Partnership Program in Hong Kong healthcare system

 

Analyze and Critique General Outpatient Clinic Public-Private Partnership Program in Hong Kong healthcare system

 

Introduction

In this paper, we have been conducted an analysis of the process of health care policy development with references to a chosen health care policy of Hong Kong. The policy that has been selected here to analyze Hong Kong healthcare system is known as "General Outpatient Clinic Public-Private Partnership Program. This paper has been covered a lot of aspects that support the adequate understanding of the health and policy-making process analysis. In order to get the relevant information about the health care policy formation process, some social ideologies and theories which shape public spending are also discussed to support the paper. On the other hand, the paper also developed constructive views on the relationship between power and politics in the construction of health and aged care policy.
Therefore, it is right to say that the paper will prove fruitful for a lot of audiences who are interested in the same area of study and want to frame their career within the similar profession. With the help of this paper, they can get relevant information about the process of policy framing and analysis to evaluate its role and obligations towards society and potential of leading profit.  Apart from this, it can also be said that the paper has been demonstrated by the study of a lot of practitioners and scholars. The paper is highly concentrated towards how to perform the policy analysis. This paper has been started by defining the background of the chosen policy in reference of which we will study the overall analysis process. Moreover, it can be said that the policy analysis is not an easy task. It has been done by the use of findings of a lot of scholars. 

Background of the Policy or Program

The “General Outpatient Clinic Public Private Partnership” is launched by the Hospital Authority during mid-2014. The main motive of this policy is to offer options for patients who require long-term out-patient consultation in general out-patient clinics. Apart from this, it is also developed with the motive to enable patient to accept private primary health care services in the community ("Hospital Authority," 2017). With the help of this care, the patient can promote the use of primary health care services and the concept of family doctor as well. Moreover, the developed program will also prove helpful in relieve the need for general out-and patient services of HA and increase the utilization of electronic health record sharing system. This program is engaged in sending an invitation to HA general outpatients with high diabetes and blood pressure.
According to this program, the treatment of the patient will perform without any cost. It will occur with the mutual cooperation of all private medical practitioners. As per the rules and regulations of this program, the patient who is suffering from high diabetes and any other problem will receive 10 subsidized outpatient services every year. These services will offer to a patient in the resolution of their chronic and sporadic diseases. Moreover, the program is asked for the required payment of only $50 per visit ("General Outpatient Clinic Public-Private Partnership Programme," 2017). The individuals who have comprehensive social security assistance or certification of exemption with valid medical fee also needs to pay the same amount as another patient. With the mutual agreement of both the doctor and patient, they will receive further treatment to get rid out of their diseases. The plan developed by the HA in favor of program is quite smooth and effective. This ensures the continuous evaluation of outcomes generated from the implementation of policy among patient.  

Healthy Policy/Program Analysis 

GOPC PPP analysis to understand the determinants of Health Problems

The range of environmental, cultural, economic, social, and personal factors that influence health status is considered as health determinants. There are a lot of factors that serve as determinants and influence purpose of GOPC PP in reference to health problems. These factors are following:
(Claxton, 2015)

Contextual Factors

These factors are a combination of national, international, and political context and had a major influence on the working structure and behavior of GOPC PPP. The contextual factors influence the policy by giving birth to a large number of changes. The first and foremost influence of contextual factors on GOPC PP program is influenced by its elites. Due to this influence, the policy management team is focusing a large number of changes. It is facing religious opposition to contraceptives. Apart from this, the influence on policy elites also becomes the reason for lack of response to negative donor funding trends by high-level politicians. The second and foremost influence of contextual factors on policy is that it brings changes in government regulations. It means that the presence of contextual factors changed the government party within Hong Kong. This further becomes the reason for the shortage of government resources which hamper the policy process within the specified working area (Watt, 1999). On the other hand, another influence of contextual factors is conservative budget officials, weak service delivery within Ministry of Health, and presence of intra-and inter-sectional competition for resources. Therefore, it is right to say that the contextual factors have enough potential to influence outcomes and working structure of GOPC PP program.

Social 

The social factors also have significant potential of influencing the working structure of GOPC PPP. The social factors include the below-mentioned determinants that affect the policy in a significant manner:
Social interactions and social support
Availability of required resources to fulfill daily requirements like health checkup equipment and various others. 
Public Safety
Quality Tools (Almgren, 2017)
Social Norms and Attitude
Residential Segregation 
Poor health outcomes are one of the important results shared by the presence of social determinants. These social factors influence the program by affecting its social and physical environment. 

Cultural factors 

Apart from the cultural and contextual factors, the policy is also affected by the presence of cultural factors. The cultural factors raise the lack of transparency and problems in decision-making issues within the internal environment.
Therefore, it is right to say that the presence of social, economic, and cultural factors influence the working behavior of the program in a significant manner (Collins, 2005). The social, economic, and cultural factors are responsible for developing a different kind of health problems among human beings. Therefore, it is necessary to establish a proper control over these issues and avoid further interruption in working behavior of the program.

Identification of Program Issues 

Weimer (2017) has been investigated problems of GOPC PP program implementation within Hong Kong. These problems are identified around the content of the change, the context of the change, and the process of the change. The presence of these issues and barriers further influence the working behavior of the program and prevent it from achieving high outcomes than the others. The below mentioned are some issues identified by the analysis of policy:
Issues around the content of the change

The issues regarding the content of the change influence its professional environment and working behavior of each private doctor. The first and foremost problem associated with the content of the change is lack of agreement between the management parties and stakeholders. Due to the lack of agreement, they don’t’ even understand their roles and responsibilities by being a member of the program ("General Outpatient Clinic Public-Private Partnership Programme," 2017). This further raises poor management that requires active initiatives to make significant improvements. The second and foremost issue faced by the professional team of GOPC PP program is lack of clarity about the nature of the change and how the proposed changes fitted with related and existing services. Due to the lack of awareness about the changes in external environment, it becomes failure to give better treatment to its patient. 

Issues around the context of the change

Apart from the content of the change issues, the program also faced context issues. This issue brings a set of various sub-problems that serves as a barrier to its growth. The first and foremost issue is a poor fit with program priorities ("Hospital Authority General Outpatient Clinic Public-Private Partnership Programme," 2016). The main priority of the program should toward give better treatment to its patient. But, the company is highly concentrated towards a particular set of diseases that may find in some or fewer cases among human beings. On the other hand, the second and foremost challenge issue is lack of indirect and direct resources to support the change. Due to the lack of resources, the program team becomes a failure in the management of the changes.  

Issues around the Process of the change

Moreover, the policy and program also faced the process regarding issues during its implementation procedure. The first and foremost issue regarding the management of the process of the change is divergent views among health professionals about responsibility. It means that the program professionals do not have enough information and knowledge about their roles and responsibility. Due to the lack of information and divergent views, the professionals become a failure in providing the best treatment to its patient ("Hospital Authority," 2017).  The second and important issue that arises during their working process is a conflict with longstanding professional boundaries and norms. The presence of conflict always becomes the reason of their unsatisfied treatment. 
Therefore, it is right to say that the policy and program are full of a lot of issues that create further problems in its existing and management structure. Therefore, the program requires immediate improvement to develop satisfied customers and win the confidence of other potential users.

Evaluation and assessment of entire process for developing the Policy 

In order to develop the GOPC PP program, its management team has been followed a large sequence of the process that contained different elements. The two foremost components are health financial and public consultation. The entire program development has been done through the use of below-mentioned initiatives and process: 

Define the Context

The first and foremost stage of the program development process is a determination of context. Generally, it can be said that each country is different from others. The difference exists in terms of politics, economy, culture, and health systems. In each and every country, health policies face economic, social, and political pressures (Dimick, 2014). Therefore, the first step taken by the GOPC PP team is the development of a comprehensive profile of Hong Kong. This has been done with the reason to get significant knowledge about the background information of country in health policy context and understand the determinants of health problems. With the help of country profile, the program implementation team able to consider all factors that indirectly or directly influences the health policies.  

State the Problem

The second stage is to determine the health problem facing by individuals. The health problem is a condition or situation that has a huge potential of influencing the outcomes of a determined policy. A good problem statement is prepared here to evaluate the needs of human beings and their different health problems (Exworthy, 2008). This will serve as a guide for the whole program. The problem is recognized by GOPC PP team through conceptual and empirical understanding. 

Search for evidence

After the determination of the problem statement, the program team collected significant evidence to support their findings. With the help of the collected data, they have determined the different features of their policy and program (Walt, 2008). The collection of evidence is necessary to integrate the desired solution with required outcomes. The evidence has been collected through the use of literature review. In order to develop a literature review, the previous analysis of different authors has been collected for evaluation purpose. This helps the team in analysis of evidences and integrates the final solution with required outcomes.

Consideration of Different Policy Options


Another initiative taken by the development team is consideration of different policy options. Here, the program implementation team thought about the different approaches to resolving the identified problem (Polisena, 2015). While consideration of different policy options, the program implementation considered different alternatives and performed significant analysis to find the better option.

Project outcomes

The next initiative in favor of the program development is an evaluation of outcomes of different alternatives and evaluation. The outcome analysis is performed to find the best option available for resolution of the identified problem.

Application of Evaluative Criteria

At this stage, the program implementation team compared the alternative from developed standards and took action in favor of a suitable alternative. The evaluation criteria or standard used by the team includes four important aspects (Thokala, 2016). These aspects include; Relevance, progress, efficiency, and effectiveness.

Weigh the Outcomes


The next stage later the evaluation of possible interventions or alternatives has weighed the outcomes. Generally, it is believed that a lot of inexperienced analysts become a failure in selecting between the alternatives rather than between the projected outcomes (Weimer, 2017). The professionals of GOPC PP program converted the outcomes into genuine tradeoff to evaluate their efficiency and suitability as per their objectives. 

Make Decision

Here, the decision regarding the implementation of GOPC PP program has been made by its organizers. The decision is taken in reference to collected outcomes and program objectives.

Health Financing

It is the most important part of the policy development process followed by the GOPC PP team members. Health financial is done to fund the program by utilizing effective sources. At this level, the program team members decided to play the different roles like Healthcare service funders, purchasers, and providers (Tantivess, 2008). On the basis of these roles, they decided to involve government in fulfilling the fund requirements. Therefore, the HA which is a government authority decided to fund the program for the benefit of Hong Kong patient.

Public Consultation

The last and final stage of the whole process is public consultation. At this stage, the consultation has been made with the public to evaluate the efficiency of the program to satisfy the patient requirements (Walt, 1994). On the basis of public consultation, the program team decided to treat the patient who is suffering from High Blood Pressure and diabetes as well.
Therefore, on the basis of the above-mentioned initiatives, it can be said that the GOPC PP team has performed significant efforts for the policy development in favor of the public.

Analysis of Policy Content

The content included in the GOPC PP policy and program is quite relevant and effective in nature. It is because the policy development team has been followed each and every process to demonstrate its quality content. The content is described in the policy as per customer requirements and specifications. For example, the customer wants to have a program in favor of poor citizens so that they can get better treatment of each disease. In the similar context, the program development team offered the better treatment options to its customers only after the payment of a minimal fee ("General Outpatient Clinic Public-Private Partnership Programme," 2017). On the basis of analysis of content, it can be said that the GOPC PP program is highly contributed its efforts towards improvement in patient access to primary care services. These have been done through reducing the overall fee structure of the program so that each citizen of Hong Kong can reach to the program and get better treatment to get rid of their diseases. Apart from this, it is also identified that the policy is developed with the sole motive of offer choice to patients for receiving primary care services from the private sector in their community. 
Apart from this, the policy document team also integrated relevant information in terms of eligibility for both the service providers and patient. According to the given content in policy, it can be said that the service provider who wants to be the member of the program should have a registered medical diploma with the Medical Council of Hong Kong. On the other hand, the service provider also has a member of a registered healthcare provider for the Hong Kong Governments. If the service provider fulfills this eligibility statement, they can successfully become the part of the program and can offer necessary services to their patient. Moreover, it is also found out that the main motive of the program is to target group of patient who is suffering from Hypertension, Diabetes, High blood pressure, and Hyperlipidemia ("Hospital Authority General Outpatient Clinic Public-Private Partnership Programme," 2016). In order to participate in the program, the target patient should have the potential to wait for 12 months treatment by the time they start receiving service under the program. Therefore, it can be said that the policy is awarded the relevant content that helps individuals in getting significant information and use it effectively for their personal and professional purpose.

Conclusion

After studying all this, it can be concluded that GOPC PP program is integrated the latest requirements of users. It is because the main purpose of the program is to give satisfaction to customers through offering a cheap and better treatment option. Apart from this, it can be said that the policy development process followed by the program implementation team is quite relevant and effective. It is because the program development team has been followed each and every step which has importance in development functions. Moreover, it is also identified that the program team has been followed a large number of issues and challenges during the implementation process. It is necessary for the program to follow the improvement initiatives to demonstrate the effective working of developed policy.

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