Minister's decision on SMC case a considered one

MOH's Reply

The Straits Times, 19 March 2015

Minister's decision on SMC case a considered one

We refer to the letters by Dr Ho Ting Fei ("Lessons for professional regulatory bodies"; last Thursday) and Dr Huang Shoou Chyuan ("Restoring confidence in medical disciplinary process"; Tuesday) concerning the recent court decision arising from disciplinary proceedings against Dr Lawrence Ang.

The Medical Registration Act allows both patients and doctors who are dissatisfied with the decision of the Singapore Medical Council's complaints committee in relation to a disciplinary complaint to appeal to the health minister.

This serves as an important avenue to protect the interests of patients and doctors alike, by ensuring that all disciplinary matters are dealt with in as fair and impartial a manner as possible.

The minister may either uphold the complaints committee's decision or refer the matter for a disciplinary inquiry before a disciplinary committee/tribunal.

The decision in each appeal is a carefully considered one that is made after giving full consideration to all relevant information presented, including the views of the complaints committee, and additional expert opinions, if appropriate.

Of the 68 appeals to the minister processed between 2010 and last year, seven (about 10 per cent) were referred for disciplinary inquiry before a disciplinary committee/tribunal. For the remaining 61 appeals, the decisions of the complaints committee were upheld.

The Ministry of Health respects and acknowledges the court's ruling and comments in Dr Ang's case.

We will review our processes to further streamline them.
 

Lim Bee Khim (Ms)
Director, Corporate Communications
Ministry of Health

-----------------------------------------------------------------------------

Forum Letters

The Straits Times, 12 March 2015

Lessons for professional regulatory bodies

Tuesday's report ("Why SMC was ordered to pay doctor's legal costs") raises various questions and thoughts.

First, I applaud the judges for a fair, just and honest ruling. It proves once more that our Singapore judicial system is beyond ranks and positions in its execution of justice.

The Singapore Medical Council (SMC) has much to learn, and needs to examine its deficiencies.

Despite having the full support and advice of qualified medical professionals, how did the disciplinary committee end up producing a charge that lacked clarity and making "a number of errors" in finding the doctor guilty, including taking into account "facts that it should not have considered"?

Hence, one worries whether the SMC has exercised and will continue to exercise full caution and fairness in handling every complaint and disciplinary action, in line with its professional role and responsibility.

The legal costs paid by the SMC will have a bearing on the annual fees paid by its members and consequently raise the costs of medical practice.

The SMC should seriously commit to heart the judges' comment that paying costs will "incentivise appropriate conduct in litigation". This is a good and timely reminder for the SMC.

A wrong charge, if not reversed, results not only in the unnecessary loss of income beyond a doctor's suspension, but also the loss of professional credibility.

The health minister's actions in ordering the hearing are also questionable.

Was there due diligence to examine all evidence and understand the case before ordering the disciplinary hearing, especially since the SMC's complaints committee had already found that the doctor had not been at fault?

Was adequate and appropriate advice from people with medical backgrounds given to the minister? Should the minister not bear some responsibility for the consequences?

I hope this case will be like a beacon shining light into dark corners and traps that can compromise our public regulatory systems.

Ho Ting Fei (Dr)

------------------------------------------------------------------------------

The Straits Times, 17 March 2015

Restoring confidence in medical disciplinary process

Most doctors accept that in any just society, patients have the right to expect complaints about doctors' alleged professional misconduct to be thoroughly and rigorously investigated by an independent panel, so that public confidence in the integrity of Singapore's healthcare system is safeguarded.

In the case between Dr Lawrence Ang and the Singapore Medical Council ("Why SMC was ordered to pay doctor's legal costs"; last Tuesday), the SMC's Complaints Committee initially found that Dr Ang did not have any case to answer and all charges were dismissed.

Under the Medical Registration Act (MRA), both complainant and respondent have the right to appeal to the health minister against the Complaints Committee's verdict.

In this case, the complainant appealed to the health minister, who then told the SMC to hold a disciplinary hearing, which found Dr Ang guilty and suspended him.

The perception in the medical community is that this route of appeal for ministerial intervention may encourage abuse by dissatisfied complainants, as it carries little financial cost for the complainant.

The Court of Appeal also alluded to the fact that the reason for the minister's intervention was unknown.

It said: "It is not evident why or how the decision of the Complaints Committee was considered to be unsatisfactory."

To allay the anxiety among doctors, could the Ministry of Health reveal the following statistics since the MRA was amended to allow ministerial discretion in the appeal process?

How many appeal cases have been received by the ministry from dissatisfied complainants after the Complaints Committee stage?

Of these, how many were dismissed by the minister and how many were redirected back to the SMC for review by a Disciplinary Committee?

Of those reviewed by a Disciplinary Committee, how many had a verdict that was different from the Complaints Committee's conclusion?

With this information, I hope confidence can be restored in the integrity of the SMC's disciplinary process, so that doctors can practise with the assurance that only bona fide complaints proceed to the Disciplinary Committee stage.

Huang Shoou Chyuan (Dr)