Circular No. 2010, 12th June, 2001
The terms of reference of the Working Group on the reform of the Medical Council (MC) are to review the structure, composition and the functions of the Medical Council to (1) strengthen accountability, transparency and fairness; and ensure (2) a high standard of medical care.
On the way to reform, I think that the less the change, the better; the faster the change, the better for the profession. Actually the Working Group has suggested to submit the final proposal to the Government in early September 2001 when most of us would have returned from holidays with our families.
When the whole city was talking about the segregation of the powers of the Medical Council, I was astonished to be reminded by the Chairperson of the Working Group that apart from the actual reform, the most important thing is to establish quality control of our profession, i.e. Mandatory CME for non-specialists. I am one of the very few MC members being bombarded by other MC members from time to time for objecting Mandatory CME for non-specialists. I am afraid that, together with less than a handful of colleagues, I could not stop Mandatory CME at the end of the day when other professions like solicitors and TCM practitioners are having their own Continuing Professional Education programmes; and when our Chief Executive, Mr. Tung, is pushing everybody to have lifelong education in their careers.
Should we propose an alternative offer if things turn against us? I hope that our members will think seriously whether we should compromise in the same way the solicitors did about ten years ago. According to our Hon. Legal Adviser, the Continuing Professional Development (CPD) for solicitors commenced in 1991, was implemented in phases, initially was compulsory only for the new graduates but gradually extended to the seniors. At the beginning of 2003, every solicitor will have to comply with CPD in order to obtain a practicing certificate. If the MC implements voluntary CME for non-specialists for three years starting from 1st July 2001 and then starts the compulsory CME in phases from 1st July 2004 in the same way as the solicitors, then it will take us at least 15 years from now for all colleagues to have to comply with Mandatory CME. By that time, I am sure some of us would have retired. Remember, the above proposal is just a suggestion open for discussion. The HKDU Council’s stand is still Voluntary CME similar to that of the Hong Kong Medical Association.
Another issue I wish to highlight is the proposed Professional Performance Committee (PPC) to which we objected but was insisted by the MC on setting up. I would like to put forward an alternative for members to think about. Such alternative is a “Substandard Point Deducting” (SPD) system in which the Substandard Points can be spent. In traffic offenses, points would be deducted for speeding short of suspension of driving licenses. Similarly in the SPD system, if a doctor is proven to have substandard practice, by the PPC after being tried in an inquiry but short of professional misconduct, one Substandard Point will be deducted in his/her records. When he/she has been deducted a certain number of Substandard Points for substandard practice then he/she will be subjected to penalty by the MC.
I am suggesting to remove the rights of the originally proposed PPC to send assessors to your clinics. I am suggesting to lessen our stress of being harassed by unfriendly assessors who will be peeping into your office from time to time. Certainly, I would like to listen to your comments before a formal proposal to the MC.In the enclosed Circular No. 2005, we have listed out the suggested changes brought up so far by the Working Group of the MC. The HKDU Council agrees to all of the administrative measures except No. 1.2 because we think that random selection of MC members to attend inquiry is impracticable since it does not incur any penalty. For those suggestions which require amendments of the MRO, the HKDU Council objects all except No. 2.2. We suggest that there is at least half of the total number of MC members coming from elected doctor members to achieve professional autonomy and at most the percentage of laymen member in the MC should be around 20-25%. Now, the reform is coming, it is your time to think seriously how together we can shape our future Medical Council.Please try your best to complete the enclosed survey in Circular No. 2005 to help us voice your opinions and return it to HKDU on or before 30.6.2001. Many thanks for your response!
Dr. Yeung Chiu Fat Henry
醫委會改革醫委會工作小組將要檢討醫委會的組成、結構及功能去增強醫委會的 【1】問責性、透明度及公平公正的認受性；同時要【2】保障高水準的醫療服務質素。
我相信越少及越快的改革對整體行業都有利。實際上改革工作小組已決定於本年九月初向政府提出具體的改革方案。
當全港市民關注怎樣改寫醫委會的權限，在一個會議中，我非常詫異地被改革工作小組主席提醒我：改革醫委會事小，推動強制性延續醫學教育其實是今次改革最重要的議題。隨着醫委會內反對強制性延續醫學教育的聲音越來越小，又其他專業如律師、中醫師將實行全面性強制性延續專業教育，我感覺到強制性延續醫學教育最終會降臨到大家身上，尤其我們的特首董先生積極提倡每一個香港市民要養成終身接受教育的習慣。
與其坐以待斃，不如想出一個兩全其美的辦法去解決這個強制性延續醫學教育的問題。正如本會義務法律顧問提供的資料顯示，從一九九一年開始律師行業的延續專業進修，初步只是對新畢業生是強制性的，然後逐步伸延至所有律師都要強制性。預計到二○○三年初，所有律師都要有延續專業進修的證明才可領取專業執照。若從今年七月醫委會開始三年一個循環自願性延續醫學教育，又從二○○四年（三年後）開始如律師的循序漸進式強制性延續醫學教育 （需時十二年），都要起碼從今年起到十五年後才需要所有醫生同業去實行強制性延續醫學教育。我相信到那時候，會有相當數量的同業已可榮休、弄孫為樂了。請記着，以上只是一個提議給大家去討論。而我會的立場仍然是要爭取自願性延續醫學教育，正如香港醫學會的立場一樣！
本會最近曾提出反對醫委會成立專業表現審議小組，很不幸，我們失敗了。雖然如此，我希望在這裡提出另一個方案給大家考慮，如違例超速駕駛一樣，我們可以採納一個扣分制度。如果一位同業被醫委會聆訊小組裁定沒有專業失德、但又經專業表現審議小組評定為專業表現不合格，那位同業便會被扣除一個專業表現分數，如此類推，到最後如被扣除相當數量專業表現分數後，就會被醫委會紀律處分。又如違例超速駕駛一樣，被扣除的專業表現分數在若干年後應可以自動消失。我暫時稱這個方案為 “Substandard Point Deducting” system。在這個建議下，一方面，專業表現審議小組會節省資源去派遣調查人員實地審議同業的醫務所，另一方面，不但可以避免調查人員隨時衝入醫務所帶來同業的不便及麻煩，更可以減少同業的心理負擔。至於可行與否，需要大家提供意見。
現附上本會會訊 2005 號刊載改革醫委會工作小組提出的改革課題，本會董事會對於行政措施上的提議，除了 No. 1.2，大致上是贊成，而No. 1.2這個課題需要有而又不能有懲罰性的措施是行不通的。至於需修改醫生註冊條例方面的提議，本會董事會除了 No. 2.2外全部都反對。我們相信要維繫專業自主，醫委會起碼要有一半以上的委員是由醫生選舉產生，而非業界的委員最多只可以佔總數的兩成至兩成半。 醫委會正籌備改革，敬望諸位共同獻計施策，深思熟慮設計未來的醫委會。並請填妥附上的問卷（即會員通訊 2005 號），在6月30日或之前交回本會，以便我們將您的寶貴意見傳達給醫委會，多謝。
楊超發醫生