'We realise many private doctors are very busy. They may keep very clear patient records in their own clinics but not in hospitals, especially the records of patients' clinical symptoms,' Dr Fang said.

'Those doctors are attached to the private hospitals to use the clinical services and facilities but they are not employed by the hospitals. So it is very difficult ... to press them to meet the requirement.'

Speaking at an accreditation ceremony for private hospitals yesterday, he said hospital nurses did a very good job of record-keeping.

'We keep reminding doctors they need to keep a very clear clinical record, such as patients' conditions during their stay in hospital. This is a common inadequacy shared by private hospitals,' he said.

He said a boycott of offending doctors was possible, but hospitals had not taken action so far.

It is common for private doctors to admit their patients to hospitals for surgery and other in-patient clinical services, especially when their clinics do not have the facilities and equipment to carry out the diagnosis and treatment.

Dr Fang, medical superintendent of St Paul's, said his hospital had checked 120 patients' records in 2003 and found some were unclear. The situation had improved last year 'but the inadequacy needs to be addressed and there is still room for improvement'.

Dr Fang spoke after a ceremony to mark accreditation of all 12 private hospitals by Britain's Trent Accreditation Scheme. For the first time in six years they all passed unconditionally. Previously some have had to make improvements.

Trent Accreditation Scheme board chairman Timothy O'Carroll said there was always room for improvement in doctors' record-keeping at hospitals anywhere.

It was 'a small part in the overall picture' of accreditation.

'The Private Hospitals Association is aware of this and they will be working stringently over the next two years to improve the situation,' Dr O'Carroll said.

Patients' Rights Association spokesman Tim Pang Hung-cheong warned that patients would be at risk, especially in emergencies, if hospitals did not have their full clinical records.

Mr Pang said his association had received complaints from patients who returned to hospital with complications but were told there was no full clinical record for follow-up treatment.

Under the Trent Accreditation Scheme, a report based on hospital surveys is considered by a board in Britain to determine whether the standards have been achieved. Full accreditation is given to a hospital for only two years at a time.

The scheme started in Britain about 10 years ago and was brought to Hong Kong on the initiative of private hospitals in 1999.