Wednesday, January 31, 2007

Hongkong's draw for pregnant Chinese

Mrs Huang chose to give birth to her second child, a girl, in Hong Kong, even though she comes from Guangdong province, across the Chinese border.

If she had given birth at home, she would have faced penalties of about $10,000 (£5,000) for breaking China's One Child policy.

"It all depends, there's no standard. If you have money then the penalty will be much heavier," she said.

So the $2,500 she paid for three days and two nights in a Hong Kong hospital was a good deal.

Ward Manager Nancy Chan, at Hong Kong's Queen Elizabeth Hospital maternity ward, said 35 new patients had arrived in the past 24 hours - a rate that is now normal.

It did not use to be like this. Ms Chan remembers when there were more nurses and fewer mothers, allowing for more personal care.

But in 2001, Hong Kong's highest court ruled that a child born in Hong Kong to parents who came from China had the right to residency in Hong Kong.


At first glance, that seems an insignificant perk for babies who are already citizens of China.

But Hong Kong's history as British colony and now special administrative region of China means it is much richer, and has a reliable welfare system. Gaining the right of abode in Hong Kong guarantees rights to virtually free healthcare, education and housing.

It also means a range of complexities.

Mrs Huang, for example, will be leaving hospital as soon as her paid-for package expires. But her baby girl is still under paediatric care so will stay in the hospital.

Mrs Huang is not a Hong Kong citizen but her new baby is, so the baby gets virtually free mothering at the hands of Queen Elizabeth Hospital's nurses until it is time for Mrs Huang to come to take her away.

Mrs Huang is lucky because she has relatives in Hong Kong who help her with accommodation.

She can get a three-month visitor's pass to Hong Kong quite easily so while she intends to bring up her baby in China, she can pop back to Hong Kong whenever she feels the need.

Border checks

But from 1 February, new rules mean women like Mrs Huang will find it more difficult to come to Hong Kong to give birth.


After an influx of about 20,000 non-local women to Hong Kong's hospitals last year, the government has taken a series of measures to help stem the flow.

Mainland mothers who look heavily pregnant will have to show immigration officers a hospital booking confirmation alongside their visitor's visa. If they do not have the booking, they will not be allowed in.

The government has also raised the charges for delivery in Hong Kong, and plans to beef up nursing numbers with fresh funding and training.

The key is to require women to have a medical history in Hong Kong before allowing them in to give birth.

The higher costs may deter some women. But Mrs Huang said the increased charges are still less than the penalties she would have faced for having a second child in China.

It was not easy for the government to come up with a solution to the problem, because of Hong Kong's complex relationship with China.

Its status, described in the slogan "one country, two systems" means working out where one part of the slogan stops and the other starts is a constant balancing act, as legislator Leung Yiu-chung explained.

"When you're talking about one country, we are all the same sort of citizens under the name of a nation, so they've got to have the right to go round anywhere they want to go. So it's not easy to handle this problem," said Leung Yiu-chung.

Public protest

A group of angry Hong Kong mothers, led by Ella Lau - herself due to give birth within a couple of months - may have pushed the government into taking action.

She and others became concerned about deteriorating standards of care and were resentful of outsiders coming in, jumping queues and getting services they had not wholly paid for.

"This is really making us feel worry about what kind of service we are going to receive. We think this is bit unfair to us as we are the tax payer in Hong Kong, we are supposed to enjoy a quality service," Ella Lau said.

Fellow protester Vivian Leung got frightened after reading several websites dedicated to the issue, including stories of local women left lying in corridors and deprived of pre-birth checks because hospital staff have been over-run.

"The problem is when mainland pregnant women come to Hong Kong they usually come at the very last minute. "I have seen some pregnant women waiting at emergency, at the waiting room, by themselves, waiting to the last minute till their waters broken and then they stand up," she said.

Hong Kong is not used to facing emergencies over childbirth. It has one of the best delivery systems in the world and for decades has offered comprehensive care to mothers.

"We're approaching 7,000 births in one single hospital," said Dr Danny Leung at the Prince of Wales Hospital.

"And 33 percent are from the mainland. That's not a problem by itself. The main problem is that over 70% of them did not have any booking with us. So by the time they come for delivery, we don't know about them. That puts a lot of pressure. So when they come for delivery it's an emergency situation."

Dr Alan Lau, chairman of the Private Hospitals Association, lauds the new government measures as a product of cooperation between the public and private medical sectors.

"Patients are coming in with complications like high blood pressure, abnormal babies, abnormal presentation.

"They need to go into surgery right away, especially these mothers who came at the very late stage of pregnancy usually during labour, where everything has to be done right there and then. It's pretty scary!" said Dr Lau.

BBC

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