The council has long been criticised for its slow handling of complaints. Procedures mean complainants wait an average of 58 months before a hearing is held. The council gets around 500 cases each year, but only an average of 22 make it to hearing while a majority of the rest are dropped for being trivial or groundless. Critics have also suggested the body acts as a closed shop and tends to protect doctors. To restore public confidence and ease workload, it made a reform proposal for the approval of the Food and Health Bureau in 1999. The bureau promised to take action last year.

2. How does the government plan to reform it?

At present, 14 of the council’s 28 members are appointed by the chief executive. Of the other 14, seven are elected by the city’s largest doctors’ group – the Medical Association – and seven are elected by registered doctors.

The government suggested appointing four additional lay members, making a total of eight, and expanding the council to 32 people. As the presence of at least one lay member is required when the council holds a meeting in the preliminary investigation committee, having more of them should make it easier to meet the quorum, or even allow it to hold two meetings at once.

Another major change is to turn two appointed seats to elected positions – voted by the specialists’ training school, the Academy of Medicine – but only by its 26 board members. Those members are elected by 7,400 fellows, or about 53 per cent of all doctors in the city.
The government believed the plan would speed up the waiting time for hearings from 58 to 30 months.

3. Why are some doctors’ groups opposed to the government’s bill? What do they want changed?

While they supported reform, they criticised the two positions voted on by the Academy, saying that was a “small circle”, and that it should be voted on by all doctors. Together with the additional four appointed lay members, they said it would allow the council to be dominated by government supporters. They suggested adding another four doctors directly elected by the sector to keep the number of appointees and elected people even.

The doctors’ groups expressed concern that the current balance of the council would be disrupted by the appointees, and that professional independence would be undermined. They also fear that the government has a “hidden agenda” of relaxing the examination standard to import substandard foreign or mainland doctors.
They said the proposal was rushed ahead – it was only made public three months before going to Legco – and lacked public consultation.

4. Is their fear legitimate?

In fact, under the current system, lowering the standard for foreign or mainland doctors is theoretically possible, but not an easy thing for the government to do alone.

Secretary for Food and Health Dr Ko Wing-man, who admitted that the procedure was rather rushed,

repeatedly promised that the government had no plans to relax standards. The current standard of examination for overseas candidates to practise in Hong Kong is on par with the test taken by local students in two universities’ medical schools. That means the power to lower the standard would rest with the schools. But this is merely a tradition rather than a legal requirement.

Overseas doctors could also apply for a specific position at a public hospital on “limited registration” – meaning they can work without passing the licensing exam – but only on a contract subject to renewal every year. They would have to be specialists in short supply, gaining the approval of both the Medical Council and the Academy of Medicine.
Ko has also made concessions by stating that the four additional lay members appointed by the government would consist of three representatives from patients’ groups and one from the Consumer Council – making them less likely to be government yes-men.

5. Who are the key players in the debate?

The tactic effectively led to the suspension of a meeting on June 26, giving doctors more time to bargain with the government. More lawmakers joined Leung this week by making repeated speeches during the third reading of the bill, burning out the remaining meeting time of this legislative term.

Public doctor Au Yiu-kai, a veteran respected by the sector for his extensive humanitarian work, has been seen as the mediator between doctors, government and patients’ groups.

He has been in talks with all involved and tried to help them reach consensus.

The Medical Association, the largest doctors’ group, has taken the lead in staging rallies outside Legco when the legislature was debating on the bill. A new group formed by young doctors after the pro-democracy Occupy movement, Médecins Inspirés, has also actively advocated against the bill on different social networks and media columns.

6. What happens if the bill is not passed in the current term?

If it is not passed by Friday midnight, the government will have to introduce the bill all over again next term, depending on the determination of the administration. Dr Leung believed it would buy time for the government to fine-tune the current proposal and reach consensus with the sector before submitting it to Legco again.
But Medical Council chairman professor Joseph Lau Wan-yee believed the body would face an increasing workload as there are currently 900 complaints in the backlog, and that the image of and credibility of the body would be damaged in the eyes of the public and patients’ groups.