There should not be a need to define what a hospital is, as even young children know. For the sake of Caritas Medical Centre officials and others who may not be entirely sure, though, here is the definition: an institution where the sick and injured are treated and lives can hopefully be saved. Such a lesson is necessary in light of the debacle over a seriously ill man who collapsed just outside the hospital's main entrance on Saturday. He was denied instant admission because there were no guidelines to deal with such a situation. The right response was mapped out yesterday by Hospital Authority chief Shane Solomon - although it has obviously come too late for the man, who died shortly after being eventually admitted. That Mr Solomon had to announce rules that should otherwise be common sense is incredible. It is a worrisome situation for those who rely on the public hospital system for medical care. In short, the guidelines to be implemented are that the hospital staff member who encounters a person in need of prompt treatment dials a specially designated number to the accident and emergency department and an ambulance is sent as quickly as possible. In the absence of the code on Saturday, the receptionist the man's son pleaded to for help should have phoned the general emergency hotline number for Hong Kong, 999, Mr Solomon said. Instead, the son was told to dial 999 himself. The son was naturally distraught; the woman made no effort to dial the number for him or to contact the hospital's emergency department. Caritas' chief executive officer Ma Hok-cheung said in defending the woman that she had other duties and no guiding rules had been issued to staff for such circumstances. A doctor chancing by saw the sick man lying on the ground, tried to resuscitate him, and then phoned the emergency department for an ambulance. Every minute counts in an emergency: 26 lapsed between the man's arrival at the hospital and his admission. He was pronounced dead 17 minutes later. Mr Solomon has belatedly laid out the response for public hospitals. We must assume there will not again be such a tragedy. The incident gives pause for thought, though: what other situations may arise for which hospitals and their medical staff do not have guidelines? Is our medical system so bureaucratised that only rules will prevent blunders? Is there no room for common sense? In bureaucracies, the typical response to a problem is to consult guidelines, which are essential to co-ordinate large numbers of people to deal with mass problems. If no guidelines have been determined, confusion or inaction reigns. This is where bureaucracy gets a bad name. Too often, red tape - or a reliance on it - gets in the way of efficiency. But as the incident at the weekend shows, life and death situations require thinking beyond the rules. An ever-growing catalogue of serious medical errors in our hospitals has led medical staff to be disinclined to make decisions beyond the duties they have been assigned. There is also a culture of blame in Hong Kong where citizens are overly quick to criticise those in the public eye. Hospital staff are in the circumstances prone to strictly adhere to guidelines. Fully aware of the consequences of a bad decision, they are unlikely to take the initiative. This is clearly not a healthy situation - and as has been so plainly revealed, can also be a dangerous one. We need to break the attitudes that are preventing people from taking the initiative. Rewards, not punishment, are needed for those who look beyond the rules when circumstances merit. Lives depend on it.