the HA is still planning only one step ahead. To deal with the serious problem of long waiting time, the HA has only adopted a central co-ordination approach to strengthen cross-cluster referral and transfer patients from over-loaded clusters to other clusters with more consultation quotas. With this approach of juggling an insufficient number of lids among the pots, how can the HA really resolve the problem? There is an acute manpower shortage in public hospitals, with 200 vacancies of doctors waiting to be filled. This is a real problem facing us today. This year, the authorities have claimed that the problem can be gradually alleviated in three years' time. How do we know whether we will be asked to wait three more years by then? Members of the public simply do not know how many "three more years" they must wait. If a comprehensive plan is not put in place, it will still be unable to cope with the situation. The most fundamental problem with the HA is the lack of transparency in its administration. There is no participation of front-line healthcare workers at all, thus causing a totally erroneous resource allocation policy and even a perennial shortage of healthcare workers. It is necessary for the Government to increase funding to the HA every year. In the 2013-2014 budget estimate, for example, the funding provision for the HA reaches $45 billion, an amount far exceeding the funding over the past 10 years. Nevertheless, there is no transparency in the funding criteria. The distribution of resources has been reduced to a process of "making the poor poorer and the rich richer". Heavily-loaded hospitals with no spare capacity for introducing new services are not given any funding increases, and what is more, they must also face the problem of high demand for healthcare services due to population increase, which further aggravates their tight finances. There is the saying that in order to compete for more funding, the upper and middle management of hospital clusters have kept "making up statistics" and generating bogus service demands, thus making healthcare professionals busy with referrals and in turn prolonging the waiting time for services. While front-line healthcare professionals must meet the higher service demands of the public, they must also find time to deliver the new services introduced by the hospitals in response to the funding approach. Such internal demands have further tightened the manpower situation of healthcare personnel. However, all


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the members of the HA are appointed by the Chief Executive, and despite the unreasonable distribution of resources, front-line healthcare professionals are unable to take part in management for seeking improvement. They can only watch the deterioration of the problem helpless. Thus, the HA should increase the channels of staff participation in its management, especially the participation of the staff engaged in front-line and newly introduced services, such as medical social workers and occupational therapists. The appointment system should also be abolished to allow healthcare personnel to elect members of the HA. Apart from increasing resources, the authorities should change the existing approach of resource competition; otherwise, all the reviews will just be empty talks. President, I urge the Government to provide additional funding, expand the scope of subsidy of the Drug Formulary, allow the public to genuinely take part in the management of public hospitals, and strengthen community-based primary healthcare services. In the short run, the HA should recruit more qualified doctors from overseas to fill the vacancies of doctors and shorten patients' waiting time for specialist out-patient services. In the long run, the Administration should formulate plans to increase the number of places in medical undergraduate programmes, so as to train and provide sufficient healthcare personnel. President, I so submit. MR CHARLES PETER MOK (in Cantonese): President, I was a member of the Hospital Authority (HA) for six years from 2004 to 2010. I cannot quite understand the rationale behind Dr LEUNG Ka-lau's motion. There are good reasons to have dissatisfaction with the healthcare policy in Hong Kong or with the management of the HA, or to demand improvements. But surely this does not mean that we should demand the dissolution of the HA at every turn, right? I would also like to discuss some of the reasons put forth in Dr LEUNG's original motion.


According to Dr LEUNG, since the HA is both the buyer and the vendor of healthcare services, there is a conflict of roles. First of all, are there any commercial organizations or even public organizations which are not both the buyer and the vendor at the same time? Except those organizations which do not provide any products or services, and which only give a few words of advice, all operating organizations are in such a situation. In that case, as all organizations are marked by a conflict of roles, should they all be dissolved whenever problems emerge? According to Dr LEUNG, although the Government has kept increasing funding to the HA, some hospital clusters and departments are still faced with a perennial shortage of resources and there is still the problem of varying service quality, all because of the HA's uneven resource allocation. These are facts. But there may not be any causal relationship between poor performance and the Government's funding increases. The objective reality is that as Hong Kong's population ages, as medical technology advances, and as public demand for healthcare services incessantly increases, the Government must of course increase funding. The problems with individual departments mentioned just now may instead be related to insufficient funding and resources. Of course, the management of the HA should likewise be held accountable. However, I do not think it is quite so fair for Dr LEUNG to accuse the Government of continuing to provide funding and increased funding to the HA despite its unsatisfactory performance, nor is it fair for him to use the expression "with the HA being rewarded for its misgovernance instead". Suppose we really do the contrary and stop or reduce the funding for the HA, we will end up punishing the HA on the surface but victimizing the public in reality. If one ever thinks that a government department or statutory organization which is not doing a good job must be dissolved, then all such organizations must logically be dissolved. In that case, Secretary, except your Bureau, which can be retained due to your comparatively high popularity rating, all other Policy Bureaux should be dissolved. Then, in the future, Members will not need to demand any Directors of Bureau, any Secretaries of Departments and the Chief Executive to step down. Dissolving the Government like that will do. It is alright to point out problems, but putting forth solutions is equally important. Dr LEUNG's only proposal is for the Government to act "under the principle of 'money follows patient' and in accordance with the population size of


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and number of patients in various districts, directly purchase services from public and private healthcare organizations, and allow patients to choose hospitals for treatment". But is the solution this simple? Will this system generate other problems? In general, I agree to this principle. However, I do not think it is possible to solve all the problems simply by giving all people the money, putting aside all management problems and leaving them all to doctors. Dr LEUNG hopes that the Legislative Council can be empowered to monitor HA's resource utilization and allocation. I can understand his wish. But unless the Legislative Council is transformed into the HA Board, and unless the President of the Legislative Council is to become the Chairman of the HA, I simply fail to see how we can totally monitor the HA's use and allocation of resources. In the end, the HA must still be left to manage its own affairs. It is easier said than done. What mode of governance should be adopted? How about the specific details? We must consider everything very carefully, otherwise we will just be giving vent to our dissatisfaction. In that case, it will be better for us to seriously look at some of the constructive proposals in the amendments. I think it is better for us to do so. President, when I was a member of the HA Board, I was the Vice-chairman of the Support Services Development Committee, the Vice-chairman of the Information Technology Services Governing Committee, and the Chairman of the Steering Committee of the Third Generation of the Clinical Management System Project. I could see that the resource allocation of the HA had indeed ignored the support services. What I mean is that except healthcare professionals such as doctors, all other healthcare-related professionals as well as professionals and non-professionals performing other functions, including nurses, pharmacists, and even IT and accounting personnel are accorded second priority. However, the most paradoxical point is that healthcare services and even the daily work of doctors and nurses have become increasingly reliant on these support services. Let me talk about the area of IT, with which I am more familiar. I joined the HA in 2004, and by the time I left six years later, the number of IT staff of the HA already more than doubled. The number of IT staff is more than 1 000 now. The important healthcare support systems developed and maintained range from the CMS (Clinical Management System), which gives systems support to the handling of epidemics, to the electronic health record system I am currently helping the HA to develop. The fact is that computer systems like the CMS have an uptime of five 9s all the year round.


They have to be shut down for a few hours for maintenance each year. Even if this takes place in the middle of the night, healthcare services will still be greatly affected, causing big headache to healthcare professionals. Healthcare services rely so heavily on support services, but the latter have never received any adequate attention. Let me refer to IT personnel as an example. The number of IT personnel has increased significantly, but they are employed as contract staff. Many of them are still not employed as permanent staff after working for many years; instead, they are only given a three-year IT contract. They receive different pays for the same work and are subject to many unreasonable employment conditions. The HA has simply shifted the responsibility to the contractors serving as intermediaries. The contractors are of course unscrupulous employers, but a much more serious problem is the impact on healthcare services and safety, that is, all the increased system risks. The Government and the HA must not be so oblivious of possible crises. Such contract staff have increased to several hundred in number, and all of them work in the HA headquarters. Last night, Mr Albert HO said that there had been substantial increases in the salaries and establishment of top management staff in the headquarters. As a matter of fact, I wish to say that not all employees in the headquarters are senior staff. However, such a misunderstanding can show that Mr Albert HO's comment last night about inadequate transparency is true. President, the speeches of many Members and the amendments of the two Members contain many proposals and criticisms on the HA's provision of healthcare services. Thus, in my speech, I have made it a point to raise my concern about the importance of support services and their development, including the risks entailed by insufficient investment in the IT infrastructure personnel. My hope is that besides waiting time, the Drug Formulary and the system of hospital clusters, the Government and Members of this Council can be equally concerned about the importance of support services. With these remarks, President, I support the amendments of Mr Albert HO and Dr Fernando CHEUNG, but oppose Dr LEUNG Ka-lau's original motion. Thank you, President.


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MR WONG KWOK-HING (in Cantonese): President, speaking of Dr LEUNG Ka-lau's motion, I can well understand that his purpose of moving a motion with such a sensational title as the representative of the medical sector is just to reflect the dissatisfaction he and other practising doctors feel about the many problems with the Hospital Authority (HA) at present. That is why he has put forward such an "explosive" topic on dissolving the HA. His feelings can show that the HA really needs to make a lot of improvements and active adjustments. I think that the authorities should seriously consider why such feelings should have emerged. The direction of this motion, the dissolution of the HA, is of course undesirable. But in view of the motion moved by Dr LEUNG Ka-lau, I think the Secretary really needs to consider how best to further enhance the performance and synergy effect of the HA, take serious steps to reduce resource and manpower duplication, and focus on spending more resources allocated by the Government on healthcare services, with a view to enhancing the services provided to the public and patients. I think the authorities should seriously consider this direction. Why do I think improvements and active adjustments should be made? I wish to make my point by giving two examples. According to the relevant information on the Budget submitted by the Government, there were significant increases in the public money allocated by the Government to the HA during the previous five years from 2007-2008 to 2011-2012. In 2007-2008, the rate of increase was single-digit ― 5.5%. But in 2008-2009, the rate already increased by 16%. In 2009-2010, the rate of increase was 16% again. In 2010-2011, the rate of increase was 21%; in 2011-2012, there was a drastic increase of 36.9%. The increases were very substantial, and the commitment of public money practically went up several times. On the other hand, let us look at the demographic changes during this period of time. The rates of increase were only single-digit. It was 2% in 2007-2008. And, even in 2011-2012, the rate was 4.2% only. How about the increase in the number of doctors at the same time? In 2007-2008, the rate of increase stood at 4.3%. In 2009-2010, it was 10.4%. In 2011-2012, the rate of increase was 14.1%, meaning that the increase in the number of doctors for that year was not significant. As for the number of nurses, due to time constraint, I am not going to enumerate the statistics one by one.


Also, we can observe that the number of attendances at specialist out-patient clinics, the number of bed days for general in-patient services, and the number of attendances at Accident and Emergency Departments have not shown any significant increase. Thus, this example can illustrate something. The Government has frankly committed large sums of public money to public healthcare expenses, and the resources for the purpose have been increasing substantially. But has the HA proportionately increased the number of doctors, nurses and services? This is worth studying and examining. Secretary, this is the crux of the problem. I will also cite another example, the HA headquarters. According to the information provided by the Government, the HA's overall expenditure in 2011-2012 was over $38 billion, but the expenditure of the headquarters alone already amounted to $1.319 billion, accounting for 3.4% of the HA's overall expenditure. How many employees are there in the headquarters? The number is 1 626. And, the total number of staff employed by the entire HA is over 61 000. The salary expenditure of the headquarters amounts to $1.188 billion. The number of staff in the headquarters is more than 1 600. This is not a small number at all, and it may be larger than that the number of staff in one hospital. I am not an expert in this area. But shouldn't the Secretary ponder on what can be done to help the HA achieve effective management, co-ordination, and liaison? In fact, the 1 600-odd employees of the headquarters are not directly devoted to the provision of services. Of course, I am not saying that all resources must be invested in front-line services. But how can true synergy be possible? This is worth consideration. Finally, I would like to use the remaining minute or so to talk about some realistic problems. As a directly elected Legislative Council Member returned through the Hong Kong Island constituency, I have to reflect some situations. For instance, there is a population of 70 000 to 80 000 in Siu Sai Wan. Residents of the area have strongly demanded …… MRS REGINA IP (in Cantonese): The population is 70 000, right? Not 7 million.


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MR WONG KWOK-HING (in Cantonese): Seven million? Not 7 million. Mrs IP, you have got it wrong. It is 70 000 to 80 000. Residents of the area have been strongly demanding the construction of a healthcare service facility at a vacant site next to the Siu Sai Wan Complex. The vacant site has been left unused under the sun for a number of years, and its usage is still undetermined. However, the Wan Tsui Estate Clinic nearby is very small in area. Dr PAN Pey-chyou and I once made a site visit and found the patients in a miserable situation and the clinic crammed. The clinic distributes 70 chips every day. The elderly waiting at the entrance are continuously bitten by mosquitoes. They have been "mosquito preys" for many years. On the one hand, the inadequate service at the clinic is unable to meet the needs; on the other hand, the vacant site is left unused. Thus, I am citing this example to illustrate (The buzzer sounded) …… how the Secretary can genuinely use resources to serve the residents directly …… PRESIDENT (in Cantonese): Mr WONG, your speaking time is up. MR WONG KWOK-HING (in Cantonese): …… Thank you, President. DR JOSEPH LEE (in Cantonese): President, we have discussed the topic related to the motion proposed by Dr LEUNG Ka-lau today many times before. I thank the President for treating us to breakfast this morning. I did not pay but I am glad that every time we need to continue with a Legislative Council meeting in the morning, we are treated to breakfast. I was not demanding, and as long as I could have something to fill up my stomach, I did not expect too much. However, if the President had told me that he used to treat Members to very nice breakfast, offering fried noodles in chicken sauce and abalone congee, I would have some expectations, and if it turned out that there were no such delicacies but only ordinary fried rice vercimille, plain congee and fried bread sticks, I would ask the President why it was so. What is the relevance of breakfast to the Hospital Authority (HA)? My point is to make an analogy. I took my mother to see the doctor in a hospital on Hong Kong Island ― I apologize for leaving for a while yesterday. We had to


wait half an hour just to pay the fee. Then, we had to wait two more hours for blood pressure and eyesight measurement and also a talk. When we finally saw the doctor, we had already spent over three hours in the hospital. I paid merely $160 for four or five hours of services. I think this is quite a bargain. I paid $160 for so many hours of services. How much does the Government need to spend to provide these services? On the basis of the $44 billion mentioned by Mr TANG Ka-piu just now, the share for each one of us will be $5,800. I think the Secretary also knows that if a patient pays $100 for treatment in hospital, the subsidy per hospital bed will be about $5,500. Therefore, when I pay $100, I can expect to receive services worth $5,500. But as Mr Vincent FANG just said, what services can we receive in a private hospital by paying $5,500? I do not know and it is not the subject of our discussion today anyway. However, what is the relevance to the HA? There is relevance because a policy issue is involved. President, this is like the issue of breakfast I talked about just now. Actually, I did not pay and it was some kind of free benefit for me. I was happy because it was you who paid for it, and all I asked for was just something to fill up my stomach. But if you keep giving me expectation every day, I will really begin to expect something somehow. Once my expectation is not met, I will ask the President why there is no such food. Then, the President will certainly ask, "Joe, how much have you paid?" I will reply that I have not paid, sorry. The HA is in a similar situation. It was established in 1990. At that time, the British Hong Kong Government still attached a great deal of importance to the free market. I joined the nursing profession 33 years ago, and the fee per consultation at that time was only $24. This is precisely the main point ― if you wanted any better services at that time, you must go to a private hospital. In 1990, however, the Government started to allocate one lump sum to the HA, asking it to perform better. Hence, in the first decade that followed, the HA provided welfarist healthcare services, and it also performed very well. At that time, only people who were indeed very rich would go to private hospitals. As how I might start to have expectation in the breakfast case I have talked about, everyone started to have expectation regarding the HA, because they found that it could provide very good services for such low fees ― from $28 then, to $36, $50 and $100 today. However, after the year 2000, because of economic sluggishness and poor market conditions, the Government was running short of money and forced to change the system. But it has never dared to tell the public


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explicitly that welfarist healthcare services are no longer provided. It always tries to slur over the matter only. As a result, some people still expect a lot from the HA. Actually, even the dissolution of the HA will be of no use because it is only a tool of realizing the Government's medical and healthcare policy. The question is: does the Government still adhere to a welfarist medical and healthcare policy? LEUNG Chun-ying did not state it clearly in his manifesto. He only talked about conducting a review of the HA. The Secretary may also feel helpless when he comes to meet the Members of this Council. He worked with the HA for many years and after he had left, he went back to continue working in this sector again. What exactly is the government policy? If the Government talks about a "dual-track system", it is in fact saying that it has abandoned the welfarist approach. What kind of services can we receive by just paying $100? The best services or just basic services? In Hong Kong if one wants to enjoy better healthcare services, one can go to a private hospital. There, one can receive better and quicker healthcare services. Secretary, I hope that you can review this subject. But I am not asking you to review the HA; rather, you should review the positioning of the entire public healthcare system. You must explain clearly the positioning of the entire public healthcare policy. You must state clearly the positioning of the entire policy, instead of only talking about a "dual-track system" or the $40 billion. The sum of $40 billion is definitely a very large one, but we must deal with another problem, and this problem is not related so much to the policy itself. It is about the fact that the Government has not set a clear positioning for the present medical and healthcare policy in Hong Kong. It has been evading the real issue, all the time only talking about a "dual-track system" and resorting to "verbal tricks". As a result, the public still have expectation regarding the public healthcare system. Second, it is the issue of governance. And, this is related precisely to Dr LEUNG's proposal to dissolve the HA. The Government allocates $44 billion to the HA, but its governance and performance are both very poor, and it "fattens the top and thins the bottom" or continues to create false expectations. How is the situation now? Resource distribution of the HA is a highly complicated and technical issue. Dr LEUNG proposes that "money follows patient". But this is exactly welfarism. Is the Government practising welfarism? If "money follows patient" is adopted, how much money is needed? Just $5,500 per


person, as simple as Mr TANG Ka-piu has described? If I am still young, do I need as much as $5,500? President, as you are slightly older than I, should you get $6,500? As my parents are over 80 years old, should they get $10,000 each? The calculation is very complicated. What is "money follows patient"? It also involves the very controversial issue of resource distribution. At present, the HA employs a relatively scientific approach, but this has given rise to another problem. Why are resources not distributed according to population sizes? Besides, why is it that a certain cluster with a population of 80 000 should be given such a small per capita allocation? There is also the point that if all these 80 000 persons are young, the allocation they receive may possibly be smaller than the allocation received by another group of 100 000 older people. These controversies can all reflect the problems of low transparency and misgovernance as mentioned by Mr Charles Peter MOK. It is true that the HA should be blamed for misgovernance, but should it be dissolved simply because of this? This is exactly the question that the Secretary must consider carefully. He talked about reviewing the operation of the HA. Almost a year has passed, but the findings have yet to be announced. As a result, the public still fail to know how the $44 billion is used. Moreover, is it the policy intention of the Government that the HA should use the $44 billion allocated to it only for providing basic services? The HA is at present run by professionals, and professionals like us naturally want to give the best services to the public. Here is exactly where the problem emerges. The Government does not want to allocate more funding, but the HA still continues to develop new services, thus leading to manpower shortage and insufficient room. The only focus of the HA is to get "new money" and develop new services endlessly. After launching new services, new staff and "new money" are deployed to execute the new tasks. But existing tasks are not given any attention. Therefore, even though the HA employs 2 000 new nurses and 200 new doctors every year, there is still a manpower shortage because all these staff are assigned to provide new services. Front-line workers have expectations but the HA is unable to entertain these expectations. The public also have high expectations because the HA has announced that there will be many new services, and it has recruited many new staff members. But then, people must still wait in line for half an hour to pay fees in hospital. In the end, the HA is criticized again.


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Secretary, the problem cannot be solved simply by dissolving the HA. Rather, a serious review should be conducted to see how the HA's resources can be properly utilized from the standpoint of administrative management. Another point is about the policy to be adopted. At present, people are discussing a "dual-track system" comprising public-sector and private-sector healthcare services. Under the LEUNG Chun-ying administration, what is the positioning of public-sector healthcare services? It is only when there is an answer to this question that we can see any prospects. Thank you, President. MR POON SIU-PING (in Cantonese): President, the operation of the healthcare system in Hong Kong affects the well-being of all Hong Kong people. Even though there are many problems with the performance of the Hospital Authority (HA), unless we have sufficient evidence to prove that the dissolution of the HA is conducive to improving our healthcare services, to lightly talk about dissolving the HA may not be beneficial to the development of the whole healthcare system in Hong Kong. But I am still very glad that Dr LEUNG Ka-lau has proposed this motion today to give Members of this Council a chance to express their views on the operation of Hong Kong's healthcare system. At the mere mentioning of the operation of Hong Kong's healthcare system, we will immediately think of the many problems plaguing the healthcare system for years, such as long waiting time at Accident and Emergency Departments, severe shortage of hospital beds, continuous manpower wastage and succession problems in public hospitals, manpower shortage, inadequate co-ordination among hospital clusters, varying waiting times at different specialist out-patient clinics, and also severe wastage of healthcare staff. There is a tremendous demand for healthcare services in Hong Kong, but due to limited resources, the HA cannot fully meet the expectations of various sectors. But the HA must not use this as an excuse and evade responsibility for its misgovernance. Established in 1990, the HA is now operating 41 public hospitals and healthcare organizations, 47 specialist out-patient clinics and 73 general out-patient clinics. These hospitals and out-patient clinics are divided into seven clusters according to the districts where they are located. The HA explains that the implementation of hospital clusters can ensure that patients in the same district can receive quality and sustained medical treatment. To this end, all hospitals in the same cluster must complement one another in their


operation, so that they can work in concert to provide comprehensive and complementary services to the local communities. However, this cluster system has failed to achieve any synergy. As a result of the HA's delegation of powers to the clusters, various clusters have simply scrambled for resources, thus leading to uneven allocation of resources, with certain hospitals having to take up large amount of extra work, thus victimizing both medical staff and patients. Let us look at Ear, Nose and the Throat Departments as an example. The waiting time is about two months in the Kowloon Central Cluster, about six months in the Hong Kong West Cluster and as long as three years in the Kowloon East Cluster. If each hospital only minds its own business and is unwilling to co-operate with other hospitals in providing healthcare services, the original intent of the hospital cluster system will be defeated. As regards resource utilization, it has been reported recently that the HA has drastically increased its spending on employing executive personnel. In the New Territories West Cluster alone, such expenditure has increased from $72 million to $88 million, an increase of 22%. If the governance of the HA does not improve, the public will inevitably suspect that such huge increase in administrative spending may be a form of transfer of benefits. In a recent interview, the Secretary for Food and Health said that the HA would soon embark on a review to ascertain whether the seven hospital clusters are granted too much power, and whether this has caused any "regionalism". I hope that the review can achieve some concrete results. In respect of the HA's personnel management, I have to point out that starting from 1 May this year, the HA decreased the working hours of its support staff from 45 to 44 per week. This is basically a good initiative that can improve the employees' working conditions. But the HA has failed to consider whether the working hours of the civil servants seconded to the HA should also be adjusted. As a result, in the same organization and among workers doing the same types of jobs, some work 44 hours a week but others must work 45 hours. This makes management more difficult and also creates inequality among employees. At present, the HA and Civil Service Bureau have different arguments. The HA says that the Government should be responsible for the working conditions of the civil servants, while the Government says that the HA operates independently, so the Government has nothing to do with this matter. As they


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push the responsibility to each other in this way, the civil servants on secondment are the victims. This kind of rigid bureaucratic governance must be rectified as soon as possible. President, the tenure of the Chairman of the HA, Mr Anthony WU, is about to expire. At present, there are various speculations in society regarding who the successor will be. I believe that improvement to the overall governance and services of the HA cannot be achieved by merely changing one person. The community hopes that the review of the HA referred to by the Secretary for Food and Health can improve the operation of the HA and the management of its staff, and enhance the overall quality of the healthcare services in Hong Kong. President, I so submit. DR CHIANG LAI-WAN (in Cantonese): President, I believe that some people in society also have the same question: as there is the Food and Health Bureau already, do we still need the Hospital Authority (HA)? Some people even agree with Dr LEUNG Ka-lau that since the HA is the buyer-cum-vendor, who is torn between the standpoints of hospitals and healthcare staff on the one hand and the need for looking after the general public on the other, it may end up pleasing neither side due to the long-standing conflict of its roles. Therefore, I believe Dr LEUNG Ka-lau has put forward this proposal on dissolving the HA only out of his concern that if the HA goes on like this, it may turn schizophrenic over its administration and governance. First, we must consider whether the performance of the HA has reached such a point that there is no other option but to dissolve it. Will the dissolution of the HA solve the prevailing problems? After the dissolution of the HA, can the Government save any resources? Will our healthcare services improve in quality? If the answers to these questions are all yes, then the proposal is really worth our consideration. However, I believe that the situation is not so simple. As Secretary Dr KO Wing-man has said, one of the purposes of the establishment of the HA is to co-ordinate the hospital clusters in various districts, so that once any serious incidents happen, they can be dealt with in a co-ordinated and flexible manner. For example, during the outbreak of SARS in 2003, the H7N9 epidemic earlier this year in eastern China, or the emergence of the new strain of SARS in the Middle East, we could see that the reporting system of the HA had become very well-developed.


Everyone knows that after the establishment of the HA, the environment of the hospitals, the provision of new equipment and the overall services of public hospitals have all greatly improved, and the public only need to pay very low fees. This point alone is already the envy of our neighbours in Asia. However, it is undeniable that because of population growth and the serious wastage of healthcare personnel in recent years, the overall level of the HA's services has declined. A member of the public once told me that if the HA did not improve its existing services expeditiously, it would be better to dissolve it, as proposed by Dr LEUNG Ka-lau. When I asked why he said so, he answered that as it was said in the Huangdi Neijing, the superior doctor treated illness before it occurred, the mediocre doctor treated illness about to occur, while the inferior doctor treated illness that had already occurred. He said, "If one cannot receive treatment when he falls ill, it will mean no available treatment. In that case, what is point of keeping the HA?" It is true that his remarks are not quite so objective, but they do reflect people's heartfelt feelings. When I meet with people in the community, I often hear some elderly people say that they have to wait a long time for follow-up consultations and even if they have made an appointment with the doctor, they still have to wait a long time on the appointed day. An elderly person complained to me that he had to wait six hours to see the doctor on the day of his follow-up consultation, but the doctor only spent two minutes with him. Another elderly person told me that he had to wait for his turn to have his knee joints replaced due to strain injuries. He had waited three years, but he was still waiting. He can neither walk nor do any exercise now, and he is afraid that his turn will not come even when he dies. I understand that there is truly a shortage of healthcare personnel in recent years. Because of this, the universities have finally agreed to increase the number of places by one third, so that young students aspiring to studying medicine can gain admission. The DAB is highly supportive of such an increase. In recent days, I am glad to hear that several students who have got exceptionally high scores at the Hong Kong Diploma of Secondary Education Examination also aspire to studying medicine. I hope that their wish can come true and they can serve the people of Hong Kong in the future. Finally, I wish to point out that Dr LEUNG Ka-lau's angry proposal of dissolving the HA today must just be an attempt to voice the feelings of some in


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the medical profession. Therefore, although I do not support his motion, I think that the Government should carefully consider his proposals and make an appropriate and necessary response. I so submit. Thank you, President. MR NG LEUNG-SING (in Cantonese): President, the rationale behind the establishment of the Hospital Authority (HA) is to introduce systematic management to the public healthcare system, with a view to dovetailing with the development of professional healthcare services. The HA was established in 1991 to take over the management of public hospitals in Hong Kong and provide healthcare services to the public. More than 20 years have passed. Over all these years, huge resources have been injected into the HA, and undeniably, considerable achievements have been made in the area of public healthcare. By now, Hong Kong's public healthcare system has already attained world-class standards. The high standards of Hong Kong's healthcare services can best be reflected by the top positions of our health indicators in the whole world. Over the past 21 years, the average life expectancy of Hong Kong people has risen from 75.2 years for males and 80.7 years for females to 80.6 years and 86.3 years in that order, rendering Hong Kong one of the places with the highest life expectancies. As for the death rate of Hong Kong, the infant mortality rate is a mere 1.4% per every 1 000 live births. These are evidence that certain achievements have been obtained in our healthcare system. Regarding the services of public hospitals, with rapid population increase, the development of the local economy as well as rising living standards, public demand for healthcare services has been increasing and there are also higher expectations of service quality. At its 20th anniversary, the HA commissioned The Chinese University of Hong Kong to conduct the first HA-wide Patient Satisfaction Survey. The survey results reflect that 80% of the responding patients rated the care received in public hospitals as excellent, very good or good; while almost 90% of the respondents indicated their confidence and trust in doctors and nurses of public hospitals. Since establishment, the HA has been constantly upgrading its facilities and medical equipment. For example, advanced computerized tomography


scanners and magnetic resonance imaging scanners have been procured; new medical technologies have been adopted; training has been stepped up for healthcare staff, and so on. Thus, the proposal of urging the Government to dissolve the HA due to its misgovernance and uneven allocation of resources, as contained in the motion under debate, seems unconvincing. When it comes to the effective management of a healthcare system of such a large scale, I think we cannot possibly set the objectives too high and aim at perfection. But we can conceive ways of improvement. Hong Kong is a densely populated city with a keen demand for healthcare services and very limited geographical resources, so it is impossible to meet the demand of all people for different types of healthcare services with absolute equality. It is certainly necessary to review, at appropriate times, the various issues concerning the management of the HA, such as its cluster services, its operational efficiency and its utilization of resources, and adjustments and reform must be introduced at different phases. But we must not adopt the simplistic approach of "killing it" and dissolving it as the ultimate solution. It is suggested in the amendment to the motion that democratization of the management of public hospitals and clinics should be promoted to encourage local and civic organizations to participate in such management. Attention should be paid to the risks involved. Democracy is not a panacea to all problems and I think care should be exercised when the treatment of patients is involved. The management of healthcare services is governed by standards of professional responsibility and efficiency, and it is both a matter of health and a matter of life. Local people and civic organizations should be encouraged to provide more views on service demand and patients' expectations, but their participation in healthcare management is definitely not a must. As a matter of fact, the HA has been engaging the public since 1998, and it has since been opening its general meetings and welcoming observation by the public, with a view to enhancing the transparency of its governance and upgrading its public accountability. Communications with the public have basically been smooth. Healthcare management is always a highly professional area, so what it needs is professionalism and rationalization, definitely not any democratization at will.


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As regards the issue of resources, the expenditure on public health this year accounts for 12.2% of the total Government spending. In response to the aggravation of population ageing, funding for healthcare has been increased accordingly. At the same time, it should be noted that Hong Kong is a place with a low-tax regime, so it cannot possibly follow other places with high-tax regimes in all respects. Our public resources are limited and appropriate control should thus be exercised on the utilization of various resources. With regard to the provision of healthcare services, it should first be ensured that people with genuine needs will be given appropriate and basic care, while those who can afford to pay should invest in their health and choose among the various healthcare services available in the market. Those in the healthcare sector should also consider the overall situation and minimize protectionism. If there is adequate manpower in both public and private healthcare organizations, they will be able to assist and complement each other and bring benefits to the whole community. President, although the management and development of the HA over the past 20 years can never be described as flawless, recognition should still be given to its achievements so far. Over all these years, the local healthcare sector has faced the challenges posed by a number of epidemic outbreaks and influenza pandemics, overcoming a lot of difficulties. Our healthcare team has demonstrated its unswerving determination and professional spirit, and talents are even exported overseas. I hope that the HA can keep drawing lessons from past experience, striving for further enhancement and working hard for the benefits of public health. President, I so submit. MR MA FUNG-KWOK (in Cantonese): President, there have been endless complaints in the community against the Hospital Authority (HA) in recent years, and stories about medical blunders, manpower shortage, uneven resource allocation and unduly long waiting time are heard from time to time. Is the HA really so bad that we have no other alternative but to dissolve it? My answer is in the negative. Since its establishment in 1990, the HA has been responsible for saving people's lives and its contribution is indispensable. Nevertheless, as a result of the problems mentioned above, coupled with population ageing, increasing


operating expenses and higher public expectations, it can be foreseen that the local healthcare system will only come under increasingly heavy pressure. From this perspective, I would say that it is necessary for the HA to conduct a review and introduce reform. In my opinion, the first aspect that needs a review is the question of how to reduce medical incidents because the incidence of medical incidents will have a direct impact on people's confidence in the whole healthcare system. According to figures published by the authorities, during the 12 months from October 2011 to September last year, 34 sentinel events were reported in public hospitals and the number of serious untoward events reported amounted to 102. The HA emphasized that the numbers were smaller than those in the year preceding this period, but I must still say that events of such a nature, however small the number is, should be avoided as far as possible since life and death is involved. What we need to do is to investigate all these events and ascertain whether any procedural loopholes or inadequate supervision were involved, whether there was any violation of guidelines on the part of the healthcare personnel concerned, and how improvements should be made. Besides, healthcare manpower should also be appropriately reviewed. If manpower shortage persists over long periods, with staff having to cope with a heavy workload, then as pressure increases, the chances of making mistakes will only increase and staff morale will inevitably be sinking. Faced with such a situation, most of them will choose switching to private hospitals, thus aggravating the problem of manpower shortage in public hospitals. It has been reported that due to a serious shortage of healthcare personnel, the North Lantau Hospital to be commissioned shortly would have to serve with only one third of its staff establishment in the initial period after service commencement, and the full-scale operation of the hospital would not be possible until 2016-2017. The problem with manpower planning is therefore very obvious. President, according to the Chief Executive of the HA, there is still a shortfall of over 200 doctors at present and the vacancies have to be filled by part-time and non-local doctors. This is a worrying signal. Furthermore, filling such vacancies by part-time and non-local doctors can only be a stop-gap measure, rather than any ultimate solution. The HA should enhance the remuneration package and working conditions of its staff and minimize the time spent on unnecessary non-clinical work. At the same time, timely manpower planning should also be made to increase the number of places in faculties of


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medicine, nursing departments in higher education institutes and other nursing schools, with a view to training up more local talents. Resource allocation is another issue attracting criticisms. At present, resources allocated to the seven clusters vary a great deal. For example, 13.8% of the total population of Hong Kong is living in Kowloon East but over the past few years, the funding allocated to the corresponding cluster has remained at a level of 10.1% of the total funding. The waiting time for first appointment in various specialties in Kowloon East is also the longest among all clusters, including a waiting time of 101 weeks for treatment in the Department of Orthopaedics and Traumatology. In contrast, only 7% of the Hong Kong's total population is living in Kowloon Central but the funding allocated to the corresponding cluster has been kept at a level of 14.2% of the total funding, and the waiting time for treatment in the cluster is also shorter. For example, only 24 weeks of waiting time will be needed for treatment in the Department of Orthopaedics and Traumatology in the cluster. The allocation of greater resources to clusters serving a smaller population can reflect the problems with resource allocation. Nevertheless, the HA argues that it is not feasible to distribute resources among clusters on the simple basis of relative population sizes because some clusters have to serve patients seeking cross-district medical treatment. For example, over 60% of the in-patient and specialist out-patient services in the Kowloon Central Cluster are actually offered to patients from other clusters. But on second thought, we will realize that patients in need of medical treatment should more reasonably hope to receive treatment in the districts where they live, in any case as close to their homes as possible. This is particularly applicable to elderly patients with impaired mobility. Who would want to endure the hardhip of seeking cross-district medical treatment? There are views that "regionalism" prevails in the HA, and the system is so unreasonable that each cluster simply minds its own business and all clusters compete fiercely with one another for resources. Besides, the senior management of some hospitals keeps pushing their healthcare staff to undertake more jobs and accept more referrals from other clusters, so as to generate more service demand and boost service throughput, and in turn ask for more resources with the support of all sorts of "bogus demand" so created. Hospitals with less


resources are already in a less advantageous position when competing with other hospitals, and they are now even compelled to refer some of their patients to other hospitals. Then, the resources allocated to them are further cutrailed as a result of inadequate throughput. A vicious cycle has thus emerged. I think a more desirable way is to allocate resources on the basis of population size and demographic structure in the catchment area. More resources should be allocated to clusters with a larger population size or a higher proportion of elderly residents, and service throughput should be considered a minor determining factor. It is only when these two factors are considered as a whole that we can maintain reasonableness and stability, minimize the competition for resources among hospitals, break the bad habit of pushing front-line staff for more service throughput, and formulate more objective and fair criteria for funding allocation. As a matter of fact, throughout the HA's 20 years of operation, our public healthcare system have been providing comprehensive services and protection to the public at low prices, and its has also overcome a number of major epidemic outbreaks. From this perspective, it can be said that the public healthcare system of Hong Kong is one of the best all over the world. However, precisely because of the huge gap between the fees charged by public hospitals and those of private hospitals, some middle-class people who are actually financially capable have been attracted to switch from the private healthcare system to public hospitals, or take the public healthcare system as another source of protection. Service demand is thus greatly increased, resulting in a long waiting time and rendering the system not sustainable. Therefore, I suggest that the HA should consider introducing an additional tier of services to the public healthcare system, whereby middle-class people who have the means or who have health insurance cover may choose to enjoy public hospital services at a cost somewhere between the fees charged by public hospitals and those charged by private hospitals. Moreover, certain enhanced services such as free choice of attending doctors may also be provided to open up more sources of income for the relief of HA's burden in healthcare spending. Resources thus released can be used to bring enhancements to other services. Finally, I would like to briefly respond to the amendments proposed by Members. The HA is an organization with an annual spending of tens of


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billions of public money but public opinion generally agrees that there is low transparency in its operations. The current Government has also acknowledged the problem and indicated that a review is needed. That being the case, I concur that an HA review committee should be established expeditiously to comprehensively review the HA's functions, so as to enhance transparency and facilitate public monitoring. President, I so submit. MRS REGINA IP (in Cantonese): I would like to thank Dr LEUNG for putting forward such an interesting debate topic and providing us with a lot of data for reference. Dr LEUNG served the Hospital Authority (HA) for many years and is now in private practice. He of course has a very sound understanding of the structural problems of the HA. He is therefore able to describe many problems with the HA in the original motion, such as a conflict of roles, uneven resource allocation and varying service quality, all of which I think can hit the nail on the head. However, like many Members who have already spoken, I do not think that dissolving the HA is a feasible solution. I am even of the opinion that if we adopt Dr LEUNG's proposal on applying the principle of "money follows patient" to satisfy patients' needs, many problems will result. "Money follows patient" actually means a healthcare voucher scheme, doesn't it? In fact, such a scheme is already in place. And, I can remember Dr LEUNG's saying that the consultation cost per patient in the HA was about $900 or even $1,000, and that instead of depending on the HA, the Government may just as well distribute a healthcare voucher of $1,000 to each member of the public, so that he can seek medical treatment elsewhere himself. Is that what he means? Or, after computing the per-patient costs of cataract treatment in the HA, "cataract vouchers" of a corresponding value can be distributed, so that patients may themselves seek treatment from private doctors. Such a measure looks in keeping with the free market principle, but I think that if the Government really does so, it must do something with price control, otherwise when large numbers of patients seek treatment from doctors in private practice, a result similar to the "doubly non-permanent resident babies" effect may ensue. When the business of private doctors or private hospitals increases drastically all of a


sudden, their resources will be strained, thus causing "long queues" for private healthcare services. In that case, prices will definitely rise. This can be evidenced by the increases in kindergarten tuition fees after the introduction of the Pre-primary Education Voucher Scheme. Precaution is thus necessary. Furthermore, if "money follows patient" is really adopted and everything is left to the market, all profitable cases may fall into the hands of private doctors, while patients not desired by them, such as elderly and chronic patients, will be "thrown back" to the HA. Therefore, in the end, large groups of people in the community must still need the care of public healthcare organizations. I think the adoption of "money follows patient" alone will not be feasible. Rather, the Government must formulate policies to prevent any imbalance of public and private healthcare services. A ratio should be determined, and the management of the HA should be improved, so as to prevent the problems of long waiting time and inadequate resources facing residents of densely populated or newly developed districts as repeatedly pointed out by Dr LEUNG. Nevertheless, when commenting on resource allocation, we should not focus only on population growth, and then criticize that while there has only been limited growth in the overall population, the total funding for the HA has nonetheless increased very substantially. Demand for healthcare services is not solely determined by population growth, and consideration must be given to many other factors, such as population ageing and the rising healthcare expectations of people which necessitate the conduct of many check-ups and other procedures in the course of disease treatment. As rightly pointed out by the two Members who have proposed amendments to the motion, as we treasure life or quality of living more and more and want to prolong life with expensive drugs, an increasing demand for medical resources has become a global problem. Therefore, I think the proper direction is for the Government to shoulder the responsibility of keeping the gate for the public, that is, to ensure a well-proportioned distribution of public and private healthcare services providers and the close supervision of HA governance, so that such problems as favouritism or "fattening the top and thinning the bottom", which are common among large public-funded organizations, can be avoided.


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As regards the amendments proposed by the two Members, I will strongly support those proposals that seek to enhance the HA's transparency, accountability and internal checks and balances. However, if the amendments are purely for introducing democratization to include more elected representatives, a topic which is itself open to wide interpretation, or for purely following people's demands in defiance of professional opinions in management, I would think there will be great problems. Speaking of the limitations of the Drug Formulary, I believe all Members have long been receiving many related complaints. Nevertheless, we must realize one global phenomenon, the phenomenon that new drugs and new medical procedures have become increasingly numerous and expensive. Without any cost-effective management, even the richest and strongest nations in the world, such as the United States, will find it difficult to cope with the public demand for drugs. Therefore, I support the Government's approach of provding huge funding to the Samaritan Fund at this time of sound finances, so that it can assist needy patients. As regards the proposal to expand the Drug Formulary endlessly to include all drugs of significant efficacy and those expensive drugs that are of marginal efficacy as General Drugs and Special Drugs, I am of the opinion that it fails to consider the issue of cost-effectiveness. I therefore cannot offer my support. With these remarks, I declare that I would abstain from voting on the amendments proposed by the two Members and would not support the motion moved by Dr LEUNG Ka-lau. Thank you, President. MR KWOK WAI-KEUNG (in Cantonese): President, the Government has passed the ball of legislating for standard working hours to the Standard Working Hours Committee for its discussion, but in the meantime, the Hospital Authority (HA) has brought a very delightful message to its staff: a 44-hour week inclusive of meal breaks for all HA staff as from 1 May, a commendable measure that can enable several dozen thousand employees to have reasonable rest periods. But it is a pity that the 600-odd civil servants belonging to the Department of Health (DH) but working in the HA cannot benefit from this measure because they are employed under different terms and conditions, and they must even shoulder


additional workload. Thus, two sets of personnel arrangements now exist in the HA, giving rise to unequal treatment for the same work. According to the HA, it can actually apply the same working hours across the board. But as the Civil Service Bureau and the DH have tried to shift the responsibility to each other, this benevolent measure of standardizing working hours has been reduced to an evil and divisive deed, dealing a severe blow to staff morale and causing huge grievances within the HA. I hope the Government can make amends as soon as possible and properly tackle this issue of unequal treatment for the same work, so that those civil servants working under the same roof as other HA staff can likewise enjoy standard working hours. President, the HA's implementation of standardized working hours is of course a big step forward. But on the other hand, due to mismatch of resources, there are signs that the problem of overtime work among HA staff is getting increasingly serious. This imposes heavy pressure on front-line staff, and at the same time entails public safety and public health problems. The Hong Kong Federation of Trade Unions (FTU) has always maintained that there must be overtime pay, and the HA has been doing so. Nevertheless, can overtime pay solve the problem? What we see today is the impossibility of covering 10 pots with only five lids. As we can learn from the reply to a question raised in this Council earlier on, the number of HA staff receiving overtime pay and the total of overtime payment made by the HA have multiplied in recent years. The number of staff receiving overtime pay increased from 5 282 in 2010-2011 to 11 506 in 2012-2013, a two-fold increase in just two years. Of the HA staff who have worked overtime, 99.9% are front-line healthcare personnel. The total amount of overtime pay also increased from $57.2 million in 2010-2011 to $150 million in 2012-2013. With this sum of $150 million of overtime payment, how many full-time and part-time employees can the HA recruit? President, I am going to talk about the Accident and Emergency (A&E) Departments of the leading hospitals in various districts as examples to illustrate the seriousness of manpower shortage in our public hospitals. According to papers provided to this Council, the waiting time in the case of non-urgent


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patients at the A&E Departments of public hospitals is the longest at United Christian Hospital, about 3.5 hours on average. The situation is better at Queen Elizabeth Hospital, Kwong Wah Hospital and Princess Margaret Hospital, but the waiting time is still as long as three hours. These are official average figures only. Let us also look at some unofficial figures circulating in the community. I have a newspaper before me. As reported by this newspaper from yesterday, patients attending the A&E Department of Prince of Wales Hospital in Sha Tin were unable to see the doctor even after a long wait of eight hours. Earlier, in March this year, it was also reported that some A&E patients had to wait 12 hours before they could get medical treatment. There were in fact six vacancies for doctors in the A&E Department of the Prince of Wales Hospital in Sha Tin, but for the sake of administrative convenience, the HA simply halted the recruitment exercise. The serious manpower shortage in the A&E Department has been grossly ignored and this is a reckless defiance of the health and even safety of the general public. A&E patients must wait three hours, eight hours or even 12 hours for medical treatment. But the A&E Department in North Lantau Hospital will open for eight hours only. Is this the kind of healthcare service quality expected of an advanced city? We may also look at the conditions of front-line staff as an example to illustrate the management of the HA. The FTU has recently received a request for assistance from some 700 phlebotomists with the post title of Clinical Assistant in the HA. In recent years, they have been required to perform many extra duties which are not included in the job description for a phlebotomist, including high-risk duties that should be undertaken by doctors and nurses, such as taking electrocardiogram, introducing indwelling venous catheter, performing culture tests, blood taking for paediatric patients, and so on. What are the HA's justifications for transferring the duties of doctors and nurses to phlebotomists and shifting high-risk duties to front-line staff? The arrangement puts an extra burden on the supporting staff on the front-line and also poses threat to public health. If the arrangement is made in response to a shortage of doctors and nurses, the HA has undeniably shifted the consequence and risks of its misgovernance to front-line staff.


The HA was established with the aim of effectively utilizing resources in the establishment and the management of public hospitals, and improving the quality of healthcare services. However, what we have witnessed in recent years is the situation of "fattening the top and thinning the bottom". Remuneration packages for high-ranking executives keep improving but patients have to pay for drugs of a good quality, otherwise drugs of a lower quality will be prescribed. Support to front-line staff is inadequate and medical incidents are common. The two most recent cases of medical incidents involve the transplant of a heart with an incompatible blood type for a patient with heart disease, and the switching off of a life support machine by mistake, thus causing the death of the patient concerned. Public hospitals are plagued with all sorts of irregularities in recent years, such as wrong diagnosis, wrong injections, drug dispensing errors and operating the wrong surgery. Can the situation be improved simply by creating more high-salaried executive posts? I hereby urges the HA to properly enhance its governance, address the shortage of healthcare personnel and work for public health benefits. I so submit. Thank you, President. DR LAM TAI-FAI (in Cantonese): President, Dr LEUNG's motion on dissolving the Hospital Authority (HA) is truly very shocking and radical. But as far as my observation goes, the HA has neither committed any grave mistake nor any serious offences, so there is no need to dissolve HA immediately. The speech delivered by Dr LEUNG last night only confirms my belief that there is no need to dissolve the HA immediately. President, we must comment on the performance of government departments and publicly-funded organizations from the perspective of value for money. When it comes to such a serious matter of dissolution, I must say that as indicated by recent opinion polls, people may agree more to the dissolution of the new governing team, the Executive Council or even the Legislative Council than the dissolution of the HA at this moment because life and physical health are involved.


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I think Dr LEUNG's proposal is truly a bit negative and too extreme. The word "dissolving" is deleted by the two pan-democratic Members in their amendments. This can show that Dr LEUNG's allegations against the HA are far too harsh. President, I of course do not belong to the medical sector, but I also know many doctors and nurses working in public and private hospitals. In order to have a better understanding of the operation of the HA and its pros and cons, I have deliberately consulted those from the sector to see if they support the proposal of dissolving the HA. Eventually, none of them told me that the HA should be dissolved immediately. However, they told me that in the latest two Legislative Council Elections, they all voted for Dr LEUNG Ka-lau; they are his fans. This shows that my friends from the medical sector are all reasonable persons who are calling a spade a spade, and that there is some truth in the views expressed by Dr LEUNG Ka-lau. The whole machinery of the HA has been in operation for over 20 years. Any significant changes, such as its dissolution, may pose threat to the life and health protection of the general public, thus leading to far-reaching consequences. Therefore, we must think carefully and cast our votes with all prudence rather than any great haste. As a matter of fact, the HA is the only organization in Hong Kong with experience in public healthcare administration. I fear that if it is abruptly dissolved, the medical sector will be deprived of any leadership and thrown into even greater chaos. As I have said, the lives of people are at stake, so we must think twice before making any decision. President, in 2010, the HA published the Patient Satisfaction Survey (PSS) report on its seven public hospital clusters. The findings indicated that 80% of the responding patients rated the services of public hospitals as satisfactory, while almost 90% of them indicated their confidence and trust in doctors and nurses. I believe a majority of Hong Kong people are satisfied with the services currently provided in public hospitals but of course, as we in the industrial sector understand, the engine of a machine needs an overhaul after frequent use. The HA and the public healthcare system of Hong Kong do have much room for improvement, reform and enhancement. In fact, since the establishment of the HA in 1990, a comprehensive review has never been conducted. In other words, it has never undergone any "chest x-ray", and the situation is unacceptable to the


public. A lot of people in the sector have told me that the personnel management of HA is very chaotic, marked by "regionalism", and front-line staff are very low in morale. I hereby urge the HA to promote a caring culture in the organization. A doctor has told me that a hospital once planned to procure a testing machine but there was no reply even two years after application, thus making the front-line staff very frustrated. They also complain that their senior management is subject to no supervision, and whenever anything occurs, they will only focus on public relations, and no one will be held accountable. Besides, I have also heard many members of the public and people in the sector criticize that the operation of the HA lacks any transparency, and the public are thus unable to monitor its performance and services. Actually, a lot of medical incidents in recent years are connected with the mismatch of manpower and workload. Public hospitals have attracted many complaints and the most serious problem is unduly long waiting time for services in various departments. In my opinion, the crux of the problem lies mainly in the shortage of manpower. According to the figures for 2012-2013, the longest waiting time for appointments at the six specialist out-patient departments is over 60 weeks, and the longest waiting time for new appointments at General Surgery Out-patient Clinics is 110 weeks. Truly, "the long wait may turn a minor ailment into a serious disease, and a serious disease into a fatal disease" Therefore, the HA should better utilize its resources, seek to tackle its manpower shortage and staff wastage, and shorten waiting time. Some have compared the HA to an aircraft carrier, saying that it is full of strength but lacks flexibility. Inflexibility is indeed a common problem with large organizations. Many doctors have also criticized the inefficient co-ordination between clusters and departments. Current figures also suggest that the HA now operates 41 hospitals and healthcare institutions with over 27 000 beds, together with 47 specialist out-patient clinics and 70 general out-patient clinics, employing more than 64 000 staff members in total. We can thus see that this is really a very large organization. I therefore think that the HA should conduct regular and comprehensive reviews, so as to improve its management system and keep abreast of the times. It is only in this way that the HA can enhance its efficiency and serve the people of Hong Kong more effectively.


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However, President, the amount of funding allocated to the HA by the Government in 2013-2014 is $45 billion only, accounting for only 2.4% of our GDP. The HA has really done an admirable job in looking after 90% of the patients in Hong Kong with such a small sum of allocation. Besides, we may recall that whenever any major incidents occurred in the community of Hong Kong, such as the outbreak of SARS and avian influenza as well as the hostage incident in Manila, the HA and its healthcare personnel invariably performed very professionally and responsibly. I believe the HA and its staff all deserve our recognition and commendation. Thus, President, I think the best solution to the current problems with our public healthcare system should not be any negative proposal to dissolve the HA. Rather, we should seek to enhance, reform, improve and upgrade its efficiency by, for example, increasing the interflow and co-operation between the public and private healthcare systems, encouraging public-private partnership in healthcare, and avoiding the unrealistic and unnecessary expansion of services. Attempts must be made to meet public expectations and regularly review resource distribution. This is the only way to deliver medical services of the best quality. Besides, I also hope that Members can have confidence in Secretary Dr KO Wing-man. He is a doctor by profession, and he worked in public hospitals for a long time. He is also a Director of Bureau with both the intention and the ability to do a good job. Now that he has the authoirty, he will be better able to help us improve the work of the HA, perfect its systems and upgrade its efficiency for serving the community. President, I so submit. MR LEE CHEUK-YAN (in Cantonese): President, I think Dr LEUNG Ka-lau's motion today is very successful because once the subject of dissolving the Hospital Authority (HA) is brought up, everyone has to speak on the motion. It is therefore sometimes useful to resort to "odd" tactics. I admire Dr LEUNG Ka-lau very much. He is a doctor, and he is very good at diagnosis. But it is a pity that he has prescribed the wrong remedy this time around. His diagnosis is correct, but his prescription is wrong.


I say his diagnosis is correct because he has rightly pointed out that the HA's resource allocation is uneven, as evidenced by the presence of hospital clusters with abundant resources and hospital clusters with very scanty resources. This is very unfair indeed and I absolutely agree with him. However, his "prescription" is for the dissolution of the HA and the adoption of "money follows patient". The Labour Party strongly objects to "money follows patient", and maintains that this will lead to disastrous consequences. First of all, how is "money follows patient" going to work? In the case of a cancer patient, for example, should we simply give him $100,000 if the cost of cancer treatment in public hospitals is $100,000, so that he can purchase medical services in the private market by himself? This is tantamount to the privatization of healthcare services. The Labour Party will never accept privatization. Asking the user to purchase the services he needs involves many risks. The principle of "money follows whoever", be it "money follows the elderly", "money follows student", and so on, will have the undesirable effect of distorting prices. Once the Government grants subsidy and asks the users to purchase the services by themselves, prices will rise because the market knows that this will generate demand. Who will eventually benefit? The answer is healthcare services groups or doctors. But I think in most cases, healthcare services groups rather than doctors will be the real beneficiaries. This is something we do not want to see, and we do think that we need to defend the public healthcare system of Hong Kong. It is of paramount importance that we support the public healthcare system of Hong Kong. Frankly speaking, there are not too many welfare benefits for the masses in Hong Kong. Although our public healthcare system is plagued with shortcomings, its general direction is basically correct, in the sense that it can enable both the poor and the middle class to have healthcare services. Even the middle class will find it hard to afford healthcare services. If middle-class people must turn to the private market for healthcare services, they will become poor immediately. Diseases will make them poor. One of the requests raised by Dr Fernando CHEUNG in his amendment is the inclusion of self-financed drugs in the Drug Formulary. Why is it necessary to do so? It is because the prices of drugs are far too expensive for even the middle class who


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have a monthly salary of $40,000 to $60,000. If they are made to pay $20,000 for drugs every month once they get sick, they will have to say goodbye to their middle-class lifestyle and become poor immediately. The situation will be even more devastating if they have to repay home mortgage loans. We are therefore strongly against the current practice of requiring patients to purchase drugs at their own expenses because drug prices are really too high. I think the HA is illogical. It often explains that due to high prices of drugs, patients are required to purchase drugs at their own expenses, and grass-root patients can apply for assistance from the Samaritan Fund. Nevertheless, the Samaritan Fund cannot benefit the middle class. This is very unfair to them. The middle class pay a lot of taxes, but eventually, they are deprived of the healthcare services they deserve. Therefore, we are of the opinion that if any drugs are of efficacy, patients should not be made to purchase them at their own expense because this will pose a very heavy burden to them. Patients are often told by doctors that a particular kind of drug is of efficacy while other drugs can cause side-effects. But in order to buy the drugs recommended by doctors, patients would have to pay $1,000 to $2,000 each month. How can elderly persons living on Old Age Living Allowance pay $1,000 each month on drugs of a better efficacy? There are indeed many such issues which, in our opinion, need to be changed. Besides, I would also like to say a few words on the problem of uneven distribution of resources. Dr LEUNG has provided us with some figures, and doctors' diagnoses are all based on figures. We can see that the waiting time for appointment at the Orthopaedic and Traumatology Department in Kowloon East Cluster is 107 weeks, and this is the median figure only. On the other hand, the waiting time in the Hong Kong West Cluster is 15 weeks …… Sorry, we should be talking about the number of days. We can see that the difference between the two is so large, so absurd. As a matter of fact, we can see the longest waiting time in New Territories East Cluster for a number of medical services. Dr KO may of course argue that cross-cluster utilization of services is currently allowed. But the truth is that we cannot seek cross-cluster services freely on our own, and we must be referred by one cluster to another. I wonder if patients can be allowed to switich to other clusters freely on their own as an


interim measure. Only as an interim measure and not a long-term one. But since there is such a great difference in waiting time, I wonder if patients can be allowed to choose clusters freely on their own as an interim measure. This should only be a short-term measure because making it a long-term arrangement will be unfair to patients. If the measure is made permanent, all patients in the New Territories West Cluster might switch to the Kowloon Central Cluster for medical treatment since resources allocated to the latter cluster are the most bountiful. However, it will not be desirable if all patients swarm to the Kowloon Central Cluster for medical treatment because they will have to travel long distances. Nevertheless, it can be adopted as an interim measure because some patients can wait no further. Can these patients be allowed to seek medical treatment in another cluster freely on their own as an interim measure? In case some patients need urgent operations or examinations and they do not mind spending a day on travelling to the Kowloon Central Cluster for treatment, will the authorities allow them to do so? The Administration may of course argue that this would exert very heavy pressure on the Kowloon Central Cluster or clusters with a shorter waiting time. In response, I must say that this practice can actually achieve a more even utilization of resources. But I do not think this should be made a permanent measure. Finally, I also find the situation in some districts very unreasonable. For instance, there will be no Accident and Emergency (A&E) Department in the new North Lantau Hospital and only eight hours of emergency services will be provided. How can this be possible? Lantau Island is a very large area and this is a matter of life and death. Ambulances deployed from another district have to travel a very long way before arriving at the scene. Why can't the North Lantau Hospital be equipped with the proper A&E facilities? I think distribution of resources is the source of a lot of problems and thus, I hope Dr KO will allocate resources properly. Thank you, President.


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MR ALAN LEONG (in Cantonese): President, although the Civic Party cannot support the original motion moved by Dr LEUNG Ka-lau today, we fully understand the reasons why Dr LEUNG would, in a burst of anger, propose the dissolution of the Hospital Authority (HA). All is because the HA's performance is far from satisfactory, as evidenced particularly by its uneven resource allocation among various clusters, handling of healthcare personnel workload, arrangements for drugs, and handling of patients' complaints against medical blunders, and so on. However, while the Civic Party basically considers that it is time to review the operation of the HA with the aim of making improvement, it does not think that it is a suitable time to dissolve it. President, with this introduction, I would like to specifically point out what LEUNG Chun-ying said about the HA in the Policy Address released in January this year. It is stated in the Policy Address that the HA has been established for over 20 years, and it is time to set up a steering committee to conduct a comprehensive review of its work and operation, with a view to exploring viable measures of enhancing the cost-effectiveness and quality of its services. I was not present when the Secretary spoke on the motion for the first time, so I do not know if he already gave an account of the progress in this regard. If not, I believe he should offer this Council an explanation when he replies again later. There has only been empty talk but no action. When will the Chief Executive establish the steering committee which he promised in the Policy Address released in January? President, the year 2013 is already half way through but the steering committee is still nowhere in sight. Can there be any initial results at least in the remainder of this year? I have very great worry and I doubt whether this can be possible. I therefore hope that Secretary Dr KO Wing-man, can give this Council a clearer picture later on. Who will be appointed to this steering committee? When will it be formally set up? How about its workflow and schedule of work? He should at least give Hong Kong people a rough idea so that they can know when there can be improvement. President, I think the steering committee should at least conduct a review on the reasons for the ever-lengthening of waiting time for patients despite the year-on-year funding increase for the HA. It should also explore ways to tackle the serious problem of uneven resource allocation among different clusters. The


high costs of specialist out-patient services and the lack of transparency in handling complaints against medical incidents are also areas to review. As time is limited today, I would like to focus on two points, the first of which is the uneven allocation of cluster resources. Dr LEUNG Ka-lau has provided all Members with some information and the data are in fact self-explanatory. It can be seen that in the case of the Kowloon East Cluster, my constituency, its funding is the lowest among the seven clusters, but the number of people it serves is not the smallest. Moreover, the elderly population of Kowloon East is increasing and it is projected that the elderly population of the district will increase from 140 000 to at least 170 000 in the coming ten years, with the ratio of the elderly population rising from 13% to 15%. We all know that in 2012-2013, the funding allocated to Kowloon East Cluster amounted to $4.1 billion only, the lowest among the seven clusters. As for the Kowloon Central Cluster nearby, the funding was $5.45 billion. For the Kowloon West Cluster, the funding was even $8.9 billion. President, the catchment population of the Kowloon East Cluster is actually two times than that of the Kowloon Central Cluster. According to figures provided by HA, the catchment population of the Kowloon Central Cluster is nearly 500 000. There are six hospitals with over 3 500 beds under in this cluster. However, Kowloon East Cluster, on the contrary, has a catchment population of almost 1 million but only three hospitals with 2 300 beds. Thus, senior citizens living in the district have to wait usually a long time for specialist out-patient services, and are unable to receive any proper treatments for their health problems. President, another point I would like to mention in the remaining one minute is the HA's complaints handling system. At present, a two-tier system is adopted to handle complaints lodged by patients and their family on medical incidents. Complaints can be lodged at the first instance to the relevant hospitals or clinics, and if a complainant is not satisfied with the results, he can lodge an appeal with the Public Complaints Committee (PCC) to request a review of the case. Nevertheless, only very few appeal cases are accepted and substantiated by PCC. Over 2 000 complaint cases were received by HA in 2009, among which only 270-odd cases were referred to the PCC for action, and the number of substantiated cases was merely five. There was no significant improvement in the number of cases received and handled in 2010.


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Although we cannot support the original motion today, President, we demand reform. We demand a fairer distribution of resources among various clusters. We hope that there can be a more credible and fairer mechanism for handling complaints. And, we demand a review of the expensive costs of specialist out-patient services. It is hoped that an answer would be given to us by the steering committee as soon as possible. I so submit. MR CHAN CHI-CHUEN (in Cantonese): President, the motion topic moved by Dr LEUNG Ka-lau today is "Dissolving the Hospital Authority". If the Hospital Authority (HA) were a human being, I think no one will deny that the HA is sick, critically sick or even dying. People's diagnosis of the HA will not be very different. The motion debate today concerns medical treatment, diagnose, rescue and prescription of drugs. So, let us see whether the person can be cured and whether it is difficult for him to be cured. From the perspective of cost-effectiveness, we must consider whether it would be a waste of medical resources to have him cured. When it is impossible or difficult to cure a pet, it will usually be euthanized, and both animal clinics and the Society for the Prevention of Cruelty to Animals will handle the case in this way. However, in the case of a human being, we will always give him treatment as far as possible. We will even, as the saying goes, "treat a dead horse as if it were still alive". We will still give him treatment despite how slim the chance is. In other countries, there is euthanasia. This is not the case in Hong Kong. Can the HA be cured? How have we been treating its illness? The principle adopted is "treat only where the pain is". I think this is also the best that our public healthcare system can aim at, and we will be very lucky if this aim can be achieved. In other words, only stopgap measures will be taken to treat the head for headache and the feet for its soreness, and we will just react to the problem at the time. However, sometimes, when we are treating the head, the feet will start to ache. My greatest worry, and in fact what is already happening now, is that we tend to cut off the foot when it sores and the arm when it hurts.


I have a real case to share. An uncle of mine once got his thumb hurt in an industrial accident. The thumb was badly hurt and soon after he was sent to the Accident and Emergency Department, he was told by the doctor on duty that nothing could be done and the thumb must be amputated. This is undenaibly the simplest, fastest and most efficient way to deal with the case. Nevertheless, this uncle of mine studied medical science in the Mainland for a few years and he refused to undergo the operation and preferred to treat the thumb himself. He bought a small clamp home and with the help of the tool, he put the flesh together bit by bit. The thumb was finally kept intact and he is still using it now. This example illustrates to us that if patients have total trust in doctors and follow their advice of amputation …… In fact, western medicine is about confrontation therapy, and everything in trouble will be removed. Attmepts will not be made to exhaust all possible means to have the affected part cured. Under such a medical philosophy, amputation is often advised. What we believe in, on the contrary, is wholistic care and will not cut off the head in case of headache or the foot when there is foot pain. I think the problems of the HA should also be handled in this light, but I also understand that Dr LEUNG Ka-lau, being an extraordinary doctor, is resorting to extraordinary means to tackle the problem. If he does not go to the extreme but blurs his line, how can the situation be improved? No one will take him seriously and the Bureau will not be so attentive in handling his proposal. Because we are now talking about its life and death, and a decision on whether to go head with euthanasia or giving it further treatment. Some people think that the present healthcare system of Hong Kong can be improved step by step, with public and private healthcare services complementing each other. When I was on a hunger strike earlier, a lot of healthcare personnel, voluntary workers, experienced doctors and nurses came to visit me. Knowing that we would be having a motion debate on the subject today, they shared with me their unpleasant experiences in the past. For example, they did not understand the criteria used by the HA for spending money since the smallest amount of funding was spent on drugs used for saving lives, and the biggest portion was spent on the salaries of top management. I think this is these are the facts known by all healthcare staff at the middle and lower level and even patients, and these facts cannot be denied. Front-line medical staff have been very vocal, calling for a return to the Government, and saying that the healthcare


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system should be put under the charge of the Government and all fringe benefits and salaries should be hooked up again with those of civil servants. It is really not very difficult to understand why different people share the same views on HA. I wonder if you have heard of a saying which goes, "tight on the frontline, lax at the home front"? The meaning of the saying is: while the soldiers on the frontline are risking their lives fighting a battle, the officials at the home front are leading a voluptuous life and indulging in laughter and jokes. By analogy, one can say that the HA has lost touch with the reality on various fronts. Front-line staff are complaining bitterly about manpower shortage, the tremendous workload and worsening fringe benefits. Many of them have already switched to work in private hospitals, or even re-joined the Health Department of the Government despite a pay cut. Yet, the seven hospital clusters at the home front seem to be unaware of the tight condition on the frontline, all the time clinging to their "mountain strongholds" and asking for bigger and bigger fund allocation. They think that indiscriminate increases in administrative support will ease the burden on the frontline. This is the true picture of the present situation. Quite a number of Members have already illustrated with figures in this regard and I have no intention to repeat them once again. President, let me just accept that we should perform a one-off operation to reform the HA, rather than euthanizing it. I hope HA is not terminally ill and is still curable. I generally agree to the directions proposed by Dr Fernando CHEUNG and Mr Albert HO, and am even of the opinion that more specific proposals should be incorporated into the amendment moved by Mr Albert HO on the HA. The problem now is the lack of clarity on the principle of distributing fundings and the lack of regulation and accountability. Systematization of procedures is an essential element in the reform. I would like to use the remaining time to talk about a trivial matter that happened yesterday. From the incident, we can see how inflexible and inefficient the HA is. The trivial matter of yesterday is called "blood donation request from Slow Beat rejected due to his homosexual behaviour", and why is it related to the subject under debate today? Reportedly, Dr LEE Cheuk-kwong, Consultant of the Hong Kong Red Cross Blood Transfusion Service has said that the Hong Kong Red Cross has been adopting the HIV incidence rate in the overall


population and that in the gay community as the basis of blood donation guidelines. He has stressed that the HA would review the guidelines once every half year. However, the guildlines have never been reviewed all these years. According to him, the guidelines are considered appropriate at the present stage, and that their target is on the behaviour rather than the group. His statement is just rubbish. This is just like the tolerance of homosexual love but not homosexual behaviour by the church. Homosexual love without sex is considered alright. A number of overseas countries have already amended legislation so that potential donors will not be excluded from donating blood for their whole lives merely because they have had homosexual sex on just one occasion. The time limits imposed vary from five years to one year. This set of blood donation guidelines has affected those who wish to donate blood, and I would like to take this opportunity to ask all of you to take a good look of the relevant questionnaire, which can be very well-described as the "Article 23 for Blood Donation". There is no question in the questionnaire on sexual promiscuity and non-safe sex, but respondents will be forbidden from donating blood if they have had sex with another man. As a result, those who have different sexual orientation will be negatively labelled and they will be regarded as very casual about sex, getting infected very easily and unclean. I think the HA should first of all conduct a review of the guidelines as soon as possible, and then consider if anything could be done to enhance the arrangement of questions in the questionnaire, as well as improve the wording of the questions, so as to avoid any misunderstanding. There is also another question I would like to put forward and that is, whether the HA has complied with the Code of Practice against Discrimination in Employment on the Ground of Sexual Orientation. Nevertheless, the matter is very complicated and I may need to follow up the issue again in future. MR IP KIN-YUEN (in Cantonese): President, the feelings of Hong Kong people towards the Hospital Authority (HA) and public healthcare services can be described as a mixture of love and hate. Over the past few decades, people of Hong Kong have been proud of their low-priced but excellent and efficient public healthcare services. We and most of our friends and relatives all have some personal experiences of receiving treatment in public hospitals or public clinics.


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Most of us commend healthcare personnel for their professionalism and caring attitude towards patients. However, in recent years, our personal experience and the criticisms we have heard are mostly negative in nature. For example, the waiting time for medical services is unduly long and beyond any unreasonable extent; some healthcare personnel are very unfriendly; hospitals or clinics are overcrowded, and most importantly, the number of medical incidents is increasing. Some of these medical incidents are totally beyond our understanding, and we simply cannot imagine how they can ever happen in Hong Kong. Some experts and commentators have already explored the reasons for the degradation of our public healthcare system. What Dr LEUNG Ka-Lau, mover of the original motion, has pointed out is also one of the major reasons: the HA fails to allocate resources with full regard to patient needs, thus rendering the resources for some of its clusters or departments persistently insufficient and making it impossible to resolve the problem of varying service quality. Thus, the number of complaints has been on incessant increase, with some coming from healthcare personnel and an even larger number from patients' families or patients' organizations. President, it is true that the HA must be given medical treatment, and possible remedies may be the proposals put forward in the amendments of Dr Fernando CHEUNG and Mr Albert HO, such as promoting the democratization of the management of public hospitals and clinics; increasing the HA's representativeness, transparency and accountability; streamlining its administrative structure; and reviewing its systems of remuneration and employment, and so on. In my opinion, these remedies are in line with the traditional Chinese medicinal philosophy of reinforcing the base and cultivating the primordial energy. The causes of symptoms are first identified, followed by the prescription of recuperative medicine. The confrontation therapy of Western medicine can also be adopted for speedy surgical removal and treatment. In brief, with the combination of traditional Chinese medicine and Western medicine, it is hoped that we can rationalize the HA's set-up and its unreasonable distribution of resources. Nevertheless, if we follow Dr LEUNG Ka-lau's proposal, dissolving or executing the HA on the spot without giving it any medical treatment, we will be talking about euthanasia, an approach which is presumably not the mainstream


opinion in the medical profession and the community. We therefore cannot support the proposal rashly. The main purpose of Dr LEUNG Ka-lau's motion, I suppose, may not really be the dissolution of HA; rather, he may only intend to have an anatomy of the HA in this Chamber, so that the problems can be identified. According to figures provided by the Government, the total amount of funds allocated to the seven clusters under HA in 2012-2013 was $40 billion. However, the funding has not been utilized reasonably and there is even the suspicion of "fattening the top and thinning the bottom". Since HA is a just like a separate kingdom, its resource utilization is not subject to any appropriate regulation. Apart from uneven resource allocation, there is also a very serious shortage of healthcare personnel. The manpower shortfall of HA doctors in 2012-2013 was around 250. The specialties with the most acute shortage of manpower included anaesthesia, accident and emergency, family medicine, intensive care, medicine, paediatrics and psychiatry. According to HA's preliminary estimate, the shortfall of doctors will even increase to around 290 in 2013-2014 after the central recruitment exercise for the year is completed. In recent years, many visitors have come to Hong Kong from the Mainland under the Individual Visit Scheme, and many of them seek medical treatment in private hospitals and clinics, thus significantly boosting the business throughput of private hospitals. This has resulted in a flow of doctors from public hospitals to private hospitals, and private doctors are also busy taking care of patients from the Mainland. On the one hand, the overall demand for local healthcare services has increased significantly but on the other, the Government still wants to export talents and encourage the Hong Kong medical sector to set up wholly-owned clinics and hospitals in the Mainland, thus spraying salt on the wound. Many doctors have already responded to the call. If any large numbers of local doctors, including top-rate specialists, swarm to the Mainland market, the shortage of local medical staff will only be aggravated. We must not ever think that the quality deterioration of public healthcare services will have no major impact on those who would only use private healthcare services. With the salary increases of healthcare personnel and rising drug expenses, medical inflation will lead to a marked increase in health insurance premium. Thus, people using private healthcare services will also be affected.


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Finally, I would like to briefly mention the principle of "money follows patient" proposed in the original motion. We in the education sector are also familiar with this principle, because it is similar to the Pre-primary Education Voucher Scheme. As a matter of fact, both the idea of "money follows patient" in the provision of medical services and the Pre-primary Education Voucher Scheme seek to privatize public services with the introduction of service vouchers. We oppose the application of this principle in the area of education, and in respect of healthcare, I cannot render our support either. One particular reason for our opposition is that with the huge wealth gap in Hong Kong at present, healthcare is one of the few welfare benefits that are provided more adequately. If large-scale privatization is introduced to our healthcare services, the life of grass-roots people will become even more difficult. With the increase and ageing of the local population, the demand for medical services will increase. Medical services are a must for each and everyone of us. Of partiulcar importance is the fact that unlike the case of education, healthcare does not affect young people only. Therefore, outsourcing medical services in the form of a medical voucher scheme will bring forth consequences that are even more far-reaching. We must be cautious. The reason is that the introduction of a medical voucher scheme will obviously benefit the private healthcare market; at present, public hospital patients are already in a very disadvantageous position, so it will be even more difficult to protect patient rights if the SAR Government continues to allow itself to be led by the interests of private hospitals and the medical sector. Life is priceless. We cannot possibly do any price comparison and then choose a doctor who charges the lowest fees to perform an operation for us, nor can we readily find a substitute for drugs prescribed. Therefore, I can only support the preservation of a public sector-led healthcare system. I so submit. PRESIDENT (in Cantonese): Does any other Member wish to speak?


MR ALBERT CHAN (in Cantonese): President, on behalf of the People Power, I object to Dr LEUNG Ka-lau's original motion but support the amendments moved by the two Members. President, the reason is very simple. We agree with Dr LEUNG Ka-lau in his criticisms against the Hospital Authority (HA). The HA is indeed plagued with many problems, notably the shortage of healthcare personnel. But the shortage of healthcare personnel, especially the shortage of nurses, actually stems from the inability of our education system to supply the required talents and also from the planning errors the Government many years ago. As for the shortfall of doctors, it is attributable to the stance of the Medical Council of Hong Kong (MCHK) in over-protecting the professional status of local doctors. Commonwealth doctors or even world-renowned doctors who wish to practise in Hong Kong cannot obtain a licence to satisfy the legal requirement. As a result, we are unable to recruit enough doctors even though we have the means. The shortage of doctors has led many senior doctors in public hospitals to switch to private healthcare institutions for reasons of personal career development. We cannot blame any senior and competent doctors who choose to switch from public healthcare institutions to private institutions. However, this has caused more and more competent or senior doctors in public hospitals to leave, and the HA's services have been impacted to a certain extent. Eventually, the general public are to suffer. As for nurses, the Government has undoubtedly learnt from the bitter experience and made some adjustments to enhance and re-organize training and education, in the hope of substantially increasing the number of nurses and helping to improve overall healthcare services. Nevertheless, due to the unyielding attitude and the narrow-mindedness of MCHK …… For the sake of its own interest and private interest, it shows no respect for history and tradition, and even outstanding doctors from British Dependant Territories or the Commonwealth, well-known doctors or prestigious scholars from world-renowned colleges or universities are not offered any opportunity to practise in Hong Kong. I find this absolutely unacceptable.


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That being the case, in order to improve local healthcare services, while we must improve the HA, we may even have to dissolve it as proposed by Dr LEUNG Ka-lau. However, we must at the same time make appropriate adjustments to manpower development and deployment, and liberalize the recognition of professional medical qualifications, so as to allow doctors with Commonwealth qualifications or equivalent to practise in Hong Kong. This should be a way out. President, when talking about the problems with the HA and the issue of medical expenses, there is one measure which the People Power can never accept: subsidizing members of the public with public money for purchasing services from private doctors or private medical organizations. Although similar arrangements have already been in place at present, we are of the opinion that this is in effect a form of transfer of benefits. If the Government really thinks that it has the responsibility to provide medical services, relevant resources should as far as possible be allocated to HA or government institutions. It should adhere to the principle of providing the necessary services directly, instead of inducing, through the transfer of benefits and the introduction of financial incentives, private doctors and private hospitals to provide services to the public. Health protection is another issue of concern. The Government has earmarked $50 billion for the implementation of a voluntary Health Protection Scheme (HPS). The People Power is also in strong opposition to the implementation of HPS because it is tantamount to introducing a Mandatory Provident Fund (MPF) scheme to the provision of medical services. Insurance companies and the financial market will eventually be the parties yielding the highest profits. In the end, under the pretext of "fund management", which is another form of transfer of benefits, tens of billions of hard-earned money from the general public and public money will be injected through HPS into the pockets of insurance companies, investment companies and the financial market. A huge amount of management fees will also be involved, am I right? Tens of billions have already been spent over the years for the simple task of managing the MPF. The work involved in handling HPS applications or the assessment and approval of health insurance packages will only incur far more management fees than the MPF, and the difference involved may be as great as a hundred times. Under such circumstances, investing $50 billion into the HPS is


tantamount to a transfer of benefits. While benefits are transferred to private medical organizations, predators in the financial market will also benefit. Therefore, we must give all Hong Kong people a correct understanding, and make them realize that the HPS may appear to be a benevolent measure, but it is actually equivalent to the MPF scheme. When the implementation of the MPF was discussed years ago, the Government said a lot and tried to illustrate the good intention to provide better retirement protection. However, looking back at the whole process and the detailed figures, financial data in particular, we cannot help asking where all the money has gone. The case will not be "money follows patient" as proposed by Dr LEUNG Ka-lau. If HPS is really implemented, money will in the end follow investment companies and predators in the financial market. Thus, if the Government really wants to provide quality healthcare services to the public, it can study the examples of Canada or the United Kingdom, so as to see how government regulation, organization as well as allocation and redistribution of resources can enable the public healthcare system to reasonably and fairly meet the requirement of professional development and public health, and therefore provide direct and appropriate services. Dr LEUNG Ka-lau has provided us with a very good opportunity to express our views on the issue but I hope the Government would stop burying its head in the sand like an ostrich. PRESIDENT (in Cantonese): Does any other Member wish to speak? MR LEUNG KWOK-HUNG (in Cantonese): President, I have thought that a filibuster is staged today because Dr LEUNG Ka-lau even dares to propose dissolving the Hospital Authority (HA). Though we call for cutting restrictions, we have not called for dissolving the HA. This is a very simple tactic of death before rebirth and construction after destruction. Dr LEUNG Ka-lau now calls for dissolving the HA right away, and of course no one will support his proposal. We have already waited some ten years for universal suffrage. Hence, we can do nothing about it. We still have to wait, even for something that can be accomplished easily.


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Talking about medical issues, I must to do justice to my colleague "Slow Beat" who joined hands with me to filibuster in this Council. Although this is not the land directly under the Emperor, it is still a place for monitoring the Government and upholding social justice. President, it is absolutely unacceptable that one's good intention to donate blood is rejected. In that case, they had better not come here to call for blood donation in the future, because something good has been turned into something embarrassing. This is certainly a healthcare-related issue. The relevant organization has used such a lame excuse to reject a member of the public wishing to donate blood. If the doctor has any chance to give a reply here later on, will he confirm something with this Council? The blood donated by volunteers will be further tested afterwards, right? In that case, why should they bother about the backgrounds of donors? How could they discriminate against any Legislative Member in this way? This really deserves our attention. Secretary, you should pay heed to this issue as well. Hong Kong Red Cross is not fully publicly-funded, but it still spends public money. Nonetheless, it dared to make such a shameful arrangement and play tricks in front of the experts. We always call for enacting laws to prohibit racial discrimination, for example. But today we see such discrimination right here in the Legislative Council. Anyway, I must return to the topic lest I may become long-winded and the President may reproach me. What is "death before rebirth" all about? This means announcing the intention of dissolution so as to cause your concern and force you to offer explanation. First of all, I think the establishment of HA is for the sake of separating healthcare services from government functions. Of course, this is already a general practice for the Government to transfer its obligations to a statutory authority. Relevant laws and regulations will be enacted to facilitate its exercise of the powers and discharging the duties of the Government, or in other words, to confer on it the powers to assume government responsibilities. As a result, the Government is free of responsibility like an individual. For instance, as a person, what obligations do we have in life? In school, teachers teach students that they have an obligation to pursue their own aspirations. Aspiration of the individual will lead to aspiration of society, and of course, this will involve a critical political process. Aspiration of the individual will lead to aspiration of a society, and a political process will follow. That


aspiration is realized by public authority, which is intrinsic in nature and cannot be screened. When the British Hong Kong Government withdrew from Hong Kong, it surrendered public authority either in the light of global development or as a part of its evacuation plan. Laws and regulations were enacted to facilitate the transfer of obligations to statutory bodies, one of which was HA. It is absolutely a waste of time to say that HA is a completely independent organization. All the persons-in-charge are medical practitioners. I always say that the legal sector is dominated by lawyers, and nobody else. The Department of Justice or the establishment of judges/counsels are dominated by a group of lawyers who make decisions behind the scene. Likewise, HA is dominated by medical practitioners in the sense that they have taken up the roles of practitioners, professionals and even technocrats, and here comes the problem. We all understand that medical practitioners are indispensable. The Chairman and I do not know how to treat patients. Of course patients should be treated by medical practitioners. Everything is in the hands of a group of technocrats, and many organizations have already formed in the medical sector. Thus HA has a shortcoming: a group of bureaucrats or technical personnel in charge of medical services are responsible for dealing with the Government, and the Government will present to them its view. Dr LEUNG Ka-lau has already cited many examples in his document, and I have no need to speak further on this. The key is that the Government, after dislodging its obligations, assumes less and less responsibilities. The instance relating to nursing schools mentioned by Mr Albert CHAN just now is ludicrous indeed. The school was dissolved in the hope of helping students to make progress in their studies. In other words, they were requested to study while working or only through internship. In fact, there is only one problem, and the crux of it is: who exactly should be responsible for services such as healthcare services, transportation, education and housing, which are historically considered indispensable? All criticisms about the HA boil down to the view that the Government is totally hands off after its provision of funding for HA, thus leading to misallocation of resources and other problems as mentioned by Dr LEUNG


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Ka-lau earlier on. Hence, the key to the entire problem is: the Government should increase its expenditure on housing, education and various aspects in order to increase available resources. Secondly, the Government must recover its powers and operate the services itself lest improper utilization of fund may result after the increase in expenditure. Thirdly, the Government should conduct review on practices such as increasing the share born by service users, fee hike, privatization of services, and so on. Medical insurance and mandatory medical insurance are two of the examples. In this case, President, I support Dr LEUNG Ka-lau's proposal on "death before rebirth" as a means of punishment. This is not "brain shock", but a "death penalty shock". PRESIDENT (in Cantonese): Does any other Member wish to speak? MR WONG YUK-MAN (in Cantonese): President, the Hospital Authority (HA), as the management body of Hong Kong's healthcare services and an agent between public healthcare services and Hong Kong people, should be held responsible for the ever-declining service quality and standard of the public healthcare system and the spates of medical incidents in recent years. Given the unfair allocation of resources among various clusters, patients in different clusters are entitled to entirely different medical resources. Last year, HA recorded a total expenditure of $41.8 billion, 70% or $29.6 billion of which was staff cost. While top management staff are each entitled to several millions of remuneration a year, front-line healthcare practitioners are required to be on duty continuously for 10 to 20 hours. On one hand, this practice fails to retain quality healthcare practitioners, and on the other, the enormous work pressure has also prompted a significant number of them to switch to the private healthcare system, thus leading to numerous medical incidents. The shortage of healthcare practitioners is also the cause for the unduly long waiting time for public healthcare services. In the worst case, patients have to wait 35 to 110 weeks for specialist out-patient services. The patients concerned, no matter what illnesses they are suffering from, are bound to die, right? Of course, the SAR Government, as the upstream allocator of public resources, should be held responsible to a certain extent. Over the years, the


Hong Kong Government has been extremely conservative in its fiscal policies and has maintained tax rates at low levels. It robs the poor and subsidizes the rich and sits on over trillions of reserves. But it refuses to discharge its social obligations. Simply put, under the existing Drug Formulary system, the impoverished can only use medicines with low efficacy and strong side effects. The arrangement highlights the authority's intention to reduce medical expenses. Moreover, the Samaritan Fund only provides subsidies in the case of a limited number of drugs. The healthcare financing scheme is only proposed in a bid to dislodge the burden of healthcare expenses, compel more people to purchase medical insurance, and divert them to the private healthcare system. There are structural problems in the entire healthcare system. Pharmaceutical manufacturers use patent as a means to impede the development of drugs by other pharmaceutical companies, rendering the prices of drugs to shoot up. The collusion among the healthcare sector, the insurance sector and pharmaceutical manufacturers has formed a colossal network of pecuniary interest. On this point, I would like to cite a case that my wife recently told me. My wife has been using a certain medicine in Hong Kong, and as she forgot to bring that medicine with her in a recent trip to Taiwan, she bought the same medicine in Taiwan. What was the price for it in Taiwan? Assuming that the medicine cost HK$300 in Hong Kong, the same medicine cost NT$300 in Taiwan. What a shocking price difference! This downright profiteering! On the dissolution or otherwise of the HA, I have certain reservation on the motion proposed by "Doctor Weird". I am not like "Long Hair"; he will of course support the motion. But I will not vote against it either. Dr LEUNG has proposed this motion as the representative of the healthcare and medical sector, and he had many years of service in the public healthcare system, so I have trust in his expertise, experience and criticism on the healthcare system as a whole. I think I should learn from him because I am a layman. Nonetheless, have we come to the point that HA must be dissolved? And what remedial and relieving measures are available after the dissolution of HA? I would like to learn more in these respects. Hence I have not decided my voting stance since I have not made things clear at this moment. Of course the Secretary wants me to vote against the motion. On the dissolution or otherwise of the HA, we believe that it should be considered in the light of Hong Kong's healthcare system as a whole, and


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practical analyses should be conducted. As Members are aware, in the light of the severe ageing problem faced by Hong Kong, it is necessary for the entire healthcare system to undergo fundamental reforms. The general concern is: for how much longer can the Government cope with the burden? In fact, we are having discussion on this subject, but I think this is an issue of resource allocation. Even if the HA is not to be dissolved, the various problems with the HA, such as misgovernance, "regionalism" among various clusters should at least be addressed, shouldn't they? As observed from the current situation, the allocation problem is very serious. The Government says it has increased the amount of Elderly Healthcare Voucher. Bu what purpose can this serve? This fails to address the healthcare problems of the elderly, particularly the impoverished elderly. In my view, should we wish to realize healthcare justice, the whole community should share the burden. Moreover, according to our political or social policy stance, in my opinion, this will involve re-allocation of wealth in the process. Firstly, the Government must increase funding for healthcare services. The expenses in public healthcare services was only $46 billion last year, representing a share of less than 20% in total public expenditure, and only equivalent to 5% of the GDP of Hong Kong. In this respect, Hong Kong lags far behind European economies and the United States whose public healthcare expense to GDP ratio ranges from 6.6% to 9%. This shows that Hong Kong's public healthcare expenses can be increased, or in government parlance, I should say there is still room for an increase. On the problem of financing, I believe the introduction of a progressive profits tax scheme can be the solution. The SAR Government should expeditiously abolish the Drug Formulary system which has put the lives of many people at stake, and give medical practitioners the power to make prescription, so that patients can be given the necessary treatment. Today, some impoverished elderly people suffering from terminal illnesses can only wait for death. They have no money to buy target drugs, as one dose would cost them over ten thousand dollars. What is more, public hospitals still have a shortage of over 300 specialist doctors at the moment. While the shortage and wastage of nurses has been eased recently, there is still a lot of manpower tension. The entire healthcare sector should change the existing protectionist culture, draw in foreign doctors, expand the healthcare workforce within a short period of time, reduce the work


pressure of healthcare personnel and make efforts to reduce the incidence of medical incidents. I believe these are what the Government can do with the existing resources. If it does nothing, it surely has a problem, and at that time, the doctor will have a point to propose the dissolution of HA. DR HELENA WONG (in Cantonese): President, first of all, I would like to thank Dr LEUNG Ka-lau for proposing such a shocking motion and providing a lot of analytical data. In my opinion, the many structural problems existing in the Hospital Authority (HA) pointed out by Dr LEUNG Ka-lau really deserve the attention of the Government and the public. For instance, the uneven allocation of resources among clusters, the increase in service throughput being disproportionate to the increase in resources, the unduly long waiting time for specialist out-patient services, the overly high administrative costs of the HA, and so on, are problems that we should address and review. Nonetheless, the original motion proposes to dissolve HA. On this issue, many Members have already expressed their views. Some propose resorting to a kind of radical and shocking therapy, by which HA will be put to "death" for the sake of a "rebirth" subsequently. The amendment proposed by the Democratic Party today presents another viewpoint ― we opine that HA should address these problems, and conduct a comprehensive review and reform in the meantime. Regarding the problems with the HA or the quality of Hong Kong's public healthcare services, we have heard a lot of criticisms and complaints from insiders and members of the public. Some insiders criticize that they have witnessed a lot of unfair treatment involving hospital governance, but there is no channel for them to lodge complaint. Many of them choose to remain silent on issues including staff promotion mechanisms, or whether funds should be spent on hiring front-line workers or senior management. There is a so-called complaint system, but even if a case is reported high up to the HA headquarters, or Secretary KO, it will be re-directed to the cluster concerned, and finally to the hospital concerned for settlement. In this way, the patient who lodges the complaint is suppressed. Even if Secretary KO makes a few more inquiry calls, he will only be told that things are okay.


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In fact, it is not mandatory to report the complaints about hospitals to Secretary KO. Recently, we have started to collect cases from the industry, including cases deemed by front-line doctors and nurses as highly questionable or unfair. The Democratic Party is collecting these cases in the hope of helping the HA to conduct a comprehensive review in the future. Patients and members of the public have many comments on HA. Even though Hong Kong's public healthcare system is not the worst when compared with those of other countries, we must still reform our system incessantly. The waiting time for public medical services remains very long. Very often, in public hospitals, we can still see patients lying on the beds in the corridor. Patients must still wait a long time even after they have registered and got a chip; and likewise, they must wait a long time before the next follow-up consultation. In every consultation, the doctor will ask the patient to leave shortly after about 10 seconds, because many patients are still queuing up for medical consultation outside. When one is still wondering whether the doctor is clear about his condition, the doctor has already prescribed the same pills as the last time. The patient departs, and will attend a follow-up consultation three to six months afterwards. All these scenes are worrying. Moreover, there is still the problem of the Drug Formulary. Having said so much, I think we really must review the existing situation. However, "money follows patient" is the part that we are more concerned about in Dr LEUNG Ka-lau's original motion, and some Members already mentioned that point earlier on. If "money follows patient" is adopted, we are concerned as to whether this would finally push all patients to the private market. In addition, public hospitals may need to compete with private markets, and a few critical questions should be answered: firstly, the criteria for determining the level of subsidy; whether or not the Government will subsidize all Hong Kong citizens to purchase services from public or private healthcare organizations, or whether it will only provide subsidy to specified groups; if the subsidy is not for everyone, should those not given subsidy purchase private medical insurance. However, many illnesses are not covered by private insurance available in the market. Or in other cases, if a person has suffered from certain illness, his related medical history will render him unable to take out any insurance. Moreover, the level of premium increases is proportionate to the age of the insured, and medical insurance alone may not be able to resolve the


problems in various aspects. What's more, the public have many opinions on the voluntary medical insurance scheme which is under study by the Government. The original motion has not answered these questions. Besides, if patients are diverted to the private medical system under the principle of "money follows patient", there is no mechanism in place to keep the pricing of private medical system under check, so it is also difficult to monitor the quality of private medical services. Consequently, in respect to the original motion, the Democratic Party will abstain from voting later on. Having said so much, we still strongly agree that the Government should pay heed to the various problems raised by Dr LEUNG Ka-lau. Our advice is that the Government should expeditiously establish a review committee, and we hope that it is a truly independent and objective one that is independent of the officials of HA and the Department of Health. We look forward to inviting some experts who have no conflict of interest in this matter to assist us in conducting the review. I teach in university. Each department is required to conduct a comprehensive review every three years. As a part of the review, professors, general front-line teaching staff, administrative personnel and even students will be interviewed, and they are given the opportunity to express their views in a safe and comfortable environment. I hope that the HA, when conducting review in the future, can really allow various people from different sectors to participate and express their views. I also hope that the HA can make efforts to increase the number of elected representative throughout the governance structure, including the HA headquarters, various clusters and the Hospital Governing Committees of district hospitals, so that public opinions can be reflected in the governance structure. As for how to leverage on the cluster network, and whether or not seven or five clusters are needed, they are issues that can be covered in the review. Furthermore, in respect of the allocation of resources and the level of transparency, I hope Secretary KO, by virtue of his high popularity rating, can lead the HA in conducting comprehensive and genuine review and reform. Thank you.


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MR CHAN HAN-PAN (in Cantonese): President, the motion proposed by Dr LEUNG Ka-lau today calls for dissolving the Hospital Authority (HA) at the outset. He urges that, under the concept of "money follows patient", the boundary between public and private healthcare services should be removed, and the utilization of resources should be improved through mutual competition. This concept is similar in principle to the comments given by the team of Harvard professors invited by the Government to compile a report years ago. But public hospitals are irreplaceable due to their fundamental function of providing a healthcare safety net for the public at large. Once healthcare services are fully opened up for competition, hospitals would become profit-oriented, and they will tend to invest in profitable services only, and avoid investing in services that involve high cost and risks, just like what the private hospitals are now doing. If this happens, the healthcare system for the public will become one that will tighten its purse strings ― many people are eager to help the rich patients who have only minor health problems, but people would turn a blind eye to those who are impoverished and seriously ill. From this point, we would understand that the existing healthcare safety net is indeed indispensable to the public at large. While Hong Kong's public healthcare services do need improvement in various aspects, its fundamental operation is still sound and effective. I have no idea how the introduction of market competition will be beneficial to the public; perhaps it may benefit the public in certain ways, but not necessarily many. Instead, this proposal is a bit aggressive. The DAB finds it difficult to support the proposal on handle the healthcare safety net in such an aggressive manner. I instead want to make use of today's motion to raise some suggestions, with a view to rectifying the HA's deficiency in operation and urging it to step up its improvement efforts. Under the HA's existing structure, all hospitals in Hong Kong are organized into seven clusters, which are responsible for the management of all public-sector hospitals, healthcare institutions, out-patient and specialist services, and the provision of nearly all in-patient service in Hong Kong and the provision of primary healthcare service. Each year, the HA makes planning on and allocate healthcare resources under this cluster system, which is however often criticized for being too rigid. For instance, the locations of some clusters do not tally with the administrative districts, or there are cases where one catchment area falls within more than one cluster. Wong Tai Sin is an example. According to


our colleagues serving in the district, Wong Tai Sin is served by a mix of public hospitals, including Wong Tai Sing Hospital and Our Lady of Maryknoll Hospital of the Kowloon West Cluster, United Christian Hospital of the Kowloon East Cluster and Hong Kong Buddhist Hospital of the Kowloon Central Cluster. On the surface, there is support from three clusters, and the healthcare services for the district should be more than sufficient. But in practice, local residents find this very confusing. They are worried in case they use the ambulance service, under the existing cluster system, they would not be sent to the nearest hospital for treatment; rather, they would be sent to a hospital far away, ending up in delay in treatment. Similar problems have indeed occurred, showing that the rigid cluster system is indeed deficient. The authority should address the problem. The HA allocates resources according to the cluster system, but when it comes to long-term service planning, evaluations are conducted on a district basis. The DAB has repeatedly call for the addition of obstetric service in Tseung Kwan O Hospital, but HA refuses to do so on the excuse that the local population is not large enough to justify the development of obstetric service. As Members are aware, Tseung Kwan O is quite a secluded place, so it is not convenient for local residents to travel to other districts. Local residents hope that they can receive healthcare services in their local community when necessary. But given the limitation of the cluster system, they must travel a long way for the healthcare services available in other districts. We find this arrangement very undesirable. We hope that the Government's allocation of resources will not only consider population, geographical and district factors; it should also consider the needs of local residents. In recent years, another headache of HA is certainly the long waiting time at public hospitals. For example, members of the public have to wait very long for accident and emergency service, out-patient service or even specialist service. To get a feel of the situation, I once visited Kwong Wah Hospital around midnight. I observed that the patients classified as "semi-urgent" and "non-urgent" must wait eight to ten hours. Patients in the over-crowded accident and emergency department could only sit on the chairs outside the hospital and continue to wait. Though starved and cold, they dared not to leave, lest they would miss their turn.


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Last month, I sought medical consultation from the accident and emergency department of a hospital because of an ailment. To patients suffering from diseases, every second of waiting time was so unbearable. They anxiously waited for treatment to ease their pain, yet who can understand their anxiety of not knowing how long exactly they should wait? When the waiting queue was so long, every second of waiting time reduction was a blessing to me. I cordially hope that the officials of the HA can be considerate and put themselves into others' shoes. Likewise, general and specialist out-patient services face a similar waiting-time problem. I believe the complaints that Members received from members of the public should be no less than that received by me. We can say that the crux of the problem is "huge demand for service, but inadequate manpower". As a matter of fact, Hong Kong's population ageing has accelerated over the last two decades, and this added to our burden of healthcare services. We grieved for the loss of a group of healthcare practitioners ten years ago, but worse still, we saw a reduction in medical training places subsequently. In our opinion, the Government should enhance the recruitment of medical practitioners, and try to resolve this problem by various means, such as recruiting part-time medical practitioners by offering them the standard pay rates, and relaxing the procedures of recruiting overseas medical practitioners, with a view to easing the work pressure on front-line doctors. Today, we have presented the DAB's stance on the original motion in the opening speech. We will abstain from voting with respect to Dr Fernando CHEUNG's amendment because he fails to elaborate the meaning of democratization of the management of public hospitals in his amendment. We will support Mr Albert HO's amendment as he has proposed specific suggestions and measures on the governance of the HA in the amendment. President, I so submit. PRESIDENT (in Cantonese): Does any other Member wish to speak?


MR PAUL TSE (in Cantonese): President, it is difficult for an outsider to understand a different industry. I have been thinking about how best we should tackle handle some issues which must require thorough and in-depth discussion and research before any effective and feasible solutions can be identified. We have heard a lot of figures and complaints related to, in particular, the healthcare service problems in Wong Tai Sin which Mr CHAN Han-pan has mentioned. I have also received many complaints from the residents of Wong Tai Sin, saying that "Wong Tai Sin God" is always responsive, yet the requests of local residents are always ignored. The provision of healthcare service to Kowloon East is already very undesirable, but the healthcare service provided to Wong Tai Sin is "the worst of the worst" in Kowloon East, and I believe the figures, records and complaint cases all support this point. I believe that even Dr KO Wing-man should have received many requests from members of the public for having meeting and discussion with him on the matter. So, I need not say so much. Here I only want to reiterate that the healthcare arrangement, equipment and facilities available to the residents of Wong Tai Sin are the worst in Hong Kong, so I urge the Secretary to address and pay heed to this matter. I would like to use some time to propose one or two innovative concepts, just to see if they can bring about some new ideas for the Secretary's consideration. Some Members, including Dr LEUNG Ka-lau, advocate the concept of "money follows patient"; but many Members disapprove of this concept. Then suddenly, a question comes up in my mind: can we figure out a middle-of-the-road and feasible approach? We disapprove of a bureaucratic pay structure that is not performance-linked, one which deprives staff of any motivation to improve their performance. But if the entire healthcare sector implements a commission system like certain industries, unduly keen competition and various malpractices may result. Some Members have expressed concern as to whether the concept of "money follows patient" will lead to intense competition in the future, thus benefiting healthcare groups and private doctors. Their worry is not ungrounded, but can we choose a middle-of-the-road approach and consider the concerns of both sides? On one hand, we should not rely too much on the format of fixed funding, which leaves all the funds in the hands of the Hospital Authority (HA), so that we can address the phenomenon of "fattening the top and thinning the bottom" and the problem of uneven allocation of resources among


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clusters. But on the other hand, we are not going to rely on healthcare vouchers as the only solution either. Is it possible for the authorities to lay down a foundation by the provision of certain basic facilities, investment and subsidy, but in the meantime, patients can vote with the "cash vouchers" in their hands? Though the healthcare vouchers may not be enough to pay the full fee, patients can at least use the coupons to indirectly cast a positive vote on the hospitals, clusters or organizations that provide better services. Will this be a possible solution to some widely criticized problems or the problem of lack of incentives? I hope the Secretary can take this into consideration, and Dr LEUNG Ka-lau or other members of the healthcare sector can give their opinions as well. Secondly, I want to emphasize that the shortage of medical practitioners is already a cliché. Many people are of the view that we can re-adopt the former practice of allowing doctors from Commonwealth countries and medical students graduating from countries with good medical training systems to practice in Hong Kong. Moreover, under the existing trend of globalization, many students choose to study or practise abroad in a bid to widen their exposure. I of course understand that doctors and lawyers are professions subject to stringent restrictions. The problem is not about ability, because the medical practitioners of Medecins Sans Frontieres can practise wherever they go. But doctors and lawyers are professions subject to stringent restrictions and great competition, and this is completely unreasonable. On this, in my opinion, in addition to arousing discussion in society, we can also force the Government to intervene more actively, enhance transparency and stipulate punitive measures for medical incidents. To this end, while advancing my ideas, I even challenged the rules in the hope of promoting reform in the legal sector. In my view, enhancing transparency is one of the key elements in any reform, without which any discussion on competition is futile. Nonetheless, because of human nature, people always want to see fixed charges. Patients do not want to know the details, and they only want thank the doctor or lawyer after paying the fees. I understand this is human nature. But in case of major dispute or problem of this kind, we need to be slightly creative, and force the industry concerned to lower its exclusivity. In this respect, I think it is crucial to enhance transparency by means of, for example, relaxing the requirements on advertising, setting guidelines on disclosure of information by doctors, and even relaxing the complaint mechanism in order to engage outsiders or enhance transparency. All


these will indirectly prompt an industry to lower its exclusivity gradually, and will help the market to restore balance. President, there is another issue I must mention. I agree that due to competing claims for resources, many urgently required reform measures relating to, for example, the Drug Formulary, cannot possibly be implemented immediately. In fact, Hong Kong's healthcare system is commendable at least for one thing: it will never reject a patient's request for consultation, even if the patient cannot afford the medical fee. But on the other hand, this open-door policy has caused numerous cases of default payment of fees, which has hindered the effective allocation of resources and prevented Hong Kong patients and patients with real needs from receiving the necessary treatment. On the contrary, according to my understanding, the healthcare systems of certain places are criticized for their lax control, and some women keep making appointments for consultation purely for the sake of finding someone to chat with. This phenomenon is particularly common in foreign countries. But Hong Kong is another extreme, as the waiting time for consultation is completely unsatisfactory. I hope the Secretary can once again urge the authorities to pay heed to this matter. Thank you, President. MISS CHAN YUEN-HAN (in Cantonese): President, a number of colleagues of FTU have given their speeches today. Originally, I had no intention to give my speech, but my colleague said that the motion was about dissolving the Hospital Authority (HA), and wondered how I could remain silent on such a major issue? "Fine, I will give my speech then," I said. What drives me to give my speech? Because when Dr LEUNG's motion was raised for discussion in our caucus, everyone was shocked. In fact, we would like to propose amendments, but did not know where to start with and how to get things right, because we can by no means amend the subject of the motion. Though we have a lot of discontentment with HA, we do not think we should go to the extreme of having it dissolved. According to our discussion, we believe that the dissolution of HA, if materialized, will lead to chaotic consequences. I guess that Dr LEUNG may have mixed feelings due to his familiarity with HA, so he can go to the extreme in a bid to arouse community-wide discussion. Just now I had conversations with colleagues in the lift, and we mentioned the situation in Britain and the United States. I remember that in a forum for


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local residents held in Kwun Tong ― my geographical constituency ― in April, at which time we were having a discussion on healthcare reform, a man claiming to have returned from Canada said he did not find Hong Kong's healthcare services that worse, and he mentioned many other issues as well. Subsequently, some people returning from the United States ― of course they were not local residents ― also expressed their views. They said the situation in the United States was even worse. In fact, I had experienced that personally. I actually purchased several insurance policies at that time. Because of a car crash, I was admitted to a hospital in the United States, but no one attended to me, and I was discharged from the hospital simply after a few X-ray checks. I suffered from great pain all the way from Chicago to Seattle. Later on, after returning to Hong Kong, I grumbled to my colleagues. Having heard my experience, they said I should have stayed in the hospital and refused an early discharge. Why do I mention all these? The debate on Dr LEUNG's motion has stirred up a lot of thoughts and ideas. What kind of healthcare system is Hong Kong looking for? Of course, we have the same feeling as Dr LEUNG towards the HA: a mixed feeling of love and hate. Why? I believe many Hong Kong people would commend HA for its provision of healthcare service to the public at large, regardless of their financial ability. But for those who have experienced what it takes for seeking medical consultation …… the situation of Wong Tai Sin Hospital that Mr CHAN Han-pan referred to just now is real. You can choose not to use the service of any public hospital, but if you do, even just for once, you would understand what an ordeal it is. On the surface, Wong Tai Sin is looked after by several clusters, but in fact the district is not attended to by any cluster. Mr CHAN is right. United Christian Hospital falls within Sai Kung District, so its inclusion in the cluster is meaningless; Kwong Wah Hospital falls within the district I serve, so likewise, its inclusion in the cluster is meaningless. In practical operation and from an objective perspective, their inclusion in the cluster is meaningless. Under this circumstance, many elderly people have complained, "Yuen-han, the other day, I felt unwell, so I waited for out-patient service. I arrived at the accident and emergency department between two and three o'clock in the afternoon, but you guess when I could see the doctor? Not until twelve o'clock in the midnight." The most miserable thing is that he was an elderly man; he had not eaten, and he did not know whether he should eat. At that time, I can understand his feeling: he was sick and hungry, but his turn to meet the


doctor had not yet come. At that very moment, if you proposed to dissolve HA, be frank, I would like to have it dissolved too. Sometimes, their arrangement is irritating, and I have seen many cases like this. Though as a Legislative Council Member, I no longer belong to the constituency of Kowloon East. I was returned by the whole of Hong Kong as one single constituency, but I serve Upper Wong Tai Sin Estate in my capacity as a District Council member. Every now and then, I would liaise with the healthcare practitioners serving the community. For example, my doctor, Dr CHOW, conducts health checks for elderly people in the community. He is very popular as he provides a wide range of checks. Whenever Dr CHOW is available for giving medical consultation, many people will flock in. Given that it is very difficult for them to seek medical consultation from reputable doctors like my acquaintance Dr CHOW, any such opportunity will make them very anxious, and they will try to seek medical consultation from him by all means. Some say these people can seek medical consultation from public hospitals. But these elderly people will in return tell them that they have to toil through a long waiting process for public healthcare services. For instance, a doctor told a patient who felt unwell with a lump on his neck that he was fine. The patient was not convinced, so he sought medical consultation again, and was again told that he was fine. So, the case dragged on for quite some time, and perhaps one or two years later, he came to see Dr CHOW. But this time, Dr CHOW told him that he was not fine. Certainly not fine. Dr CHOW referred him to the hospital for treatment right away. From this case, you can understand why Dr CHOW is so popular; and from this case, one just could not help wondering what on earth HA is doing? We do not mean to blame the doctors of public hospitals for making wrong diagnosis; we understand that doctors are subject to various limitations. For example, in some cases, veteran as experienced as Dr LEUNG can do nothing. In the light of those cases, medical practitioners (including Dr CHOW) serving the community once asked me whether it was feasible to provide healthcare service on a community basis. This concept is tantamount to that proposed by Dr LEUNG. I do not call for dissolving the HA. But can certain functions be separated from the HA and let the community take over? Perhaps the entire community can enjoy the resultant convenience. The authority may say it is impossible to separate the out-patient services from the HA, because that is going to create big troubles for it. If this is the case, HA should reform its structure. The reform may not necessarily focus on the seven clusters; rather, it can be


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something as elaborated in Dr LEUNG's motion, which is a method devised by him in case things go to the extreme. Dr KO, I understand your feeling, and sometimes I loathe myself for making such remarks. This time, after returning to the Legislative Council, I have joined the Panel on Health Services of the Legislative Council, but no official has ever bothered to talk with us every time after the meeting. For this reason, we particularly invited Dr KO to attend the meal that we prepared for singleton elders at the end of last year. We hope that, through this occasion, you could listen to the elderly people. Dr CHOW was also invited as a special guest to brief you on the relevant idea, to see if you would consider separating some services from HA. If the Government still follow the existing structure, I believe any reform is not going to work. As I also asked when talking to my colleagues just now, the Government has provided the HA with funding, right? There is an increase in resources indeed. Nonetheless, we can see that even after the allocation of resources, front-line doctors are still very miserable, because the hospitals fail to attract front-line doctors, and we do not know what the senior management is doing behind the scene. There is too much speculation and suspicion. I have made this remark a number of times, from the time of Dr YEUNG and Dr CHOW to the time of Dr KO now. I hope and wish that …… What makes Dr LEUNG Ka-lau initiate this motion debate today? Though we do not support his motion, we can completely understand his motive. Should we first introduce a structural reform to the system before we can solve existing problems of the HA? The difficulty that members of the public confront when seeking medical consultation (The buzzer sounded) …… Thank you, President. PRESIDENT (in Cantonese): Does any other Member wish to speak? MR IP KWOK-HIM (in Cantonese): Regarding Dr LEUNG Ka-lau's motion on "Dissolving the Hospital Authority" under debate, two DAB Members have just expressed their views. As a matter of fact, Members have put forward different views on the achievements and failures, as well as the advantages and disadvantages, of the Hospital Authority since its establishment in 1990 based on their analyses from various perspectives. Society indeed held many discussions on setting up the HA years back. Everybody can notice that over the past 23 years since its


establishment, the HA has made major improvements in many areas, and the current service quality of public hospitals likewise continues to improve. As for whether their services can fully meet people's demand, a question brought up in Mr CHAN Han-pan's narration of his personal experience a moment ago, a supply-demand relationship is at work here. I have also heard from many private medical practitioners that public healthcare services are expected to thrive, so private medical practitioners may possibly face many problems with their "rice bowls". Various sides hold different views in this regard, and I believe that such concerns do exist. As such a gigantic organization, the HA naturally needs to address many problems arising in the course of management, especially those with resources distribution and management. I also heard Dr LEUNG Ka-lau say that his proposed dissolution of the HA stemmed precisely from its management problems. All this is a fact. The DAB supports the saying that the HA has room for change, improvement, upgrading or review. So, we find that several recommendations in Mr Albert HO's amendment are acceptable and agreeable to us. But there is an issue concerning the broad principle. We have great reservations about the proposal of immediately dissolving the HA, because in our view, this move must be backed up by sufficient justifications, and we must consider people's various views. Therefore, regarding the voting on this motion, the DAB will vote against this original motion on dissolving the HA. Speaking of the amendments, I wish to point out that we will not support Dr Fernando CHEUNG's amendment, just as Mr CHAN Han-pan said a moment ago. The main reason is that it carries the wording "democratization of management", and so on. But there is no mentioning of any concrete arrangement for this proposal. In his amendment, Mr Albert HO proposes to, among other things, increase the HA's transparency. As I said just now, we may give our support. But there is a big problem. Our support for his amendment will lead to a practical problem. The original motion is entitled "Dissolving the Hospital Authority", so we think that our support for his amendment may mislead Hong Kong people into thinking that we are in favour of the proposal of dissolving the HA. In that case, the DAB has no alternative but to abstain from voting on Mr Albert HO's amendment. Thank you, President.


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MR SIN CHUNG-KAI (in Cantonese): President, to begin with, I must make it a point to say that even the cleverest housewife cannot cook a meal without any rice. Honestly, a focus of today's discussion is whether the healthcare expenditure committed by Hong Kong is sufficient to cope with our needs. The Economist I am now reading has made a comparison between various places in the world. True, the United States is quite an exception, in the sense that it spends 17.9% of its Gross National Product (GNP) on healthcare, but then we can also see that many other advanced countries, including France, Germany, Switzerland, Denmark and Japan ― a country closer to us with a sizable elderly population ― invariably invest 9.5% to 11.5% of their GNP in healthcare. In contrast, Hong Kong's spending in this regard still remains on a relatively low level. Certainly, one can say that this may be because the operation of our healthcare system is effective and efficient. But I must argue that if this had been the case, Dr LEUNG Ka-lau would not have proposed this motion today. In that case, we should conduct a review to ascertain whether the resources we have invested are sufficient to cope with our actual needs.

I remember that Donald TSANG once stated in a policy address the intention of increasing healthcare expenses to 15% to 17% of the Hong Kong Government's overall expenditure. We need to review whether this can be realized; and, even if the answer is in the affirmative, whether our needs can be met with this percentage of healthcare spending. Nevertheless, I myself also have some feelings, and I wish to discuss the matter with Honourable Members. Certainly, in the course of discussion, I have heard some Members talk about their personal experiences about the Hospital Authority (HA). I can also sense that Hong Kong people's criticisms against the HA are quite severe. But some people who have returned from overseas, especially many returnees from Canada, may think that Hong Kong provides very satisfactory healthcare services when compared with Canada. In that case, are we unaware that we are actually in a very satisfactory situation? This likewise merits our review and study. Of course, I also have some first-hand experience because my parents are very old already. My mother is a frequent patient of HA hospitals, so I have first-hand experience. In my view, there is certainly room for improvement. But I must say that considering the relatively limited resources committed by the Government, we should base our comments on objective facts, rather than


levelling overly severe criticisms. That said, I think that one thing is crystal clear: regardless of whether we will conduct a review, healthcare manpower shortage is already a pressing problem. I think Members may remember that in the Legislative Council Election last year, one of the debate topics was about whether the HA should be allowed to recruit overseas medical practitioners as a means of increasing the local supply of medical practitioners. Of course, to us, it will be best if Hong Kong itself can train up sufficient medical practitioners. In any case, this is better than drawing on external sources, the reason being that Hong Kong is equipped with two outstanding universities, so it should be able to train up sufficient healthcare professionals and medical practitioners of a high quality. That said, we can still observe a shortage of nurses and other related manpower. On this issue, regardless of whether there is an organization called the HA, or whether the HA should be dissolved, Hong Kong should still ensure that its healthcare training is sufficient. The issue of sufficient manpower should precede any other matters for discussion. Some Members also spoke on the "money follows patient" principle just now. Speaking of economic development, my attitude is very liberal. But in the case of healthcare services, I have strong reservations about the "money follows patient" principle. The reason is that hospital services are meant to save lives, and that requires planning and relatively long-term preparation. It is utterly impossible to propose the idea of "money follows patient" today and put it into practice immediately. In case a hospital is always crowded with people seeking medical consultation, how are other hospitals supposed to utilize their resources? A merit of the present cluster system is the referral of patients among hospitals. It has its merits. Certainly, if there is anything unsatisfactory, we must still conduct a review. Therefore, in his amendment, Mr Albert HO seeks to amend the original motion with a main focus on a review of this aspect. Lastly, I wish to say a few words in response to Mr IP Kwok-him's views. Just now, he said that he had no alternative but to abstain from voting on Mr Albert HO's amendment. However, I hope that he can read the wording of Mr Albert HO's amendment again. In his amendment, Mr Albert HO has basically deleted …… I am sorry. Let me say it again more clearly. He has deleted the words "dissolve HA" and "money follows patient" following "this Council urges". In the motion as amended by him, he has added ", on the premise of maintaining the public sector-led healthcare services and making them an


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important social security system in Hong Kong, reform HA" after "demanding the Government to keep increasing funding, with HA being rewarded for its misgovernance instead ……". Although the motion is entitled "Dissolving the Hospital Authority", Mr Albert HO has actually deleted the wording "dissolve HA" in his amendment. I hope that Mr IP Kwok-him can reconsider the whole matter and determine whether the contents are consistent with the stance of his party. I do not intend to make use of the topic under discussion to criticize anybody. But Ronnie CHAN, Chairman of Hang Lung Group, recently "fired the cannon" at John TSANG, saying that he always refrained from spending when he should. In response, LEUNG Chun-ying said that there had been "seamless co-operation". I have no intention to make use of the topic under discussion to criticize anybody, but I still wish to express my hope that John TSANG can use the healthcare expenses in a way that can suit Hong Kong's needs. In particular, by 2030, people aged 65 or above will account for 29% or 30% of the Hong Kong population. Honestly, time really flies, but it takes around 10 or eight years to build a hospital. I think that if Mr TSANG fails to make any proper preparation and long-term investment to dovetail with the situation of population ageing in the future, he may really turn himself into an eternal sinner. I hope that in his reply to this issue later on, the Secretary can put forward longer-term preparations for coping with the pressure of population ageing on Hong Kong's healthcare services, so as to avoid turning himself into an eternal sinner in reality. PRESIDENT (in Cantonese): Does any other Member wish to speak? (No Member indicated a wish to speak) PRESIDENT (in Cantonese): Dr LEUNG Ka-lau, you may now speak on the two amendments. The speaking time limit is five minutes. DR LEUNG KA-LAU (in Cantonese): President, may I request a headcount? Please do a headcount.


PRESIDENT (in Cantonese): Will the Clerk please ring the bell to summon Members back to the Chamber. (After the summoning bell had been rung, a number of Members returned to the Chamber) PRESIDENT (in Cantonese): Dr LEUNG Ka-Lau, please speak. DR LEUNG KA-LAU (in Cantonese): I am sorry, Honourable colleagues. I hope everybody can listen to my speech here. President, we understandably need time to digest new ideas. Whether this motion can be passed is not the most important concern. I am grateful to the 29 Members for their views on this motion, and for enabling me to realize their misunderstanding about the healthcare policy. I propose to dissolve the Hospital Authority (HA) absolutely not for the reason of venting my anger. This proposal actually represents my thoughts after a thorough study of the system. As a matter of fact, these ideas were already put forward in the Harvard Report released 14 years ago, and they are not my original ideas. A few minutes is hardly enough for me to explain their details. Well, I just wonder whether the Rules of Procedure can be amended to provide the mover of a motion with one minute for responding to each of the Members who have spoken. That way, I can have 29 minutes to explain the matter more clearly. I wish to respond to three main points …… PRESIDENT (in Cantonese): Dr LEUNG, you should speak on the two amendments. DR LEUNG KA-LAU (in Cantonese): Alright. The two amendments mainly seek to amend the part concerning the "money follows patient" and "publicly-run" concepts. I must give a response in this regard. First, I wish to clarify to everybody that even if the HA is dissolved, public hospitals will continue to exist. Maybe, the seven clusters can actually develop better separately. Are Members aware of the most important function of the HA? Resource distribution. If the HA fails to distribute resources properly, someone else should take over this role. Who should it be? It should be the


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Secretary. The reason is that the HA is unable to rein in the clusters. But I believe the Secretary is able to do so. Therefore, even if the HA is dissolved, the current portfolio of LEUNG Pak-yin will only be taken over by the Secretary. Public hospitals are not directly operated by the HA. Members please do not get this wrong. There are two important concepts, one of which being "money follows patient". I must emphasize that it is a very strong incentive to improve the relevant services. Despite Mr Albert HO's deletion of these words of mine, he nonetheless has proposed, in point (3) of his amendment, "to formulate a fair and reasonable funding system, and allocate funding to respective districts and hospitals in accordance with the population sizes of and numbers of patients and types of diseases in various districts". This is in essence the same as the "money follows patient" principle. Some Members mistakenly believe that under the "money follows patient" principle, everybody can only receive $5,300, an amount obtained by dividing $40-odd billion by 7 million people. I do not mean anything like this. Neither am I talking about the healthcare voucher because it is only applicable under certain circumstances. What is meant by "money follows patient"? In the case of a colorectal cancer patient, the service costs borne by public hospitals amount to $100,000, and four weeks is required as waiting time. If someone tells the Government that they can give immediate treatment to the patient at a mere cost of $90,000, with this amount charged to the Government rather than to the patient, then the Government may think, "This is so worthwhile! Now that I am understaffed, and I must bear $100,000 as costs, if you are willing to take over right away, I will let you do so." Yesterday, Dr Joseph LEE asked the Government a written question about the HA's service costs. I am talking about Question No. 20. Members should by now have realized that the charge of a gastroscopy ranges from the lowest $10,350 to the highest $23,700. I believe that many Members have undergone gastroscopies before. How much does a private hospital charge for this procedure? Only several thousand dollars. How long does a public hospital patient need to wait before receiving a gastroscopy? Two to 11 months. Speaking of a proctoscopy, a waiting time of six months is required, with the costs amounting to $11,000. What has actually happened? Why should there be any problem if someone tells the Government, "The HA charges exorbitant prices and patients must wait a long time. I can take over right away and charge lower prices instead."?


Moreover, another concept is also very important. What is meant by "publicly-run"? Are universities publicly-run? Universities have their own councils, reserves and self-financing programmes, the profits and losses of which are universities' own responsibility. Internationally, "public healthcare expenses" means that the government is the one who pays. But if a profit-making service operator can provide better yet less expensive services, then why should there be any such differentiation? The Harvard Report already put forward the above idea 14 years ago. Maybe people are accustomed to the status quo, taking things for granted with deep-rooted perceptions. The National Health Service in the United Kingdom is financed by public money. Most of its service providers operate on a self-financing basis, rather than being run by the government. But their services are still known as "public services". I wonder why people always emphasize that public services must be run by the Government, must be run by the HA. I just find it utterly unthinkable as to why it is impossible for other operators to provide less expensive yet better services. President, I so submit. SECRETARY FOR FOOD AND HEALTH (in Cantonese): President, I am grateful to Honourable Members for their valuable views on the original motion and the amendments. I have listened carefully to the many views on improving public healthcare services and the operation of the Hospital Authority (HA) expressed by Honourable Members in their speeches. Before giving my reply, I wish to state the following things clearly. From 1981 to 1989, I was a front-line doctor at a public hospital; between 1989 and 2004, I held a managerial post in the HA and the former Hospital Services Department; and, during the period from 2005 to 2012, I was a specialist in private practice. I have listened to the various views put forward by Honourable Members just now. In that case, my reply should naturally focus on the management aspect of the HA. But the views of two Honourable Members have left me with no alternative but to first express my views on the healthcare system as a whole. Mr SIN Chung-kai has said that we must be very clear about the amount of resources spent by the Government on Hong Kong's public hospital system or on the entire hospital system. The latest figure is that Hong Kong's overall healthcare expenditure currently accounts for 5.2% of its GDP, with 2.4% spent on public hospitals. In other words, public and private hospitals each take up half of our total healthcare expenditure. Of the public expenditure committed by


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the Government, the expenditures of the HA and the entire public healthcare sector account for around 16.7%. It is the latest figure I have, close to the middle of the range between 15% and 17% mentioned by Mr SIN Chung-kai a moment ago. I agree with Mr SIN Chung-kai that the figures for other developed countries, except the United States, invariably fall within the range of 8% to 12%, so in comparison, our overall healthcare expenditure is at a rather low level. Among all the developed countries, there is only one country with a level of healthcare expenditure comparable to ours ― Singapore. What Miss CHAN Yuen-han has talked about relates to a fundamental question: how do we want our healthcare system to be like? Regarding this question, Dr LEUNG Ka-lau has brought up in his closing speech the problems highlighted by the Harvard Report some time ago. As a matter of fact, the Government of the previous terms ― from the British Hong Kong Government to the SAR Government ― had conducted no less than five or six consultation exercises regarding healthcare system reform. During such exercises, different issues were brought to Hong Kong people's attention. The Rainbow Report released in 1993 was already aware of the fact that as a place upholding a low tax regime, Hong Kong might not be able to sustain its public healthcare system in the long run with its public expenditure commitment. So, the report proposed a co-payment approach as a means of progressively containing the proportion of government subsidies to 80%. But this proposal was turned down. Subsequently, there came the Harvard Report. Apart from putting forward the need for fair competition, one of its proposals was marked by an overtone of a general mandatory insurance system. This system bears some resemblance to the one adopted in Canada, just as two Honourable Members have mentioned. Members can judge whether it is a desirable system. In any case, after rounds of consultation, in the early 2000s, the authorities gradually introduced the model of self-contribution to one's account, a model adopted in Singapore, as an option for Hong Kong people. This model has its merits. As I said just now, Singapore is the only developed country capable of maintaining a healthcare system without inducing many criticisms, despite the fact that its proportion of healthcare expenditure to GDP, doctor-population ratio and bed-population ratio are comparable to Hong Kong's. After all these proposals had been rejected, there came a dual-track system comprising public and private healthcare sectors. It is the subject of our current discussion, and Mrs Regina IP has placed much emphasis on it in her speech.


Mr CHAN Han-pan has even pointed out that the public healthcare system is a cornerstone of Hong Kong's healthcare system and a safety net for all people. Such is the nature of our existing healthcare system. What are the problems with this system? This system has its own merits, because the Government continues to assume the responsibility of providing public healthcare services to ensure that people will not be deprived of any healthcare services due to financial reasons. But there is the problem of sustainability. In addition, Hong Kong is equipped with a pretty large-scale private healthcare system as another option for us. So, Hong Kong is different from the United Kingdom, in a way that under the National Health Service, British people are completely devoid of any choice; despite their dissatisfaction, no other options are available to them; and, even if they are willing to pay more, they still have no choices. In contrast, Hong Kong people have choices. Therefore, we believe that after several rounds of consultation on the dual-track healthcare system, people should agree to its retention. In that case, our future task should be the adjustment of the balance between public and private healthcare services. I now move on to talk about which of the following two approaches should be more desirable: to split the responsibility of managing the public healthcare system, or to leave it to a single organization. In this connection, several Members have put forward their views. Mr WONG Kwok-hing has pointed out that the HA can achieve synergy with its role; Mr NG Leung-sing has pointed out that a single framework should be in place for management purposes; Dr Fernando CHEUNG, who proposes an amendment, likewise has pointed out that the HA plays the role of ensuring the standardization of quality and quantity. I agree that a very important function of the HA is to maintain a uniform standard across different districts and clusters. As a statutory body, the HA was established precisely for the purpose of enhancing the effectiveness and efficiency of hospital services. It has been in existence for more than two decades. We can by no means describe the services of the HA as perfect. Honourable Members have already voiced many criticisms and lots of dissatisfaction. I agree that the matters under their criticisms do exist. But, as Mr NG Leung-sing has pointed out, its healthcare services are of a high quality, commanding international recognition. And, Mr Vincent FANG has also pointed out that the HA uses 2.4% of Hong Kong's GDP, or about half of Hong Kong's total healthcare expenditure, to provide 90% of Hong Kong's in-patient services. As indicated by the HA's statistics, under its


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seven clusters, there are annually around 1.5 million in-patient and discharge episodes; 2.3 million attendances at the accident and emergency (A&E) departments; 9.2 million attendances at specialist out-patient clinics; and 5.9 million primary care attendances. I believe that a comparison with other systems will enable us to see that all these figures are astronomical. All such services are provided by the HA as a single framework. Since its establishment, the HA has indeed made significant improvements to Hong Kong's healthcare services in several areas. Such improvements are mainly found in the quality of healthcare services, the efficiency of the entire system, and the service culture. Some Members have even said that the service quality of the HA in the late 1990s was so satisfactory that some private hospitals were caught in operational difficulties. This brings out the issue concerning the sustainability of the entire healthcare system. Certainly, the HA will then expect me to explain on its behalf how it has sought to improve healthcare services through upgrading its facilities and developing evidence-based medicine, family medicine, day care services, and new modes of healthcare services. But I am not prepared to go into the details. With people's increasing demand for public health ― I must point it out here, of course ― many Members have talked about population growth, and the disproportion between funding increases and population growth. But many other Members have likewise advised us that we should not look at population growth alone. They have told us to take account of population ageing, the upgrading of healthcare service technologies and also people's heightening expectations for healthcare services, saying that we should consider all these factors. As a matter of fact, over the past few years since the previous-term SAR Government, we have already made adjustment to the balance between public and private healthcare services based on our needs. We do not want to give people the feeling that we only "inflate" the public healthcare system without optimizing the private healthcare system. Therefore, the HA has launched many public-private partnership (PPP) schemes, the targets of which include cataract patients. We once allocated additional resources to public hospitals, so that they could shorten the waiting time by performing more cataract operations at night. But we later found that after the waiting time had been reduced, there was a backflow of patients from private doctors, thus prolonging the waiting time again. As a result, the Cataract Surgeries Programme was launched under the PPP model. Under the arrangement of tripartite payment, a portion of the charge is


borne by the patient, and another portion by HA subsidies, along with charge reduction by the private doctor concerned. Subsequently, the Tin Shui Wai Primary Care Partnership Project and the Haemodialysis Public-Private Partnership Programme, which aims to provide haemodialysis services to end-stage renal disease patients through the bought places in the private sector, were launched. Both Mr NG Leung-sing and Dr LAM Tai-fai have pointed out that the HA attaches a great deal of importance to patient satisfaction, and has thus undertaken some surveys in this regard. The survey outcomes show that patients generally consider the effectiveness of the HA acceptable. Apart from pointing out the HA's functions of achieving overall synergy and standardizing service quality, Mr TANG Ka-piu has also highlighted one important point, saying that the HA has taken up the role as a training provider. In other words, the entire framework has assumed the responsibility of training doctors, nurses and allied health staff in various fields. Several Members, including Dr CHIANG Lai-wan, Dr LAM Tai-fai and Mr NG Leung-sing, have pointed out the HA's important role in major public health incidents and disastrous events. Therefore, I would say that the proposal of devolving the HA's responsibility of managing the various clusters to individual clusters may not be unfeasible in the case of daily service delivery. But speaking of major disastrous events, Members will find that the HA actually plays the very important functions of arranging for triage and co-ordinating overall response actions. In incidents involving epidemic diseases, Honourable Members can also see the functions of the HA. As a matter of fact, the HA has continued to commission consultants to conduct reviews of the service demands, as well as its organizational structure and governance, and has introduced certain improvement measures. I wish to give an account to Honourable Members here. True, Honourable Members may find that some of these reviews are acceptable while some are not because they were all undertaken by the HA itself, but then I think that in order to be fair to the HA, I must tell Honourable Members that the HA is an organization in ongoing pursuit of self-improvement. Concerning the resources for the HA, some Members have said that the resources allocated have increased substantially; some have commented that the


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resources allocated are insufficient; and some other have expressed concern about whether the resources allocated are used completely on front-line staff or spent on the management aspect. Although the Government's recurrent funding for the HA has increased from $31.1 billion in 2008-2009 to $44.4 billion in 2013-2014, representing an cumulative increase of 43%, as I said just now, this amount only accounts for around 2.4% of our GDP. Let me now talk about the next level down the hierarchy. Some Members have expressed concern about how the HA distributes the resources it receives to the various clusters; whether there is any uneven distribution; and whether regionalism exists. Here, I wish to explain, on the HA's behalf, its internal resources distribution arrangements. At present, there are altogether seven hospital clusters. The HA must have regard for the service population of each cluster, meaning the population sizes of the districts a cluster covers. But this explanation of mine alone is too general to reflect the reality. I do not believe that any organization can base its resources distribution solely on population size. So, I wish to add that the HA is required to formulate detailed year plans, examine the local services of a cluster, and, having regard to the differences in the characteristics and population structures of its districts, ascertain whether anything is especially in need of improvement. Moreover, many Members have expressed the view that distributing resources on the sole basis of clusters' population sizes may bring flexibility to the relevant arrangements. But I am afraid that this is not possible. Our present delineation is based on people's residential districts, but I must ask: how big is Hong Kong? Hong Kong only measures some 1 000 sq km, but its population size is comparable to that of a country. In such a tiny place as Hong Kong, many people need to cross districts to study or work, and may frequently travel to different districts in Hong Kong. In that case, I do not think that it is realistic to ask all people to seek healthcare services only in their own residential districts. So, in order to assess the amounts of resources for various clusters more appropriately, the HA has now adopted the "casemix" mechanism referred to by Miss Alice MAK just now ― she is not so supportive of this model, though. Under this mechanism, "benchmark patients" is used as the basis of computation. It is actually a relatively scientific approach. Of course, we may hold discussions on whether this approach works well. After computing the number of patients, we will proceed to examine the number of patients in need of cross-district services. Then, we will make adjustment based on the number of


patients served by each cluster and the complexity of cases with patients suffering from the same diseases. Finally, we will compute our resources allocation based on this "benchmark patients" approach. My hope is to point out that it is a relatively scientific approach, and that we may hold discussions on whether it works satisfactorily. We may discuss issues such as whether the computation is accurate and whether anything under this approach can be improved. But I do not believe that using population size as the sole basis of computation is feasible. Healthcare manpower shortage is another problem brought up by many Honourable Members. Among them, Mr TANG Ka-piu, Mr CHEUNG Kwok-che, Mr NG Leung-sing and Mr MA Fung-kwok have even highlighted the importance of manpower planning. In this regard, we very much agree with them. But I must say that overall manpower planning must be undertaken not only by the HA but also by the Government. I believe that Honourable Members are all aware of the previous-term SAR Government's establishment of a high-level committee known as the Steering Committee on Strategic Review on Healthcare Manpower Planning and Professional Development. It is now taking forward the relevant tasks. In addition, several Honourable Members have talked about whether resources increases are proportionate to service growth. According to the statistics provided by the HA, when compared to 2009-2010, the growth rates of in-patient services and day in-patient services in the revised estimates for 2012-2013 are 5.8% and 20.3% respectively. This shows that one cannot simply look at in-patient services alone. The reason is that having regard to the international trend, the HA has adopted a strategy of substituting day services for certain services as far as possible in the case of those patients without hospitalization needs. Therefore, Honourable Members can see that the growth rate of day in-patient services is over 20%. And, specialist out-patient attendances and primary care attendances have increased by 5.5% and over 15% respectively. Honourable Members can see that apart from increasing service volume, the HA has also continued to adjust the various service modes. In any case, regarding healthcare personnel shortage, many Members have already spoken on the background. Let me add a few words here. The Government had slashed a portion of manpower for several years in the early 2000s due to financial reasons. This is particularly the case with the admission quotas for medical programmes. Honourable Members should all know that


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medical training spans longer periods, so this move has led to a shortage of doctors these years, not to speak of the few years ahead. Therefore, with limited resources, we are very often forced to focus our resources on meeting priority needs. The HA is now using this approach. Several Members have talked about the problem of long waiting time at A&E departments, including Mr CHAN Han-pan, Mr POON Siu-ping, Mr KWOK Wai-keung and Miss CHAN Yuen-han. Nevertheless, I wish to ask Honourable Members to note that in 2012-2013, A&E departments were able to meet the waiting time targets for 100% and 97% of their patients respectively classified as "critical" and "emergency" under the triage system. In other words, no waiting time was required in the former case, whereas in the latter case, a waiting time of 15 minutes was required before medical treatment. In fact, most A&E patients are "semi-urgent" or "non-urgent" patients. Members of the Legislative Council Panel on Health Services may have listened to the HA's report. In this regard, we will seek to dovetail with the relevant arrangements, so that "non-urgent" patients need not wait too long. And, under the current circumstances of limited manpower, we have adopted an "internal part-time" mode, under which A&E doctors or doctors in other specialties are paid with a special allowance to work extra time on a part-time basis as a means of assisting in alleviating the long waiting time problem faced by "non-urgent" A&E patients. Dr Fernando CHEUNG, Mr TANG Ka-piu, Miss Alice MAK, Mr CHEUNG Kwok-che, Dr CHIANG Lai-wan and Dr Helena WONG have expressed grave concern about the waiting time for specialist services under the various clusters. Speaking of specialist services, we are likewise forced to adopt the triage arrangement. What I mean is that our trained nurses ― or doctors in some cases ― will distinguish, with the aid of guidelines, which patients are in a more urgent condition based on the information provided by the referring doctors in their referral letters. Confirmed cancer patients, for instance, may need to wait shorter periods, whereas other patients whose condition is relatively stable may need to wait a longer time. In any case, improving waiting time is a priority task for the current-term Government. As far as our understanding goes, the HA has already launched a series of measures to this end. Certainly, some of the measures relate to cross-cluster referrals, just as Honourable Members have said. We will gradually consider the referral of some specialist out-patient clinic patients whose condition is relatively stable to private doctors for follow-up consultation, and


also the provision of subsidies by the HA or the Government through the HA to such patients, so as to enable them to seek medical consultation from private doctors at a charge comparable to those of public hospitals. As for Mr LEE Cheuk-yan's proposal of giving patients the freedom to choose their desired clusters for medical consultation, I must say that although it is meant to be a short-term measure, a complete freedom of choice will be met with difficulties. Generally speaking, the HA encourages patients to seek medical consultation within the clusters covering their places of residence as far as possible. But we will still refer cases with exceptional circumstances such as sustaining injuries at work or in other districts to other clusters. Some cases requiring specialist services are under central co-ordination, and the patients of such cases will be referred to different medical centers for treatment. Such cases include organ transplants, serious burns, and serious traumas. Other examples include coronary artery bypass graft surgeries. In 2013, there were roughly 20 cross-cluster referral cases. Speaking of joint replacement surgeries, cross-cluster arrangements are even required. As Members said just now, joint replacement surgeries take the longest waiting time. This is actually the case in many countries. The HA has completed the cross-cluster arrangements for 300 cases. Anyway, the HA now faces many challenges, including population ageing and population growth. I must make it a point to say that the average amount of resources for providing hospital treatment to an elderly patient is 240% of that for a non-elderly patient. The service costs associated with a patient aged 65 or above per 1 000 people have increased from $18 million in 2008-2009 to $21 million in the revised estimates for 2012-2013. All this has actually reinforced my earlier argument that we cannot simply look at population size, and that population structure is likewise very important. Some Members have also expressed concern about how the future situation will be like in the face of population ageing and population growth. At the previous meeting of the Legislative Council Panel on Health services, I already briefed members on the HA's formulation of a blueprint setting out the hospitals in the districts of Hong Kong that would require alteration, expansion or addition works in the light of the changes in population growth and population structure in the two to three decades ahead.


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Speaking of drugs, many Members, including Dr Fernando CHEUNG, Mr WONG Yuk-man, Mr LEE Cheuk-yan, Miss Alice MAK and Mr CHEUNG Kwok-che, have voiced their grave concerns about the HA Drug Formulary (the Drug Formulary). They have invariably asked whether a complete opening of the Drug Formulary is possible. But Mrs Regina IP and Mr Vincent FANG have instead pointed out that no countries in the world can possibly put in place any drug formulary with complete openness. By "complete openness", they mean that as soon as a drug is developed and launched in the market, it will be immediately adopted and covered by our existing subsidies. I must point out that a mechanism for effectively managing the Drug Formulary is necessary. As a matter of fact, Honourable Members have raised all sorts of concerns. I do not think that I can possibly respond to them one by one here. Their concerns include district services, health protection, medical doctors' practice, blood transfusion, redress mechanism and the remuneration discrepancies between civil servants and HA staff. Due to time constraints, I am sorry to say that I am unable to respond to them one by one now. Rather, I can only follow them up in the future. Speaking of reviewing the HA's effectiveness, a majority of Honourable Members have indicated their agreement to such a need in their speeches. While the HA has persistently introduced measures and conducted its own reviews from time to time, society nonetheless holds the view that in order to cope with the various challenges resulting from social changes, a review independent of the HA's should be conducted. We will soon set up a steering committee to comprehensively review the service management and the system of HA clusters. The issues to be covered include the policies on risk management, waiting time, resources distribution, cost-effectiveness and personnel appointment authority. Is the devolution of powers an appropriate course of action? And, which arrangement is more desirable ― to devolve more powers or to take back some? All such issues will be covered by the review. On a broader level, the review will even cover the overall cost-effectiveness of the HA. The membership of the steering committee will definitely, and mainly, be drawn from community figures outside the HA. Honestly speaking, our original plan is to announce the membership list of the steering committee in July, but due to some technical problems facing us at present, I can only promise Honourable Members that it will be announced in August.


The HA is the public healthcare service provider, so its effective operation is naturally a matter of great concern to the broad masses. And, as the HA's operation mainly relies on government subvention, we must ensure that the HA strives to upgrade the cost-effectiveness of its services and optimize every bit of government subvention resources. Here comes the last question: is "money follows patient" feasible? Honestly, Members may sense a "money follows patient" overtone in certain PPP schemes I mentioned a moment ago. For example, our subsidy scheme enabling some long-waiting cataract patients to undergo cataract operations in the private sector is actually marked by a slight overtone of "money follows patient". But I believe that what the original motion proposes is a full-scale "money follows patient" arrangement, meaning that all money is distributed to clusters in proportion to their population sizes. Certainly, there are bound to be many different approaches, and I can naturally appreciate this. One such approach is the distribution of several thousand dollars to everybody, with its usage being a matter for themselves. Another approach can be the distribution of money to all clusters based on their population sizes. But many Members have invariably pointed out that a full-scale "money follows patient" arrangement is not feasible. I very much agree to the views of these Members. We must admit that on the one hand, healthcare services are commercial in nature on the one hand, but not fully commercial on the other. What I am trying to say is that we cannot run all our healthcare services the same way as we run a business. Therefore, I will continue to uphold the twin-track healthcare system in Hong Kong in the future, facilitate its sustained and balanced development with various government policies, and prevent it from titling towards one side or a full commercialization. Finally, I hope Honourable Members can continue to support our efforts of persistently improving the overall quality of healthcare services in this regard, and also our review of the HA's operation for the purposes of enhancing the HA's efficiency, and improving its internal management, resources distribution, and personnel appointment authority. And, I also hope that everybody can treasure the professionalism of Hong Kong's healthcare personnel, just as Mr TANG Ka-piu has said, and enable our time-tested twin-track healthcare system currently in place to continue to fulfil its public health function. Thank you, President.


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PRESIDENT (in Cantonese): Will Dr Fernando CHEUNG please move his amendment to the motion. DR FERNANDO CHEUNG (in Cantonese): President, I move that Dr LEUNG Ka-lau's motion be amended. Dr Fernando CHEUNG moved the following amendment: (Translation)

"To add ", as" after "That"; to add ", with patients having to purchase at their own expense drugs which are of significant efficacy but expensive" after "a long time"; to delete "in this connection," after "misgovernance instead;"; to delete "dissolve HA, and under the principle of 'money follows patient'" after "urges the Government to" and substitute with "review the operation of HA and put forward a reform plan,"; to delete "directly purchase services from public and private healthcare organizations, and" after "in various districts,"; and to add "; the relevant reform plan should include: (1) to promote democratization of the management of public hospitals and clinics, and encourage more local and civic organizations to participate in such management; (2) in accordance with the needs of individual communities, to allocate additional resources to increase healthcare services, and comprehensively implement the cross-cluster patient referral scheme to shorten the waiting time for specialist services; (3) to increase the transparency of HA's use of resources, and enhance the monitoring of HA's creation of high-salaried posts, so as to prevent the occurrence of the situation of 'fattening the top and thinning the bottom'; and (4) to allocate additional resources to expand the Drug Formulary, and include all drugs which are of significant efficacy and have marginal benefits but are expensive as General Drugs and Special Drugs, so that medical practitioners can prescribe drugs with greater flexibility and more patients can use such drugs at standard fees and charges, and to put in place a discretionary mechanism for medical practitioners to exercise their professional judgment to provide patients with drugs not in the Drug Formulary" immediately before the full stop."

PRESIDENT (in Cantonese): I now propose the question to you and that is: That the amendment, moved by Dr Fernando CHEUNG to Dr LEUNG Ka-lau's motion, be passed.


PRESIDENT (in Cantonese): I now put the question to you as stated. Will those in favour please raise their hands? (Members raised their hands) PRESIDENT (in Cantonese): Those against please raise their hands. (Members raised their hands) Mr Tommy CHEUNG rose to claim a division. PRESIDENT (in Cantonese): Mr Tommy CHEUNG has claimed a division. The division bell will ring for five minutes. PRESIDENT (in Cantonese): Will Members please proceed to vote. PRESIDENT (in Cantonese): Will Members please check their votes. If there are no queries, voting shall now stop and the result will be displayed. Functional Constituencies: Mr Albert HO, Mr James TO, Mr Frederick FUNG, Dr LEUNG Ka-lau, Mr CHEUNG Kwok-che, Mr Charles Peter MOK, Mr Dennis KWOK, Mr IP Kin-yuen and Mr POON Siu-ping voted for the amendment. Mr Tommy CHEUNG, Dr LAM Tai-fai, Mr NG Leung-sing, Mr Frankie YICK, Mr YIU Si-wing, Mr MA Fung-kwok, Miss CHAN Yuen-han, Mr KWOK Wai-keung, Mr Christopher CHEUNG, Mr Martin LIAO and Mr Tony TSE voted against the amendment. Dr Joseph LEE, Mr WONG Ting-kwong, Mr CHAN Kin-por, Mr IP Kwok-him and Mr Steven HO abstained.


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Geographical Constituencies: Mr LEE Cheuk-yan, Ms Emily LAU, Mr Ronny TONG, Ms Cyd HO, Mr Paul TSE, Mr Alan LEONG, Mr LEUNG Kwok-hung, Mr Albert CHAN, Mr WONG Yuk-man, Ms Claudia MO, Mr WU Chi-wai, Mr Gary FAN, Mr CHAN Chi-chuen, Dr Fernando CHEUNG, Mr SIN Chung-kai and Dr Helena WONG voted for the amendment. Mr WONG Kwok-hing, Mr WONG Kwok-kin and Miss Alice MAK voted against the amendment. Mr CHAN Kam-lam, Mr TAM Yiu-chung, Mr CHAN Hak-kan, Mrs Regina IP, Mr Michael TIEN, Mr CHAN Han-pan, Dr Elizabeth QUAT, Dr CHIANG Lai-wan and Mr Christopher CHUNG abstained. THE PRESIDENT, Mr Jasper TSANG, did not cast any vote. THE PRESIDENT announced that among the Members returned by functional constituencies, 25 were present, nine were in favour of the amendment, 11 against it and five abstained; while among the Members returned by geographical constituencies through direct elections, 29 were present, 16 were in favour of the amendment, three against it and nine abstained. Since the question was not agreed by a majority of each of the two groups of Members present, he therefore declared that the amendment was negatived. MR RONNY TONG (in Cantonese): President, I move that in the event of further divisions being claimed in respect of the motion on "Dissolving the Hospital Authority" or any amendments thereto, this Council do proceed to each of such divisions immediately after the division bell has been rung for one minute. PRESIDENT (in Cantonese): I now propose the question to you and that is: That the motion moved by Mr Ronny TONG be passed.


PRESIDENT (in Cantonese): Does any Member wish to speak? (No Member indicated a wish to speak) PRESIDENT (in Cantonese): I now put the question to you as stated. Will those in favour please raise their hands? (Members raised their hands) PRESIDENT (in Cantonese): Those against please raise their hands. (No hands raised) PRESIDENT (in Cantonese): I think the question is agreed by a majority respectively of each of the two groups of Members, that is, those returned by functional constituencies and those returned by geographical constituencies through direct elections, who are present. I declare the motion passed. I order that in the event of further divisions being claimed in respect of the motion on "Dissolving the Hospital Authority" or any amendments thereto, this Council do proceed to each of such divisions immediately after the division bell has been rung for one minute. PRESIDENT (in Cantonese): Mr Albert HO, you may move your amendment. MR ALBERT HO (in Cantonese): President, I move that Dr LEUNG Ka-lau's motion be amended. Mr Albert HO moved the following amendment: (Translation)

"To add ", given that" after "That"; to delete "HA is both the buyer and the vendor of healthcare services with a conflict of roles, which on the one hand procures the relevant services for the public and on the other hand


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must take care of its own interests as the service provider, thus resulting in its inability to" after "however," and substitute with "HA has now been established for 23 years and still cannot"; to delete "in this connection," after "misgovernance instead;"; to delete "dissolve HA, and under the principle of 'money follows patient' and in accordance with the population size of and number of patients in various districts, directly purchase services from public and private healthcare organizations, and allow patients to choose hospitals for treatment" after "urges the Government to" and substitute with ", on the premise of maintaining the public sector-led healthcare services and making them an important social security system in Hong Kong, reform HA"; and to add "; the relevant measures should include: (1) to increase HA's representativeness, transparency and accountability, including appointing more elected public opinion representatives to HA and the Hospital Governing Committees of district hospitals to improve governance, and to clarify the powers and duties of Hospital Governing Committees to enable them to fulfil the governance function; (2) to make public HA's existing manpower establishment and planning, and streamline its administrative structure and review its remuneration and employment systems, so as to make reasonable use of public money and avoid the occurrence of the situation of 'fattening the top and thinning the bottom'; (3) to formulate a fair and reasonable funding system, and allocate funding to respective districts and hospitals in accordance with the population sizes of and numbers of patients and types of diseases in various districts; (4) on the premise of protecting patients' well-being, to study whether it is necessary to retain or reform the cluster system; and (5) to expeditiously establish an HA review committee to comprehensively review HA's functions, and appoint non-HA members and persons who are not officials of the Department of Health as committee members to ensure the committee's independence and objectivity" immediately before the full stop."

PRESIDENT (in Cantonese): I now propose the question to you and that is: That the amendment, moved by Mr Albert HO to Dr LEUNG Ka-lau's motion, be passed.


PRESIDENT (in Cantonese): I now put the question to you as stated. Will those in favour please raise their hands? (Members raised their hands) PRESIDENT (in Cantonese): Those against please raise their hands. (Members raised their hands) Mr IP Kwok-him rose to claim a division. PRESIDENT (in Cantonese): Mr IP Kwok-him has claimed a division. The division bell will ring for one minute. PRESIDENT (in Cantonese): Will Members please proceed to vote. PRESIDENT (in Cantonese): Will Members please check their votes. If there are no queries, voting shall now stop and the result will be displayed. Functional Constituencies: Mr Albert HO, Mr James TO, Mr Tommy CHEUNG, Mr Frederick FUNG, Dr Joseph LEE, Mr CHAN Kin-por, Dr LEUNG Ka-lau, Mr CHEUNG Kwok-che, Mr Frankie YICK, Mr Charles Peter MOK, Mr IP Kin-yuen and Mr POON Siu-ping voted for the amendment. Miss CHAN Yuen-han, Mr KWOK Wai-keung and Mr Martin LIAO voted against the amendment.


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Mr WONG Ting-kwong, Dr LAM Tai-fai, Mr IP Kwok-him, Mr NG Leung-sing, Mr Steven HO, Mr YIU Si-wing, Mr MA Fung-kwok, Mr Christopher CHEUNG and Mr Tony TSE abstained. Geographical Constituencies: Mr LEE Cheuk-yan, Ms Emily LAU, Mr Ronny TONG, Ms Cyd HO, Mr Paul TSE, Mr Alan LEONG, Mr LEUNG Kwok-hung, Mr Albert CHAN, Mr WONG Yuk-man, Ms Claudia MO, Mr Michael TIEN, Mr WU Chi-wai, Mr Gary FAN, Mr CHAN Chi-chuen, Dr Fernando CHEUNG, Mr SIN Chung-kai and Dr Helena WONG voted for the amendment. Mr WONG Kwok-hing, Mr WONG Kwok-kin and Miss Alice MAK voted against the amendment. Mr CHAN Kam-lam, Mr TAM Yiu-chung, Mr CHAN Hak-kan, Mrs Regina IP, Mr CHAN Han-pan, Dr Elizabeth QUAT, Dr CHIANG Lai-wan and Mr Christopher CHUNG abstained. THE PRESIDENT, Mr Jasper TSANG, did not cast any vote. THE PRESIDENT announced that among the Members returned by functional constituencies, 24 were present, 12 were in favour of the amendment, three against it and nine abstained; while among the Members returned by geographical constituencies through direct elections, 29 were present, 17 were in favour of the amendment, three against it and eight abstained. Since the question was not agreed by a majority of each of the two groups of Members present, he therefore declared that the amendment was negatived. PRESIDENT (in Cantonese): Dr LEUNG Ka-lau, you may now reply and you still have three minutes 49 seconds.


DR LEUNG KA-LAU (in Cantonese): President, the Secretary has mentioned earlier that the Hospital Authority (HA) plays the role of co-ordination and consolidation, but the problem is HA has failed to do so, thus spurring me to look for a change. I believe the Secretary will also be able to achieve what the HA can achieve and deliver what HA has failed to deliver. I would like to briefly respond to the manpower issues raised by a number of Members just now. If we are convinced by excuses such as ageing population, advances in medical technology, increasing demand of the community and manpower shortage, the Government and the HA will be able to shirk their governance responsibilities completely. Moreover, we can expect no change in the coming four to five years. Let me elaborate the real meaning of "manpower shortage" and I think three minutes should be enough. If HA, in response to the current service demand, could have employed 6 000 doctors with the funding at hand but has a team of 5 500 doctors only, the problem of manpower shortage does exist and there is a shortfall of 500 doctors. For example, though an average establishment of 12 doctors has been provided to each clinical department, these departments are respectively served by 11 doctors only. However, according to reports from HA, the average number of weekly working hours for doctors is 51 hours, reflecting that some doctors are working like a dog while the workload for some others is still acceptable. Some Members have asked if it is feasible to pay for the overtime work of the 11 incumbent doctors with the funding allocated for the recruitment of the twelfth doctor, a vacancy which has not been filled. As a matter of fact, many of my doctor colleagues are willing to work overtime to meet the service demand but the point is: there should be reasonable compensation for the overtime hours worked. If HA is willing to do so, it will in fact not be necessary to take four or five years to solve the so-called problem of manpower shortage. With the present resources and funding, it should in fact not be difficult for HA to tackle the problem. But why is it not properly addressed? Resources in private market have not yet been taken into account in the analysis set forth above. Frankly speaking, there is also quite an abundant surplus of manpower in private market, so why is the problem still unresolved despite of all these? I can only maintain that the crux of the problem still lies in


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the inadequacies in HA's regulation and governance. This is the point I want to add. President, I so submit. PRESIDENT (in Cantonese): I now put the question to you and that is: That the motion moved by Dr LEUNG Ka-lau be passed. PRESIDENT (in Cantonese): Will those in favour please raise their hands? (Members raised their hands) PRESIDENT (in Cantonese): Those against please raise their hands. (Members raised their hands) Dr LEUNG Ka-lau rose to claim a division. PRESIDENT (in Cantonese): Dr LEUNG Ka-lau has claimed a division. The division bell will ring for one minute. PRESIDENT (in Cantonese): Will Members please proceed to vote. PRESIDENT (in Cantonese): Will Members please check their votes. If there are no queries, voting shall now stop and the result will be displayed. Functional Constituencies: Dr LEUNG Ka-lau voted for the motion.


Mr Tommy CHEUNG, Mr Frederick FUNG, Dr Joseph LEE, Mr WONG Ting-kwong, Dr LAM Tai-fai, Mr CHEUNG Kwok-che, Mr IP Kwok-him, Mr NG Leung-sing, Mr Steven HO, Mr Frankie YICK, Mr YIU Si-wing, Mr MA Fung-kwok, Mr Charles Peter MOK, Miss CHAN Yuen-han, Mr KWOK Wai-keung, Mr Christopher CHEUNG, Mr IP Kin-yuen, Mr Martin LIAO and Mr Tony TSE voted against the motion. Mr Albert HO, Mr James TO, Mr CHAN Kin-por and Mr POON Siu-ping abstained. Geographical Constituencies: Mr LEUNG Kwok-hung voted for the motion. Mr LEE Cheuk-yan, Mr CHAN Kam-lam, Mr TAM Yiu-chung, Mr WONG Kwok-hing, Mr Ronny TONG, Ms Cyd HO, Mr CHAN Hak-kan, Mr WONG Kwok-kin, Mrs Regina IP, Mr Alan LEONG, Mr Albert CHAN, Ms Claudia MO, Mr Michael TIEN, Mr CHAN Chi-chuen, Mr CHAN Han-pan, Miss Alice MAK, Dr Fernando CHEUNG, Dr Elizabeth QUAT, Dr CHIANG Lai-wan and Mr Christopher CHUNG voted against the motion. Ms Emily LAU, Mr Paul TSE, Mr WONG Yuk-man, Mr WU Chi-wai, Mr Gary FAN, Mr SIN Chung-kai and Dr Helena WONG abstained. THE PRESIDENT, Mr Jasper TSANG, did not cast any vote. THE PRESIDENT announced that among the Members returned by functional constituencies, 24 were present, one was in favour of the motion, 19 against it and four abstained; while among the Members returned by geographical constituencies through direct elections, 29 were present, one was in favour of the motion, 20 against it and seven abstained. Since the question was not agreed by a majority of each of the two groups of Members present, he therefore declared that the motion was negatived.


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PRESIDENT (in Cantonese): Third Member's motion: Following up the matter on Mr SNOWDEN's disclosure of the United States Government's hacking into the computer systems in Hong Kong. Members who wish to speak in the motion debate will please press the "Request to speak" button. I now call upon Mr MA Fung-kwok to speak and move the motion. FOLLOWING UP THE MATTER ON MR SNOWDEN'S DISCLOSURE OF THE UNITED STATES GOVERNMENT'S HACKING INTO THE COMPUTER SYSTEMS IN HONG KONG MR MA FUNG-KWOK (in Cantonese): President, I believe Members can still recall the Octopus Card Incident that took place several years ago. At that time, because of the joint follow-up efforts of the New Century Forum and other organizations, the Octopus Cards Limited was found to have sold the personal data of its customers for profit. As the entire city was outraged by the incident, the company's Chief Executive had to take the blame and resign, while the Chairman of the MTR Corporation Limited had to apologize to the public. In order to preclude the occurrence of similar incidents, the Legislative Council passed the amendments to the Personal Data (Privacy) Ordinance in 2012 to enhance protection for the personal privacy of members of the public. Hence, the public thought we could finally have peace of mind. In an interview with the South China Morning Post on 15 June this year, Mr Edward SNOWDEN unveiled that the intelligence agencies of the United States (US) have been extensively hacking into and monitoring their non-military targets since the "PRISM" operation was launched 2007. Such targets, including China, public officers of Hong Kong, students, The Chinese University of Hong Kong (which is a major network node of the local Internet network), and telecommunications companies, have been under their surveillance for the past five years. Mr SNOWDEN has also disclosed other surveillance operations targeted at the European Union, G20 Summits, the "BRICS" countries, and more than a dozen Latin-American countries. Such operations are just beyond imagination.


The infringement on personal privacy posed by the "PRISM" operation is far more serious than the Octopus Card Incident. It has gravely breached Article 12 of the Universal Declaration of Human Rights, which stipulates that "No one shall be subjected to arbitrary interference with his privacy, family, home or correspondence, nor to attacks upon his honour and reputation. Everyone has the right to the protection of the law against such interference or attacks." Besides, the operation has also infringed upon Article 30 of the Basic Law, which stipulates that "the freedom and privacy of communication of Hong Kong residents shall be protected by law", not to say the Law of Hong Kong. The "PRISM" operation has gravely encroached Hong Kong people's rights to privacy of communication and personal privacy, as well as our country's sovereignty over Hong Kong, thereby rendering all protection for Hong Kong people' privacy into waste paper. We really have to thank Mr SNOWDEN for stepping forward to realize his notion that "I do not want to live in a world where everything I do and say is recorded". If he had not unveiled the matter or acted as a whistle-blower, the billions of people across the world would still be completely in the dark about what has been going on, not knowing that we have been put under surveillance round the clock and spied on in all aspects over the years. This is just like the secret agent movie "The Lives of Others" in reality, with us being the main characters who are living in white terror, with round-the-clock and all-pervasive surveillance following us wherever we go. One can only tremble with fear. President, I would like to make use of this motion debate today to express the strong dissatisfaction of the people of Hong Kong with the US Government in this regard, and to urge the SAR Government to request clarification from the US Government, so as to safeguard the security of cyber communications in Hong Kong, and ensure the protection of Hong Kong people's privacy. We have three reasons to express our dissatisfaction with the US Government, and the first one is that the surveillance project of launched by the US Government is neither ethical nor reasonable. In the September 11 terrorist attack condemned by all, 3 000 innocent people were killed, including two people from Hong Kong. In the subsequent years, Hong Kong has been trying our best to collaborate with and assist the US in its anti-terrorism efforts. Both the US ― Hong Kong Policy Act Reports prepared by the US Government and the annual reports on anti-terrorism actions


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submitted to the Congress have recognized and praised Hong Kong's anti-terrorism efforts and good partnership. What is more, Hong Kong has even been commended as the most diligent and successful region in implementing the Port Security Agreement for anti-terrorism purposes. Hong Kong is by no means an enemy of the US or a hiding place for terrorists, but rather a good helping hand and a good partner for the US in terms of anti-terrorism collaboration and economic collaboration. Nonetheless, Hong Kong is included as a surveillance target in the "PRISM" operation. Whether the US is doing this out of terrorism phobia, demand for business intelligence, or other secret political motives, it is just incomprehensible and unacceptable to us. All such deeds which do grave damages to human rights and personal dignity and betray one's partners in anti-terrorism collaborations must be strongly condemned. President, the second reason why we have to express dissatisfaction with the US Government is that it is overbearing and unreasonable of the US to require Hong Kong to extradite SNOWDEN. When its ugly deeds were unveiled, the OBAMA Government did not make any comments at first, it was only until the eve of the G8 Summit the US Government rushed to adopt all kinds of sophistry to quench the fire on different fronts, so as to save its President from embarrassment. In this connection, the Director of the Central Intelligence Agency argued that it was through cyber surveillance that over 20 terrorist attacks had been successfully prevented; the White House Chief of Staff claimed that the surveillance programme had been examined by the executive, the legislative and judicial branches of government; and Congressman and former Vice President of the US, Richard Bruce CHENEY, has even tried to divert people's attention by groundlessly accusing SNOWDEN of being a spy working for China. All along, Washington has been accusing Chinese enterprises of online infringement, so as to exert pressure on China. However, the fact unveiled by SNOWDEN proves that China is in fact the victim, as the US Government hacks into Chinese networks and infrastructural facilities extensively. The US has shamed into anger and is behaving like "a thief crying thief", as it has brought a fabricated accusation of buying off SNOWDEN against China. In exposing that the intelligence agency of the US Government is the world's largest hacker, SNOWDEN has unveiled the real face of the US


Government which has always claimed to uphold human rights, liberties and democracy. As a result, this highly confidential intensive surveillance programme of the US is made known to the world. All the dirty deeds involved which should be kept in secret are now completely exposed. Under the pretext of anti-terrorism and national security, the OBAMA Government is putting the interests of the US on top of the interests of the peoples across the world, thereby harming the rights of different countries and their nationals. President, SNOWDEN has caused the US Government to lose face gravely and get besieged on all fronts. As such, when he was hiding in Hong Kong to "blow the whistle", the US Government requires the SAR Government to issue a provisional warrant of arrest to arrest SNOWDEN and extradite him to the US. Eventually, SNOWDEN left Hong Kong silently for Russia to seek political asylum in other countries. The US Government subsequently condemned the Hong Kong Government for deliberately letting SNOWDEN leave the territory. As such, Hong Kong is dragged into an international political turmoil for no reason. President, according to a statement made by the Secretary for Justice on 25 June, the arrangements for surrender of fugitive offenders between the US and Hong Kong has to comply with the provisions under the Fugitive Offenders Ordinance (Cap. 503) and the relevant agreement the two parties have signed in 1996, one of such is that the criminal offences alleged by the US Government have to satisfy the dual criminality requirement under Hong Kong law before the extradition procedures can be commenced. Since the "PRISM" operation was unveiled by SNOWDEN, the US Government has not denied the existence of such a programme. On the other hand, the US Government has not expressed any apology for the matter either, it just kept pressing Hong Kong to arrest SNOWDEN in accordance with the extradition agreement. As referred to by many Members during the relevant adjournment debate, the extradition agreement has specified that to invoke the agreement, the offences involved have to satisfy the dual criminality requirement. Which piece of US law has SNOWDEN's whistle-blowing incident broken? Is there any corresponding legislation in Hong Kong in this regard? These are very serious legal issues, the US Government just cannot evade them by giving some ambiguous statement.


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President, in dealing with the SNOWDEN incident, the SAR Government has all along been acting in accordance with the law, withstanding pressure from various sources, upholding importance principles like the rule of law and procedural justice. Actually, in its paper requiring Hong Kong to extradite SNOWDEN, the US Government has failed to provide specifically the offence SNOWDEN has committed as well as his passport number. What it more, Mr SNOWDEN's full name as shown in the relevant paper is incorrect. The SAR has tried in vain to seek clarification. Subsequently, the US Government alleged that SNOWDEN's US passport has been revoked. However, it was not until 27 June, five days after SNOWNDEN had left Hong Kong, that the Immigration Department of Hong Kong received from the US Government a notification of SNOWDEN's passport being revoked. All in all, the paper provided by the US Government in this regard was inattentively prepared and full of mistakes. Even after SNOWDEN had left Hong Kong, the US has blamed Hong Kong many times for letting SNOWDEN go. The US tries to turn Hong Kong's legal system into its political tool by twisting some serious legal issues into minor technical issues. In addition to blaming others for its perfunctory performance, the US Government has also threatened to revoke various proposed concessions for Hong Kong. All such deeds are reflective of how rude and unreasonable the US Government is. The third reason why we have to express our dissatisfaction is that the US has been behaving hypocritically like "a thief crying thief" in dealing with cyber security issues. The cyber world is a "double-edged sword". On the one hand, it changes the development of modern history and brings about various kinds of convenience and colours of life that were beyond imagination in the past; on the other hand, if it is attacked, manipulated or monopolized by someone, the results can be detrimental. This virtual political rivalry does not involve any military weapons, swords and spears, or bloodshed and fatal casualties. Cyber attacks are done quietly and without leaving a trace, capable of not only stealing military, commercial and scientific secrets, but also sabotaging hostile countries and even interfering with management control system of societies, nations and regions. In addition, cyber attacks may also paralyse the automatic computer system of various infrastructural and livelihood facilities like transportation, water supply, power supply, security, finance, medical services, and so on, and may even cause them to collapse totally.


Admittedly, the US has an edge in terms of advantage of Internet technology. Internet technology originated from the US and has now become very common across the world, but the US is still taking the lead in server and network technology when compared to many other places. Nevertheless, just because the US has an edge in Internet technology does not mean that it can be free from restraints and limitations, do whatever it wants, benefit itself at the expense of others, or disregard the sovereignty of other countries and the human rights and privacy of these countries' nationals. Quite the contrary, the US should do a good job in playing its role as a power country and leader, guiding countries to develop and maintain a reasonable code of order. Not long ago, the US strongly condemned the Chinese hackers for launching a massive attack on the US networks, stealing intelligence from US business establishments and arms suppliers. The US kept crying out to China that she must deal with cyber security issues properly. But then, while such words are still ringing in our ears, SNOWDEN has unveiled the double standards of the US government and its "thief crying thief" practices. All these facts are evidence proving that China is also a victim of hacking activities. All of a sudden, the "World Police" striving to maintain justice and priding on democracy has become the "Big Brother" in George ORWELL's novel 1984, which is a dictatorial government subjecting its people to close surveillance. The evil deeds of the US are now exposed to the world, but this great country lacks the courage to rectify its mistakes. Instead, it just keeps making rude and unreasonable accusations. In the just concluded Fifth Round of China-United States Strategic and Economic Dialogue, the US Government still claimed that it was very disappointed because Hong Kong had not send SNOWDEN back to the US. State Councillor YANG Jiechi firmly responded to the US, saying that "the Hong Kong Government has acted in full accordance with the law in handling the SNOWDEN incident, and such actions have nothing to be blamed for", thereby doing justice to the SAR Government at the highest level. President, just because we criticize the US does not mean that we are not aware of the importance of Hong Kong maintaining a cordial relationship with the US. The US is still the world's most powerful and richest country, and also a very important trade partner of Hong Kong. We certainly cherish the cordial relationship between Hong Kong and the US, but justice and the truth should not be twisted just because the US is a powerful country. A genuinely cordial relationship should be based on genuine mutual respect and mutual trust. If the


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US regards Hong Kong as an important partner, and value the importance of our mutual co-operation, they must give the people of Hong Kong a clear account of the incident and an apology openly. In addition, they should also delete the information collected, undertake not to carry out similar operations again, and let the SNOWDEN incident come to an end as soon as possible. Mencius said, "When one by force subdues others, they do not submit to him in heart, they submit just because their strength is not adequate to resist; when one subdues others by virtue, they truly admire him and sincerely submit ……". Cyber security is not only about the development of technology, but has also extended to the governance of cyberspace security across the world. Countries must strengthen the multinational collaboration among themselves and formulate Codes of Conduct, so as to boycott and counter hegemonic rampage on the technology front. President, I very much agree with the decision made by the House Committee last Friday to send letters respectively to the US Government as well as the Senate and the House of Representatives to express condemnation and dissatisfaction, demand the US to stop all similar Internet surveillance operations immediately, and urge the Senate and House of Representatives of the US Congress to solemnly investigate into such illegal activities conducted by the OBAMA Government. President, I propose this motion for debate today because it is my hope to express strongly and clearly to the US Government the dissatisfaction harboured by the Council and the people of Hong Kong, and to support and urge the SAR Government to stand firm, reason with the US Government, follow up the matter persistently, and request the US Government to stop its surveillance activities and destroy the information so collected, so as to restore justice for Hong Kong. Besides, the US Government should also be requested to openly and solemnly give a clear account of what it has done. With these remarks, I beg to move. Thank you, President. Mr MA Fung-kwok moved the following motion: (Translation)

"That, as Mr SNOWDEN, a former technical assistant for the Central Intelligence Agency of the United States ('US'), disclosed during a media interview the matter on the US Government's surveillance of and hacking


into Hong Kong's communications networks, this Council expresses strong dissatisfaction with the US Government in this regard, and urges the SAR Government to request clarification from the US Government, so as to safeguard the security of cyber communications in Hong Kong, and ensure the protection of Hong Kong people's privacy."

PRESIDENT (in Cantonese): I now propose the question to you and that is: That the motion moved by Mr MA Fung-kwok be passed. PRESIDENT (in Cantonese): Three Members wish to move amendments to this motion. This Council will now proceed to a joint debate on the motion and the three amendments. I will first call upon Mr Charles Peter MOK to speak, to be followed by Mr Ronny TONG and Mr SIN Chung-kai respectively; but they may not move amendments at this stage. MR CHARLES PETER MOK (in Cantonese): President, I thank Mr MA Fung-kwok for proposing this legislative session's last motion. I support the wording of the original motion, and I hope that Honourable colleagues will support the amendments proposed by me and two other Members. In particular, I would like to explain that my proposed amendment seeks to step up, on the basis of the contents set out in Mr MA Fung-kwok's motion, our request to the United States (US) Government. Also, it is my hope that in addition to requesting clarification from the US Government, the Hong Kong Government will specifically require the US Government to be held accountable for the matter, to stop stealing data from our networks, and to immediately destroy the information so collected. Mr SNOWDEN has left Hong Kong for a few weeks, and we have seen been watching the news every day to care for his whereabouts. In this connection, I think we should be grateful to him for unveiling this unknown dark side of the US Government involving in cyber surveillance activities. Over the past few weeks, people around the world have discovered bit by bit that the different corners of the five continents, the so-called allies or enemies of the US, particularly the allies, and even some so-called strategic partner countries are the


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surveillance targets of the US to monitor objects. What is more, not just than the US Government but many powerful countries in the West are doing the same thing. These governments use national security and anti-terrorism as their pretext, and collect or analyse network data of ordinary citizens. Their purpose is to find out every move of each and every person on the Internet. As people are afraid that they may be under surveillance, they may tend to exercise self-censorship on the Internet, and thereby resulting in a chilling effect, which may in effect weaken the efforts to monitor the government and democracy. Contrary to these countries claimed objective, so far no neutral research studies or statistics have shown that collecting network data is of any proven help to anti-terrorism efforts and prevention of terrorist attacks. However, I hope that in debating this motion today, Honourable colleagues will not focus solely on making a political statement against the US's surveillance activities, or even accusing each other of holding double standards and not making a clear stance against the US Government's activities in this regard. I really do not want to see that this debate will cause Hong Kong to split up unnecessarily. In fact, in the past few weeks I have received some emails from members of the public questioning why I did not protest against the US Government's activities in this regard, and I answered them that on as early as 15 June, I had participated in a demonstration outside the US Consulate to voice out on the spot my objection to their activities and to ask the US Government to give a clear account of the matter. At that time, Mr LEUNG Kwok-hung was also present. In addition to participating in the procession, I have also asked the Secretary for Security during the urgent question session of a Council meeting whether the SAR Government would follow up the matter with the US Government. He did not respond at that time. A week later, after SNOWDEN had left Hong Kong, he came out and said concernedly that he had requested the US Government to give a clear account of the matter. However, up to now, as far as we know, the outcome has yet to be seen. I have also written to the Privacy Commissioner for Personal Data (the Commissioner) two weeks ago to request the Commissioner's Office to proactively investigate into the US Government's hacking into Hong Kong's


communication networks. The reply from the Commissioner was that "as the Office does not have jurisdiction over data users outside Hong Kong" and "acts of intrusion are activities at state level", "it does not have any authority to take appropriate follow-up actions". The Commissioner also mentioned that he noted that the Secretary for Security had written to the US Government, and he would "urge the Administration to actively follow up the matter and to give an account of the incident to the people of Hong Kong expeditiously to allay everyone's concerns". So, the entire matter is just like a "ball" being kicked around different government departments. President, I have also written to the Chief Executive's Office (CEO) two weeks ago to request the Hong Kong Government to give an account of the progress of the efforts to request the US Government to explain its cyber surveillance activities and be held accountable for the matter, and express our concern for the relationship between Hong Kong and the Central Government, in particular the need or otherwise of the Hong Kong Government to seek assistance from the Central Government in requesting the US Government to give an explanation. In my view, this incident does involve issues between countries and at diplomatic level, and we should therefore request the Central Authorities to make things clear, so doing may not be a problem even under the principle of "one country, two systems". However, the Hong Kong Government does have a responsibility to let the people of Hong Kong know the circumstances and conditions under which it will seek assistance from the Central Government; besides, whether this should happen now or in the future, it would be better to let the public know in advance than afterwards. As such, in the letter I sent to the CEO and item (3) of my proposed amendment, I have expressed my hope that the Government will clarify this point. I can tell Members that the CEO has responded to my letter, only that the reply letter does not have any substance apart from acknowledging receipt of my letter. Hence, the letter I sent on 3 July is in effect still waiting for a real reply. President, item (1) of my proposed amendment urges the Government "to formulate relevant policies to enhance the information security of Hong Kong's small and medium enterprises (SMEs), including assisting them in using more world-class and locally researched and developed information security technologies …… to further support local research work on information technologies, and generate demands for local information technology products". Indeed, the SNOWDEN incident has caused the people of Hong Kong to wonder


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whether the infrastructural facilities of the Government or other large organizations are sufficiently equipped to tackle the hacking activities conducted by world-class hackers or intelligence agencies. However, the issue I have been emphasizing in the past few weeks is that the real problem actually lies in the attacks from general hackers every day, as these hackers attack the networks of both the local ordinary Internet users and the SMEs. So, the real problem is that while we spend all out time worrying about how to prevent spyware attacks, the doors of the network systems of most SMEs and individual users are left wide opened, and no one care to bother about the thieves coming in and out frequently. So, about two weeks ago, I joined Ir Dr LO Wai-kwok and a group of IT professionals and organizations, including the local security system company producing world-class cyber security systems in Hong Kong, to hold a press conference to urge the Hong Kong Government to strengthen support for the development of local technology products, procure and use more local products and services, so that these local businesses and their products can be rooted in Hong Kong and extended to the world. Besides, I believe this will practically help to enhance our overall cyber security. Also, I had previously asked the Government during an oral question session what other laws and regulations, apart from the Interception of Communications and Surveillance Ordinance, it had in place to monitor the surveillance, monitoring and eavesdropping activities conducted by governments of other places, individuals or businesses. The Government's response included a lot of information on the Crimes Ordinance, including even the "universal" offence of dishonest use of computer systems, as well as sections 24 and 27A of the Telecommunications Ordinance. However, as I dug further into the matter, it was eventually disclosed that sections 24 and 27A of the Telecommunications Ordinance, which were really targeted at surveillance activities, had so far been invoked to institute merely zero and three prosecutions respectively. What is more, at that time the Secretary even said that the three prosecutions were concerned with stealing television signals. In other words, there have never been any surveillance activities involving Hong Kong in the past. Please stop kidding, even if we put aside the SNOWDEN incident and just take into account the situation within the community, I do not think the people of Hong Kong will believe that there have not been any surveillance activities here before. Whether such situation implies


that the existing laws concerned should be reformed, or something is wrong on law enforcement front, the Government should not take the matter lightly. Otherwise, it will not do Hong Kong any good even if we have in place the most remarkable information infrastructure, because our networks may still be like a "unguarded castle" and we have no way to hold the relevant parties legally accountable for the cyber attacks. I believe Mr Ronny TONG will further expound on this aspect when he speaks on his proposed amendments later on. Last but not least, I wish to point out that we should enhance the community's awareness of the need to protect their personal data privacy online, keep a close watch on network privacy and freedom of information, and in particular, check if the Government has abused the loopholes in the system to escape supervision. We need to remain vigilant all the time, sit together with different stakeholders to discuss issues relating to data privacy and freedom of information, and participate earnestly in the consultation activities held by the Government and advocate policies. Many people may feel that their personal online behavior will be under surveillance in any case, and since their personal data are not of value to other people, they become indifferent to the matter and adopt a "give-up" attitude, which is to take no protective measures at all. This is so wrong. Protecting one's personal data and privacy is an unshirkable responsibility of each and every network user, and for the users who have frequent access to sensitive information, they particularly need to protect themselves and encrypt all the data used. President, I so submit. It is my hope that Members will support my proposed amendment, as well as the original motion and the amendments proposed by other Members. Thank you, President. MR RONNY TONG (in Cantonese): President, I am very grateful to Mr MA Fung-kwok for the motion he has moved today. While I do agree with the wording of his motion, I need to point out that this Council has decided last week to write to condemn the United States (US) Government and request the US Congress to step up actions to monitor its Government's telephone tapping activities. As such, the speech I am going to deliver today and my proposed amendment will mainly be focused on the SAR Government's long-term negligence of the basic constitutional rights of the people of Hong Kong.


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Actually, the Basic Law has very clear provisions in this regard: "The freedom and privacy of communication of Hong Kong residents shall be protected by law. No department or individual may, on any grounds, infringe upon the freedom and privacy of communication of residents except that the relevant authorities may inspect communication in accordance with legal procedures to meet the needs of public security or of investigation into criminal offences." We can see that this provision provides no room for maneuver for the Government, or for other individuals, departments, or individual government. The freedom and privacy of communication of Hong Kong residents must be protected of by law. In this regard, I believe the Secretary may also recall that before the passage of the Interception of Communications and Surveillance Ordinance (hereinafter referred to as the "Tapping Ordinance"), we had strongly urged the SAR Government to enact legislation to protect the privacy and freedom of communication of the people of Hong Kong. At that time, the Government lead by Donald Tsang just tried their best to avoid taking on any work as usual, and eventually issued an Administrative Instruction saying that the said Administrative Instruction is sufficient to protect Hong Kong people's privacy. In the end, Mr LEUNG Kwok-hung took a case against the Administrative Instruction all the way to the Court of Final Appeal, and Court of Final Appeal's judgment was against the Government. Then, the Government submitted the Tapping Ordinance within a very short period of time and required the Legislative Council to pass that piece of legislation within three months. President, you may also recall that at that time we debated the Tapping Ordinance overnight. Actually, this Tapping Ordinance has nothing to do with the original motion under discussion today, as the Tapping Ordinance seeks to monitor only telephone tapping and interception of communications by law-enforcement personnel. This Ordinance has nothing to do with telephone tapping and interception of communications by non-law-enforcement personnel, but our concern is precisely the relevant practices of non-law-enforcement personnel. The reason why the US Government or any other government, public security agencies can do whatever they want to in Hong Kong is that the SAR Government has never fulfilled their due constitutional responsibility, which is to


legislate to protect the privacy of communication of the people of Hong Kong. In this regard, Secretary LAI and Secretary SO have provided some very angry answer on different occasions. Why do I consider their answers angering? This is because their answers to the people of Hong Kong were completely misleading. They described the current situation as if we do not have any laws to officially protect the privacy of communication of the public, but there are other laws that indirectly protect Hong Kong people's rights in this regard. President, this is complete nonsense. First of all, I must it clear that I am now talking about telephone tapping and interception of communications. I hope that the Secretary will not rise to tell me some acts involving the "stalking law" or the "paparazzi", because we are not discussing such acts, we are talking about telephone tapping and interception of communications. If someone engaged in telephone tapping or interception of communications is a law-enforcement officer, we can at least assume that his purpose is justified, as he may be doing so to detect and even prevent crime, or may be to track down the wanted law offenders. Hence, we can assume that his purpose is justified. However, if the persons engaging in telephone tapping or interception of communications are non-law-enforcement personnel, their purpose must be undesirable. Even if the persons concerned are from the media, I will also insist that they should not be allowed to do these things. Frankly, freedom of press is certainly very important, but freedom of the press is not any overriding rule. All of our basic rights (even the freedom of expression) are subject to limitations, I can never accept the media engaging in interception of other persons' communications in producing their entertainment news. Members may recall that not long ago, a newspaper in the United Kingdom was in great trouble as a result of intercepting the communications of the royal family. In the end, the Prime Minister almost had to resign to take blame for the incident, and naturally the newspaper concerned had to close down. That being the case, we should understand that what we are discussing today is not freedom of the press, and I hope that the Secretary will not try to be evasive and speak on a lot of irrelevant things when he makes his speech in response later on. Just now I said that the Secretary and the SAR Government are misleading the people of Hong Kong. Why did I say so? This is because every time we asked them about the matter, they would always refer to a number of other laws,


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saying that such laws could protect the public. However, this is definitely not the case, as we are talking about different issues. For example, in answering a question raised by Mr Charles Peter MOK earlier on, the Secretary for Security has made mention to sections 24, 27 and 27A of the Telecommunications Ordinance. Yet these clauses are totally irrelevant to the matters we are discussing today, because section 24 is applicable only to telecommunications officers or persons who have official duties in connection with a telecommunications service, for those persons who are outside the said categories, the provision is not applicable to them. We are not talking about these personnel, we are talking about the US Government or non-law-enforcement officers. Section 27 is about activities which damage, remove or interfere with a telecommunications installation, and is also totally irrelevant to the subject matter we are discussing now; as for section 27A, it is about any person who, by telecommunications, obtains unauthorized access to any programme or data held in a computer. President, we are not talking about any programme or data, we are talking about your emails and mine, your telephone communications and mine. Hence, this provision is not applicable as well. I really do not understand why the Secretary can be so "thick-skinned" and use these provisions as the authorities' grounds for not legislating to protect the basic rights of the people of Hong Kong. In raising his other views to the Legislative Council some time ago, the Secretary for Commerce and Economic Development, Mr Gregory SO, mentioned that we already had in place legislation on protection of personal data privacy, as well as the offence of dishonest use of computer systems, and they should be helpful in this regard slightly. First of all, as we all know, the Personal Data (Privacy) Ordinance is really not any legislation safeguarding the personal data privacy of the public. However, on seeing the title of Ordinance, many members of the public have mistaken it for a law protecting our rights. In fact, this is not so. This Ordinance only regulates the so-called data collectors, and it also expressly provides that violation of this Ordinance will not give rise to any civil and criminal liabilities. The Privacy Commissioner will take legal action only after he had advised the person concerned to rectify his behavior and that person did not respond to the Commissioner's advice. Basically, as reflected in many other cases that took place in Hong Kong, even the police, police officers or police stations have leaked out someone's personal data, hey will not be in trouble. Hence, this piece of legislation just cannot offer any help.


As regards the offence of dishonest use of computer systems mentioned by the Secretary, in fact I really do not know what this offence is. Even though the Secretary said that this could be of help, at present the legislation concerned does not have any extraterritorial effect. In other words, if any Americans should come to Hong Kong to intercept our communications, we cannot invoke this piece of legislation to monitor them or institute prosecutions against them. President, how can we further protect the privacy and freedom of communication of the people of Hong Kong? In my view, we need to draw up a law to deal specifically with telephone tapping and interception of communications. I have said earlier on that we are not discussing any stalking behavior or acts of "paparazzi", we are talking about the most basic protection, and this protection seeks to enable us to prevent someone from coming to Hong Kong to steal our personal data recklessly like the Americans do. We have to set out clearly in the provisions that if the outcomes indicate that their activities have infringed upon the privacy of the people of Hong Kong, regardless of the location where such activities were carried out, such activities should be regarded as criminal acts in so far as Hong Kong is concerned. President, this approach is not unique, nor is it something new, we have many other laws which are directed at the outcomes of activities. A recent example is the Competition Ordinance. The Competition Ordinance has also prescribed that for any activity conducted in any corner of the world, if the outcomes of the activity emerges in Hong Kong, then it is an illegal act as far as Hong Kong is concerned. If the Americans should engage again in putting the secret communications of the people of Hong Kong under their surveillance, when the person concerned arrived in Hong Kong, we would be able to monitor them and may also issue an arrest warrant to arrest the Americans committing crimes in Hong Kong. President, I hope the SAR Government will legislate to safeguard our liberties. MR SIN CHUNG-KAI: President, I wish to amend the motion moved by Mr MA Fung-kwok on "Following up the matter on Mr SNOWDEN's disclosure of the United States Government's hacking into the computer systems in Hong Kong".


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The original motion states: "That, as Mr SNOWDEN, a former technical assistant for the Central Intelligence Agency of the United States ('US'), disclosed during a media interview the matter on the US Government's surveillance of and hacking into Hong Kong's communications networks, this Council expresses strong dissatisfaction with the US Government in this regard, and urges the SAR Government to request clarification from the US Government, so as to safeguard the security of cyber communications in Hong Kong, and ensure the protection of Hong Kong people's privacy." I support Mr MA Fung-kwok's motion as well as the amendments made to it by the following Council Members: Mr Charles Peter MOK, Mr Ronny TONG, and of course, myself. President, Hong Kong's cyber security systems and technology levels are in a position of considerable disadvantage to that of the United States. It became apparent to Hong Kong that we are at this disadvantage when Edward SNOWDEN, a former analyst of the Central Intelligence Agency of the United States, disclosed in an interview with the South China Morning Post that the United States Government had been hacking into computer systems in both Hong Kong and the Mainland since 2009. According to Mr SNOWDEN, the United States Government has acquired huge quantities of communications information from the computer systems of The Chinese University of Hong Kong, local public officers, enterprises and students. We urge the SAR Government not only to request clarification from the United States Government about the security of cyber communications in Hong Kong, but more importantly the SAR Government needs to review and strengthen the monitoring of online security systems and enhance Hong Kong's technological level. In order to better position Hong Kong so that this situation does not occur again, we must make the necessary reviews and amendments in the legislation in order to strengthen Hong Kong's security of cyber communications. (THE PRESIDENT'S DEPUTY, MR RONNY TONG, took the Chair) First of all, we need to review our legislation. There are a couple of Ordinances that need to be reviewed. They include the Telecommunications


Ordinance, the Crimes Ordinance and the Theft Ordinance, as well as the Interception of Communications and Surveillance Ordinance. In March 1992, the Hong Kong Government gazetted for the first time a Bill on computer crimes. The Bill introduced new types of criminal offences concerning activities involving computers. The Bill addressed issues relating to computer fraud and computer abuse, which constitute major threats to information systems and security. The Computer Crimes Bill has now become a law in Hong Kong. Enacted in 1993 through amending the Telecommunications Ordinance, Crimes Ordinance and the Theft Ordinance, the law created new offences and broadened the coverage of existing offences. As it has already been in place for 20 years, I believe we need to revisit these three ordinances, namely the Telecommunications Ordinance, the Crimes Ordinance and the Theft Ordinance, in order to enhance them so that we can protect Hong Kong from being hacked again. In particular, we must review the Criminal Jurisdiction Ordinance. The jurisdiction of the courts of Hong Kong is limited to acts occurring within the geographical boundaries of Hong Kong unless otherwise specified. The offences of unauthorized access to computers and access to computer with criminal or dishonest intent often cover criminal acts that are transnational in nature. A perpetrator can gain access to a computer in Hong Kong even when he is in an overseas country. As Mr SNOWDEN has pointed out to the world that the United States has hacked into our computer systems, we need to have legislation in place in order to deal with this type of situation if it arises again. As Mr Charles Peter MOK says in his amendment, Hong Kong must target "the enforcement loopholes in respect of governments, organizations, commercial organizations and individuals outside Hong Kong, so as to strengthen the combat against …… unauthorized retrieval and retention of network information". That is why we must review the Criminal Jurisdiction Ordinance (Amendment of Section 2(2)) Order 2002 which was supported without giving reasons to this Council. We must also revisit the Interception of Communications and Surveillance Ordinance (ICSO), which came into force on 9 August 2006. The ICSO provides a stringent regulatory regime for the interception of communications and specified kinds of covert surveillance operations by public officers. This framework, set out in the ICSO, is designed to regulate the tension between enforcement agencies observing the privacy of the public on the one hand and


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combating crime and protecting public security on the other. I propose two major amendments to the ICSO. Firstly, we should follow the example set by the Australian Government/the Australian system under their Telecommunications (Interception and Access) Act 1979 and define what is meant by the term "public security" under our ICSO. Adoption of such a robust and comprehensive definition as outlined in section 4 of the Australian Act, would better clarify the instances where interception and surveillance is appropriate as well as reduce the likelihood of abuse. Furthermore, we must make provisions in the Ordinance in order to criminally sanction law-enforcement officers and other public officials granted power under the Ordinance, for misuse or abuse of such power granted. Imposition of these sanctioning provisions would further deter abuse of the powers granted to law-enforcement officers under the ICSO. Our current security policies are in dire need of review as the current structure is ill equipped to deal with this new world of cyber crime and hacking that we now face. In addition to reviewing Hong Kong's online security systems and relevant legislation, we should also consider developing an act similar to the United States Freedom of Information Act. Introducing this act would provide the right to Hong Kong citizens to access information from the Government, except if it were protected from public disclosure. The United Kingdom also has a system in place which is similar to that of the United States. Under the United Kingdom's Freedom of Information Act 2000, their House of Commons and the House of Lords are required to make information that they hold available to the public in certain circumstances upon application. Individuals also have the right to request access to personal data about themselves under the Data Protection Act 1998. So, enacting a Freedom of Information Act would help enable citizens of Hong Kong to be in the know about their Government. Hong Kong prides itself on being open and transparent. Having this act would further Hong Kong's desire to be transparent and would renew the people's trust in their Government. I urge the Government to explore this further. I would also like the Government to investigate the secret agreement that was just revealed a couple of days ago involving Telstra Corporation Limited (Telstra), PCCW Limited (PCCW) and United States Federal Bureau of


Investigation. According to Crikey, an independent media outlet, the United States Government agencies signed a secret agreement that gave the United States an extremely broad level of access to all the telecommunications passing in and out of the United States. The documents that were published show that the stimulus for the agreement to be signed was the application of Telstra/PCCW submarine cable joint venture Reach, which operates major underwater fiber links between a number of Asian countries, as well as Australia and the United States, to provide telecommunications services from the United States back in 2001. The agreement stipulates that Reach must ensure that the data was maintained for the United States Government and must not be stored in a manner which could be subject to mandatory destruction under the laws of foreign countries. This means even though Telstra was majority owned by the Australian Government at the time of signing the agreement, it would be required to avoid deleting the stored data, even if required to do so under the Australian law. We must know if this is just the tip of the iceberg and if other cable or telecommunication companies sign similar agreements with other government departments. It is imperative that we must investigate this matter as it directly relates to Hong Kong's security. The Office of the Telecommunications Authority should make an investigation report to this Council regarding this issue. Deputy President, I believe (The buzzer sounded) …… DEPUTY PRESIDENT (in Cantonese): Mr SIN, your speaking time is up. SECRETARY FOR SECURITY (in Cantonese): Deputy President, first of all, I need to thank Mr MA Fung-kwok for moving this motion today subsequent to the urgent question raised on 19 June, so that Members can continue to focus their discussion on "following up the matter on Mr SNOWDEN's disclosure of the United States Government's hacking into the computer systems in Hong Kong". Over the past few weeks, the Legislative Council has held many discussions on this topic. At the meeting of the Panel on Information Technology and Broadcasting held on 8 July, government personnel from the Commerce and Economic Development Bureau have also reported to Members the Government's information security policies, the relevant guidelines issued, as well as the measures taken in this respect.


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I understand that Members' concerns for this issue are mainly focused on several aspects: firstly, whether the technical expertise of the Government's information system security efforts is sufficient to prevent and combat hackers hacking into local computer systems; secondly, if technology crimes like unauthorized access to computers should take place, how are the police going to follow up the matter; thirdly, in view of the media coverage accusing the United States (US) Government of hacking into Hong Kong's computer systems, how is the SAR Government going to follow up the matter with the US authorities. I will now make a brief overview of the three aforesaid points, and I will make a response again after listening to Members' views. With regard to information security, cyber security and the combat against technology crimes, the amendments proposed by Mr Charles Peter MOK and Mr SIN Chung-kai have mentioned enhancing information security and cyber security technologies to achieve world-class standards. As far as the combat against technology crimes is concerned, the Police Force is well-equipped with world-class expertise and competence in terms of its personnel training and other auxiliary resources. On the personnel training front, the Technology Crime Division of the Commercial Crime Bureau has recruited police officers with relevant computer knowledge to join the work. The Technology Crime Division also collaborates with the Police Academy in organizing regular internal professional training courses to upgrade the professional competence of members of the Technology Crime Division. As for other auxiliary resources, from 2007 to 2012, the Police Force has allocated a total of $10 million-odd to update and purchase additional equipment relevant to training in combating technology crimes, as well as computer forensics and investigations, with a view to enhancing the efficiency of the efforts to combat technology crimes. In order to further strengthen Hong Kong's defence against various kinds of cyber threats, the police established the Cyber Security Centre in December 2012. The Cyber Security Centre operates round-the-clock to enhance our cyber security. We believe that the work of the Cyber Security Centre can enhance Hong Kong's response to and defence against cyber attack incidents.


In addition, the Office of the Government Chief Information Officer (OGCIO) also keeps collaborating with the relevant industry and professional bodies in organizing activities to help the business sector, small and medium enterprises and the public to enhance their awareness of and knowledge in protection for computer systems and information. The OGCIO will continue to maintain close contact with the industry and relevant information security experts to listen to their advice and guidance. Regarding the support for the local information and communications technologies industries, Mr Charles Peter MOK has suggested in his proposed amendment that efforts should be made to further support local research work on information and communications technologies. The Innovation and Technology Commission has been providing financial support for local universities, research centres and enterprises to carry out studies on the application of information security technologies, such as encryption algorithms, cloud computing security and privacy protection technologies. I would like to take this opportunity to expound on responsibility of the public. Some Members have proposed attaching importance to personal computer security, which I very much agree. Relevant government departments will continue to urge and educate the public to take note of the key issues of cyber security when using the Internet, including avoiding browsing suspicious websites, keeping their personal data safely, installing and starting the firewall and anti-virus software, regularly using anti-virus software to scan their computers, and avoiding using the same set of login passwords for different online accounts. Cyber security is an issue which the community as a whole must look squarely at. The Government, the industry, and members of the public all need to stay highly vigilant all the time and take the necessary measures to ensure cyber security. As for the interception activities conducted by non-public officers, Mr Ronny TONG has expressed concern for the interception activities conducted by non-public officers. Article 30 of the Basic Law stipulates clearly that "The freedom and privacy of communication of Hong Kong residents shall be protected by law. No department or individual may, on any grounds, infringe


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upon the freedom and privacy of communication of residents except that the relevant authorities may inspect communication in accordance with legal procedures to meet the needs of public security or of investigation into criminal offences". The purpose and designated scope of the Interception of Communications and Surveillance Ordinance seeks to regulate the lawful interception of communications and covert surveillance activities by law-enforcement agencies for the prevention or detection of serious crime and the protection of public safety, the Ordinance is not applicable to non-public officers and non-governmental organizations or individuals. However, this does not mean that non-public officers can conduct such interception of communications and covert surveillance activities, as the relevant activities may constitute other offences. Some Members request the Administration to step up regulation of interception activities by non-public officers. The Secretary for Constitutional and Mainland Affairs has responded at a Council meeting earlier on that since the issues involved are very complex and sensitive, the Bureau is dealing with five privacy protection-related Law Reform Commission reports in phases, and will plan the way forward in consultation with the various parties concerned. In addition, Members and the public are most concerned about the way the authorities have been following up with the US Government the case of Hong Kong's computer systems being hacked into. The Security Bureau has already sent a letter to the US Government on 21 June to formally request an explanation. We hope the US Government will provide the people of Hong Kong with a complete and comprehensive explanation expeditiously. Deputy President, I have outlined above the Government's efforts to combat technology crimes, as well as the SAR Government's follow-up actions in respect of Mr SNOWDEN's allegation that the US Government has hacked into Hong Kong's computer systems. I will make a response after listening to Members' views expressed in the motion debate. Thank you, Deputy President.


DR CHIANG LAI-WAN (in Cantonese): Deputy President, this "PRISM" incident is indeed a mirror reflecting another mirror. What is the other mirror? The other mirror is an "evil-exposing mirror". Some countries and individuals always pretend as angels, holding up flags of liberty and human rights in their hands. But they have no idea that in front of the "evil-exposing mirror", their real being is exposed and everybody can see how hypocritical they are. In 1791, the United States (US) passed first and fourth amendments to the Constitution of the United States, and the major objective of such amendments is to protect the US nationals' freedom of speech and personal privacy. In the wake of the September 11 Incident, the US passed the Patriot Act which seeks mainly to empower the Government to subject its people's communications to surveillance when absolutely necessary. If any one country prefers to monitor its people and intercept their communications, other countries will not take any regulatory actions, and no countries can do that either. However, the issue in question now is that the US is intruding into the privacy of the people of Hong Kong. It is a commonly recognized fact across the world that Hong Kong is one of the safest cities on earth, and it has never been a place where terrorist activities take place frequently. As such, what types of communications does the US intend to intercept in Hong Kong? What indeed is the US trying to do? The US has all along been boasting of its utmost respect for human rights, and Barack OBAMA has also openly stated that the US will not go to extreme ends in order to arrest SNOWDEN. Yet while his words are still ring in people's ears, the US has revoked SNOWDEN's passport in the absence of any trial or judgment. Is the US showing due respect for human rights in taking such actions? The US has also stated openly that it will not allow any other countries to provide political asylum for SNOWDEN. And for this reason, a number of countries have refused to let the Bolivian presidential plane fly across their airspaces. Should such kinds of Hegemonic acts be considered as the proper manner of any country? This time the "evil-exposing mirror" has also exposed the real face of some of the Members who always talk about citizen rights, freedom of speech, human rights legislation, privacy rights, and so on in a high profile manner. However, this time they just keep their mouths shut, as if they are standing on the same side front as the US. Their behaviour is indeed condemnable in my view. In


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particular, Ms Claudia MO and Mr Gary FAN even write to OBAMA to plead mercy for SNOWDEN. Have they lost their mind? If SNOWDEN had expected others to plead mercy for him, he would not have unveiled the secrets in the first place. SNOWDEN has betted his own life, do these two Members think he is not aware of the consequences he may incur? I believe if SNOWDEN just does not know whether to laugh or to cry when he learns of what these two Honourable Members have done. Many people of Hong Kong cannot but heave a deep sigh upon learning their deeds. Hong Kong is now under attack, yet these two Members have given in so quickly, it is just so embarrassing! They are very good at criticizing the Government, but for our part, we will definitely keep our minds clear in the face of issues of major importance involving right and wrong. In my view, in case Hong Kong should really be caught in difficult times or trouble, we would be very miserable if we had to rely on these two Members to defend us. Comparatively speaking, Mr Ronny TONG is "smarter", as he has at least criticized the Government and each of the departments and Policy Bureaux concerned. This is a smarter move. Dr KWOK Ka-ki is also very clever, as he at least knows how to make good use of the incident to drag our motherland into the scene. He said, "the so-called 'cyber police' intercept all the details of people's communications. The US does that, so does our Motherland." However, one thing Dr KWOK may not know is that the size of the US cyber police is beyond compare by other countries. According to the data from the United States National Security Agency, currently about 1.2 million people have permitted access to data of highest classified levels. In other words, one out of every 250 Americans is engaged in intelligence work. And that explains why the US Government is so keen to capture SNOWDEN, as it is afraid that the SNOWNDEN effect may spread and become out of control. This incident has also reflected the fact that Hong Kong really needs to enhance his cyber security systems. How come Hong Kong is completely in the dark about the "burglary" that takes place in our networks? Certainly, the Government does not have to follow the practice of the US and recruit a large number of employees to take charge of intelligence work. I think Mr Gary FAN will definitely support the Government, as he "understands very much that in order to safeguard national security, it is somehow inevitable for countries to put their nationals under surveillance". For this reason, I believe Mr Gary FAN will


definitely support the Government to legislate to enhance the local security of Hong Kong. Today, many people in Hong Kong are still using the anti-virus software developed by the US. As such, the most urgent task for the Government is to expeditiously review the existing cyber security systems, step up the development of firewall and anti-virus software, and plug the loopholes in the existing cyber security laws. Certainly, the most important task is that we must persistently request the US Government to clarify whether it has monitored and hacked into Hong Kong's communications systems. I so submit. Thank you, Deputy President. MR IP KWOK-HIM (in Cantonese): Deputy President, all along, the general public used to learn about spying activities from Hollywood movies. In reality, the majority of the public are leading a plain life while observing all rules and regulations, and have totally nothing to do with the exciting spying world. However, in the past month, plots that are found in spy movies took place in real life, as SNOWDEN, a former employee of the United States (US) Central Intelligence Agency (CIA) confirmed in person with the media that the US Government had implemented more than 60 000 hacking operations into the computer systems across the world. So far the US Government has not admitted or denied the allegations in clear words, and I think this can be taken as a tacit admission. This incident caused the peaceful city of Hong Kong ― a medium-sized city ― to become a major disaster area of a spy war. People cannot but wonder whether the reality is affected by movies or movies are inspired by the reality. In this connection, I believe Mr MA Fung-kwok should have a much better idea, as he is a member of the movie production industry. The US Government has all along been boasting of its respect for human rights and liberties, and considering itself as the "World Police". We can always hear the US Government criticizing the human rights situation of other countries. And the US Government is particularly busy on the cyber security front, as it has been vigorously accusing others as hackers. It is China's practice to "discipline oneself stringently and treat others leniently". Given that the US Government has put itself on such a moral pedestal, naturally we all think that the US must be


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highly virtuous, or it will not be in any position to criticize others. Some people in the political sector admire the US Government so much that they even follow the lead of the US. But then, this famous "World Police", the US Government, is in fact acting contrary to its claims like "a thief crying thief", as it has intruded into the privacy of countries and individuals across the world. According to SNOWDEN's disclosure, the US Government has been putting the world under surveillance, and its targets include even the US's traditional allies in Europe. In addition to its allies, the hacking targets of the US Government include also cities of all sizes, sparing not even a small city like Hong Kong. Starting from 2009, the US Government has been hacking into the computer systems in Mainland China and Hong Kong, monitoring hundreds of surveillance targets. Its hacking activities in Hong Kong are even conducted across sectors and fields, encompassing universities, civil servants, businesses and even students. While the US Government has been advocating human rights and liberties very ostentatiously, it is actually the "Big Brother" who has violated human rights and liberties most completely. Let us think about this: which country on earth is equipped with ample resources like the US Government, so much so that it can intrude thoroughly into everybody's privacy? The privacy and freedom of communication enjoyed by the people of Hong Kong is thus violated by the US Government. How can we not feel very angry? What makes us even more angry is that instead of showing any regret, the US Government has even tried to shift the focus of the matter by condemning the HKSAR Government for not handing over SNOWDEN to the US. The US Government wants to arrest SNOWDEN because has unveiled its evil deeds, yet it has failed to give us the full name of SNOWDEN. This is so ridiculous. This is already ridiculous enough for a robber to require the victim to hand over the informer, but even more ridiculous is that some victims are really willing to join hands with the robber to capture the informer. The US Government has requested the SAR Government to arrest SNOWDEN even though the information it provides us with is incomplete and it fails to give us SNOWDEN's full name. However, according to some press report, a former Honourable colleague ― Mr Martin LEE from the Democratic Party ― has opined that the SAR Government should, at any rate, arrest


SNOWDEN and wait for the US Government's instructions. Perhaps Mr Martin LEE is too concerned about the possible damage to the US's interests, so much so that he has to drag other countries into the scene. As such, he has alleged without providing any evidence that both the Chinese Government and the British Government have also engaged in interception of communications. As always, he has defended the US Government whole-heartedly. This is really eye-opening for the people of Hong Kong. The Democratic Alliance for the Betterment and Progress of Hong Kong (DAB) supports the motion moved by Mr MA Fung-kwok. In the face of the despicable hacking activities conducted by the US Government, the DAB considers that the Legislative Council should protest strongly against the US Government on behalf of all the people of Hong Kong, and request the US Government to provide the people of Hong Kong a clear and thorough account of what has happened. The DAB finds the three proposed amendments somewhat peculiar. Mr Charles Peter MOK's amendment proposes to delete "and hacking into Hong Kong's communications networks" from the wording of the original motion. As a former employee of the CIA has already disclosed very clearly that the US Government had hacked into Hong Kong's networks, I really cannot understand why Mr MOK proposes to delete the said wording. Is it because Mr MOK has a lot of friends engaging in the US intelligence sector and has thus learnt about the hidden truth? If so, I hope very much that he can share what he knows with the people of Hong Kong. As for the other proposed amendments, they all emphasized particularly the insufficiency of the SAR Government in terms of the laws enacted and the information security efforts. It seems to me that the amendments are hinting that these are the reasons why Hong Kong's communications networks have been under attack. The speech delivered by the Secretary just lasted seven minutes 15 seconds, of which six minutes were spent on making a response in this regard. In our view, these proposed amendments are putting the cart before the horse and serving to divert people's attention. As such, the DAB will not give them our support. Thank you, Deputy President.


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MR TOMMY CHEUNG (in Cantonese): Deputy President, according to SNOWDEN, a former employee of the United States (US) Central Intelligence Agency, the US has been monitoring the computer networks in Hong Kong and China since 2009, and its surveillance targets include The Chinese University of Hong Kong (CUHK), government officials, commercial organizations and even students. What is more, it successful rate of hacking into Hong Kong's computer systems exceeds 75%. Should that really be the case, the interests of the general public in Hong Kong are gravely involved, and the SAR Government should sweep this incident under the carpet. Early this month, in conducting online inspections, the Technology Crime Division under the Commercial Crime Bureau of the Hong Kong Police Force noticed that the personal data of a number of teaching staff members and students held in the webpage of CUHK's Department of Mechanical and Automation Engineering, including their names, email addresses, teaching staff/student numbers, as well as login passwords, had been transferred to a website outside Hong Kong. While the police are still investigating into causes leading to the theft of the Department's data, the initial investigation results indicate that the relevant data were stolen after the server of the Department's webpage had been hacked into. From this incident we can see that Hong Kong's computer networks are indeed under attack. Hong Kong prides itself on its free economy and well-developed and advanced telecommunications infrastructure, and those are also the factors that enable us to become the financial, international trade and logistics centre of the Asia-Pacific region. Besides, many international organizations also set up their regional headquarters of regional offices in Hong Kong. As our fully open market system allows access from Internet users directly and indirectly, data storage service providers are able to develop prosperously. In particular, the development of Hong Kong as a data centre is concerned with storage of important local and international data and information, it is imperative that our cyber security systems are failure-proof. At present, Hong Kong has in place a number of ordinances prescribing against computer-related offences, such as the Telecommunications Ordinance (Cap. 106) which prohibits unauthorized access to computer by telecommunications; the Crimes Ordinance (Cap. 200) which combat access to computer with criminal or dishonest intent; and the Theft Ordinance (Cap. 210)


which combat crimes seeking to destroy, deface, conceal or falsify the records held in a computer. Hence, judging from the surface, we do have a reliable environment as far as information security is concerned. However, the relevant incident has revealed that the US intelligence agencies may steal from the Internet Hong Kong people's private data, which means that the relevant ordinances referred to just now have failed to safeguard thoroughly Hong Kong people's privacy in the cyber world. Given that safeguarding liberties, human rights and privacy is a very important core value cherished by the people of Hong Kong all along, and Hong Kong is an international financial and information centre, it is very important for us to have in place a stringent set of cyber security systems. If it is proven that the US has secretly put Hong Kong under surveillance without any prior application or approval, the US has not only violated the privacy of the people of Hong Kong but also damaged Hong Kong's reputation for upholding freedom of information, keeping data content vetting-free and ensuring due protection for privacy of information. If the data of Hong Kong's commercial activities should be monitored and controlled by hackers, it would be very difficult for the Hong Kong economy to develop in a level playing field. As such, the Hong Kong Government should take up the matter with the US through the relevant agency of our country. If the National Security Agency has really conducted cyber surveillance activities targeted at the non-government communications networks in Hong Kong as disclosed by SNOWDEN, the Hong Kong Government must fulfil its responsibility to safeguard the privacy and interests of the people of Hong Kong, and request the Ministry of Foreign Affairs to urge the US to immediately stop hacking into Hong Kong's network facilities. One thing for sure, Hong Kong people do not allow their online data (such as online banking data, chat room records, emails, photos, documents, passwords, and so on) to be exposed unreservedly. Cyber security and privacy protection are Hong Kong people's rights, the Hong Kong Government must take actions to review Hong Kong's cyber security issues. With regard to Mr Charles Peter MOK's proposed amendment, we agree that the Government should review the relevant ordinances expeditiously to plug the loopholes therein. In particular, the existing Interception of Communications and Surveillance Ordinance is indeed inadequate, as it seeks to regulate the local law-enforcement agencies, and


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is inapplicable to non-law-enforcement agencies and interception activities conducted outside Hong Kong. I have already mentioned just now that what the Government should do at the present stage is to focus on reviewing expeditiously the ordinances relating to computer crimes, so as to safeguard Hong Kong's cyber security; and it seems to me that the proposal to enact legislation on protecting the freedom of confidential communications put forward in Mr Ronny TONG's amendment is but an attempt to take advantage of the present situation, as the proposal does not have any direct connection with the relevant incident. Moreover, the most urgent task before us should be to develop an anti-theft cover for Hong Kong's network systems, we should direct our attention to the irrelevant fields. As regards the amendment proposed by Mr SIN Chung-kai, we agree that the authorities should review and strengthen the monitoring of online security systems and enhance their technological level, so as to ensure the protection of Hong Kong people's privacy. I so submit. MR MARTIN LIAO (in Cantonese): Deputy President, in addition to showing us some spying activities, the whistle-blowing incident staged by SNOWDEN, a former employee of the United States (US) Central Intelligence Agency, has also torn off the mask the US has all along been wearing as a protector of human rights and freedom. According to SNOWDEN's disclosure, the US National Security Agency uses anti-terrorism as its pretext to implement the "PRISM programme" to secretly monitor the computer networks across the world, including hacking into the computer systems of Hong Kong and Mainland China, and tapping confidential conversations of diplomatic personnel (including its allies). With regard to Hong Kong, we have been the target of large scale hacking activities for four years long. In addition to the Hong Kong Internet Exchange of The Chinese University of Hong Kong (CUHK), the computer systems of government officials, non-government organizations, members of the business sector, the general public and even students are also their surveillance target, and the successful rate of hacking into such computer systems is said to stand high at 75%. Besides, as the major Internet access points are operated by American companies, the US Government just takes advantage of this situation and force the computer tycoons like Cisco, Facebook, Google, Microsoft, Apple, and so on to hand in large amounts of online communications information of


Internet users across the world. Given that so far the US Government has not denied the accusations made by SNOWDEN, I believe what SNOWDEN has disclosed should be the truth. The people of Hong Kong finally see that despite the moral pedestal it has been occupying and its self-claimed role as the protector for universal human rights and freedom, the US in fact has no respect for human rights and is the largest manipulator behind the hacking activities across the world. That being the case, how can the US be in any position to boast of its virtuous acts and comment on international cyber security? The US Government has pointed out in the past that the purpose of collecting online information from different countries of the world was to prevent terrorist attacks. Deputy President, anti-terrorism is indeed an important task, and we surely do not want to see the US or any other countries on earth being under terrorist attack; nevertheless, we believe anti-terrorism is an issue which must be handled and undertaken jointly by the different countries of the world. However, it seems that the surveillance targets as reported in the press have far exceeded the scope of anti-terrorism, and anti-terrorism is but a pretext which nobody accepts. Does that mean that whenever the European Union (EU) meets, Hong Kong's government officials as well as the leaders and diplomatic personnel of EU countries will be suspected of being terrorists by the US? This is no different from spreading salt over wounds. Even though many of the US's allies are also targets of the surveillance and telephone tapping activities conducted by the US, because of the common interests they share, all these countries could do is to put forward a political stance to pacify their own nationals. In my view, the most outrageous part is that even though Hong Kong is a victim of the US's surveillance programme, instead of giving us a clear account of what has happened, the US is pressing the SAR Government to accede to its requests. Instead of demonstrating its ethos as the world's most powerful country, the US is showing the world how unreasonable and hegemonic it is. Former Vice President of the United States, Richard Bruce CHENEY, has once accused SNOWDEN of spying for China, I am afraid he has to change the accusation to spying for Russia these days. Deputy President, I believe Hong Kong has all along been co-operating earnestly with the US on the anti-terrorism front, and yet we are now being treated like this. I cannot but show disdain for this country. This incident has damaged the cordial relation that we have all along been maintaining with the US, and has impacted gravely on the local community's trust


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in the US. As this incident involves also national security and the rights of the public, the Government should solemnly raise our objection to the US and hold it accountable for the deeds concerned. Deputy President, the SNOWDEN incident has revealed that the surveillance and interception activities conducted by the US are not only immoral and unjust, but have also trampled on human rights. Hence, it should be condemned. It should be noted that the said activities are conducted outside Hong Kong and may involve act of state, and such activities may not constitute an offence under the US laws. What is more, there are also other issues like the jurisdictional exemption enjoyable by sovereign countries and jurisdiction. Hence, no matter how perfectly the relevant local laws and regulations are amended, they can hardly be enforced. All in all, this is in essence a political and diplomatic issue, and so the Government may report the matter to the Central Government, which may in turn negotiate and follow up with the US through diplomatic channels. At the same time, we must also urge the international community to confine the interception activities conducted by government strictly within the scope of prevention of terrorist attacks and anti-terrorism, and to formulate a just, effective and internationally recognized regulatory system to monitor such anti-terrorism measures. Deputy President, this incident has also revealed that there are indeed a great deal of loopholes in Hong Kong's cyber security systems, as so far the Government and other relevant parties like CUHK have not noticed any traits indicating that their computer information systems had been hacked. From this we can see that Hong Kong's cyber security systems are unable to resist state level hacking activities conducted by military or intelligence agencies. The Government should review anew the various aspects of Hong Kong's cyber security systems, enhance the relevant establishment and installations required for online surveillance, enhance the technological level of anti-surveillance measures, and actively look into ways to enhance cyber security technology. Deputy President, I support the motion moved by Mr MA Fung-kwok. I so submit. MR WONG KWOK-KIN (in Cantonese): Deputy President, even though Mr SNOWDEN has already left Hong Kong for quite some time, the aftermath of the


storm stirred up by him is still lingering in Hong Kong. During his stay in Hong Kong, SNOWDEN blew the whistle and pointed out that the United States (US) had monitored and hacked into the communications networks of our country and other countries of the world, including the networks of the academic, commercial and public bodies. Regrettably, so far the US Government has yet to provide Hong Kong with a clear account of the matter. On the contrary, it has acted like a thief crying thief and condemned Hong Kong for letting SNOWDEN leave the territory. In addition to expressing its dissatisfaction, the US Government has threatened to cancel the study on the visa-free arrangement for HKSAR passport holders. This is indeed a ferocious country. Actually, in addition to revealing the US Government's secret hacking into the computer systems of Hong Kong and other places in the world, a more important contribution of SNOWDEN's disclosure is that it has torn off the hypocritical US Government's mask. All along, the US has been acting as if it is the "World Police", claiming that it is the protector for freedom and human rights. Apart from criticizing other countries from a moral pedestal, it has time and again condemned hackers from foreign countries (including China) for attacking its cyber networks and impairing its interests. However, when the truth is told, it is revealed that the "World Police" is indeed the "World Hacker". The surveillance targets of the "PRISM programme" implemented by the US scatter all over the world, public bodies and non-government organizations alike are included in the programme. So, the US is indeed the world's most massive online intruder. Deputy President, the phrase "a thief crying thief" can best describe the behaviours of the US. In the face of such activities which contravene gravely the freedom and privacy of communication of the public, we must condemn the US Government and express our strong dissatisfaction with it in this regard. Now, may I urge the SAR Government to follow up this matter persistently to solemnly request the US through various channels to expeditiously give a comprehensive account of the relevant accusations, and to undertake not to engage in similar activities again? This incident is indeed a serious matter, as it involves the interests and privacy of all Internet users in Hong Kong. I believe the local community as a whole definitely does not wish to see that the matter remains unsettled in the end.


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Deputy President, seeing their privacy has been infringed upon, members of the public in the US, other countries of the world and Hong Kong alike are condemning the US Government for its activities in this regard. According to some recent reports in the media, human rights organizations in Europe have indicated that they are prepared to take the matter into court to require the US to restore justice for them. Looking back on Hong Kong, what have those "aptly named" human rights organizations done so far? Mr LAW Yuk-kai from Hong Kong Human Rights Monitor has commented on this incident when SNOWDEN was still in Hong Kong, but rather than condemning the inappropriate activities of the US, he cautioned that the Hong Kong Government might not be handling the SNOWDEN incident in compliance with the law. He even made use of the SNOWDEN incident to write to the New York Times to criticize the HKSAR Government for its allegedly dropping performance in safeguarding people's political rights and freedom since Hong Kong's reunification with China. Deputy President, this organization has been using human rights protection as its name card and making all sorts of comments on human rights issues in a high profile manner. But then, in the face of this incident of massive violation of human rights, this organization has said nothing about the US's hacking into Hong Kong's networks to steal the data of local organizations and individuals. I have to raise this question: Such attitude is attributable to the fact that the said organization is hold double standards or it tends to "harass the kind but yield to the ferocious"? Compared to the virtuous and high profile manner in which Mr LAW Yuk-kai has talked about safeguarding human rights in Hong Kong, one cannot help but query whether this so-called human rights organization and Mr LAW Yuk-kai are sincerely safeguarding the basic rights of the public, or they are just selectively directing against a specific target. Do they have any hidden political objectives as well? Deputy President, the Federation of Trade Unions (FTU) wishes to thank Mr MA Fung-kwok for moving this motion to provide Members with an opportunity to express their views in this Chamber. The FTU supports the original motion and the technical amendment proposed by Mr SIN Chung-kai. As regards the amendments proposed respectively by Mr Charles Peter MOK and Mr Ronny TONG, we consider that they have, in effect, diverted people's attention and confused one's focus, thereby shifting the responsibility from the US


Government to the SAR Government. As such, the FTU does not support these amendments. Deputy President, I so submit. MR YIU SI-WING (in Cantonese): Deputy President, Mr SNOWDEN has already left Hong Kong, but the "PRISM programme" he had disclosed, in which the intelligence agencies of the United States (US) implement surveillance of the general public, has left behind quite a number of warnings and points to ponder for Hong Kong. When the matter was first disclosed, the Government's reply just kept saying that the computer systems of the Government had not been under malicious attack, the Hong Kong Internet Exchange of The Chinese University of Hong Kong was operating properly, cyber security was safeguarded in Hong Kong, and we had in place a series of ordinances to safeguard people's privacy. Nevertheless, all these answers have failed to address people's concern. The US employed cover-up measures to hack into Hong Kong's computer systems, naturally such hacking activities would hardly leave any traits. Hence, the motion today, which urges the SAR Government to request clarification from the US Government, so as to safeguard the security of cyber communications in Hong Kong, and ensure the protection of Hong Kong people's privacy, is indeed worthy of our support. We are now in the midst of the Big Data era, leaving behind footprints of our lives everywhere on the Internet, thereby increasing greatly the risk of our personal data being leaked out. Some of the data which were considered as non-privacy-related have changed substantially. By analysing information like clients' consumption patterns, daily life habits, access locations, and so on, data companies can categorize their clients for marketing and trailing purposes. The "PRISM programme" disclosed by Mr SNOWDEN makes use of covered-up measures and loopholes in telecommunications products to monitor the privacy of the general public; besides, renowned telecommunications enterprises are also required to share information with the Government. In fact, as early as in 2008 some media in the US have already reported that the intelligence work of the US Government were not relying so much on spies as in the past, with 90% of their intelligence originating from open information published on various media. This year, the academic journal Scientific Reports publishes the outcomes of a latest study, pointing out that if so long as a certain mobile phone user has


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appeared in four access points, researchers can make use of the big data to analyse and compute the data to identify the relevant user from millions of other users, and the accuracy of such analysis can be as high as 95%. From this we can see that with well-developed technologies, the fragmented information of an individual can still be consolidated easily for other's uses without employing any spying strategies. So, we can justly assume that the security of cyber communications in Hong Kong and protection of personal privacy are at risk. As such, the Government should never adopt an indifferent attitude in this regard. With the cloud computing technology becoming more common, data information can even break through physical constraints and become more easily accessible. Under such circumstances, the rights to data information are not very equitable. While the Government and large enterprises are already in a better position to collect various kinds of information from clients, the clients are helpless in this regard. In order to legalize the information collected with the help of innovative technologies, Internet companies tend to amend their rules and regulations to make it difficult for their clients to make judgment. Last year, Google updated its privacy policy. Judging from the surface, the new provisions are to give clients greater convenience in using the company's services, but the information monitoring agency of the European Union (EU) has rolled out a combined proceedings operation against this privacy policy, pointing out that Google's new privacy policy has violated EU's Privacy Protection Act. The privacy protection departments of the United Kingdom, Germany and Italy have contacted the company to urge it to amend the controversial policy on client's privacy rights. Deputy President, information technology was first developed by the US, and most of the computer systems, office software and anti-virus software we use are programmed by US companies, if the engineers developing the products are from the same source as the hackers with special background, the hackers will know of the loopholes in the systems, as well as the ways to hack into the system without alerting the victims. Hence, in order to prevent Hong Kong's information from leaking out, the safest way is to use the software developed locally. The other day, more than a dozen Internet organizations held a press conference to urge the Government to take the lead in using original software developed locally, pointing out that Hong Kong already has in place our own world-class cyber security technologies and anti-network surveillance technologies. I give them my support. Now that we already have developed


our own mature and reliable technologies, the Government should take the lead in using the locally developed products. The Government should also encourage enterprises of various sizes to use such products, and proactively develop cyber security infrastructure. Deputy President, under the "one country, two systems" framework, Hong Kong has been playing the role as Mainland China's south door and upholding the free economy principle; as such, commercial and political forces from different directions all wish to obtain various types of information in Hong Kong. In addition to implementing appropriate regulation and enhancing security measures, the Government should also change its regional concept proactively and seek co-operation opportunities with countries and regions on good terms with us. Through exchanging information with these countries and regions, the Government should seek to better understand the latest intelligence, exercise adequate judgment in respect of the cyber world, master new technologies, new policies and new trends promptly, and amend the relevant laws and regulations timely. It is my hope that by implementing the series of measures referred to just now, Hong Kong can avoid being used by international cyber criminals as a channel for violating people's privacy and stealing confidential information, while the people of Hong Kong can enjoy genuine protection for their privacy. Deputy President, I so submit. IR DR LO WAI-KWOK (in Cantonese): Deputy President, on 5 June, the Legislative Council debated a motion on "Safeguarding freedom of information, of the press and of the Internet". Incidentally, SNOWDEN, a former technician of the Central Intelligence Agency of the United States (US), came to Hong Kong a few days later to disclose to the media that since 2009, the US National Security Agency has allegedly been hacking into and monitoring the networks and computer systems on the Mainland and in Hong Kong through the "PRISM programme", and the surveillance targets include The Chinese University of Hong Kong (CUHK), public officers, enterprises, and so on. Through the said programme, the US has secretly accessed a considerable amount of relevant information. If the allegations made by SNOWDEN should be the truth, the problem revealed is indeed shockingly and outrageously serious. The US is not only leading the world in network technologies, it is also a real "cyber thief" and "super hacker" with no respect for the rights to freedom of cyber communications


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and personal privacy that all of us are entitled to. Even though the SAR Government and CUHK have respectively indicated that they noted no traits of attack on their networks, the worries harboured by the people of Hong Kong have yet to be addressed. Would it be possible that the technologies employed by the hackers are so advanced that we could not detect any traits of attack? The allegations made by SNOWDEN have indeed raised the alarm for Hong Kong's cyber security. The importance of cyber security to Hong Kong is self-evident. As an international financial and trade centre, Hong Kong is a free and open city enjoying a competitive edge in terms of freedom of information and network communications. The public at large in Hong Kong are able to receive information on the latest trends in the world's political, economic, cultural and technological development in no time, while different trades and industries can be the first in grasping the best development opportunities. However, all these are subject to a major premise, and that is our networks and computer systems must be protected in a stringent and effective manner. On 10 August 2011, the HKExnews website of the Hong Kong Exchanges and Clearing Limited was under attack by hackers, thus causing a number of stocks to suspend transaction and many investors to suffer losses. Now that CUHK is also on the US's list of cyber surveillance targets disclosed by SNOWDEN, the situation is even more outrageous and worrying because the Hong Kong Internet Exchange of CUHK is a focal point of Hong Kong's Internet services. If this focal point should be under attack and paralysed subsequently, the damages so incurred would be beyond imagination. Deputy President, what tactics could the SAR Government adopt in relation to the charges SNOWDEN has directed to the US authorities? No doubt the Government should make clear Hong Kong's stance on the matter solemnly, and request the US Government to clarify the matter expeditiously, destroy all the network data it has stolen in the past, and promise to stop its surveillance of Hong Kong's networks and computer systems. Taking into account the cyber security in Hong Kong, the SAR Government must formulate more aggressive policies and measures, collaborating with relevant local stakeholders proactively, and enhance comprehensively the technological level of Hong Kong's information security and cyber security systems. In this connection, the major measures concerned


should include integration and enhancement of frameworks and resources. At present, cyber security is dealt with by quite a number of agencies in a multifarious manner. The Office of the Government Chief Information Officer is mainly tasked with the information security of government networks and computer systems, while the Hong Kong Computer Emergency Response Team Coordination Centre is responsible for providing the local enterprises and Internet community with information related to computer security incidents, and offering corresponding technical support services. As regards the Cyber Security Centre set up by the police towards the end of last year, it is mainly tasked with the security of the information system network of critical infrastructures. Given that cyber security is getting increasingly important and complicated, and involving more and more stakeholders, the authorities should integrate and enhance the existing frameworks and resources expeditiously, with a view to strengthening Hong Kong's integrated response capability to tackle network security incidents. Besides, the authorities should proceed immediately with the necessary steps to review and amend the relevant ordinances. At present, the legal provisions applicable to hackers obtaining unauthorized access to computers include: Section 161 of the Crimes Ordinance (Cap. 200), which deals with "Access to computer with criminal or dishonest intent"; section 27A of the Telecommunications Ordinance (Cap. 106), which deals with "Unauthorized access to computer by telecommunications"; and the relevant provisions under the Interception of Communications and Surveillance Ordinance which seeks to regulate the conduct of interception of communications by public officers. The authorities should keep pace with the times and plug the various law-enforcement loopholes, thereby stepping up the actions against crimes involving network attacks and unlawful interception of network information. Further still, the relevant authorities should also revise the Government's procurement policy to make better use of the locally developed information technologies. On 4 July, Mr Charles Peter MOK and I joined with more than a dozen local information technology organizations to hold a press conference. As reflected by the industry, the Government tends to choose the information security products developed overseas when procuring information security technologies, thereby increasing Hong Kong networks' risk of being attacked by overseas bodies on the one hand, and suffocating the development of the local information technology industry on the other. Actually, Hong Kong already has in place the relevant award-winning technologies, only that enterprises are faced


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with all kinds of hurdles when trying to promote the relevant technologies to local government departments and businesses. In my view, the Government should review comprehensively its procurement policy and encourage the use of advanced information security technologies that are locally developed. In procuring these inexpensive quality products, the Government can make the best use of public money, lower local networks' risk of being attacked by overseas hackers, and give local information technology talents an opportunity to give full play to their abilities, achieving several goals in one go. Deputy President, the SAR Government must deal with this cyber security issue at the level of Policy Bureaux. As such, I consider that the Government should set up a Technology and Communications Bureau to be tasked with promoting technological development, including giving full play to the advantageous positions of local cyber security technology personnel, thereby safeguarding Hong Kong's cyber security and protecting the information of enterprises and the privacy of the general public from infringement. With these remarks, Deputy President, I support the motion moved by Mr MA Fung-kwok. MR CHRISTOPHER CHEUNG (in Cantonese): Deputy President, earlier on, a former employee of the Central Intelligence Agency of the United States (US) named SNOWDEN came to Hong Kong and disclosed the US's secret communications interception operations across the world. In this connection, the US National Security Agency (NSA) implemented the so-called "PRISM programme" to conduct massive interception and surveillance of the non-government communications networks worldwide (including ours), thereby violating gravely our personal privacy. So far the US has not expressed a single world of apology in respect of its undesirable deeds. On the contrary, as SNOWDEN has already left Hong Kong lawfully before being extradited to the US for trial, the US was very much embarrassed and channeled its anger to Hong Kong on the pretext that we have deliberately let SNOWDEN escape. From this we can see clearly the hegemonic and hypocritical nature of the US. According to SNOWDEN's disclosure to the media, the NSA has been implementing this "PRISM programme" since 2009 to hack into the computer networks in Hong Kong and Mainland China, as well as the networks of public


officers, business operations and even students. What is more, The Chinese University of Hong Kong (CUHK), which is a long-standing academic institution, is also on the list of surveillance targets. The US is interested in CUHK because the majority of the network communications in Hong Kong are conducted through the Hong Kong Internet Exchange managed by CUHK. In other words, close to 4 million Internet users in Hong Kong have most probably become victims of the said programme. If SNOWDEN had not disclosed the truth of the matter, we would still be the characters in the real life version of the movie "Overheard" and remain in the dark about what is happening. The US has also considered itself as the "World Police", and this incident really broadened our perspective of this super power of the world, as the US is actually monitoring and stealing our network communications like the "Big Brother" in a famous British political fiction. The crux of the problem remains that so far the US still does not consider it has done something wrong and keeps on arguing that surveillance activities of such kinds are necessary and reasonable. What is more, it even acts like a thief crying thief, depicting itself as a victim of China's hacking activities, and expressed disappointment about the SAR Government's failure to extradite SNOWDEN to the US for trial in accordance with the Surrender of Fugitive Offenders Agreement signed between Hong Kong and the US. But then, it has been avoiding issues like its carelessly prepared extradition documents, highly immoral communications interception activities, and so on. Besides, the US has issued a global ban on SNOWDEN to prevent SNOWDEN from applying successfully for political asylum in other countries. The US is making every effort to achieve this end, and even at the expense of its allies. In this connection, the Bolivian presidential plane was forced to land in Austria en route to enable officials to board and inspect whether SNOWDEN was hidden inside. All in all, we cannot but feel that the US is very unreasonable and hegemonic in this incident. Deputy President, I agree very much that this Council write to the US Government and Congress in accordance with the decision made last week by the House Committee. The letter is to express our dissatisfaction with the US in this regard and raise our objection to the US Government's hacking into out network systems and stealing our secrets and privacy. We have to make clear to the US that we are the real victims, and we will not remain silent any more under the hegemonic power of the US.


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In answering Members' questions earlier on, government officials from the SAR Government have tried to pacify us by saying that nothing unusual had been found with the information flow at CUHK's Hong Kong Internet Exchange. The public officers were in fact trying to say that there were not any traits showing that our network systems have been hacked. However, I wish to point out that not many people have confidence in such guarantee. This is because SNOWDEN has disclosed a great deal of evidence to the media, pointing out how our network communications had been monitored and intercept by the NSA. In other words, the Government must learn a lesson from this experience and have effective discussions with the information technology industry. Adequate support must be provided for the Hong Kong Computer Emergency Response Team Cooperation Centre and the Cyber Security Centre set up last year, so as to enable them to have the necessary manpower and resources to safeguard our cyber security, and prevent our freedom and privacy of communication from reducing into empty talks. Hong Kong is an international city and international financial centre where lots of multi-national and multi-regional business activities take place every day. If the confidential business information should be intercepted, this would mean unfair transaction to both the local and overseas investors, and out reputation would also be damaged. This is by no means anything desirable. When the HKExnews website of the Hong Kong Exchanges and Clearing Limited was under attack by hackers in 2011, many investors suffered losses. With the advancement of information technology, many people of Hong Kong are using smart phones and doing their work with computers, if our network systems should be under attack, we would all be at risk. Deputy President, as small and medium sized enterprises (SMEs) are not so good at protecting themselves, I hope very much that the Government will help the SMEs to install proper cyber security systems, so as to prevent them from becoming victims of cyber hegemony and suffer losses. Deputy President, I so submit. The Business and Professionals Alliance for Hong Kong supports fully the motion moved by Mr MA Fung-kowk and the amendments proposed to it.


MR DENNIS KWOK (in Cantonese): Deputy President, in the wake of the SNOWDEN incident and during the period when SNOWDEN was still in Hong Kong, some White House officials have openly said that if the Hong Kong Government did not extradite SNOWDEN to the United States (US) immediately, it would mean that the Hong Kong Government does not have any commitment to the rule of law. Deputy President, this is so outrageous! Hong Kong's commitment to the rule of law does not need the US Government's comments. This is what the White House said (I quote): "If Hong Kong doesn't act soon, it will complicate our bilateral relations and raise questions about Hong Kong's commitment to the rule of law." (end of quote) This is sheer disrespect for Hong Kong's commitment to the rule of law, and complete negligence of Hong Kong's existing judicial independence and judicial system. In considering whether or not to extradite a suspect to other countries, the Courts of Hong Kong have to follow the established legal foundations and procedures before making any extradition decisions. We do not need some US officials or the US Government to say something like the extradition or otherwise of a certain person is reflective of our commitment to the rule of law. In the face of such distorted argument, I must stand up to make it clear that Hong Kong definitely does not welcome any foreign governments ― including the US Government ― to comment on our commitment to the rule of law like this. The embarrassment of some US media and officials has turned into anger after the incident, and so they took the opportunity to criticize Hong Kong's commitment to the rule of law and condemn us for deliberately letting SNOWDEN escape instead of extraditing SNOWDEN immediately or arresting SNOWDEN in accordance with their request. However, if the explanation given by the Department of Justice is true, the Judiciary of the US Government has indeed failed to fulfil all the requirements and furnish accurate information in making the extradition request. As such, the Department was unable to implement their request raised in accordance with the relevant legislation, and this was due to decisions made in the light of the rule of law and the relevant legal foundations. If the US Government has respect for the rule of law and really understands what that means, it should know that the most important part of the rule of law is procedural justice. If the US has failed to follow the relevant procedures in requesting the immediate arrest of SNOWDEN, I believe the Department of Justice cannot implement the request right away. Hence, the decision was made in the light of Hong Kong's commitment to the rule of law, I


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really do not understand on what basis can the US officials criticize the way we have handled the matter. Actually, Hong Kong has in place a number of laws enabling the Hong Kong Government to help other countries handle anti-terrorism or "money-laundering" matters. For example, under section 3 of the United Nations Sanctions Ordinance (Cap. 537), if the United Nations Security Council decides to impose sanctions on other countries, the Hong Kong Government has a responsibility to implement the sanction decision of the United Nations through local laws. Deputy President, these laws all share one common feature, which is a provision similar to section 12D of the United Nations (Anti-Terrorism Measures) Ordinance (Cap. 575). This provision provides a legal basis for the Hong Kong Government, so that all departments of the Hong Kong Government, including the law-enforcement agencies, are granted with permission to disclose information to other countries in accordance with the relevant legislation when the countries are making the request for national security purposes. As regards the question of whether the Hong Kong Government has ever acceded to the request made by the governments of other countries to obtain information concerning some people of Hong Kong, I have written to the Government and the Subcommittee to Examine the Implementation in Hong Kong of Resolutions of the United Nations Security Council in relation to Sanctions (I am a member of the Subcommittee) to request the Government for a clear account of the issue. The Government has yet to reply and to clarify whether any countries have indeed requested to obtain information on Hong Kong people under the relevant ordinances. The Government also has to clarify which countries have made such request frequently and their grounds for making the requests, the number of requests made and how often are such requests made. In fact, the Government should disclose such information to the public and make it clear the amount of information the Government has given to foreign government in accordance with the relevant legal basis and ordinances. Deputy President, you have also proposed an amendment to urge the Government to amend the wording of the Interception of Communications and Surveillance Ordinance. Certainly, your proposed amendment does represent the stance of the Civic Party. I believe you will further expound on that later on and that is why I do not want to dwell on that. All in all, we have always been handling issues of this kind in accordance with the legal basis, principles and


procedures. Hence, I hope very much that upon conclusion of this incident, nobody would question Hong Kong's commitment to the rule of law. Thank you, Deputy President. MR KENNETH LEUNG (in Cantonese): Deputy President, I have never spoken in public on the issue of Mr SNOWDEN as I was in England when it was hotly debated. However, the issue has almost been settled and I have also read a lot of different theories and opinions. I really consider this a complicated blend of human rights, legal, diplomatic and security matters. At this point, I can tell you I do have some views and opinions. Thanks to Mr MA Fung-kwok for proposing this motion debate. The main focus of his motion lies in these few sentences: "this Council expresses strong dissatisfaction with the US Government in this regard, and urges the SAR Government to request clarification from the US Government, so as to safeguard the security of cyber communications in Hong Kong". These few sentences bring out the focus and essence of this motion. My friend, Mr Charles Peter MOK, adds a few more words in his amendment, that is, "hold the US Government responsible, and request the US Government to stop its theft of Hong Kong's network data and immediately dispose of the information obtained", together with other technical amendments. To me, so long as the abovementioned have been included in the motion or all the amendments, I will throw my unreserved support behind because our network security is of great importance to our status as an international financial centre, as well as our freedom of speech and human rights. Nonetheless, taking the whole incident into perspective, I come to realize two main points which I would like to question the SAR Government. First, I have noticed that over these few decades, when handling diplomatic, semi-diplomatic, "G2G" or even what the LEUNG Chun-ying administration referred to as "homeland relationship" affairs, the SAR Government has somehow appeared to be at a loss, and at times, we can even say that it is irresponsive. Apart from saying that it is slow in reacting to this SNOWDEN incident, I also want to describe briefly the other two incidents. The first is the hostage incident which took place in the Philippines three years ago. I understand that the then Chief Executive Mr Donald TSANG picked up the phone right away and clarified with the Philippine President AQUINO III, but three years have passed and the Philippine Government has never made a formal


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apology and compensation to the HKSAR Government. We are extremely angry. The second incident is one that just happened recently when the Jiangmen municipal government proposed last week to construct a nuclear fuel processing facility. This relates to environmental protection and is opposed by many local residents, and even the Macao SAR Government raised questions with the Jiangmen municipal government to understand the matter. Unfortunately, our SAR Government has made no response on this. I held a press conference yesterday, expressing the hope that the HKSAR Government can maintain close contact with the government of the Guangdong Province on these matters of important bearing on our environment, well-being and property, and gain better understanding. In respect of these so-called semi-diplomatic or diplomatic incidents which in fact happen frequently, or even matters of "homeland relationship", I also hope that the HKSAR Government can set up special groups to handle them. This is because although Mr LEUNG Chun-ying has told us that the Government attaches great importance to "G2G", "homeland relationship" and relationship with other countries, I fail to see prompt associated action to protect the interests, human rights and security of Hong Kong people. I wish the SAR Government can give me a response in this regard. Another point I would like to mention is, apart from the technical amendments relating to the Computer Crimes Ordinance, the Theft Ordinance and the Interception of Communications and Surveillance Ordinance proposed by colleagues in their amendments, I would like colleagues to note, and would like government officials to explain to me, as to why despite its passage in 1995, section 33 of the Personal Data (Privacy) Ordinance relating to the prohibition against transfer of personal data to place outside Hong Kong has not yet taken effect. Can they give me a clear explanation? I have asked the Government repeatedly on the legal level but to no avail. In connection with this piece of legislation, is the Government conniving overseas forces to intercept personal data in Hong Kong? I wish the Government can give a clear reply on this today, explaining why after all these years, section 33 is still not effective legally? Thirdly, I wish the SAR Government can learn a lesson from the SNOWDEN incident and follow up the matter with our country's Ministry of Foreign Affairs, asking the US Government to clarify with us and guarantee that there will be no recurrence of similar incidents in the future. Deputy President, I so submit.


MR TONY TSE (in Cantonese): Deputy President, regarding Mr SNOWDEN's revelation of survelliance by the US Government and the hacking into Hong Kong's communications networks, we are all aware that in the meeting held last week, the House Committee unanimously approved the call for the President of the Legislative Council to write to the two Houses of the US Government to express the dissatisfaction of this Council towards the incident and to condemn the US, while urging the US to monitor its Government at the same time. Deputy President, this is really rare for I can see that Members of different political parties within the Council share the same objective and take on the same attitude in making known to the US our demand and dissatisfaction, hoping that the US Government can respond as soon as possible and give a full explanation to the people of Hong Kong. This incident has not only revealed that since 2009, the US Government has conducted surveillance and hacked into the computer systems and communications networks of Hong Kong, stirring up extensive social discussion, but also, it has again aroused great concern of the public and the industrial and commercial sectors towards Hong Kong's network security and information security. In his reply to Members' questions earlier, the Secretary for Security Mr LAI Tung-kwok expressed that the whole society should be concerned about network security, the Government, the sector and all stakeholders should raise their awareness, and take the necessary measures to safeguard network security. If the Government is determined to do a good job in this aspect, I hope the Secretary can explain afterwards what targeted measures and policies there will be to enhance the guarantee of network security. Deputy President, since Hong Kong is an international financial and information centre, it is of paramount importance that a secure system and reliable networks are in place. In the present cyber world, hackers are becoming more and more rampant, and they will launch mutual attacks in different countries and regions. There have been reports in the past that the US has waged network attacks within the country and against other countries. Although hackers are not using genuine guns and ammunitions, the damage done by network attacks can be colossal, enough to impact individuals, small and medium enterprises, large multinational enterprises, companies, and even the operation of a society or the overall country. Thus, regardless of whether it is on the level of the individual, the industrial and commercial sectors or the Government, there must be sound network security and information security, otherwise, dire consequences may result.


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It is incumbent upon the Government to enhance network security and information security as the everyday life of the public and the operation of the industrial and commercial sectors have become closely knit with computers and networks, and our society has become a cyber society. Therefore, the Government must put in more resources to provide better infrastructure for information security, and complement this with sound legislation and policies. Hong Kong does not lack high quality technical and information professionals, and we have all the conditions and ability to build up a cyber-safe city. Let us look at this example. Hong Kong will be spending $800 million to set up a territory-wide electronic health record sharing system, which will serve as a platform for public and private medical institutions to link the medical history of patients through a computer network. Since this involves an enormous amount of individually sensitive information and data, it is a highly risky information infrastructural project and must therefore come with a system of high information security to ensure that patients' privacy will be adequately protected. Moreover, cloud computing has become a global trend, and the industrial and commercial sectors and the Government will gradually apply the related technology to push ahead business reform and the improvement of public services. I learn that the Government will establish its cloud computing platform, applying the cloud technology to relaunch its central information technological service which may involve platforms exclusive to the Government, the outsourced parties as well as public cloud platforms available for public use. Actually, regardless of the type of cloud platforms, it is imperative that the Government must draw up adequate information security measures and must at the same time carefully pick and handle the information to be put onto the cloud platform to enhance protection of privacy and information security. Deputy President, just as what State Councillor YANG Jiechi said, the SAR Government has handled the SNOWDEN incident in accordance with the law. There should be no criticism of that, and all parties should give their respect. I believe the Government has handled this incident according to the laws and procedures of Hong Kong. Under the general principle of "one country, two systems", it is very important for the SAR Government and the Central Government to communicate and discuss if incidents involving foreign affairs crop up.


Deputy President, I support censuring the US Government for hacking into Hong Kong's computer and communications networks, which has seriously infringed upon individual privacy. I so submit. MRS REGINA IP (in Cantonese): Deputy President, talking about the whistle-blowing incident of Mr SNOWDEN, since he disclosed in early June to the whole world the extensive cyber surveillance programme of the United States (US) to steal individual information, the whole world is shocked, turning it into an extremely serious case. Let us revisit some topics which Mr SNOWDEN has disclosed since early June. (THE PRESIDENT resumed the Chair) First, he disclosed that within the country, the US can ask the telecommunication company Verizon for all telephone records. This only affects its nationals. Second, he disclosed that the United States National Security Agency (NSA) has a PRISM programme which is much worth our concern. The NSA of the US can have direct access to the servers or routers of nine major information technology companies, including those which the people of Hong Kong are familiar with and make us of frequently, such as Google, Apple, Facebook, Skype, Yahoo, AOL, YouTube, and so on, to access email content, search history, file transfer and online chats. Mr SNOWDEN also disclosed in Hong Kong all online information of political figures, government officials and business celebrities who have come under the US surveillance, and that the Hong Kong Internet Exchange of The Chinese University of Hong Kong (CUHK) has been hacked into. This is very serious. Therefore, I think it is very timely for Mr MA Fung-kwok to propose this motion which is worth the Government's attention. I demand that apart from expressing our strong dissatisfaction to the US Government, the Government should ask the information technology companies like Apple, Yahoo and Google if they allow the US Government to have direct access to information of Hong Kong people. This is also much worth our attention. Given the seriousness, what has this young man SNOWDEN told The Guardian? He himself stated: "I, sitting at my desk, certainly had the authorities


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to wiretap anyone, from you, or your accountant, to a federal judge or even the President, if I had a personal e-mail." The power is so huge. I note that some amendments today ask for the strengthening of our legislation to target governments and bodies outside Hong Kong, law-enforcement loopholes involving business organizations and individuals. While these are all necessary, I consider we should pay special attention to the US because undoubtedly, the US is home to the most advanced technology and the Internet is its invention. American information technology companies are at the world's forefront, so their influence is the strongest. Secondly, I also have to point out it is simply timely for us to demand that the US Government face the issue squarely. Apart from the passing of the call last week by the House Committee for the US Congress to implement the function of monitoring the Government and demanding that the US Government offer an explanation, I am also aware that the US Congress held a debate yesterday to discuss the legislation concerned ― the Foreign Intelligence Surveillance Act. So, under this Act, there is this special Foreign Intelligence Surveillance Court which lacks transparency. Some Members of the Congress have pointed out the shortcomings of this Court: first, only the prosecution is present in this Court but not the defence. There is only the NSA to represent the Government, applying to the Court for warrants, but there is no one to represent the victims of surveillance or those whose confidential information have been stolen. This is in breach of the principle of the adversarial system under the common law. Second, the Court has only one Judge, making black-box operation totally possible. Third, the appointment of the Judge for the Court purely rests with John ROBERTS, the Chief Judge of the US federal court. Thus, this system very much lacks transparency. Although the US claims to respect democracy and human rights and export its values to the world, its legislation in fact allows certain systems to absolutely go against the principles of public accountability, high transparency and the adversarial system under the common law. Under such legislation, acts of surveillance and stealing of confidential information can take a heavy toll all over the world. I have particularly noted that during a web chat conducted in Hong Kong, this young Mr SNOWDEN clearly pointed out that this is very dangerous because "What if the system crashed" while surveillance is underway? A lot of civilian organizations will be


affected. This Mr SNOWDEN is a very sensible young man. Although he has disclosed a lot of secrets, he has not in fact compromised the military secrets of the US; he has just pointed out how the US has conducted surveillance on some civilian organizations in the world. If its system crashes, the operation of the Internet Exchange of CUHK may be compromised, and this will also affect our airport, and the Hong Kong Exchanges and Clearing Limited. It is therefore a serious matter. Given the fact, I fully support Mr MA Fung-kwok's motion. The focus of this debate today should be primarily on the expression of dissatisfaction to the US Government, and to urge it to conduct a thorough investigation. Of course, I have paid attention to the public sentiment in the US. To the Americans, half of them support Mr SNOWDEN ― 70% of the young population ― but in respect of Hong Kong's non-co-operation, or Hong Kong's complaint against the US, its attitude is however one of contempt. Nonetheless, as a legislature accountable to the people, I consider our duty to pass this motion. Thank you, President. MR WONG YUK-MAN (in Cantonese): President, has the United States (US) ever put our local communication networks under surveillance and hacked into them? Has it ever violated the confidentiality and privacy of the people of Hong Kong? Although we cannot prove the allegation, there must be a reason for it. The Chinese University of Hong Kong has denied being hacked into, but simple commonsense can tell that Mr SNOWDEN's allegation is not pointless. Since the Americans possess the most sophisticated information technology and communication technology, they must be idiots if they do not take leverage by making use of such technologies to watch over the world. Can we believe that the US is clean? No way! Nowadays, these technologies are closely knit with us. We have become smartphone addicts, and bowing our heads to browse the web is part of our lives. The Internet portals and social platforms are all inventions of the US, aren't they? They would make use of these platforms for surveillance unless they are idiots. In his motion, Mr MA Fung-kwok proposed that the Legislative Council should express strong dissatisfaction to the US Government. In my opinion, this is our duty. Even the House Committee has passed a motion calling upon you, President, to write a letter. I think this letter should not only be sent to the


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Congress of the US, but also to the US Government. This is what should be done. However, I will look at this issue from another angle. Mr SNOWDEN said that since Hong Kong has a long tradition of allowing its people freedom of speech and taking to the streets to protest, he therefore chose to come to Hong Kong. As such, many people from the pro-establishment camp have immediately borrowed his words to speak for this autocratic SAR Government. As the Secretary for Security, LAI Tung-kwok can but lie with the police, accusing other people of telling lies. Someone has spoken for him, quoting this foreign guy that there is freedom of speech in Hong Kong, and the people can take to the streets. Everybody, therefore, has an excuse to defend the SAR Government. Nevertheless, we must not forget that the SAR Government always wants to watch over people's views and opinions expressed online, as once pointed out by Mr SHIU Sin-por. While the SAR Government is now working on the copyright legislation, it has tried before to control online comments through the Control of Obscene and Indecent Articles Ordinance. Can we still trust that it does not want to do this? Am I right? This is beyond its reach, but this is what it is yearning for. Hong Kong is only a user of the so-called information technology. If we can be the inventor like the US, it will definitely make trouble for us, so to speak. The pro-establishment camp has found the SNOWDEN incident a big treasure since its emergence. Ms Starry LEE, a Member of the Executive Council from the Democratic Alliance for the Betterment and Progress of Hong Kong, remarked, "China, though named a hacker, has turned out to be a victim of computer hacking by the Americans. This is simply awkward." This shows how shallow she is. Therefore, the title of this speech of mine today is "Can Criticizing the United States Cover Up the Shame of China?" People with some knowledge will know that currently, China's expenditure on maintaining social stability is even higher than its defense budget, and of the expenditure on maintaining social stability, a large portion is used for conducting surveillance on online comments. Nevertheless, the two mouthpieces of the Chinese Communist Party, Wen Wei Po and Ta Kung Pao, have taken this opportunity to criticize the opposition camp for having double standards. In fact, some people of the opposition camp have stayed shy and acted strangely. This is also a fact. Nonetheless, the Americans do have a sense of shame. However hypocritical they are, they will tell the world that they have in place a check-and-balance system, the Congress and other means. On the contrary, the


Community Party is shamelessly watching over and intercepting its people's communications, as well as requiring them to register their real names on the Internet, penalizing them for their online comments. When webpages are screened out, the action is always claimed to be necessary for maintaining social stability and safety. The freedoms of information and speech have all along been relentlessly cracked down upon. I would like to quote a passage from Joe CHUNG's bestselling China is Stranger Than Fiction. His debut I Don't Want to be Chinese Again is incredibly popular and has been reprinted for dozens of times. The passage I would like to quote reads: "The Chinese Government or Chinese people are hanging more on to the eccentricity of digging into any misdeeds of the Americans, then taking them as excuses for similar misdeeds of China …… similar cases are cited as evidence, and this kind of eccentricity has gradually spread to Hong Kong …… This mindset of the Chinese, which is contrary to emulating those better than oneself and seeking the cause in oneself instead of someone else is consistent, from 'so as the foreign countries' as said by LU Xun to 'so as the United States' as said today …… The anti-American sentiment of the Chinese is but the fig leaf for self-humiliation or for humiliating their countrymen." (End of quote) Commenting what the pro-establishment camp has said and done now with this passage of Joe CHUNG is the most appropriate. Its xenophobic rhetoric and mindset of "down with the US imperialists and Soviet revisionist" still belong to the Cultural Revolution era, basically different from the Hong Kong society which claims itself to be a metropolis. In the 21st century, this appears all the more naive and ridiculous. Honourable colleagues, the children of the senior cadres of the Chinese Communist Party have been fleeing to the US, the People's Bank of China has kept buying the Treasury Bonds of the US in large amounts, even Mr SHIU Sin-por has held secret talks with the Consulate General of the US on political issues, such unconstructive comments of the pro-establishment camp will only expose the people of Hong Kong to ridicule. The pro-establishment camp should focus on safeguarding the security and freedom of information, instead of hiding its motive and taking the opportunity to do harm to the community. In an earlier interview with Bloomberg News in New York, "689" CY LEUNG just acted as a "human recorder", repeating the words "no comment"


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over and again as we can see. Is it not the same for LAI Tung-kwok? He also acted as a "human recorder", regardless of whether he was responding to Members' oral questions or giving his reply in pertinent motion debates. What purpose can this Secretary for Security serve? When it comes to information security of Hong Kong, reference is always made to that particular document. We in the Panel on Information Technology and Broadcasting also have those similar documents, or words similar to what the Security Bureau has said, only to no effect. Dare they stand up against the "Yankees"? Certainly not. I can bet you they even dare not write to the US Government to protest in the name of the SAR Government. Do they have the guts to do so? Thus, we are asking you, President, to write a letter. You must not decline. Otherwise, I will despise you. This is all I want to say. MS CYD HO (in Cantonese): Today, I speak in support of the original motion and all the amendments. This SNOWDEN incident in fact is telling the people of Hong Kong that besides having to modernize technology, we also have to open our eyes to the whole world because in the borderless and timeless world of information technology, everyone can be subject to the control of technology hegemony. Be it whichever government, everyone's privacy is likely to be easily encroached upon, everyone has to learn to protect himself. I am speaking because I do not want any colleague to have this misunderstanding that if no Member from the Labour Party speaks, this is tantamount to siding with the United States (US) Government. Therefore, President, I must speak and have my speech recorded. This disclosure by Mr SNOWDEN that the National Security Agency of the US is eavesdropping and intercepting communications has served to awaken us to the fact that universal human rights and national interests have to be taken together. Mr SNOWDEN was born and raised in the US, he leaked secrets for the benefit of public interest, telling the world that the US Government is not only conducting surveillance on the Americans, but also its ally, the European Union (EU). Even the headquarters of the EU are a subject of wiretapping.


We surely despise such acts but viewing from the angle of universal human rights, although national interests are involved, we in Hong Kong of course resents having our privacy being encroached upon by any governments. We should not tolerate other governments relying on their technology hegemony to intercept communications and gain access to more information so as to handle certain international affairs, at the expense of the policies and interests of the HKSAR and China. That said, I very much hope that besides having in mind national defense and interests, we really have to consider the value of universal human rights as this sees no borders. If we are viewing from the angle of national defense, the SAR Government really has no role to play. Since Mr MA Fung-kwok first raised an oral question on the incident, we, the Labour Party, have asked the Secretary if the incident involved national defense and diplomacy. When speaking in other occasions thereafter, we have clearly stated our stance. If such a super technology hegemony can intercept communications everywhere for information to facilitate the formulation of certain international diplomatic policies or even military policies, why then is it not an issue of national defense? During those two to three weeks Mr SNOWDEN stayed in Hong Kong, the incident had not yet risen to the level of national defense, it was still handled independently by the SAR Government, and we had generally acted in accordance with the laws of Hong Kong. When asking the US to clarify the identity of Mr SNOWDEN, it is obvious that we had been clumsy. Fortunately, Mr SNOWDEN left soon and we did not have to expose our clumsiness. The SAR Government did not have to be criticized for failing to act independently, but China had not escalated the incident to the level of national defense promptly. To Hong Kong, this is already a blessing as the rule of law in the SAR has not been undermined. However, we also have to think it over before it is too late since similar incidents may happen again in the future. President, one of the amendments today suggests "to review the approach and procedures for handling similar incidents in the future, including considering the circumstances under which the Central Government's assistance will be sought in the relevant incidents", but I think it should instead be reworded as to consider under what circumstances and what mechanisms to adopt to bring up with the Central Government, whether or not the incident should be escalated to the level of national defense and diplomacy. Otherwise, it will again be handled in this same clumsy manner.


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President, the last point I would like to mention is the protection for the whistle-blower. The US in fact has a piece of legislation to that effect and has also put in place an administrative system, but when the Republicans come to power, this system exists only in name, making it hard to protect the whistle-blowers. Since a lot of people are afraid of using it, the system becomes ineffective. As a result of this incident, we know that even if there are related legislations, if the administrative measures and systems fail, there is no way the people can be protected. On the contrary, I hope Hong Kong can take a look at the pertinent legislations. When someone has to disclose some information regarded as sensitive for the benefit of public interest, we should protect him and let him do so without fear, so that the public will not be harmed. Finally, this incident makes us aware that more often than not, when people disclose information because of universal values, they will likely be regarded as betraying their countries. The people of Hong Kong are always shrouded by the shadow of Article 23 of the Basic Law. This time, we clap wholeheartedly for Mr SNOWDEN who has betrayed his country. What if the same happens in Hong Kong? How should we view the person concerned if he discloses information because of public interest? I wish this incident will rouse public awareness to universal human rights, privacy, national interests and national defense and arrive at a balance. Thank you, President. MR NG LEUNG-SING (in Cantonese): President, the SNOWDEN incident has stirred up a "City of Spy" discussion in Hong Kong. Actually, Hong Kong has long been practising the free port policy, providing news freedom and free access for people, making it an ideal place for the collection of all kinds of intelligence and meeting different people. In recent years, many articles have recapped the spying events in Hong Kong in the 1950s, for example, the United States (US) supporting the then "third force" in Hong Kong against the activities of the Mainland Government; Taiwan agents had also orchestrated the "Kashmir Princess" incident to do harm to the Chinese leaders. All these are still so vivid. However, documents showed that the then British Hong Kong Government conducted certain surveillance on all forces, thus silencing the then "third force" under the rule of the British Hong Kong Government.


Lately, the US keeps on expanding its agent system under the name of anti-terrorism, putting global communications and contact records under surveillance, stealing private personal data and the confidential data of nationals of other countries. Even the allied European Union (EU) nations are not spared. In the past, the US agent system came under the military and would stay away from the civilians, but now, it has crossed the boundary. According to specific information disclosed by Mr SNOWDEN, the US Government coerced network software companies and various large servicing companies into handing over information, with the number of companies involved exceeding 1 000. It can be seen that the US is attaining its ends by hook or by crook, and the situation has become extremely disgusting. The agent system of the US has mastered sophisticated technology. In the digital era, it can reach every where. According to what Mr SNOWDEN had disclosed to the South China Morning Post, the US had since 2009 made Hong Kong a target, and had hacked into computers of universities, social organizations and personal computers several hundred times, with a success rate of 75%. The situation is serious. In this connection, I have the following observations. First, the HKSAR Government can consider setting up special units tasked with conducting surveillance and banning foreign spying activities which have gone overboard. In the past, even the Special Branch of the British Hong Kong Government could make use of the evidence to dissuade the "third force", safeguarding public law and order in Hong Kong to a certain extent. Under the present structure, the SAR Government should establish security-related institutions in accordance with the law. It should take a leaf from the book of the international community, putting in place "carrots" and "big sticks" for successful governance. In his amendment, a colleague stressed the need for policies and ordinances to combat the relevant acts of communications interception and unauthorized retrieval and retention of network information. In fact, the effect of this on hacking from outside is relatively minor. I'm afraid the technology level has also to be enhanced, instead of relying solely on existing civilian commercial techniques and talents to stand up against the extraterritoriality of the US agent system which is equipped with sophisticated technology. Action should also be taken from more dimensions.


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Third, after all, the counterbalance effect on the technical level is the most practical, suffice for attaining the actual strength of national grade technology before improvements can be made to information security and network security. As reflected, The Chinese University of Hong Kong (CUHK) is better equipped in terms of Internet technology, the Government can consider asking CUHK to take the lead and work in concert with the other institutions to look into ways to enhance the level of resisting attacks. The Government on its level can also consider cross-border co-operation, seeking to work with our counterparts on the Mainland and ask them for support. Fourth, during the meeting of the House Committee last week, we arrived at the decision of writing to the US Government and the two Houses to express our concern towards the incident, and to urge them to promptly explain and clarify the matter of hacking into the computers of Hong Kong. Some colleagues of this Council identify very much with the "legitimacy" and "democratic system" of the US Government, thus, my advice for those colleagues who are closely related with the political circle of the US is to call a spade a spade, and to firmly reject the despicable act of the democratically elected US Government of encroaching upon the privacy of the people around the globe. The EU Commissioner for Justice also said that the US will be urged to expressly guarantee that the basic rights enjoyed by the people of the EU in respect of data protection will be respected. The German Chancellor is also to discuss with the US President the issue of network surveillance. In this connection, I suggest that the SAR Government must closely watch the development and pay attention to the impact the information which may be stolen will have on Hong Kong, the people concerned and the related organizations in the future, and to take appropriate action and respond where necessary. President, I so submit. PRESIDENT (in Cantonese): Does any other Member wish to speak? MR CHAN KAM-LAM (in Cantonese): President, in the past two months, the SNOWDEN incident has aroused great repercussions in the international community. The people of Hong Kong are particularly concerned about what in


fact the US has done to their privacy right. Therefore, when the SNOWDEN incident first emerged, everyone is very much concerned about whether he would further disclose as to how the US agents steal the information of Hong Kong's celebrities or political figures every day. As a result, everyone is much alarmed after the incident came to light. On the other hand, people are like reading a novel on agents, paying great attention to what new developments there are every day. After Mr SNOWDEN's departure from Hong Kong, everyone sighs a relief because if he remains in Hong Kong, the SAR Government will be under great pressure, particularly the US has repeatedly asked the SAR Government to repatriate Mr SNOWDEN. Upon Mr SNOWDEN's departure, someone came out to "take advantage", referring to himself as Mr SNOWDEN's agent, and even said something which he should not have, having no regard for the profession's confidentiality code. As a result, there has been much discussion among the Hong Kong people as disclosing the whereabouts of Mr SNOWDEN will in fact seriously jeopardize his safety. Frankly, some of what Mr WONG Yuk-man said earlier was right because the US does possess sophisticated technology and is conducting surveillance on the messages exchanged among different countries and people around the world every day. If we say the US will not conduct surveillance, it is tantamount to saying it is an "idiot". Nonetheless, Mr WONG Yuk-man continued to say that the allegation could not be proven. To me, these words sound very much like defending the US. While he said the US is hacking into our networks, he next said there was no proof, and this is like saying that people are smearing the US. However, the fact is that the US cares much about Mr SNOWDEN becoming a fugitive, which also explains why Mr SNOWDEN is not leaving without a reason. Upon his arrival in Moscow, President PUTIN also said openly that Mr SNOWDEN cannot leave Russia, mainly because the US has imposed substantial political pressure on the international community, making it difficult for him to proceed. I believe PUTIN is also very much distressed by this incident. Therefore, although many South American countries want to receive Mr SNOWDEN, they are faced with many difficulties.


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Mr WONG Yuk-man said the SNOWDEN incident is a shame for the US. If that is the case, I am puzzled. If the US sees it a shame, it should have stopped, right? In today's world, many democratic countries are under the influence of the so-called values of the US. However, as we can see, have Asia, the Middle East and numerous African democratic countries ever been in peace? Of course, we definitely will not chide the US because of the problems pertaining to democracy which it has planted around the world. Democracy is what we are after. However, every country should have in place a system which suits the country's development. Thus, although we in Hong Kong have to follow the Americans, we also have to be careful. What Mr NG Leung-sing said earlier was right. Political figures in Hong Kong who have contact with the political circle of the US should actually reflect. President, on the issue of the US infringing upon human rights through the networks, some people make no comment, but some have expressed great concern. As we all know, the US is doing this on a daily basis, and infringing upon human rights through networks is already trivial. The world is seeing a lot of aggressive wars fought with genuine weapons, not only intangible network attacks. Moreover, the US is launching cultural attacks on other countries every day. Therefore, the people of some countries are afflicted by wars, and their suffering way exceeds the calamity which results from our networks being hacked into by the US. We must condemn hegemony, be it network hegemony or economic hegemony. I believe through the SNOWDEN incident, people around the world will realize that even if democratic awareness and values are to be exported, there should be a respect for the other countries, and should refrain from using its own dominance to attempt to interfere with the internal affairs of others, or compelling others to act according to its wish. President, I so submit. PRESIDENT (in Cantonese): Does any other Member wish to speak? (No Member indicated a wish to speak)


PRESIDENT (in Cantonese): Mr MA Fung-kwok, you may now speak on the amendments. The speaking time limit is five minutes. MR MA FUNG-KWOK (in Cantonese): I am much thankful that a total of 19 Members have spoken today on my motion, and am also very grateful to Mr Charles Peter MOK, Mr Ronny TONG and Mr SIN Chung-kai for moving their amendments, which I now would like to respond to. This "PRISM" programme disclosed by Mr SNOWDEN has undoubtedly reflected the failure of the existing laws of Hong Kong to regulate the illegitimate surveillance activities of overseas organizations, prompting us to worry about possible loopholes in Hong Kong's local network security system. Thus, I realize that it is from the two perspectives of amending or reviewing legislations, and enhancing Hong Kong's local network security, that the three Members proposed their amendments, with the hope of perfecting Hong Kong's network security and privacy protection. I think there is room for examining and studying these proposals and making improvements, but I also agree that the Government should expeditiously look into these two areas to step up protection. Nonetheless, there is one point I would like to emphasize. At the moment, our networks are hacked into by the National Security Agency of the United States (US) which has the absolute edge of being equipped with sophisticated technologies and an estimated annual budget of up to US$10 billion, and the "PRISM" programme is of a multinational intelligence collecting nature, the handling and resolution of the situation may involve the realms of national sovereignty and diplomacy. Perfecting our legislations and technologies alone may not solve the entire problem. For the matter to be handled well, we have to clearly and forcefully express the dissatisfaction of the Hong Kong people to the US Government, which is the source of surveillance. My worry is that while the amendments of the three Members have not deviated from the original motion, they have nonetheless blurred my purpose in the original motion which is to lash out directly at the acts of the US, rendering the amendments unable to bring out the effect of the original motion. President, in his amendment, Mr Charles Peter MOK has added words to hold the US Government responsible, specifically requesting the US Government to stop its theft of Hong Kong's network data and to immediately dispose of the


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information obtained. I very much agree with him, but the other proposals of Mr MOK have expanded the original motion of about 100 words to 400, with two-thirds unrelated to criticizing the inappropriate acts of the US. As regards Mr Ronny TONG's amendment, he has shifted the focus of the issue to "enact legislation on protecting the freedom of confidential communications". He is blaming the SAR Government for not doing a good job in protection which results in surveillance and eavesdropping. I beg to differ. President, in principle, I do not object to enacting legislation, but I consider a review of existing legislations a more direct and speedy way of plugging the current loophole. Furthermore, the offence of hackers attacking computers should be added to the Criminal Jurisdiction Ordinance as soon as possible so that the Courts in Hong Kong can exercise jurisdiction on cross-boundary computer offences. Regarding the amendment of Mr SIN Chung-kai, the focus has been on how to enhance the internal information security capabilities of the Government, construing the SNOWDEN incident as a reflection of loopholes existing in Hong Kong's information security. This may also blur the purpose of the original motion which is to criticize the inappropriate acts of the US. President, we can see from the SNOWDEN incident how unjustified the US Government is in its way of handling things and how it throws its weight about everywhere. On the issue of surveillance, it is like a devil rebuking sin, holding double standards. Up till now, it still owes Hong Kong and the whole world an explanation. To express our indignation, I implore colleagues to join hands against the external forces, show support for the original motion so that the legislature can stay focused in expressing clearly the dissatisfaction of the Hong Kong people to the US Government. Thank you, President. SECRETARY FOR SECURITY (in Cantonese): President, I would like to thank Honourable Members for putting forward their valuable views on the motion of "Following up the matter on Mr SNOWDEN's disclosure of the United States (US) Government's hacking into the computer systems in Hong Kong". Having carefully listened to Honourable Members' speeches, I hope to make a


reply mainly in the following areas. My reply will cover the policy areas of the Commerce and Economic Development Bureau and the Constitutional and Mainland Affairs Bureau. In respect of information security, network security and combating technology crimes, the Government attaches a great deal of importance to the security of information systems and networks. The authorities have implemented various measures for the security of computer systems within the Government and personal computer systems, as well as combating technology crimes. Targeting on potential information security problems and the risks of computer systems being hacked into, the Office of the Government Chief Information Officer (OGCIO) has all along been adopting effective measures and techniques, including the information security services of the local industry as well as advanced security facilities and techniques, so as to continuously enhance the information security capability within the Government. At the same time, the Government is also very concerned about public awareness of information security, as well as the security of personal computers and the possible invasion of privacy. Regarding the importance of network security, the OGCIO has formulated information security policies and measures concerning the prevention of information security attacks and network intrusion within the Government. And, it has also installed advanced network intrusion prevention systems available in the industry, timely updates important information systems, and regularly conducts security risk assessments and third-party audits on such systems, so as to ensure that the various bureaux and departments can timely identify information security threats and rectify loopholes, adopt appropriate security measures for protecting the Government's information systems and data, and earnestly abide by established information security policies. The OGCIO has also formulated policies and measures for the protection of sensitive information, requesting the bureaux and departments to encrypt all confidential files during storage and transmission, and allowing only authorized persons to access application systems and data to ensure the protection of data. On the promotion of information security among various social sectors, the Government is concerned about people's computer security. And, it has noted the spread of computer viruses, hacker attacks and malicious programs through the Internet, as well as the trend of increasing computer threat incidents. As the


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use of the Internet is gradually becoming popular nowadays, users may have unconsciously downloaded malicious programs and spread viruses, thus becoming unwitting accomplices of hackers. Problems such as the damage of key information by viruses, the illegal seizure of financial information and the presence of large numbers of junk emails all show that effective information security measures and network invasion prevention work are critically important. In respect of exchanges with experts, Mr YIU Si-wing said that the authorities need to hold joint discussions with local and non-local computer experts on enhancing techniques and measures relating to network security. The OGCIO continuously maintains close contacts with the industry and information security experts through meetings, forums and seminars. In the past year, the OGCIO attended eight public seminars on information security held by the local industry or professional organizations, and addressed those present on the subject of information security. The OGCIO plans to hold an information security roundtable meeting in August this year, so as to jointly discuss with local experts information security situation in Hong Kong and the world, and listen to their views and advice on the various information security measures of the Government. On the other hand, the OGCIO constantly maintains close contacts with international information security experts and attends international meetings, so as to ensure that we receive the latest information security news. In April 2014, the OGCIO will host the ISO/IEC JTC 1/SC 27 meeting. Some 300 information security experts and professionals from over 30 economies will meet and discuss information security techniques and associated standards at the meeting. In respect of combating technology crimes, the Hong Kong Police Force (HKPF) possess the expertise and competence of international standards. As far as crime detection is concerned, a three-tier investigation framework is currently adopted by the HKPF with investigation units at the levels of the Headquarters (the Technology Crime Division of the Commercial Crime Bureau), Regions (Technology Crime Units) and Police Districts to ensure optimal resource utilization for effective and efficient investigation of such crimes. Furthermore, a round-the-clock Cyber Security Centre was set up by the HKPF in December last year. Through strengthening communication and co-ordination between the HKPF and relevant stakeholders, conducting thematic researches and auditing network security measures, this Centre aims to prevent and enhance the response


to possible attacks against information systems of critical infrastructures. Despite the trend of increasing cyber attack cases, we are confident that the Centre is able to step up our response to and defence against cyber attack incidents. The several incidents detected by the Centre recently serve as the best examples. Regarding co-operation with international law-enforcement agencies (LEAs), in view of the hidden nature and the cross-boundary characteristic of technology crimes, co-operation with international LEAs is a very important part of our investigation. The HKPF never relaxes its efforts in international co-operation. Through established co-operation mechanisms, instant notifications and co-operation are initiated with various technology crime investigation teams in the world whenever necessary. Apart from that, the Senior Superintendent of the Technology Crime Division of the HKPF also chairs the Interpol Asia-South Pacific Working Party on Information Technology Crime. Regarding international co-operation, I would like to point out that it is a cross-border crime for any overseas hackers to attack Hong Kong's computer systems. As the relevant cases involve hacking from outside Hong Kong, the HKPF needs to spend a long time obtaining relevant information from overseas organizations at the time of investigation and evidence collection. Also, as cross-boundary cases involve different jurisdictions, it is more difficult to take law-enforcement actions. Some Members said that the authorities need to review the relevant legislation on computer crimes. Mr Charles Peter MOK, Mr Tommy CHEUNG and Ir Dr LO Wai-kwok all advised the Government to review the relevant legislation and strengthen the co-operation between various government departments. I would like to point out that combating computer-related crimes has all along been an inter-departmental effort. The Government constantly reviews the relevant regulatory framework and administrative measures, and the various departments take law-enforcement actions against crimes of hacking into computers in response to the nature of crimes and according to the relevant legislation. Combating computer hacking and related crimes has all along been an inter-departmental effort. At present, various government departments have put in place measures for combating various computer and cyber crimes, and


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promoting and protecting the security of information systems. The Hong Kong Computer Emergency Response Team Co-ordination Centre (HKCERT), established with funding support from the Government, provides computer security incident related services for the local Internet community, including monitoring and responding to computer security incidents, issuing alerts, and raising public awareness on Internet security. The OGCIO has established the Internet Infrastructure Liaison Group (IILG), comprising members from the OGCIO, the HKPF, the Office of the Communications Authority, the HKCERT, the Hong Kong Internet Registration Corporation Limited, the Hong Kong Internet Exchange and the Hong Kong Internet Service Providers Association. Through the IILG, the stakeholders have established closer communication and co-operation. These communication and liaison channels have been operating smoothly. The HKPF constantly pays heed to technological development and the changes in criminals' modus operandi, and updates regulatory and law-enforcement strategies when necessary. The HKPF has listed combating technology crimes as one of its Operational Priorities 2013, so as to focus on combating increasing technology crimes more effectively. Dr CHIANG Lai-wan, Mr YIU Si-wing and Ir Dr LO Wai-kwok all opined that, due to security reasons, the authorities should support the development of renowned information security techniques through local research. This is a very good suggestion. As a matter of fact, the Government has arranged various centrally organized information technology contracts for providing information technology products and services to the bureaux and departments, including standing offer agreements relating to information security services. In 2009, the relevant service contracts were let out through public tendering process to nine companies, of which five are local companies. And, two out of the five companies are small and medium sized enterprises (SMEs). In 2012, the Government spent about $15 million on procuring information security services from the said nine operators, of which about $11 million (about 73%) were spent on services provided by the five local companies. The Government always supports local research on information and communications technology (ICT). The Innovation and Technology Commission constantly provides funding to assist local universities, research and development centres as well as enterprises in conducting applied research on information security techniques, such as encryption algorithm, cloud computing security and privacy protection. In order


to promote locally-branded products, we hold the Hong Kong ICT Awards every year, with the aim of commending and promoting the excellent achievements and contributions of Hong Kong ICT professionals, business corporations and organizations. The Awards also encourage local practitioners to develop innovative and creative solutions, which will uplift the professional image of Hong Kong's ICT sector, both locally and internationally. The winner of the Award of the Year in 2013 is a local information security company. The following are my concluding remarks on network security and information security. The OGCIO continuously organizes different events in collaboration with the industry and professional bodies, so as to enhance their awareness of and concern about information security. It also encourages SMEs to adopt appropriate security modes and operational arrangements for the safe use of computer and online services. The Government also publishes information security related news reported in Hong Kong and overseas in its information security portal (www.infosec.gov.hk) to keep the public apprised of emerging security issues that may affect them. Through the HKCERT, the authorities also promote and provide various methods for preventing information security attacks, timely provide the latest information security news and alerts, and assist all social sectors in responding to security incidents and obtaining technical support. The Internet is open and global. In order to safeguard a safe online environment, and strengthen network and information security, the Government, industry stakeholders, security experts, the industrial and commercial sectors, SMEs and the public all need to join hands and co-operate. The OGCIO will continuously launch various information security measures, so as to protect the information systems and data of the Government, and deepen public awareness of information security. The HKPF will also continue to maintain close contacts and co-ordination with stakeholders and the industry, so as to ensure the network security of information systems of critical infrastructures, and combat various technology crimes. On regulating the interception of communications and covert surveillance operations by non-public officers as well as privacy protection, I understand that Honourable Members and the general public are very concerned about regulating the interception of communications and covert surveillance operations by non-public officers as well as privacy protection recently. Mr Tommy


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CHEUNG said that the authorities should consider extending the regulatory scope of the Interception of Communications and Surveillance Ordinance (ICSO), so as to regulate the interception of communications by non-public officers. I hope Honourable Members can understand that the purpose and designated scope of the ICSO is to regulate LEAs' lawful interception of communications and covert surveillance operations for the prevention or detection of serious crimes and the protection of public security. The ICSO makes provisions for a complicated and sophisticated mechanism, so that designated LEAs can comply with such stringent procedures and requirements by filling in documents, submitting applications and conducting surveillance according to the authorizations granted. Under the ICSO, before LEAs carry out any interception of communications and covert surveillance, they are required to obtain an authorization from a panel Judge or a designated authorized person, and the relevant operations are also subject to the oversight of the Commissioner on Interception of Communications and Surveillance (CICS) as specified by the ICSO. Given the specific and unique design of the stringent regulatory regime under the ICSO, it is inappropriate and infeasible to extend the ICSO to cover non-public officers or non-governmental organizations. Mr SIN Chung-kai also advised the review of the ICSO. In this regard, the Government has finished the relevant work, consulted the relevant stakeholders, particularly the CICS, and reported the progress to the Panel on Security in a timely manner. In fact, at the Legislative Council Meeting two weeks ago, Mr Frederick FUNG already raised an oral question on regulating the interception of communications and covert surveillance by non-public officers. The Secretary for Constitutional and Mainland Affairs pointed out in his reply on that day that, as for the regulation on non-public officers, the Government has carefully examined the two reports of the Law Reform Commission of Hong Kong (LRC), Regulating the Interception of Communications and The Regulation of Covert Surveillance. The authorities need to carefully consider whether the conduct of non-public officers in this respect should be regulated, given that when the reports were published, the Hong Kong media sector and journalists expressed their worry that the relevant recommendations might compromise press freedom. Accordingly, the Government opines that it must consider very carefully views from all parties concerned, ensure the proper protection of different rights and interests, and refrain from taking actions rashly.


As a matter of fact, the relevant recommendations in the five LRC reports on privacy all touch on the sensitive and controversial issue of how to strike a balance between protection of individual privacy rights and freedom of the media. There have been mixed responses and divergent views from different sectors of the community. The Government has to reconcile the differences and balance the legitimate interests of all parties, with a view to forging a consensus on the way forward by all social sectors. Given the complexity and sensitivity of the issues involved, the Constitutional and Mainland Affairs Bureau is handling the five reports by stages and will determine the way forward after discussions with the parties concerned. Since the report on "Stalking" is comparatively less controversial than the other four reports, the bureau is dealing with it first. A public consultation exercise was conducted between December 2011 and March 2012 to gauge public views on the recommendations but a consensus was not reached. The public, the media and other sectors had grave concerns about the likely impact of the recommendations on the freedom of the press and freedom of expression. The authorities attach great importance to concerns on the protection of press freedom. We are studying the views collected and related issues, and have commissioned a study of overseas experience by a consultant in this regard in order to map out the way forward. Both Mr Charles Peter MOK and Ms Cyd HO inquired about the circumstances under which the SAR Government would seek assistance from the Central Government. Under the principle of "One Country, Two Systems", the SAR Government has maintained normal communication with the Office of the Commissioner of the Ministry of Foreign Affairs in the Hong Kong Special Administrative Region concerning the SNOWDEN incident. I believe that Members present likewise do not wish to see the reoccurrence of similar incidents in the future. In case a similar incident happens in the future, we will sustain such communication when any need arises depending on the situation. Regarding Mr Kenneth LEUNG's views on the handling of the SNOWDEN incident by the SAR Government, I would like to say that the Government has handled the incident strictly according to the law. Mr LEUNG also talked about the Jiangmen incident. The Jiangmen incident is not related to the topic of this debate, but I can tell Mr LEUNG that the SAR Government has communicated with the relevant Guangdong authorities in a timely manner.


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Finally, I believe Honourable Members are most concerned about how the SAR Government has approached the United States and followed up the US government agencies' reported hacking into the computer systems in Hong Kong. As I have said in my opening remarks, the SAR Government, like Honourable Members and the general public, is very concerned about the US government agencies' reported hacking into the computer systems in Hong Kong. The Security Bureau sent a letter to the US Government on 21 June requesting an explanation formally, but regrettably, the US Government has hitherto given no reply whatsoever. We are very disappointed at this. The House Committee of the Legislative Council decided last Friday that the Legislative Council would send letters to the US Government as well as the House and Senate, so as to express its discontent with and condemnation of this incident, and request the Congress of the US to monitor its executive authorities. I would like to thank Honourable Members for following up the incident through another channel. As Hong Kong is an advanced city, its cyber networks are very extensive in coverage, and have become an indispensable and daily information tool for members of the public as well as industrial and commercial organizations. We attach a great deal of importance to the free flow of information, personal privacy and network security. I would like to thank Honourable Members who have spoken successively for supporting the Government to solemnly request the US Government to explain its stance on this incident. We are looking forward to a satisfactory and comprehensive account given to Hong Kong people by the US Government. The SAR Government will continue to strive to follow up this incident. Thank you, President. PRESIDENT (in Cantonese): Mr Charles Peter MOK, you may move your amendment to the motion. MR CHARLES PETER MOK (in Cantonese): President, I move that Mr MA Fung-kwok's motion be amended.


Mr Charles Peter MOK moved the following amendment: (Translation)

"To delete "as Mr SNOWDEN, a former technical assistant for the Central Intelligence Agency of the United States ('US'), disclosed during a media interview the matter on" after "That," and substitute with "SNOWDEN, a former employee of the Central Intelligence Agency of the United States ('US'), recently disclosed to the media"; to delete "and hacking into Hong Kong's communications networks," after "surveillance of" and substitute with "Hong Kong's networks and computer systems and its collection of Hong Kong people's information and data;"; to add "hold the US Government responsible, and request the US Government to stop its theft of Hong Kong's network data and immediately dispose of the information obtained; this Council also urges the Government to implement the following measures," after "from the US Government,"; and to add ": (1) to formulate relevant policies to enhance the information security of Hong Kong's small and medium enterprises, including assisting them in using more world-class and locally researched and developed information security technologies; and, by capitalizing on Hong Kong's concern about information security arising from the SNOWDEN incident as an opportunity, to further support local research work on information technologies, and generate demands for local information technology products; (2) to review the Computer Crimes Ordinance (including the relevant provisions of the Telecommunications Ordinance, the Crimes Ordinance and the Theft Ordinance) and the Interception of Communications and Surveillance Ordinance, targeting the enforcement loopholes in respect of governments, organizations, commercial organizations and individuals outside Hong Kong, so as to strengthen the combat against the relevant acts of communications interception and unauthorized retrieval and retention of network information; and (3) to review the approach and procedures for handling similar incidents in the future, including considering the circumstances under which the Central Government's assistance will be sought in the relevant incidents" immediately before the full stop."

PRESIDENT (in Cantonese): I now propose the question to you and that is: That the amendment, moved by Mr Charles Peter MOK to Mr MA Fung-kwok's motion, be passed.


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PRESIDENT (in Cantonese): I now put the question to you as stated. Will those in favour please raise their hands? (Members raised their hands) PRESIDENT (in Cantonese): Those against please raise their hands. (Members raised their hands) Mr IP Kwok-him rose to claim a division. PRESIDENT (in Cantonese): Mr IP Kwok-him has claimed a division. The division bell will ring for five minutes. PRESIDENT (in Cantonese): Will Members please proceed to vote. PRESIDENT (in Cantonese): Will Members please check their votes. If there are no queries, voting shall now stop and the result will be displayed. Functional Constituencies: Mr Tommy CHEUNG, Mr Frederick FUNG, Mr Charles Peter MOK, Mr Kenneth LEUNG, Mr Dennis KWOK, Mr Christopher CHEUNG, Mr IP Kin-yuen and Mr Tony TSE voted for the amendment. Mr NG Leung-sing, Miss CHAN Yuen-han and Mr TANG Ka-piu voted against the amendment. Mr WONG Ting-kwong, Mr CHAN Kin-por, Mr IP Kwok-him, Mr Steven HO, Mr MA Fung-kwok, Mr Martin LIAO, Mr POON Siu-ping and Ir Dr LO Wai-kwok abstained.


Geographical Constituencies: Ms Emily LAU, Mr Ronny TONG, Ms Cyd HO, Mr Paul TSE, Mr Alan LEONG, Mr LEUNG Kwok-hung, Mr WONG Yuk-man, Mr WU Chi-wai, Dr Kenneth CHAN and Mr SIN Chung-kai voted for the amendment. Mr WONG Kwok-hing, Mr WONG Kwok-kin and Miss Alice MAK voted against the amendment. Mr CHAN Kam-lam, Mr TAM Yiu-chung, Mrs Regina IP, Dr Elizabeth QUAT and Dr CHIANG Lai-wan abstained. THE PRESIDENT, Mr Jasper TSANG, did not cast any vote. THE PRESIDENT announced that among the Members returned by functional constituencies, 19 were present, eight were in favour of the amendment, three against it and eight abstained; while among the Members returned by geographical constituencies through direct elections, 19 were present, 10 were in favour of the amendment, three against it and five abstained. Since the question was not agreed by a majority of each of the two groups of Members present, he therefore declared that the amendment was negatived. MR RONNY TONG (in Cantonese): President, I move that in the event of further divisions being claimed in respect of the motion on "Following up the matter on Mr SNOWDEN's disclosure of the United States Government's hacking into the computer systems in Hong Kong" or any amendments thereto, this Council do proceed to each of such divisions immediately after the division bell has been rung for one minute. PRESIDENT (in Cantonese): I now propose the question to you and that is: That the motion moved by Mr Ronny TONG be passed.


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PRESIDENT (in Cantonese): Does any Member wish to speak? (No Member indicated a wish to speak) PRESIDENT (in Cantonese): I now put the question to you as stated. Will those in favour please raise their hands? (Members raised their hands) PRESIDENT (in Cantonese): Those against please raise their hands. (No hands raised) PRESIDENT (in Cantonese): I think the question is agreed by a majority respectively of each of the two groups of Members, that is, those returned by functional constituencies and those returned by geographical constituencies through direct elections, who are present. I declare the motion passed. I order that in the event of further divisions being claimed in respect of the motion on "Following up the matter on Mr SNOWDEN's disclosure of the United States Government's hacking into the computer systems in Hong Kong" or any amendments thereto, this Council do proceed to each of such divisions immediately after the division bell has been rung for one minute. PRESIDENT (in Cantonese): Mr Ronny TONG, you may move your amendment. MR RONNY TONG (in Cantonese): President, I move that Mr MA Fung-kwok's motion be amended. Mr Ronny TONG moved the following amendment: (Translation)

"To delete "," after "That" and substitute with "although the Government has proposed amending the Interception of Communications and


Surveillance Ordinance to allow the Commissioner on Interception of Communications and Surveillance to check law-enforcement agencies' interception or surveillance products,"; to add "which further highlights the inability of the Ordinance to regulate telephone tapping and interception of communications by non-law-enforcement agencies or individuals and from outside Hong Kong, and to protect Hong Kong people's right to confidential communications against encroachment," after "communications networks,"; and to delete "," after "from the US Government" and substitute with "and enact legislation on protecting the freedom of confidential communications,"."

PRESIDENT (in Cantonese): I now propose the question to you and that is: That the amendment, moved by Mr Ronny TONG to Mr MA Fung-kwok's motion, be passed. PRESIDENT (in Cantonese): I now put the question to you as stated. Will those in favour please raise their hands? (Members raised their hands) PRESIDENT (in Cantonese): Those against please raise their hands. (Members raised their hands) Mr IP Kwok-him rose to claim a division. PRESIDENT (in Cantonese): Mr IP Kwok-him has claimed a division. The division bell will ring for one minute. PRESIDENT (in Cantonese): Will Members please proceed to vote.


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PRESIDENT (in Cantonese): Will Members please check their votes. If there are no queries, voting shall now stop and the result will be displayed. Functional Constituencies: Mr Frederick FUNG, Mr Charles Peter MOK, Mr Kenneth LEUNG, Mr Dennis KWOK, Mr Christopher CHEUNG, Mr IP Kin-yuen and Mr Tony TSE voted for the amendment. Mr Tommy CHEUNG, Mr NG Leung-sing, Miss CHAN Yuen-han and Mr TANG Ka-piu voted against the amendment. Mr WONG Ting-kwong, Mr CHAN Kin-por, Mr IP Kwok-him, Mr Steven HO, Mr MA Fung-kwok, Mr Martin LIAO, Mr POON Siu-ping and Ir Dr LO Wai-kwok abstained. Geographical Constituencies: Ms Emily LAU, Mr Ronny TONG, Ms Cyd HO, Mr Alan LEONG, Mr LEUNG Kwok-hung, Mr WONG Yuk-man, Mr WU Chi-wai, Dr Kenneth CHAN, Mr SIN Chung-kai and Dr Helena WONG voted for the amendment. Mr WONG Kwok-kin voted against the amendment. Mr CHAN Kam-lam, Mr TAM Yiu-chung, Mrs Regina IP, Mr Paul TSE, Dr Elizabeth QUAT and Dr CHIANG Lai-wan abstained. THE PRESIDENT, Mr Jasper TSANG, did not cast any vote. THE PRESIDENT announced that among the Members returned by functional constituencies, 19 were present, seven were in favour of the amendment, four


against it and eight abstained; while among the Members returned by geographical constituencies through direct elections, 18 were present, 10 were in favour of the amendment, one against it and six abstained. Since the question was not agreed by a majority of each of the two groups of Members present, he therefore declared that the amendment was negatived. PRESIDENT (in Cantonese): Mr SIN Chung-kai, you may move your amendment. MR SIN CHUNG-KAI (in Cantonese): President, I move that Mr MA Fung-kwok's motion be amended. Mr SIN Chung-kai moved the following amendment: (Translation)

"To delete ", as" after "That" and substitute with "the Hong Kong authorities have all along stressed that they attach much importance to the Government's internal information security capabilities, but"; to add "which indicates that there is room for improvement on the part of the authorities in respect of information security and cyber security;" after "communications networks,"; and to add "at the same time, to review and strengthen the monitoring of online security systems and enhance their technological level, so as to" after "in Hong Kong, and"."

PRESIDENT (in Cantonese): I now propose the question to you and that is: That the amendment, moved by Mr SIN Chung-kai to Mr MA Fung-kwok's motion, be passed. PRESIDENT (in Cantonese): I now put the question to you as stated. Will those in favour please raise their hands? (Members raised their hands)


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PRESIDENT (in Cantonese): Those against please raise their hands. (Members raised their hands) Mr IP Kwok-him rose to claim a division. PRESIDENT (in Cantonese): Mr IP Kwok-him has claimed a division. The division bell will ring for one minute. PRESIDENT (in Cantonese): Will Members please proceed to vote. PRESIDENT (in Cantonese): Will Members please check their votes. If there are no queries, voting shall stop now and the result will be displayed. Functional Constituencies: Mr Tommy CHEUNG, Mr Frederick FUNG, Mr Charles Peter MOK, Miss CHAN Yuen-han, Mr Kenneth LEUNG, Mr KWOK Wai-keung, Mr Dennis KWOK, Mr Christopher CHEUNG, Mr IP Kin-yuen, Mr TANG Ka-piu and Mr Tony TSE voted for the amendment. Mr NG Leung-sing voted against the amendment. Mr WONG Ting-kwong, Ms Starry LEE, Mr CHAN Kin-por, Mr IP Kwok-him, Mr Steven HO, Mr MA Fung-kwok, Mr Martin LIAO, Mr POON Siu-ping and Ir Dr LO Wai-kwok abstained. Geographical Constituencies: Ms Emily LAU, Mr Ronny TONG, Ms Cyd HO, Mr WONG Kwok-kin, Mr Paul TSE, Mr Alan LEONG, Mr LEUNG Kwok-hung, Mr WONG Yuk-man, Mr WU


Chi-wai, Dr Kenneth CHAN, Mr SIN Chung-kai and Dr Helena WONG voted for the amendment. Mr CHAN Kam-lam, Mr TAM Yiu-chung, Mrs Regina IP, Dr Elizabeth QUAT and Dr CHIANG Lai-wan abstained. THE PRESIDENT, Mr Jasper TSANG, did not cast any vote. THE PRESIDENT announced that among the Members returned by functional constituencies, 21 were present, 11 were in favour of the amendment, one against it and nine abstained; while among the Members returned by geographical constituencies through direct elections, 18 were present, 12 were in favour of the amendment and five abstained. Since the question was agreed by a majority of each of the two groups of Members present, he therefore declared that the amendment was passed. PRESIDENT (in Cantonese): Mr MA Fung-kwok, you may now reply and you have one minute 54 seconds. MR MA FUNG-KWOK (in Cantonese): President, once again let me thank Honourable colleagues for their enthusiastic participation in this debate today and the views they have expressed. In fact, the motion I move today seeks to deal with two aspects, one involves the issues on the external front and the other the issues on the internal front. The major spirit of the motion is to deal with the external front. It is my hope that we can join efforts to deal with the external front unanimously. We have to express clearly our dissatisfaction with the US Government's online infringement and surveillance of our communications networks and privacy, in the hope that the SAR Government will, in the light of the stance expressed by the Council, request the US Government to provide clarification in respect of the incident. In addition, the SAR Government should also reason with the US Government and follow up the matter persistently, requesting the US Government to stop its surveillance and hacking activities, destroy the information so collected and apologize for what it has done, so as to restore justice for Hong Kong. In my view, these points must be expressed very


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clearly. Just now many Honourable colleagues have also referred to issues on the internal front when expressing their views or proposing amendments to the motion, I believe they have their points and such points do worth giving continuous attention to by the SAR Government, including reviewing and updating laws and regulations, enhancing technological level, strengthening protection, raising cyber security awareness, and so on. I hope we can join our efforts in this respect and express clearly our stance, which is to express our strong dissatisfaction with the US Government. Thank you, President. PRESIDENT (in Cantonese): I now put the question to you and that is: That the motion moved by Mr MA Fung-kwok, as amended by Mr SIN Chung-kai, be passed. PRESIDENT (in Cantonese): Will those in favour please raise their hands? (Members raised their hands) PRESIDENT (in Cantonese): Those against please raise their hands. (No hands raised) Mr MA Fung-kwok rose to claim a division. PRESIDENT (in Cantonese): Mr MA Fung-kwok has claimed a division. The division bell will ring for one minute. PRESIDENT (in Cantonese): Will Members please proceed to vote. PRESIDENT (in Cantonese): Will Members please check their votes. If there are no queries, voting shall stop now and the result will be displayed.


Functional Constituencies: Mr Tommy CHEUNG, Mr Frederick FUNG, Mr WONG Ting-kwong, Ms Starry LEE, Mr CHAN Kin-por, Mr IP Kwok-him, Mr NG Leung-sing, Mr Steven HO, Mr MA Fung-kwok, Mr Charles Peter MOK, Miss CHAN Yuen-han, Mr Kenneth LEUNG, Mr KWOK Wai-keung, Mr Dennis KWOK, Mr Christopher CHEUNG, Mr IP Kin-yuen, Mr Martin LIAO, Mr POON Siu-ping Mr TANG Ka-piu, Ir Dr LO Wai-kwok and Mr Tony TSE voted for the motion as amended. Geographical Constituencies: Mr CHAN Kam-lam, Ms Emily LAU, Mr TAM Yiu-chung, Mr WONG Kwok-hing, Mr Ronny TONG, Ms Cyd HO, Mr WONG Kwok-kin, Mrs Regina IP, Mr Paul TSE, Mr Alan LEONG, Mr LEUNG Kwok-hung, Mr WONG Yuk-man, Mr WU Chi-wai, Dr Kenneth CHAN, Mr SIN Chung-kai, Dr Helena WONG, Dr Elizabeth QUAT and Dr CHIANG Lai-wan voted for the motion as amended. THE PRESIDENT, Mr Jasper TSANG, did not cast any vote. THE PRESIDENT announced that among the Members returned by functional constituencies, 21 were present and 21 were in favour of the motion as amended; while among the Members returned by geographical constituencies through direct elections, 19 were present and 18 were in favour of the motion as amended. Since the question was agreed by a majority of each of the two groups of Members present, he therefore declared that the motion as amended was passed. END OF SESSION PRESIDENT (in Cantonese): I now adjourn the Council. We will meet again in the coming Legislative Session. Adjourned accordingly at eighteen minutes past Four o'clock.

OFFICIAL RECORD OF PROCEEDINGS Thursday, 18 July ...

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