'Settle spats via conciliation '

17 Jan 2009, The Straits Times

Question

Name of the Person: Heng Cho Choon

Medical Mediation Scheme offers a win-win solution to settle disputes

THURSDAY'S report, 'Quicker action on patients' complaints against doctors', and proposals to amend the Medical Registration Act (MRA) are welcome news to doctors, as well as patients who are not adequately protected as the MRA was last amended only partially in 2007.

Under the current MRA, a patient's complaint must be in writing and supported by a statutory declaration, which means he needs a lawyer. The complaint is submitted to the complaints committee of the Singapore Medical Council (SMC). It goes through several committees, depending on its seriousness and complexity. This is time-consuming, if not cost-prohibitive.

Both doctors and patients have rights and responsibilities when medical services are provided. Patients must inform their doctor of all information known to them concerning their health and past treatment. This enables their doctor to make a proper clinical assessment of their health and provide appropriate treatment.

Doctors must maintain their professional competence to observe professional ethical obligations and encourage good communication to ensure their patients receive a reasonable standard of care.

In New South Wales, patients can complain to the New South Wales Medical Board and the Health Care Complaints Commission. The commission can also refer the complaint to the Health Conciliation Registry for conciliation with the consent of both parties. The registry is independent and cannot receive complaints direct from the public.

If settlement is reached through conciliation, animosity between doctor and patient can be defused.

Conciliation is an opportunity for parties to discuss a health-care complaint and agree on possible options for a final outcome. A professional conciliator goes a long way towards assisting the process in a neutral setting.

All documents provided by the commission are confidential. During the conciliation meeting, parties identify and discuss topics relating to the complaint with the help of a conciliator. The aim is to negotiate an outcome acceptable to all involved.

We need a body similar to the Health Care Complaints Commission. If the dispute cannot be resolved with conciliation, it can be referred to the complaints committee of the SMC and finally the courts.

Reply

Reply from MOH 

Mr Heng Cho Choon in “Settle spats via conciliation”, ST, 17 Jan 09 suggested for a complaints commission where doctor-patient complaints can be settled through conciliation in a neutral setting.

The Ministry of Health (MOH) and the Singapore Mediation Centre (SMC) agree with Mr Heng that a conciliation process would aid in resolving health-care complaints more quickly and less expensively. In fact, since January 2008, MOH and the SMC had jointly set up a Medical Mediation Scheme (MMS) to provide mediation services for healthcare disputes.

Patients or their families who are unhappy with the clinical care or services provided by a healthcare institutions can take up mediation to amicably resolve their disputes. The mediator will  help to get the parties to agree on certain terms of settlement.  There is no judgement passed during mediation as to who is right or wrong.   If the dispute is resolved at the end of mediation, parties will sign a formal contract to agree on the specific terms of settlement. If mediation fails, the parties can proceed to other private means of dispute resolution, including litigation.  Most mediation sessions do not take more than 1 day.

Though there is a small fee involved, mediation still saves time and costs for parties, compared to the costs of litigation.  Its non-adversarial nature also helps parties maintain relationships in the long term. To find out more about the scheme, parties may contact MOH at moh_info@moh.gov.sg(tel: 1800 2254122) or the SMC at enquries@mediation.com.sg (tel: 63324366).