Hong Kong Medical Council reform may be a bitter pill for doctors to swallow, but it’s a necessary remedy
Mike Rowse says the arguments against increasing the number of lay members, and looking at bringing in doctors who were trained abroad, don’t hold water
There is no bigger fan of the quality of medical care in Hong Kong, including in our public hospitals, than yours truly. Around a year ago, my life was saved by being admitted promptly to hospital, on my GP’s insistence, to deal with a mystery infection: the first blood test was for necrotising fasciitis, commonly known as flesh eating disease; luckily it was negative. And, 15 years ago, when my unborn son was diagnosed in the womb with a life-threatening illness, an emergency caesarean operation, followed 20 hours after birth by brain surgery, rescued him from an uncertain future (or, in the worst case, no future at all). You should see him now.
So, naturally, when the subject of reform of the Medical Council was discussed on a radio show I co-host every week on RTHK, I came into it from an angle basically supportive of the doctors. But, after a thorough debate on the matter, I realised the story is not so simple.
There are presently 28 members of the council, 14 elected and 14 appointed by the chief executive. All those who are elected are doctors; seven of them are members of the Medical Association (in essence, the doctors trade union) and the other seven are members of the profession who are not in the association. A private members bill – put forward by Tommy Cheung Yu-yan from the catering functional constituency – which the government has decided to support, proposes to add four more lay members to the council.
At first sight, that seems unfair to the doctors as it upsets the balance between elected and appointed members and, indeed, the Medical Association representative claimed this would undermine professional autonomy.
But, on closer inspection, it turns out that no fewer than 10 of the 14 appointed members are themselves doctors, and the chief executive does not actually get to choose them. Five organisations each have the right to nominate two people. The five are the University of Hong Kong and Chinese University (which each have a medical faculty), the Hospital Authority, Academy of Medicine and the Department of Health. The key point here is that all 10 must be doctors. Therefore, even if the proposed changes go through, this will not put lay members in charge of professional standards, it will simply alter the current ratio of 6:1 to 3:1, with medical personnel still very much in the majority.
In deciding to support the bill, the government said it wanted to improve the mechanism for investigating complaints and disciplinary inquiries. There was also a case for reviewing how the council approaches the issue of non-locally-trained doctors.
These are two sore points as far as the community at large is concerned. There is a perception – possibly an unfair one – that the council takes too long to investigate complaints and is, in general, overprotective of doctors’ interests. There have been some high-profile cases reported in the media which took years to reach a conclusion. The additional lay members would help cases be dealt with more quickly. Most doctors would prefer to see the delay issue addressed so that it does not reinforce the impression of institutional bias.
It is the second aspect which catches the eye, and which led Cheung to introduce his bill. He has been quite open about his interests and has declared them publically: he has a daughter and son-in-law who both qualified as doctors in the US, and both practise there.
They want to come back here to work, but have run into the buffer of the protectionist wall that the Medical Council has thrown up to deter them, and others, from doing so. We don’t need to go into the detail about how this is done, suffice to say it is the result of present policies and procedures.
At a time when Hong Kong is suffering from a shortage of medical personnel, it is clearly wrong to be obstructing professionals coming in from some of the toughest jurisdictions. A doctor who could treat US President Barack Obama is certainly qualified to treat Madam Wong from Wong Tai Sin.
Sorry doctors, much as I respect you, I don’t agree with your opposition to the changes. You have misdiagnosed this one: open wide and take your medicine.
Mike Rowse is the CEO of Treloar Enterprises and an adjunct professor at the Chinese University of Hong Kong. firstname.lastname@example.org