There are good reasons why public hospitals are subject to a code that ensures serious medical incidents causing death or injury are promptly reported to the Hospital Authority. And there is no good reason why private hospitals should not feel bound by it. Apart from the principle of accountability for patient safety, a prompt, uniform reporting system generates feedback and interaction among doctors, nurses and administrators that is in the best interests of patients.
The Hospital Authority developed the code in response to a distressing rash of serious medical blunders in its hospitals a few years ago. Private hospitals are not immune to such failings. Nonetheless, compliance with the code by registered private hospitals was made voluntary, reflecting their day-to-day autonomy, though they are regulated by the Department of Health. The result has been disappointing. The Audit Commission revealed recently that private hospitals failed to report more than half of nearly 100 recorded serious incidents from 2008 to last year within the prescribed 24 hours, and failed to file investigative reports on 60 of them within four weeks. The commission said the department's failure to adequately regulate private hospitals risked under-reporting of mistakes.
Secretary for Food and Health Dr Ko Wing-man has admitted that the department has not fully exercised its power. He rightly says private hospitals should align their procedures for reporting mistakes with those of public hospitals, indicating that they will come under pressure to be more forthcoming about medical blunders. He said the department would also take more steps to ensure private doctors suspected of misconduct faced disciplinary hearings.
The reporting system for private hospitals is confidential and does not involve disciplinary measures. Indeed, of the 100-odd cases reported from 2008 to 2011, only three were made public by the department, without the names of the hospitals or any other details. Since they are not named and shamed, they have no excuse for not complying for the sake of patient safety.