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There is a pressing need to move our systems of healthcare towards one emphasising Local evidence
primary care and care nested in the community to better respond to the changing suggests a
needs of our population and simultaneously relieve pressure on an overburdened
public hospital system. The benefits of care in the community abound. Care needs HKD8.4 saving

to be continuous and lifelong, joined-up and centred around the needs of our on acute care
communities of persons. New models of care need to work across different care costs for every
types, multiple settings, and involve multidisciplinary service provider teams in HKD1 invested

various provider organisations. Transformation of Hong Kong’s health system must

focus on reconfiguring how and what we deliver. System-level changes need to be into community
made to tackle fundamental underlying problems with the current health system to health

be fit for purpose in the 21 century. (E. Leung, personal
st
communication,
October 20, 2018).
CHANGES NEEDED FOR A CHANGING WORLD

Our study looks into the complex system-wide changes which need to be
developed, designed and implemented in Hong Kong. The transformation will build
on the gains and achievements we have already accomplished, to better protect
and promote health for our future. A major focus of this report is how Hong Kong
can prepare and adapt in the face of an ageing population and growing burden of
chronic disease to best enable us to live not just long lives, but full, healthy and active
and meaningful ones. We identify a primary care-led integrated person-centred
health system as the key to supporting all of our citizens over their life course.
To achieve this, primary care must be accessible and provide comprehensive care.
This must be led by closer coordination in its provision, with hospitals, and with
social care for continuity over the life course. Pivoting our system away from its
current emphasis on hospital-based, episodic and acute care towards care in the
community that is continuous, person-centred and caters for the holistic needs of
individuals will transform the delivery and experience of care, and improve health

outcomes and efficiency.
None of this can be achieved without system-wide service integration. Essentially,
we need to transform how health services are designed and delivered. Delivery
of cross-sector and multidisciplinary healthcare is necessary and made possible
through horizontal integration within and across services delivered at the same
level of care be it health or social care. Vertical integration across different levels
of care from primary to hospital care must be managed, as must the role of the
private sector, particularly in public-private care collaboration and coordination.
Concurrently, adequate community support based on assessed needs will prevent
avoidable hospital admissions and facilitate delivery of health improvement initiatives.
Well-developed information and communication technologies and infrastructure
can facilitate information exchange which further supports integrated services. A
visionary health system delivering high-quality care demands a workforce of equal
excellence. Clear strategic goals, enabling policies, appropriate funding mechanisms,
and enhanced health workforce planning ensures adequate training and education
for the right mix and skills of healthcare professionals. Enabling, executing and
overseeing all of these steps will require forward-looking and steadfast governance
to build on existing foundations facilitating the implementation of integrated person-
centred care.

Our Hong Kong Foundation, under the leadership of Professor E.K. Yeoh, Director of
the Jockey Club School of Public Health and Primary Care at the Chinese University
of Hong Kong, has researched the subject of this report to inform policymakers,
stakeholders and the public on the urgent need for change and the critical
opportunities to address the challenges facing our health system. This report serves
as a resource and a starting point for dialogue and deliberation for the Government,
legislators, professionals, practitioners, the community of persons and others
engaged in the health system, in the hopes of stimulating discussion and decisions

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