殖民時期的香港一直被丛书新自由主義的經典例子。加上香港殖民政府的剝削本質，它一般不會提供廉價醫療服務給予普羅大眾。然而，儘管有「積極不干預主義」這口號，殖民政府仍然於香港留下了龐大公營醫療系統。為什麼龐大公營醫療系統與放任自由主義並存於二次世界大戰後的香港社會？ / 為了解答以上疑問，本研究將從一九六四年醫療改革，探討香港戰後醫療政策。本文認為，香港研究忽視了冷戰對香港公共衛生的影響。文獻回顧後，實證研究分為三部分。第一部分提出「衛生關注」(Sanitary Concern)不足以構成醫療改革的原因。第二部分通過文本分析，發現六十年代的主流報章不重視醫療改革，由此可見改革並非基於公眾的訴求。最後的部分從戰後政府檔案，發現長遠的公營醫療規劃沿於五十年代後期。同時，戰後公營醫療系統的擴張，更可能是因為殖民政府為了確保足夠的戰時緊急醫療服務，及防止左派利用社區診所滲透入基層。 / Hong Kong has been regarded as a textbook example of Neo Liberalism. The exploitative nature of a colonial government makes it unlikely for the colonial state to make commitment for low-cost medical services to the general public. However, the slogan of “positive non-interventionism notwithstanding, the strong public health sector in Hong Kong is also a colonial legacy. Why was such a state-centered medical system established in a laissez-faire society after the Second World War? / This thesis aims at investigating the 1964 hospital reform in Hong Kong to study the colonial governance and arguing that the Cold War factor has been neglected in the analysis of the medical-institutional change. After the literature review, there are three empirical sections to support this explanation. The first part finds that sanitary concern was not a strong reason for the reform. In the second part, a context analysis on newspaper during the 1960s shows that the hospital reform was simply neglected by most newspapers, which implies that the reform was not the direct result of public pressure. The final part looks into the long-term medical planning since the late 1950 and several related medical policies through different archives in order to demonstrate the impacts of Cold War’s politics on Hong Kong’s medical services provision. Evidences suggest that self-sufficiency of military-emergency medical services and control over the growing influence of left-wing community clinics could be a more convincing explanation for the reform. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Tang, Kai Yi. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2012. / Includes bibliographical references (leaves 156-165). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts also in Chinese. / Thesis/Assessment Committee --- p.i / Abstract --- p.ii / Acknowledgments --- p.iv / List of tables, graphs and figures --- p.v / Acknowledgments --- p.vii / Chapter Chapter One --- Introduction --- p.1 / Chapter 1.1 --- The 1964 medical white paper: the first commitment in the colonial history --- p.2 / Chapter 1.2 --- A state-centred medical system as a colonial legacy --- p.6 / Chapter 1.3 --- The research question --- p.8 / Chapter 1.4 --- Methodology --- p.10 / Chapter 1.5 --- The central argument and outline of the thesis --- p.12 / Chapter Chapter Two --- Literature Review --- p.14 / Chapter 2.1. --- Politics of health in Hong Kong: a sudden change from the voluntary sector to the state? --- p.14 / Chapter 2.2 --- The origin of public health in Britain, India and Singapore --- p.17 / Chapter 2.3 --- Inadequate explanations for the 1964 hospital reform --- p.19 / Chapter 2.4 --- The nature of the Colonial governance: laissez-faire or Interventionist? --- p.21 / Chapter 2.5 --- British Hong Kong: Lacking commitments to local community --- p.24 / Chapter 2.6 --- The partial vision of public health in the colony --- p.25 / Chapter 2.7 --- Financial conservatism, the Pound crisis and social reforms in Hong Kong --- p.29 / Chapter 2.8 --- “1967 riot“ and “MacLehose“ as a explanation for the post-War social reforms --- p.33 / Chapter 2.9 --- An alternative: Cold War, the colonial governance and social service provision --- p.37 / Chapter Chapter Three --- Sanitary concern, diseases and state interventions in Hong Kong: Did the epidemic matter again? --- p.44 / Chapter 3.1 --- The origin of sanitary concern in Victorian Britain --- p.44 / Chapter 3.2 --- Impacts and limitations of sanitary concern in Hong Kong --- p.48 / Chapter 3.3 --- The 1894 Plague as a turning point: the first expansion in the colonial medical system --- p.50 / Chapter 3.4 --- Shadow of sanitary concern after the War --- p.53 / Chapter 3.5 --- Health profile in Hong Kong: a gradual improvement? --- p.56 / Chapter 3.6 --- A epidemiological transition in infectious diseases since 1945 --- p.59 / Chapter 3.7 --- Conclusion: Did diseases really matter? --- p.64 / Chapter Chapter Four --- Public opinion on public health: a driving force to the reform? --- p.65 / Chapter 4.1. --- The political culture in post-war Hong Kong --- p.66 / Chapter 4.2 --- From the rise in telephone fees to a social event in newspapers --- p.69 / Chapter 4.3 --- A content analysis on newspapers in 1964 --- p.72 / Chapter 4.4 --- Most medical news: informative but not critical --- p.73 / Chapter 4.5 --- Hospital reform: simply ignored? --- p.77 / Chapter 4.6 --- Reform: a result of public pressure? --- p.81 / Chapter 4.7 --- A social event: “charity clinics problem“? --- p.84 / Chapter 4.8 --- Conclusion: an ignored reform by an active Chinese community? --- p.88 / Chapter Chapter Five --- Politics of public health in post-war Hong Kong: clinics, hospitals and the Cold War --- p.89 / Chapter 5.1 --- British in Cold War: to defend a valuable but vulnerable port --- p.90 / Chapter 5.2 --- Coincidence: A growing government medical sector since 1957 --- p.97 / Chapter 5.3 --- Planning since 1957: reserved lands, standard clinic design and Executive Council --- p.108 / Chapter 5.4 --- Planning in New Territories: a Heung Yee Kuk’s petition for a new hospital --- p.113 / Chapter 5.5 --- A forgotten alternative in medical financing: medical insurance schemes --- p.117 / Chapter 5.6 --- Politics between Hong Kong and London: Mayo Clinic --- p.120 / Chapter 5.7 --- Incinerators and generators: the role of civil hospitals in defence --- p.123 / Chapter 5.8 --- Civil hospitals in M.D.S.: to defend the indefensible Colony --- p.124 / Chapter 5.9 --- “Inconsistent planning: to defend Hong Kong without military hospitals? --- p.135 / Chapter 5.10 --- Threats from the communist: regulations on refugee doctors and charity clinics --- p.138 / Chapter 5.11 --- Conclusion: 1964, a year of no significance? --- p.144 / Chapter Chapter Six --- Conclusion --- p.145 / Chapter 6.1 --- Summary of arguments --- p.145 / Chapter 6.2 --- A reference point: Cold War’s politics and the medical reform in Singapore --- p.148 / Chapter 6.3 --- Implications on public health and Hong Kong studies --- p.152 / Chapter 6.4 --- Limitations and directions of further study --- p.153 / Reference --- p.156

Taking into account of the colonial nature of modern Hong Kong, this author is to examine how the TWGHs as a medical space gradually developed from one that used only Chinese medicine into one in which Chinese medicine and western medicine coexisted. However, it finally became a western style hospital using only western medicine in the inpatient services in the 1940s, along with the growing hegemony of western medicine that was underpinned by colonial power. The multidimensional relationships among different agents in the process of transformation of medical services in the TWGHs constitutes another important theme of this thesis. These relationships touched upon a series of significant interactions between colonial government and Chinese community, colonial authorities and the Tung Wah Board of Directors, Chinese and western medical practitioners, Chinese community and the Tung Wah authorities, and so on. / The implantation, dissemination and expansion of modern western medicine, as an important part of western learning that infiltrated into the Orient, exerted profound impacts on Chinese traditional medical patterns and Chinese medical ideas and practices. As the center for exchange between Chinese and Western Culture, Hong Kong became a significant space for the spread and practice of western medicine. A wide range of western medical services and activities were delivered and developed by the colonial government, western missionaries, benevolent societies, and private practitioners in order to promote the development and popularization of western medicine among the Chinese community, including the establishment of hospitals, dispensaries and clinics, the opening of medical schools and training of western doctors, and the promotion of public health education. / This thesis also points out that the early intense prejudice and resistance against western medicine is not necessarily and cannot be entirely attributed to the underlying difference in the concept and practice of healing and sickness in the two different medical systems. Instead, I argue that a number of technical and practical factors in the delivery of western medical services provided by different agencies greatly affected and determined the choices and uses of the Chinese population. At the same time, the gradual recognition and reception of western medicine among the Chinese was not only the passive result of the compulsory western medical system developed by the colonial government, but also an active realization of the real efficiency and value of western medicine among the indigenous population and their consent and acceptance of its ideology and cultural value, to a great extent. / This thesis examines the confrontation and interaction between Chinese medicine and Western medicine, and the diverse and complicated Chinese attitudes towards western medicine by studying the history of the introduction of western medicine into Hong Kong and the case of transformation of Chinese and western medical services in the Tung Wah Group of Hospitals (TWGHs) during the period between 1894 and 1941. The history of the TWGHs dates back to the opening of the Tung Wah Hospital in 1870. Originally intended for the accommodation and treatment of those Chinese who had strong fears and prejudices against western medicine, the Tung Wah Hospital was founded to provide treatment only by Chinese doctors using Chinese medicine. The bubonic plague of 1894 in Hong Kong marked an important turning point in the history of medical services of the Tung Wah Hospital. Since then, western medicine was formally introduced into the Tung Wah Hospital in 1897. / 楊祥銀. / Adviser: Hon-ming Yip. / Source: Dissertation Abstracts International, Volume: 69-02, Section: A, page: 0715. / Thesis (doctoral)--Chinese University of Hong Kong, 2007. / Includes bibliographical references (p. 279-306). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in Chinese and English. / School code: 1307. / Yang Xiangyin.