Medical sector needs greater transparency

PUBLISHED : Monday, 18 August, 2014, 4:30am
UPDATED : Monday, 18 August, 2014, 1:21pm

Five years ago a sustained rash of medical blunders prompted the authorities to send special teams into our hospitals to monitor compliance with patient-safety guidelines, which means trying to ensure that treatment does no harm. The move was aimed at halting repetition of the same kinds of mistakes in routine, basic procedures. It complemented other measures to restore public confidence, such as prompt reporting and follow-up of what the Hospital Authority called "sentinel" incidents involving patient safety. For a time in the years since, medical blunders dropped off the radar. Lately they have popped up again, with worrying familiarity. In one of the latest, a pathologist at United Christian Hospital made mistakes in reports on 118 patients, leading to the wrong treatment of 17 of them. This sustained pattern of error was picked up eventually after the pathology department identified three of the inaccuracies in a routine internal review. Such a disturbing example suggests the review system may itself need reviewing. Thankfully the hospital ruled out significant health risk to the patients, although the misinterpretation of breast cancer as a benign tumour suggests more than a little element of luck.

Medical treatment can never be risk-free, nor would it be realistic to expect that human error can be completely eradicated. The latest unusual case could be a one-off involving personal factors. But it also suggests the work of those special teams dispatched in 2009 is never done and that there is a case for more permanent spot audits.

Meanwhile, the chairman of the Medical Council, the profession's self-regulating watchdog, says it should take over investigation of hospital doctors' blunders from the Hospital Authority, which has stopped referring cases to the council.

Professor Joseph Lau Wan-yee says he was prompted by concerns that the authority, which employs 40 per cent of the city's doctors in hospitals that treat 90 per cent of patients, is sweeping cases under the carpet. The council itself has been under fire because of slow handling of complaints and the lack of public representation in its disciplinary hearings. It needs to follow through with efforts to remedy these problems. That said, there is a case for the authority to refer medical incidents and patients' complaints to an independent body. A transparent system of accountability that fairly represents the interests of doctors, patients and medical institutions would do much to maintain public confidence in the whole health sector.