The Medical Council needs transparency

PUBLISHED : Thursday, 17 May, 2007, 12:00am
UPDATED : Thursday, 17 May, 2007, 12:00am

Hong Kong's doctors are governed by an international code of ethics that clearly lays out their duties and obligations. The self-regulatory organisation that ensures their compliance, the Medical Council of Hong Kong, does not so closely follow the rules, though.

Doctors, the code states, must 'deal honestly with patients and colleagues, and strive to expose those doctors deficient in character or competence, or who engage in fraud or deception'. The council does take disciplinary action against doctors it has determined to have failed their obligations, but the manner in which the process is carried out is so closed that the people of Hong Kong - whom it claims to have the best interests of at heart - are generally left in the dark about its decisions.

As we reveal today, transparency is so lacking that doctors found to have broken the code of conduct are not revealed for all in the community to easily see, let alone be shamed. While proceedings are open to the public, impending cases are indicated on the council's website only with the barest detail. No written judgments are released and there is no assurance that they ever will be, even if requested.

In essence, those doctors who have not been competent, honest or ethical - attributes essential for a profession with the power of life and death in its hands - are able to blend unnoticed into society despite their misdemeanours. They may be fined, suspended from practising for a time or struck off the council's list of registered medical practitioners - whichever, we, the people who should know which doctors abide by the regulations, are too often none the wiser.

Council chairwoman Felice Lieh Mak says it would be unfair to name and shame doctors found guilty of professional misconduct by posting their names and details of the cases on the organisation's website. This is the practice with many other medical regulatory bodies, though, and beyond exposing such doctors to the public, there is the good reason that it provides a rationale for rulings.

Such a practice is generally followed by the judiciary in Hong Kong, and it is this transparency that is partly the reason for our rule of law being so strong. Those found guilty are named and their sentence indicated. Judgments can be readily reviewed and compared with other cases to determine if they are fair. Through seeing how the system works and the reasoning for rulings, we know what is right or wrong. In the public glare, those found guilty will know the implications of again breaking the law.

The Medical Council performs a similar role to the judiciary when dealing with disciplinary cases in that it determines the guilt of doctors accused of misconduct, and passes sentence. Those found at fault have their names forwarded to authorities for publication in the Government Gazette, a volume that is too dense in nature for many in the community to bother with. But the exact reasons for a ruling are not generally available in written form, as they are in judicial cases. Requests for a written judgment, as this newspaper has found, may be months in coming, if at all. Patients of doctors dealt with by the council may wish to pursue cases for compensation or review, and the lack of documentation may affect their chances.

Such lack of openness is not becoming for so important an organisation. On its website, it states its aims are 'ensuring justice, maintaining professionalism and protecting the public'. Without transparency, there is no certainty the council is doing its job properly.