Long criticised for its inefficiency in handling patients’ complaints, a reform in the Medical Council of Hong Kong (MCHK) has been a long time coming – and is heartily supported by patients and doctors in general. Ideally, the amendment bill would minimise the number of bottlenecks in the current process of MCHK hearings; and improve the mechanisms of investigating public complaints and disciplinary inquiries.

Medical Council reform bill in 2016 not passed

Although a reform is urgently needed to accelerate hearing processes, the Medical Registration (Amendment) Bill 2016 failed to attain approval from the Legislative Council after a marathon of debates.

Currently, there are 28 members in the council, 14 of them appointed by the Chief Executive, seven elected by Hong Kong’s largest doctors’ group - Medical Association and seven elected by registered doctors.

The [4+0] proposal put forward by the government was intended to appoint four additional lay members to the council, without the addition of any doctors, and is claimed to be able to reduce the waiting time for a hearing from 58 to 30 months.

However, doctors opposed the [4+0] proposal, as the four additional lay members were to be directly nominated by the Chief Executive, breeding fears that these nominees would be government yes-men and giving them this power to easily manipulate council decisions would be disastrous.

They feared that greater government control over the council would lead to decisions like relaxing admission requirements of non-locally-trained doctors to relieve the shortage of manpower in public hospitals. This is a situation that doctors are already distressed over, as the general opinion is that importing substandard doctors from foreign countries or Mainland China risks imposing detrimental effects on the public’s health.

The failure of the long expected reform bill has, to some extent, exacerbated the strained relationship between doctors and patients. Patients’ rights groups have long urged the medical sector to accept the government proposal, with some going as far as to accuse the doctors of opposing the bill for personal interests, but on the other hand doctors ascribe the broken relationship between patient advocates and the medical sector to the government’s unwillingness to listen to their concerns and engage in discussion.

Survey reveals citizens are of same mind as doctors

In November 2016, a tripartite platform was formed with representatives from doctors’ unions, patients’ rights group and lawmakers, with the aim of ensuring better communication and understanding is reached amongst all parties before any more attempts to introduce relevant bills into legislature.
Prior to the tripartite’s first meeting on 17th January 2017, a survey was conducted involving 1003 citizens aged 18 and above, 1202 doctors and 27 Election Committee (EC) members. The poll showed that 46% of citizens, 82% of doctors and 100% of EC members agreed with the maintenance of a 1:1 ratio of elected members and government appointees in the Medical Council.

On the other hand, 78% of citizens, 83% of doctors and 85% of EC members opposed the idea of exempting overseas doctors from local examinations to practise in Hong Kong. “During the previous Medical Reform proposal, doctors opposed such a change in fear of compromising the healthcare standards of Hong Kong, but received criticism from the public. This survey is proof that the citizens are actually of the same mind as the doctors,” said Dr Pierre Chan, elected member of the 2016 Hong Kong Legislative Council, who also called for the survey.

68% of the citizens and 93% of the EC members supported the setting up of an independent organisation to take on medical complaint cases. However, only 25% of the practitioners supported the idea. Another 79% of the citizens, 50% of practitioners and 85% of the EC members voted in favour of the Medical Council hearing procedures.

The strained relationship between the government and the medical sector

Despite ongoing discussions in the tripartite platform, the government is proposing to increase the number of assessors from its current 14 to 100 to resolve the issue of numerous accumulated unresolved complaints. While practitioners agree with the idea of significantly reducing the time required for hearings, they warned that a decision should only be made once consensus is reached.

Representatives of the tripartite platform also protested the fact each of them were only granted five minutes to voice their opinions in the meeting, considering this pre-set time constraint to be a barrier to more in-depth discussions. With just two more meetings left, the medical council is concerned about whether a consensus can be reached before they adjourn next month. MIMS

Read more:
Medical Council reform bill lapsed
HK: Lawmakers not keen to add non-doctors to Medical Council
Woo Kwok Hing's election manifesto 2017: Health care policies and the people