SINGAPORE: Patients may face a time limit when filing complaints against doctors to the Singapore Medical Council (SMC) in the future, the Ministry of Health (MOH) said on Tuesday (May 21).
This time limit, while still up for debate, could be three years, in line with civil negligence standards, it added.
This is one of the changes MOH said it is looking at, as it gave an interim update on the findings of a workgroup formed to review SMC's disciplinary process and the taking of informed consent by doctors.
There is currently no time bar.
“When we look at the past cases, anecdotally there have been a few cases where the complaints are made many years after the incident itself, and there are various reasons why that should not be entertained,” MOH said.
MOH noted that quality of evidence would be diminished and that such a limit makes the process fairer.
The health authority said that while the SMC has "no choice" but to get a response from the doctor involved when a complaint is made, the doctor may find himself with incomplete records on the case, given the time lapse.
The workgroup added that it is "very frustrating" to the doctor, as there is currently no time limit on when a complaint can be made, while there is one on the retention of documents related to the patients.
It said that complaints were brought to the SMC even more than 15 years after the supposed issue.
“(Doctors) feel very disadvantaged in the event that they can't even find the notes,” it said.
The 12-member workgroup, which includes co-chairpersons Assoc Prof Ng Wai Hoe, deputy group chairman of the SingHealth Medical Board and Senior Counsel Kuah Boon Theng, managing director of Legal Clinic LLC, was set up on Mar 13.
To date, it has had 13 engagement sessions with hospitals from the private and public sectors, which were attended by more than 1,000 doctors.
The workgroup was formed on the back of a recent controversy when a S$100,000 fine was imposed on an orthopaedic surgeon for failing to obtain informed consent before giving a patient an injection.
PROCESSES TO BE IMPROVED, MADE QUICKER
Complaints made after too long a period may be filtered out through a screening process, as the MOH seeks to make the SMC's work better and quicker.
The screening process is likely also to filter out repeat cases and “outrageous and frivolous” cases which are not on misconduct There is currently no screening process.
Together, such cases make up about 10 per cent of the complaints to the SMC annually, which works out to be about 15 cases, MOH said.
The remaining cases will then be sorted into different categories by a three-person Complaints Committee.
The cases will be evaluated to assess if they require mediation. MOH said it expects a “fair number" to need mediation. The others may be assessed to require a formal enquiry by a Disciplinary Tribunal or merit further investigation.
The mediation may be done with the help of the Singapore Mediation Centre, MOH said. MOH said that the committee will have more resources, such as more training and possibly, public service prosecutors, in order to play this role.
MOH is also exploring implementing stricter criteria on extensions of time for each stage of the proceedings. Its aim is to complete the proceedings generally within a year to one-and-a-half years from the receipt of the complaint to the decision of the Disciplinary Tribunal.
As opposed to the committee or tribunal being able to extend the deadline at their own discretion, there could be judicial oversight.
Regarding the gathering of informed consent, MOH is considering changing a test used to guide doctors on how much information to give patients, so as to provide more clarity on how the test can be applied in their practice.
The workgroup's review is expected to be completed by the end of this year.