Legal action urged to rein in cut-price clinics

PUBLISHED : Monday, 22 June, 2009, 12:00am
UPDATED : Monday, 22 June, 2009, 12:00am

Patients who visit clinics that are part of chains or who use medical cards issued by health schemes could be missing out on the best drugs because much of the money goes to middlemen, a lawmaker has warned.

Companies that pay for their employees' health services or patients who join medical schemes are kept in the dark about how their money is used, said Leung Ka-lau, legislator for the medical sector. About half of it went to middlemen.

Medical companies remain outside the grasp of government regulations, and this has prompted Dr Leung to prepare a private member's bill demanding the registration of such organisations.

A doctor, who refused to be named, said he had served in more than five health maintenance organisations - companies that run chains of clinics or outsource medical services. He said patients were given the cheapest drugs, usually costing less than HK$20, in order to save money.

Patients covered by the medical plans are usually allocated a little more than HK$100 for every visit they make to the doctor. After deducting administrative costs and consultation fees, little remains to pay for the drugs.

'What drugs can you buy with HK$20? You can imagine,' he said.

Such drugs are likely to be less effective than more expensive ones. Doctors also face pressure to prescribe less than the full course of drugs. 'A course of antibiotics usually lasts five to seven days,' the doctor said. 'But with a medical card, the costs can only cover a course of two to three days.'

But by doing this, a doctor faces the risk of being prosecuted by the Medical Council for not giving a full prescription. In the meantime, the companies that run the chains or outsource the services are out of the picture as far as the law is concerned.

Dr Leung called for the compulsory registration of companies that provide direct medical services to patients to ensure they can be held accountable for their decisions.

He has proposed that at least half of the directors in a company that runs a chain of clinics should be registered doctors in order to guarantee standards.

Under current regulations, such companies are registered as commercial organisations instead of medical companies. Its directors are not accountable to the jurisdiction of the Medical Council even if the company is found to have used unethical practices.

There have been cases in which doctors employed by the chains have been found guilty of professional misconduct for decisions they did not make. In one case a doctor who had not even started work at a newly established clinic was held accountable for the advertisements put out by the clinic.

Dr Leung has drafted an amendment to the Medical Registration Ordinance and plans to table it as a private bill after the summer break.

The president of the Medical Association, Tse Hung-hing, said he supported tighter regulations on medical companies.

A spokesman for the Food and Health Bureau said the government guaranteed the quality of medical services by monitoring individual medical staff.