Hong Kong hospital chief quits

Authorities search for replacement to reform hospitals, improve infectious disease surveillance

By | June 27, 2005

The chief executive of the Hong Kong Hospital Authority, William Ho, has become the fourth top health official to resign in the aftermath of Hong Kong's severe acute respiratory syndrome (SARS) crisis. His successor will face several challenges, not least of which is helping improve the region's response to infectious diseases like SARS and avian flu.

Speaking to reporters last Thursday, Ho, who himself fell ill with SARS during Hong Kong's outbreak in 2003, called the crisis "the most difficult time in the entire history of the Hospital Authority.'' He also admitted to having considered quitting immediately after the crisis, but said he stayed on because he felt the authority needed strong leadership.

Ho's illness during the worst of the SARS outbreak prevented him from carrying out his duties, but also saved him from some of the heavy criticism heaped on other top officials during a legislative hearing investigating the handling of the crisis.

The former secretary for Health, Welfare and Food Yeoh Eng-kiong, and former Hospital Authority chairman Leong Che-hung took it upon themselves to step down a year ago at the hearing's conclusion. Another top health official, Margaret Chan, left Hong Kong to work at the World Health Organization just weeks after the SARS crisis ended.

Louis Shih Tai-cho, vice president of Hong Kong's Medical Association, told The Scientist that Ho's impending resignation had been rumored for some time, as was his tumultuous relationship with the new Secretary of Health and Welfare, York Chow.

Shih said that Hong Kong's new hospital chief should be someone who is able to liaise between Hong Kong public hospitals and its small number of private hospitals.

"For the past 10 years the healthcare system was under [former health secretary] Dr. Yeoh, widely regarded as a proponent of the universal public healthcare system. The private system was largely ignored," he said.

Shih said the Hospital Authority's inability to monitor and support private hospitals during the SARS outbreak contributed to an embarrassing cover-up of a SARS cluster in a private hospital—one that resulted in the unchecked spread of the disease and the deaths of several patients and health workers.

But when asked if the new Hospital Authority chief should be able to demand better disease surveillance from his or her mainland Chinese counterparts, Shih said bilateral relations were better left to higher authorities.

"I think the chief executive on the Hospital Authority can demand transparency or health data to be linked [between Hong Kong and mainland China]...but it's very difficult if the mainland side says no.… He would have very little bargaining power," according to Shih.

He suggested that Hong Kong's Centre for Health Protection, a bureau that opened last yet to monitor infectious disease and train epidemiologists, is the best interface with mainland Chinese authorities on the disease control front.

But former medical lawmaker Lo Wing Lok, who served during the SARS outbreak, told The Scientist that the new hospital chief should be able to forge closer informal ties with his or her counterparts in neighboring Chinese provinces.

"We did not receive soft intelligence from across the border [in mainland China] because we didn't have too many friends across the border! We need to make it easier for soft intelligence to reach Hong Kong," he said.

Lo said that the neighboring former Portuguese colony of Macau faired far better during the SARS outbreak because doctors received warnings about the mysterious new disease well ahead of the official media reports through informal contacts with mainland Chinese doctors.

Hospital officials said they welcome overseas candidates and will not limit the search for a new hospital chief to the city and greater China. Ho will serve until September when his contract expires.

In Hong Kong alone, SARS infected some 1,755 residents, killing at least 299 sufferers in 2003. Globally, SARS infected an estimated 8,000 people of whom approximately 800 died of SARS-related complications.

Ho's resignation last week coincided with the swearing in of Hong Kong's new leader, chief executive Donald Tsang. Hong Kong's last leader, Tung Chee-hwa, stepped down in March, more than halfway through his second term as leader, citing health concerns.

Tung's popularity had fallen over the years, due in part to his handling of SARS. Many believed he should have led efforts to demand better information from neighboring Guangdong province where the disease is thought to have started spreading between humans in the fall of 2002.

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