Replies to LegCo questions

LCQ9: Dispensing error in private clinics

Following is a question by the Hon Andrew Cheng and a written reply by the Secretary for Health, Welfare and Food, Dr York Chow, in the Legislative Council today (May 16):

Question:

Regarding the problem of dispensing error by private clinics and medical organizations, will the Government inform this Council:

(a) of the number of incidents of dispensing error in private clinics and medical organizations in the past five years, the penalties imposed on the health care workers involved, and the compensation made to the patients concerned;

(b) given that recently a private clinic was found to have dispensed a syrup containing isopropyl alcohol to a patient, whether the Administration, the Medical Council of Hong Kong and the Hong Kong Medical Association have further reviewed the relevant dispensing procedures and taken measures, including stipulating the qualification of staff responsible for dispensing medicine and increasing their responsibility, so as to minimize errors in dispensing and mixing medicine; if so, of the details; and

(c) given that in reply to a Member's question at the Legislative Council meeting on October 25, 2006, the Secretary for Health, Welfare and Food said that the separation of prescribing from dispensing of drugs (SPD) would require a thorough discussion by the stakeholders and the community as a whole, and that a consensus should be reached by members of the community before any major change should be made, and the Administration would continue to listen to the views of all the stakeholders, of the details of the views received by the Government so far; and whether it will make a decision expeditiously on the implementation of SPD, and study the conditions, ancillary facilities and preparatory work required for the implementation of SPD; if so, of the details; if not, the reasons for that?

Reply:

Madam President,

(a) In the past five years, five cases of dispensing error in private clinics were brought to the attention of the Department of Health (DH) and the Medical Council of Hong Kong (MCHK):

Year     No. of cases
2005     2
2006     1
2007     2

Legal proceedings on one of these cases have commenced. DH is investigating another case and will submit the evidence to the Department of Justice to consider if prosecution should be made.

As for disciplinary actions against the medical practitioners involved, the MCHK is following up three cases. In another case, the medical practitioner involved was found guilty of misconduct in a professional respect after inquiry, and the MCHK ordered the name of the medical practitioner to be removed from the General Register for a month, suspended for 12 months provided that the medical practitioner does not commit any other disciplinary offence during that period.

Patients affected may lodge a claim for compensation from the health care practitioner or organisation involved through civil proceedings. We do not have information on the compensation payable.

(b) The Administration attaches importance to the safe dispensing of drugs in private clinics. To further ensure the protection for patients, the MCHK conducted in July 2005 a review of the provisions on drug dispensing in its Professional Code and Conduct for the Guidance of Registered Medical Practitioners (the Code). The revised provisions were published in Issue No. 11 of the Newsletter of the MCHK in August 2005. Under the revised Section 10.1 of the Code, a medical practitioner who dispenses medicine to patients has the personal responsibility to ensure that the drugs so dispensed are strictly in accordance with the details in the prescription and are properly labelled before the drugs are handed over to the patients. The Code also requires medical practitioners to lay down appropriate procedures to ensure that the drugs are properly labelled and correctly dispensed, and follow the Good Dispensing Practice Manual issued by the Hong Kong Medical Association (HKMA). Medical practitioners must supervise the entire dispensing process and ensure that their staff comply with the procedures. The MCHK may consider taking disciplinary action against registered medical practitioners who are in breach of the above requirements. The HKMA is also reviewing its Good Dispensing Practice Manual and will make appropriate changes to the Manual where necessary.

(c) Separation of prescribing from dispensing of drugs (SPD) has for many years been in practice in public hospitals and clinics, and in private hospitals. These together constitute the bulk of the drug dispensing activities in Hong Kong. Currently, patients have the right to ask their doctors at private clinics for a prescription and obtain the drugs from pharmacists in community pharmacies. We have received views on SPD from various organisations. Those in favour of the practice argue that SPD provides patients with useful drug information and serves as a further safeguard for proper use and dispensing of drugs. Those with reservations express their worries that SPD would lead to increase in medical expenditure and cause inconvenience to patients, and at present there are not enough qualified pharmacies and pharmacists to cater for the needs, etc. We maintain an open mind on this matter. As SPD could have far-reaching implications on, among others, the current role of doctors in solo-practice, manpower demand for pharmacists and medical expenditure of the public, and may involve a major change of patient behaviour, the matter would require a thorough discussion by the community as a whole. We consider that the well-being of patients should prevail and any changes to be introduced should be conducive to the cooperation between doctors and pharmacists. At this stage, we encourage members of the two professions to enhance their exchanges and cooperation on drug dispensing.


Ends/Wednesday, May 16, 2007
Issued at HKT 14:15

NNNN