The Hospital Authority (HA) of the Hong Kong Special Administrative Region is preparing to get tough with non-residents who fail to pay their medical bills, with government figures showing that unpaid fees had climbed to HK$322 million (US$40.75million) in the last five years.

Non-residents, mainly new mothers from the mainland, are responsible for 70 percent of that amount.

Withholding elective surgery and specialist and outpatient services for non-residents; deferring registration of babies in Hong Kong pending the settlement of bills; and improving fee-collection are among the proposals HA is considering to cut down on the number of delinquent non-residents.

HA is also considering contracting a debt-collection agency to pursue unpaid bills, especially from mothers who have already returned to the mainland, according to officials.

The proposals come in response to concerns that the growing number of mainland women who come to the special administrative region to give birth had strained Hong Kong's medical services.

Government officials announced last week that more and more mainland women are traveling to Hong Kong to give birth. The announcement sparked a public outcry and intense media coverage.

Figures released last Wednesday indicated that more than 10,000 mainland women have had babies in the city so far this year. The number has almost doubled every year since 2001, according to the Security Bureau.

The trend has negatively affected health services in Hong Kong since many mainland mothers do not pay the fees for prenatal services, delivery and hospital stay.

"To use hospital services, they have to pay HK$20,000 (US$2,531) for a three-day, two-night stay, which includes all the services they require," said an HA spokesperson.

"Normally we expect the mother to come in person to register before the birth, but sometimes they will come right when they are just about to deliver. We have to attend to them immediately because of the emergency, and then they leave without paying," the spokesperson said.

Beyond the question of finances, staff and resources at public hospitals have been stretched, which has affected both services and the quality of care available to local mothers.

Last month a group of pregnant women staged a rally to protest against the deteriorating conditions.

The influx of emergency births has also put a strain on frontline hospital staff and midwives and represents a danger to patients, said Danny Leung Tse-nong, senior obstetrician at the Prince of Wales Hospital. The hospital handles a large number of mainland mothers.

"Most of these women do not have full medical records, and this can cause problems, especially in prenatal care when diagnosing congenital defects or possible obstetric complications. The additional workload also affects others who may have to wait longer for services, for example, a lack of space after delivery because all the postnatal beds are full. More obstetric services are required or else all users will have less to share, and the overall service will deteriorate," Leung said.

Some mainland mothers seem to hope that by giving birth in the city, they will achieve quick residency for their new-borns under the Basic Law.

The immigration department said it is adhering to non-discriminatory policies regarding pregnant mainland women entering the territory, and no policy change is planned.

(China Daily December 12, 2006)