Replies to LegCo questions

LCQ2: Mechanism for handling medical incidents and complaints

Following is a question by the Hon Paul Tse and a reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (June 18):

Question:

The Medical Council of Hong Kong (MCHK) is vested with statutory powers to conduct inquiries into complaints about the professional conduct of registered medical practitioners, and may take disciplinary actions against those practitioners found to be guilty of professional misconduct. It has been reported that MCHK receives about 500 complaints each year, but conducts disciplinary hearings on only 22 of such complaints on average. Some members of the public have criticised that the fact that MCHK is mainly composed of medical professionals will easily give rise to the situation of "doctors harbouring each other", such as imposing lenient penalties on those doctors guilty of professional misconduct. Moreover, MCHK has taken a very long time in handling some of the cases, causing grievances among the victims of medical incidents and their families. For instance, concerning the death of a newborn son of a couple in 2005, it is not until recently (i.e. nine years after the incident) that MCHK has adjudicated that the doctor concerned is guilty of professional misconduct. This case has aroused wide public concern about the composition, operations and complaint handling procedure of MCHK. In this connection, will the Government inform this Council:

(1) whether it has assessed if the current composition, criteria for appointment of its members and modus operandi of MCHK are conducive to its handling of complaints in an objective, fair, credible and efficient manner; if it has assessed, of the methodology and outcome of the assessment, as well as the relevant follow-up actions taken; if not, the reasons for that, and whether it can immediately conduct such an assessment; as some members of the public consider that the penalties meted out by MCHK to doctors guilty of professional misconduct are often too lenient, thus lacking sufficient deterrent effect, of the follow-up actions the authorities will take;

(2) as it has been reported that the couple in the aforesaid case have spent more than $1 million on legal fees and engaging medical specialists to prepare independent assessment reports, etc., of the policies and measures put in place by the authorities to assist those victims of medical incidents and their families who have financial difficulties and lack medical expertise in seeking justice; and

(3) whether it will examine the establishment of a new independent redress mechanism (such as office of the ombudsman for medical services) dedicated to handling complaints about medical incidents?

Reply:

President,

(1) The Medical Council of Hong Kong (MCHK) is an independent statutory body established under the Medical Registration Ordinance for handling matters relating to the registration and regulation of medical practitioners in Hong Kong, including the conduct of inquiries and disciplinary proceedings concerning the professional conduct of registered medical practitioners. The MCHK comprises 24 medical practitioners and four lay members. Among the medical practitioner members, seven are elected by registered medical practitioners, seven others are elected by the Hong Kong Medical Association, while the rest are nominated by the Director of Health, the University of Hong Kong, the Chinese University of Hong Kong, the Hospital Authority and the Hong Kong Academy of Medicine and appointed by the Chief Executive. The four lay members are also appointed by the Chief Executive.

The MCHK handles complaints received against registered medical practitioners, conducts investigations into allegations of professional misconduct and takes disciplinary actions in accordance with the procedures laid down in the Medical Registration Ordinance and the Medical Practitioners (Registration and Disciplinary Procedure) Regulation. If the MCHK finds that a medical practitioner is guilty of professional misconduct, it can impose punishment by issuing him disciplinary order or even revoke his professional registration.

Upon receipt of a complaint concerning the professional conduct of a registered medical practitioner in Hong Kong, the Preliminary Investigation Committee (PIC) of the MCHK will conduct preliminary investigation into the case and make recommendation to the MCHK as to whether or not an inquiry should be conducted. The PIC comprises seven members, including a chairman and a deputy chairman elected from among members of the MCHK and a lay member of the MCHK.

In accordance with the Medical Registration Ordinance and the relevant established procedures, the MCHK processes all complaints according to any or all of the following three steps:

(a) Initial consideration by the chairman and the deputy chairman in consultation with a lay member of the PIC to decide whether the complaint is groundless, frivolous or not pursuable, and therefore the MCHK cannot or should not proceed further with it or that it should be referred to the PIC for full consideration;

(b) Conduct of a PIC meeting to examine the complaint as well as to consider the explanation of the medical practitioner concerned, with a view to forming a decision as to whether there is a prima-facie case to refer the complaint to the MCHK for a formal inquiry; and

(c) Inquiry by a panel of the MCHK comprising at least five council members including a lay member to hear evidence from both the complainant and the defending registered medical practitioner.

The MCHK conducted 119 disciplinary inquiries in the five years from 2009 to 2013, of which only seven were found unsubstantiated. The punishment imposed on medical practitioners included warnings and reprimands. In 76 cases, the registration of the medical practitioners was revoked and the period of removal from the General Register ranged from one month to permanent removal. The MCHK's judgments with reasons are uploaded onto its website and the relevant sentences are also gazetted in accordance with the Medical Registration Ordinance.

In a bid to expedite the complaint-handling process and inquiry proceedings so as to cope with an increasing number of complaints, the MCHK suggested in June this year to increase the number of lay assessors and allow lay assessors to substitute lay members of the MCHK in forming the quorum in preliminary investigations and inquiries. The Administration is actively considering the proposals.

(2) The Government attaches great importance to the quality of healthcare services and the safety of patients, and endeavours to establish an effective mechanism for handling medical incidents and complaints. In this regard, different institutions play different roles in the process of handling medical complaints or incidents. In addition to the MCHK and other statutory regulatory bodies for healthcare professions, which have established procedures for handling complaints against professional misconduct, the Hospital Authority has also put in place a mechanism to handle complaints lodged by patients, their families and the public. Upon receipt of complaints against private hospitals or reports of medical incidents, the Department of Health will conduct investigation and require the hospitals concerned to take appropriate rectifying measures, or refer the cases to relevant professional regulatory bodies for follow-up actions.

Outside the medical system, the Office of The Ombudsman is responsible for investigating complaints against public services including medical service, with a focus on the existence of any maladministration. Incidents involving death are referred to the Coroner's Court for inquests. Patients or their families may also take legal action against the relevant medical institutions or personnel through civil proceedings. The Judiciary will consider whether the plaintiff suffers any loss and award damages accordingly.

Complainants who wish to seek legal advice may make use of the free legal advice services provided by the Legal Advice Centres in District Offices and the two legal professional bodies. The Legal Aid Department meanwhile provides legal representation for eligible applicants in civil or criminal proceedings in the courts of Hong Kong.

(3) Against the backdrop of a growing and ageing population which poses increasing demand for healthcare services, the Government has set up a high-level steering committee to conduct a strategic review on healthcare manpower planning and professional development in Hong Kong. Chaired by the Secretary for Food and Health, the steering committee will assess the manpower needs of the healthcare professions which are subject to statutory regulation and put forward recommendations regarding their professional development. The scope of the strategic review covers the regulatory framework for the healthcare professions, including the functions and composition of the regulatory bodies concerned. The Administration will follow up on the recommendations of the steering committee as appropriate upon completion of the review.

Ends/Wednesday, June 18, 2014
Issued at HKT 16:41

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