Restrictions hinder health care system

PUBLISHED : Sunday, 14 August, 2011, 12:00am
UPDATED : Sunday, 14 August, 2011, 12:00am


For the second time in recent years a court has overruled the Medical Council on a doctor's right to advertise qualifications and experience. As a result, Hong Kong cardiologist Dr Lau Yuk-kong can now list himself as a Fellow of the American College of Cardiology after a six-year battle with the council. So can about 10 other local doctors who he says also hold the credential. The council had ruled that it was not a formally assessed specialist qualification. In a judicial review, the Court of First Instance said six years of full-time postgraduate training, two passes in American exams and 18 months' specialised practice could not be said to lack formal assessment.

This is a victory for commonsense, given also that the credential is recognised in Britain, Australia, New Zealand, Canada and even on the mainland. It is also in the public interest. Prospective clients have a right to know as much as is reasonable about professionals they are interested in hiring. Why should patients and doctors be any different?

The same public-interest argument was raised in 2008 when the Court of Appeal ruled that a ban on advertising by doctors breached their constitutional right to free speech.

Historically, restrictions were seen as necessary to prevent the rampant promotion of medical practices eroding public trust in the profession. But traditions and conventions which may once have served to inspire public confidence have no place in a modern, informed consumer society.

Meanwhile, the profession remains divided over a proposal to relieve an acute doctor shortage by allowing a small number of foreign-trained medics - preferably Cantonese speakers - to practise in our hospitals without sitting the local licence examination. New light has been cast on the issue with the disclosure that fewer than 10 per cent of foreign doctors who sit the Medical Council examination do well enough to get a licence. Dr Cheung Hon-ming, president of an association of doctors who have passed the exam, says it is too difficult.

The problem seems to be that the exam, devised by academics from the city's two medical schools, covers almost all subjects in a five-year medical course, while local graduates are examined mainly on the final year's curriculum before entering an internship. Opponents of the proposal to bypass the exam claim it would undermine quality and put patients at risk. It could also be argued that an exam that eliminates nearly all the candidates and contributes to a shortage of hospital doctors also does nothing for quality of care.

The public interest would be served by striking a fairer balance, starting with more comparable examinations for all doctors including local medical students. A significant increase in the meagre public representation on the Medical Council ought to be part of that process.