The health secretary says it is unreasonable to judge upcoming changes in public hospital charges simply by focusing on fee increases for certain services, stressing that an extra 1.1 million people will be eligible for partial or full fee waivers under the proposal.

At a Legislative Council panel meeting, Lo Chung-mau fielded questions on the reform, which is set to take effect from January.

Election committee representative Chan Wing-kwong noted that people seeking general outpatient services will soon have to pay HK$150 per consultation, triple the current amount.

"What factors do you consider when deciding on the new fee level?" he asked.

"I understand there are fee waivers, but for those who are not eligible, how do you ensure they receive prompt medical assistance even when they are facing financial difficulties?"

In response, Lo said it was unreasonable to judge the reform simply by focusing on how much more patients will have to pay.

He stressed the government’s goal is to gradually reduce the subsidy rate for public hospital services from 97.6 to 90 percent over five years.

"I wouldn't say a reduction to 90 percent is our ultimate goal either because the reform will continue," Lo said.

"We also need to evaluate the overall sustainability of Hong Kong's healthcare system and financing.

"Right now we’re adjusting the fees based on the subsidy rate.

"We wish to retain a higher subsidy rate for in-patient and complicated services, while the subsidy level will be lowered for outpatient and minor cases."

The health secretary added that the aim of the reform is to focus resources on helping the most critically ill patients, while 1.4 million people will benefit from a revamped fee waiver mechanism, up from the existing 300,000.

But many lawmakers felt it was not easy for patients to find out if they are eligible for the waiver or which procedures will be covered.

Federation of Trade Unions lawmaker Kingsley Wong said people receiving welfare payments will obviously be eligible but noted there are only 600,000 or so of them.

"What about the remaining 800,000 people – how can they tell if they’re eligible too?" he asked.

David Lam, who represents the medical and health services sector, wanted to know if patients can pre-register for waivers or only find out whether they are eligible after a consultation.

Lo said any fee reduction is time-sensitive as the patient must meet income and asset requirements.

"As long as authorities are well prepared and applications are not unduly delayed, there is no need for patients to pre-apply first," he replied.

Hospital Authority chief executive Tony Ko said patients who face sudden financial hardships can seek a one-off waiver from a social worker.