The Hospital Authority is trying to define to what extent medical staff, their supervisors and a faulty system should be held responsible for errors. A senior authority source said the organisation was looking into the idea of a 'just culture', with accountability for human and institutional errors. An international debate on the issue has centred on the criminalisation of medics over human errors. The authority is assessing the impact of a Prince of Wales Hospital doctor, who made a mistake and could face a charge of manslaughter. A three-member panel highlighted human error, gaps in specialist training and flaws in the system that led to an injection being administered incorrectly. The source said the organisation was trying to stipulate principles for accountability on errors. 'We want to establish a just culture at public hospitals, meaning we have to lay down some basic principles on what responsibilities individual doctors and the system have to bear in case of medical incidents,' the source said. 'There can't be hard and fast rules, but at least we should have a concept of it.' The source added that doctors with differing experience and seniority should have different levels of responsibility. 'Consultants should be held responsible for their own work, while junior doctors ... should not be held completely responsible,' the insider said. It is understood that when the recent drug blunder happened, the female doctor at the Prince of Wales Hospital was planning to take her specialist examination in oncology the following week. Public Doctors' Association president Duncan Ho Hung-kwong said some doctors were frustrated that the authority tended to put all the blame on junior staff. 'If an overworked doctor makes a mistake, should we only blame the doctor?' Dr Ho asked. In an editorial in 2003, the British Medical Journal warned that an increase in prosecutions for medical manslaughter reflected society's changed attitude towards the idea of accountability. 'The test of gross negligence has been an element of gross negligence manslaughter for well over 100 years, but its application to the surgery and hospital ward has changed in recent years,' the journal said. 'Our modern day intolerance of accidents as innocent events has tended to turn medical mistakes resulting in death into tragedies calling for criminal investigation.' The journal reported in 2000 that only four doctors were charged with manslaughter in the UK during the 1970s and 1980s, but 17 were charged during the 1990s. In the 2? years since the piece, another six doctors have been tried for manslaughter.
