Speech of the Hon KP Chan on Motion on Establishing an Independent Statutory Office of the Health Service Ombudsman at the Legislative Council on November 30th, 2011 (Synopsis)
- With the recurrence of medical incidents in recent years, patients are at serious risk. It is also adversely affecting the Government’s plan to develop health services as pillar industry. Under current arrangements, the public may first complain to the hospital or clinic concerned. Further complaints may be made to the Public Complaints Committee of the Hospital Authority and the Medical Council of Hong Kong (regulator of the profession). Alternative channels are available but they are perhaps too tedious to the general public or unhelpful for resolving medical disputes.
- Actually, today’s subject was debated previously in the first year (2007/8) of the current term of this Council. The Motion was then carried. Time flies and we are in the final year of our term. At this juncture, I would like to talk about the need of an independent statutory Office of the Health Service Ombudsman by reference to facts and figures.
- In Hong Kong, regulation of ethics and handling of complaints against misconduct of the medical profession are vested with the Medical Council. However, the law does not define what is meant by professional misconduct. It is left to the Council to consider it case by case and set yardsticks on individual merits. Acceptability by the patient, the public and the community is not necessarily relevant in the deliberation.
- Of the 28 members of the Medical Council, 24 are practitioners. The other four are laymen. It is an arrangement of internal discipline and a far cry from autonomy and self-regulation of any other profession.
- Another culprit of the Medical Council is that it takes years to handle complaints. Take the rulings in this year as an illustration. Most of the cases occurred five or even six years ago. Even if patients and family were adamant to pursue their cases, they often could not afford the substantial legal expenses to fight against counsels for the defendant. This would grossly disadvantage the under-privileged.
- Complaints received by the Medical Council from 2000 to 2010 jumped twice from 227 to 493 cases in a decade. Of these 493 cases, roughly only 20 per cent were considered pursuable after initial inquiry. Among these pursuable cases, only 40 percent were formally investigated and heard. In a nutshell, of some 500 cases of complaints, only 40 cases were finally adjudicated. Substantiated cases were much less.
- The Public Complaints Committee of the Hospital Authority for public hospitals is no better. In its report of 1999, the Harvard Expert Group already found that the Committee had ruled most complaints and appeals unsubstantiated. There is not much improvement after 11 years. Of 255 cases investigated in 2010, only 5 cases were substantiated. Equity and justice of the complaint system are in doubt.
- Although the Public Complaints Committee comprises members from the public who are independent of the Hospital Authority, they are all appointed by the Board of the Authority. In this regard, the Hospital Authority is the service provider, the subject of complaints and the commissioner of investigation. Therefore, it lacks transparency in potential conflicts of interest and self-investigation.
- I support the Amendment of the Hon Paul Chan that calls for review of the composition of the Medical Council. I also call for review of appointments to the Public Complaints Committee. For instance, its membership should be appointed by the Chief Executive and may include members of the Legislature, the Consumer Council and sufficient patient groups in order to improve independency and transparency.
- As the Government intends to further develop health services, there is an imminent need for a simple and effective complaints system to safeguard patients or consumers and their rights. The existing arrangements are unsatisfactory. Both the professional body and government departments have their own power of investigation, adjudication and disclosure. It is hard for the public to meaningfully monitor complaint cases and figures, to track medical incidents and trend and to assess relevant risks before accepting any service. Thus, medical practitioners and institutions might evade professional responsibilities.
- I support the establishment of an independent statutory Office of the Health Service Ombudsman. Actually, the Legislature first discussed the public aspiration for an independent ombudsman as early as in 1999. I am confident that this Motion would be carried and urge the Government to consider today’s Motion seriously.