There is a well-established association between health, social and environmental factors, many of which are amenable to legal interventions.1 2 Legal issues affect health in multiple ways by structuring, perpetuating, and mediating the social determinants of health found in the dynamic interconnections between the medical, social, and legal arenas.3 Examples include legal issues related to housing (such as the threat of eviction or environmental health hazards due to substandard housing), financial disputes, domestic violence, and other forms of physical or sexual abuse.4 Medico-socio-legal collaboration, from a medical perspective, refers to a health-related case with social and legal implications to the extent that an attending doctor, after eliciting the patient’s history and conducting a physical examination, seeks input from social workers or requests investigation by law enforcement agencies to benefit the patient and especially to improve their health outcomes.5 In various settings, notably Canada, the United Kingdom, and the United States, primary care practitioners have brought legal advice directly to their patients through medico-socio-legal partnerships, to help address legal issues that have been identified in primary care settings as deleterious to patient health.6

Legal services offered in the primary care setting are typically provided in partnership with a full-service legal aid clinic, rather than by having a lawyer on staff. This is because the legal advice given is by nature often complex and specialised, and also because of the privileged nature of the client–legal service provider relationship. These services are often most effectively offered in the context of team-based care, where a multidisciplinary group of professionals works together to address patients’ needs in a more holistic way, rather than focusing solely on their medical conditions, and to look at underlying social and legal issues that are affecting their health. Examples of well-established legal services in primary care include the legal clinic at McMaster Family Practice7 and the Health Justice Program offered by St Michael’s Academic Family Health Team, both in Toronto, Canada.8 Colvin et al9 reported that the engagement of social workers significantly enhanced the effectiveness of the existing medico-legal partnership.

In Hong Kong, there are a number of medical and social collaboration programmes linking public hospitals and non-governmental organisations (NGOs) to serve the population. An example is the Jockey Club End of Life Community Care Project, which specialises in end-of-life care for older citizens.10 However, the integration of legal advice into the primary care setting as a form of medico-social collaboration has thus far remained unexplored. Based on international experience, and given the high levels of poverty and social deprivation in the city, along with evidence of their deleterious effects on health, it is likely that there are issues that could be amenable to amelioration through legal advice. What remains unknown is which legal issues would arise if such a service were made available in the primary care setting in Hong Kong, and the extent to which a service would be appreciated by patients.

Our team, comprising family physicians from the Department of Family Medicine and Primary Care, The University of Hong Kong, along with experts in social work and legal training, conducted four sessions of medico-socio-legal consultations at the Kwai Tsing District Health Centre and the Kowloon City District Health Centre Express in April and May 2024. We began with a talk on common medico-socio-legal issues such as chronic diseases, mental health, and advance directives, followed by individual consultations with experts from the three fields. In total, 37 clients (32 female and 5 male) were recruited by two collaborating NGOs—the Lok Sin Tong Benevolent Society Kowloon and the Kwai Tsing Safe Community and Healthy City Association—to attend the individual consultations.

Taken together, their concerns reflected the core values of family medicine, namely, that biopsychosocial issues are intertwined. Examples included financial difficulties and marital concerns, either resulting from health conditions or contributing to them; obstacles in accessing Mandatory Provident Fund investments due to health issues; caregiver stress in addition to chronic illness; litigation involving inheritance and housing issues; transfer of legal property rights; and disputes among family members. In follow-up calls, most clients reported experiencing both physical and psychological relief from having their concerns heard and addressed in a one-stop “clinic” within the community setting, where experts from all three fields provided coordinated advice. In one case, a client who had been embroiled in a civil legal dispute for years continued to express anger and health-related concerns during follow-up, prompting our team to consider longer-term needs for medico-socio-legal collaboration in the primary care setting.

After the consultations, the majority of clients affirmed that the sessions had strengthened their physical and mental health. They expressed hope to see more joint clinics of this nature within the primary care setting. As service providers, we found that it was both feasible and effective to implement a medico-socio-legal clinic to alleviate patients’ physical and psychological suffering by providing comprehensive information from relevant experts to address their problems. The unique feature of our initiative was the integration of expert input from medical, social, and legal perspectives.

The overarching aim of this initiative was to raise awareness of the health impact of legal issues, acknowledge the interactions between social determinants and health, and propose interventions that promote health justice within Hong Kong’s primary healthcare system. We seek to highlight the current service gap and explore the possibility of establishing sustainable medico-socio-legal clinics in the primary healthcare setting. Cross-sector collaboration in primary care can be strengthened by identifying opportunities and resources for the government or NGOs in the public sector—and for newly established District Health Centres supporting private healthcare providers—to develop such joint clinics and offer improved services.

Concept or design: WCW Wong, JE Parry.
Acquisition of data: WCW Wong, ETY Tse, PY Lu, CLW Chan, A Lee, KW Tong.
Drafting of the manuscript: JE Parry, ETY Tse.

All authors had full access to the data, contributed to the study, approved the final version for publication, and take responsibility for its accuracy and integrity.

All authors have disclosed no conflicts of interest.

The authors acknowledge administrative support for client recruitment and provision of service venues by the Lok Sin Tong Benevolent Society Kowloon and the Kwai Tsing Safe Community and Healthy City Association, in their respective District Health Centre Express in Kowloon City and District Health Centre in Kwai Chung. Special thanks to Mr Eugene KY Chan for providing administrative assistance to the project and contributing to the initial draft of this article.

The content of this editorial has been presented as oral presentation in the 26th WONCA Asia Pacific Regional Conference (WONCA APR 2025) in Busan, Republic of Korea, 24-27 April 2025.

This editorial received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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