醫療：由慈善醫院到醫院管理局

1. 1843–1872: missions, government and Chinese merchants

On 1 June 1843 the Medical Missionary Society opened the Medical Missionary Hospital at Morrison Hill, Hong Kong’s first hospital. In 1848 the Government founded the Government Civil Hospital, the first public medical facility. The two represented different routes: one run by a missionary body, the other by the colonial state, with different patients and fee arrangements.

On 1 June 1869 the Government set up a hospital committee to plan a Chinese hospital, with 20 Chinese community leaders and merchants among its members. That November the Governor granted land on Po Yan Street in Sheung Wan and allocated HK$115,000 for construction. Tung Wah Hospital’s foundation stone was laid on 9 April 1870 and it opened on Po Yan Street in 1872. Tung Wah was more than a hospital: it was a vehicle for Chinese merchants to manage charity, mediate disputes and maintain social order. Medicine, philanthropy and Chinese community power were entangled from the start.

2. 1887–1911: medical education, nursing and specialist hospitals

On 16 February 1887 the Alice Memorial Hospital opened on Hollywood Road and began operating the next day, serving Chinese patients with Western medicine. On 1 October the Hong Kong College of Medicine for Chinese was founded inside it, with Sun Yat-sen among its first graduates. Hospital, medical school and professional registration began to form a system: patients first, then students, then doctors who could be examined and registered.

On 5 September 1893 the Nethersole Hospital’s nursing school began operating, Hong Kong’s first nurse training school. On 6 June 1903 Tung Wah’s infectious diseases hospital opened in Kennedy Town with 68 beds. On 9 October 1911 Kwong Wah Hospital in Yau Ma Tei began service as the first medical institution on the Kowloon peninsula. These institutions pushed medicine from charity towards specialisation, training and district coverage, but access was still divided by ability to pay, race and geography.

3. 1950–1982: tuberculosis, clinics and new-town hospitals

Post-war population growth made tuberculosis a major public health problem. On 16 February 1951 the Kowloon tuberculosis clinic opened with United Nations support, providing free examination and treatment and becoming the first such clinic after the Second World War. On 5 May 1958 the Jockey Club’s floating clinic vessel “Chihang” began service under the Medical Department, reaching rural and fishing villages along the eastern coast. Both show medical services moving beyond hospital walls into communities and remote areas.

On 1 November 1982 Prince of Wales Hospital opened in Sha Tin with 1,448 beds, serving mainly residents of the New Territories East and becoming the first fully air-conditioned public hospital in Hong Kong. Its scale and location reflected new-town growth and population movement: hospitals could no longer be concentrated only on Hong Kong Island and core Kowloon, but had to follow people into the New Territories.

4. 1990–2003: the Hospital Authority and clusters

In 1990 Hong Kong enacted the Hospital Authority Ordinance, making the Hospital Authority a statutory body. On 1 December 1991 it began managing government hospitals, aided hospitals, specialist clinics and convalescent homes. On 17 May 1993 it introduced clusters, dividing hospitals and clinics into eight networks. On 1 July 2003 it took over 59 general outpatient clinics from the Department of Health. These three steps turned a fragmented public system into a centrally managed network.

Integration brought benefits: resources could move across hospitals, specialties could be concentrated and information systems unified. But central management also shifted power from individual hospitals and the Medical Department to a statutory body. Frontline workloads, waiting times and resource allocation became system-level questions, not simply matters of how well one hospital was run.

5. The limits of this dossier: healthcare is more than hospitals

This dossier focuses on hospitals and the public system’s institutional turns. It does not have enough registered entries to cover primary care, family doctors, mental health, elderly care, dentistry or Chinese medicine. The role of private hospitals and the insurance market is only sketched; each needs its own official statistics and policy documents.

Likewise, medical incidents, waiting times, staffing, fees and fairness in resource allocation cannot be judged from a few chronology entries. Depth means making four lines clear — who runs, who manages, who pays and who benefits — not turning every healthcare problem into a verdict on the Hospital Authority.

Another difficulty is the point of entry: whether a patient first goes to an emergency department, a general outpatient clinic, a private doctor or a specialist referral directly shapes waiting and cost. Fees, referral rules and local supply together determine who gets treated sooner. These arrangements sit outside the hospital building, yet they decide whether the system is fair.