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Singapore Medical Council to tighten disciplinary framework, processes

The SMC will increase training for matters relating to medical law, and continue to amend its internal processes and policies to strengthen the medical industry's disciplinary framework. 

SINGAPORE: The Singapore Medical Council (SMC) on Thursday (July 24) said it broadly agrees with the recommendations made by the Review Committee for Disciplinary Processes to strengthen the disciplinary framework for the local medical industry - and the Ministry of Health (MOH) has in turn accepted the recommendations.

In a phased, two-step approach, the Council intends to first amend its internal processes and policies first, then recommend its proposed changes to the Medical Registration Act and Medical Registration Regulations to the MOH.

One of the issues SMC had to deal with was the fact that it juggled multiple, often conflicting, roles - be it an investigator, prosecutor, judge, complainant and beneficiary.

Recognising this, the Council said it will consider separating the adjudication function from its members. In other words, no Council member will be appointed in the complaints panel or review committee, it stated.

However, given that it would take time to build up the necessary expertise among non-council members to serve in these groups, the SMC said it will retain its current framework but adopt a phased approach for changes in the future.

The Review Committee also recommended for the establishment of an independent Appeals Committee, to consider any appeal cases against the decision by the Complaints Committee. SMC said it has been receiving an increasing number of complaints over the years as the pool of doctors is growing. Last year, it received 172 complaints.

Currently, if someone is contesting the decision by the Complaints Committee, he or she can appeal directly to the Health Minister. But the Review Committee felt that this process was not desirable as it required the Minister to rely on an advisory group, comprising MOH staff, to decide on the matter. 

As such, it would be more transparent to have an Appeals Committee to consider appeal cases instead. The SMC said it will be working with MOH to explore the possibility of the Appeals Committee.

Some measures to tighten the SMC's  disciplinary framework have already been implemented, such as increasing training initiatives on matters relating to medical law and the management of disciplinary complaints for both the complaints Committee and Disciplinary Tribunal.

As for the Disciplinary Process for doctors - it will soon be heard before a Disciplinary Tribunal consisting of not just doctors but also lawyers. This is aimed at speeding up the process and improving its efficiency.

As part of its effort to be more transparent, SMC has also agreed to publish the annual costs spent on disciplinary hearings.

The review of the SMC started after the High Court slammed the Council, the medical profession's watchdog, for a disciplinary hearing.

Dr Chong Yeh Woei, a past president of the Singapore Medical Association, said: "We have to allay the public's fears and concerns over the transparency of the SMC's proceedings, as well as the long delays, which I think were one of the main issues. On the doctors’ side, they will want to ensure they receive a fair trial."


MOH ACCEPTS RECOMMENDATIONS

The Ministry of Health (MOH) on Thursday welcomed the recommendations on the Singapore Medical Council’s disciplinary processes. MOH said it will work with the SMC on its subsequent proposal to amend the Medical Registration Act and Medical Registration Regulations.

The ministry also noted that the SMC has moved quickly to implement some of the recommendations to streamline current processed which do not require legislative changes.

In a press release, MOH said: “The Council members have developed substantial expertise and experience under the current disciplinary processes. To enable non-council members to take on these functions in the disciplinary processes will require time and effort to build up the necessary expertise.

"The training of doctors and laypersons to be more heavily involved in the disciplinary proceedings will also need to be planned, structured and continuously maintained. Nonetheless, MOH recognises that the active involvement of professionals in the disciplinary processes, including regular training, brings out the altruism of the professionals.”

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