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Hong Kong health care and hospitals

In wake of uproar over ban on Hong Kong doctor, Hospital Authority to issue guidelines for health care workers

City’s medical community calls for clarification of roles after Dr Wong Cheuk-yi disciplined over fatal blunder involving nurses

PUBLISHED : Thursday, 17 May, 2018, 11:11am
UPDATED : Thursday, 17 May, 2018, 7:44pm

Hong Kong’s Hospital Authority will issue guidelines clarifying the roles of health care workers, after an outcry in the medical community over a doctor being found guilty of professional misconduct for a blunder that killed a patient.

Doctors’ groups met representatives from the authority, which runs Hong Kong’s public hospitals, including its chief executive Dr Leung Pak-yin, on Wednesday evening to express their unhappiness with the Medical Council’s verdict on Dr Wong Cheuk-yi.

Earlier this month, Wong was banned from practising for six months for failing to take proper steps to prevent 73-year-old patient Wang Keng-kao’s permanent tracheostoma – an opening in his windpipe – being treated as a temporary one. He was also found guilty of failing to alert or instruct nursing or other medical staff that the wound was permanent and not temporary. 

Wang died at Kowloon Hospital in November 2011. Gauze was later found covering the opening in his throat – the only channel through which he could breathe – and taped down at all four edges by nurses.

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Three nurses involved in the case were found guilty of professional misconduct by the Nursing Council in 2016. They were banned from practising for one month. Nine of their colleagues were cleared.

For example, if a nurse has already managed a patient’s wound, should there be another nurse to check again?
Dr Mak Siu-king, Public Doctors’ Association president 

The watchdog’s move to censure Wong was criticised by the city’s medical groups and unions, who said the decision implied doctors should monitor nurses’ performance, which could lead to mistrust between the two parties and cut into the time doctors spend taking care of patients.

The various organisations have called for a clearer definition of the roles of doctors and nurses.

Between last Thursday and Sunday, the Frontline Doctors’ Union collected 5,682 signatures for a petition stating its dissatisfaction with the council’s verdict.  

Public Doctors’ Association president Dr Mak Siu-king, who attended the meeting on Wednesday, said the authority had agreed to issue protocols delineating the roles of doctors and nurses in their clinical duties. 

“For example, if a nurse has already managed a patient’s wound, should there be another nurse to check again, or any other assessment to follow?” Mak said.

 

While the details of the protocols were not given during the meeting, Mak said he was satisfied with the overall response from the authority.

Dr Au Yiu-kai, co-chairman of the authority’s Doctors Staff Group Consultative Committee, said there had been confusion among the medical sector after the Wong verdict.

“Do doctors have to monitor nurses’ work? Now we don’t intervene in their work,” said Au, who also attended the session. 

He added that the guidelines were expected to be issued when Wong’s case was completely concluded. In general, a doctor can launch an appeal against a council ruling within a month of the verdict.

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Apart from the protocols, Mak said, the authority would also encourage more doctors to be involved in ward rounds by paying them an allowance under the special honorarium scheme.  

Frontline Doctors’ Union vice-chairman Dr Seamus Siu Yuk-leung, who was also at the meeting, said his group hoped the authority’s representative on the Medical Council would take a more active role in explaining working conditions at the authority to other council members.

Leung said the Hospital Authority was concerned about the case and noted that the council’s verdict had led to widespread discussion among the medical sector and the public.

He added that the authority had been in touch with Wong to understand his needs and concerns, including work arrangements, follow-up on the council’s verdict, and personal and family issues caused by the case. 

He said he hoped the case would not affect relationships between medical staff and patients.