Hong Kong’s reform of public healthcare subsidies is unlikely to cause conflicts over fees between patients and frontline workers, as “critical” and “emergency” cases are understood to be life threatening, a government A&E doctor has said.

Under the reform announced by authorities on Tuesday, a two-tier fee structure will be implemented at accident and emergency departments, depending on how urgent patients’ conditions are under a five-level triage system, rather than a standard rate of HK$180 (US$23).

Patients triaged in the top two categories – “critical” and “emergency” – will be treated for free. The rest – “urgent”, “semi-urgent” and “non-urgent” patients – will have to pay HK$400.

Cheng Chi-hung, an accident and emergency medicine consultant with the Hospital Authority’s New Territories East Cluster, said on Thursday that it would be unlikely for patients to argue with medical staff over how they are triaged so they can pay lower fees.

“Which types of patients are ‘critical’? We are talking about those who need to be treated immediately, such as those who have stopped breathing or those who are suffering from cardiac arrest,” he said on a radio programme.

“The types of patients that are ‘emergency’ patients are those whose vital signs are at a critical level or have passed that critical level. For instance, those who have difficulty breathing, such as those with bronchiectasis, where their blood oxygen level is relatively low when they arrive at the A&E department.”

Cheng noted that patients classified as “critical” or “emergency” were those with lives at risk, while “urgent” cases were those that had not reached a life-threatening stage but which nonetheless required treatment as soon as possible.