Building bridges: cross-border healthcare reform
Professor Chung Mau Lo is one of Hong Kong’s most eminent surgeons and medical researchers, internationally renowned for his pioneering work in the field of hepatobiliary surgery.
In November 2016, he was appointed Chief Executive of the HKU-Shenzhen Hospital and he currently remains Head of the Department of Surgery and Chin Lan-Hong Professor and Chair of Hepatobiliary and Pancreatic Surgery at the HKU Li Ka Shing Faculty of Medicine. He is also Chief of Service of the Department of Surgery and Director of the Liver Transplant Centre at Queen Mary Hospital.
Despite the heavy workload associated with these multiple responsibilities, Lo doesn’t think it is a good idea for surgeons to give up operating and he apologises profusely for being a few minutes late. He had just completed nearly seven hours of surgery. An eighteen-year-old post-transplant patient from Macau required the removal of a small recurrent cancer attached to one of the large vessels of his liver.
“I needed to take out part of the wall of the vessel to make sure this is a cure for him,” said Lo and explains there were some complications because of a narrow blood vessel and the size of his spleen.
“It’s probably no less difficult than a liver transplant- it’s very challenging because of the tissue healing,” he said. While he is gradually stepping down from his responsibilities at Queen Mary Hospital in June this year to concentrate on the new role in Shenzhen, Lo will still be involved with the Department of Surgery three sessions per week to assist in surgical procedures and teaching duties.
“I still give lectures to medical students. I enjoy it and it means I can make an impact on the next generation. This role probably has more impact than dealing with patients,” he said.
Lo outlines the value of the HKU-Shenzhen hospital, which opened in 2012, and makes the point that real patients and clinical cases are needed, otherwise it is impossible to undertake medical training and research. He believes the new hospital in Shenzhen could be a “goldmine” of new clinical data.
“There was a lot of scepticism about this hospital when it opened but there are 17 million residents in Shenzhen and 90 million in Guangdong province,” he said and explains there is a higher proportion of Hepatitis B and liver cancer patients than in Hong Kong. The surgery department at the HKU-Shenzhen hospital, where he remains the Chief of Service, already performs over 100 liver resections per year.
“A completely new hospital can be very innovative. When I walked into the Queen Mary thirty years ago, it was already fifty years old,” said Lo. Starting from scratch in Shenzhen there are now 2,500 mainland staff supported by about 200 HKU doctors, with about 40 on site at any one time.
He sees his role not just about treating patients and performing surgery but delivering healthcare reform and training. Lo outlines a number of innovations introduced at the hospital that were first met with great resistance before being gradually adopted across the city and province.
A simple appointment system was regarded as revolutionary because local hospitals resembled “more of a market than a medical centre” with patients arriving in the early hours and issuing bribes to be seen first because of a “lack of trust in the healthcare system”.
“We had to ban under the table red packet payments to medical staff,” said Lo.
Lo goes on to explain how his team have refused to adopt the practice, common in Chinese hospitals, of prescribing intravenous (IV) antibiotics even for basic conditions like the common cold.
“You will see huge banks of IV equipment in every Chinese outpatient department,” said Lo and explains the problem is that hospitals must be self-financing but the fees they charge are regulated.
The so called ‘green book’ dictates that the hospital must charge HK$12 for a consultation. This price is unrealistic, so the hospitals have little choice but to overcharge and employ expensive and unnecessary treatments in order to help make ends meet. After initial opposition to the HKU-Shenzhen Hospital’s refusal to use IV banks in outpatient clinics, the Guangdong authorities banned excessive IV use in July 2016.
“The reform is beginning to happen in Shenzhen,” Lo said and sees nothing inappropriate about an eminent medical researcher being involved in the process of improving healthcare policy and hospital management.
“What is the role of an academic doctor?” asks Lo.
“We want to treat patients of course, but we also want to be innovators and improve the level of treatment. This is a wonderful opportunity for HKU to be involved in vital healthcare reform in China,” he said and believes medicine is not just the discipline of science but about the humanities too.
“You must be able to help people. Research can mean playing with molecules or a virus in a laboratory but there are more important things. The Shenzhen hospital is one big laboratory and we are experimenting with new healthcare services and new training systems,” he said, comparing his new role in Shenzhen with his role as a surgeon.
“Today my operation saved the life of one 18-year-old person but through curbing practices like the misuse of IV injections we could save thousands of patients who die from allergic or adverse reactions to the drugs, reduce the prevalence of superbugs, and save money for more treatment,” he said.
Professor Lo Chung-Mau BBS, JP, has over 20 years of clinical, teaching and research experience in hepatobiliary surgery. His pioneering work in adult right-lobe living-donor liver transplantation has revolutionised the practice of liver transplants worldwide. Lo was awarded China’s top national honour of First-class State Scientific and Technological Progress Award in 2005. He received the First-class Award in Research Achievements, Ministry of Education of China in 2013 and First-class Scientific and Technological Award of China Medical Association in 2014. In recognition of his contribution to public services, Lo has been appointed a Justice of the Peace by the Government of Hong Kong SAR in 2012, and awarded the Bronze Bauhinia Star in 2016. He was awarded a Croucher Senior Medical Research Fellowship in 2004.
To view Lo’s personal Croucher profile, please click here.