Hong Kong health care and hospitals

Case of patient left on operating table reveals the extent of doctor shortages in Hong Kong

Albert Cheng says that the government and Hospital Authority must reform policy and address long-standing problems to recruit more talent for public hospitals, to avoid more incidents that risk patients’ well-being

PUBLISHED : Thursday, 02 November, 2017, 6:02pm
UPDATED : Thursday, 02 November, 2017, 7:16pm

The media recently exposed a bizarre medical incident at the liver transplant centre in Hong Kong’s Queen Mary Hospital. On October 13, a surgeon supervising a liver transplant allegedly left the patient on the operating table for three hours, so he could perform surgery at a private hospital.

After Dr Kelvin Ng Kwok-chai left, Dr Tiffany Wong Cho-lam, the patient’s chief surgeon, did not proceed with the surgery, choosing to wait for Ng’s return, according to reports. The patient was left with nurses and an anaesthetist who monitored his status during the surgeons’ absence.

Eventually, Ng returned, some 90 minutes later than expected, and the operation was completed.

The patient is now in a stable condition, but the incident could have resulted in serious complications.

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Professor Lo Chung-mau, the centre’s director, admitted that the three-hour delay was “unsatisfactory” but stressed that Ng was only there to supervise, not to perform the operation. He said situations in which surgery is paused for three to four hours can occur for a variety of reasons but, in this case, the delay was unacceptable because it involved waiting for a surgeon.

However, instead of questioning Ng’s actions, Lo pointed the finger at Wong, the chief surgeon. He said she had misjudged the circumstances and should have sought help from other supervisors and medical experts instead of waiting for Ng to come back. He indicated that Ng was only a “part-time surgeon” who contributed his expertise to a public hospital and it was understandable that his working hours could be irregular.

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In other words, from Lo’s point of view, because Ng sets aside some time in his busy schedule and helps out at the hospital, he shouldn’t take most of the blame.

Lo has revealed a major reason for the recurring medical incidents in Hong Kong, which have raised concerns that the mishaps are more systemic than incidental.

Medical professionals are overworked at public hospitals due to a lack of manpower. Hence, the disgruntled and overloaded doctors often move to greener pastures in the private sector, worsening the shortage of medical personnel in the public sector.

One medical expert after another has moved to private hospitals, mostly attracted by the flexibility in working hours, lighter workloads and better pay.

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It takes at least 10 years to nurture and train a surgeon. There are currently 11 surgeons in the liver transplant team of Queen Mary Hospital. There is a need to bring in external help to train and guide young surgeons; that is why Ng was invited to join the team as a supervisor.

Hong Kong faces a serious shortage of medical personnel. The government and Hospital Authority should play hardball and take the lead to retain existing doctors and attract overseas professionals.

To ease public doctors’ burden, the Medical Council should objectively review the requirements for overseas doctors to practise in Hong Kong. To bring in “voluntary surgeons” is not a sustainable solution; this recent incident proves the difficulties for a surgeon to strike a fair balance between practising at a private hospital and supervising at a public one.

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The recent medical incident and the responses by the relevant personnel have also triggered another concern, of a perceived cover-up. This shows that the Medical Council needs to be more transparent to earn public confidence. Adding more members from outside should help improve how disciplinary hearings are held, and allay concerns that the council is overly protective of its own people.

Council reform is long overdue, but it is less urgent than the manpower shortages at public hospitals. Hospital staff are stretched to breaking point, and if the situation carries on, more incidents will occur, putting more lives on the line. Policy must be reformed and long-standing problems addressed at their root.

Albert Cheng King-hon is a political commentator. [email protected]