SINGAPORE: In the future, patients could be getting an outcome on complaints to the Singapore Medical Council against their doctors within 18 months, said the Ministry of Health (MOH) on Friday (Sep 13).
Currently, there is no time limit on the process.
Senior Minister of State for Health Edwin Tong outlined measures his ministry is exploring to achieve such a timeline, based based on interim recommendations by a workgroup formed to look into SMC’s processes.
Among them is the setting up of a new inquiry committee to conduct a “fast triage” of complaints within three weeks.
This committee can throw out cases that lack substance or are “vexatious”, refer the cases to a three-person Complaints Committee for investigation or channel cases in which there has been a possible misunderstanding to mediation.
A legal advisory unit will provide legal advice to the inquiry committee, so it will have a better sense of the legal threshold for cases.
Speaking at the sidelines of a scientific congress held at the Carlton Hotel in Bras Basah, Mr Tong said that overall, the timelines at each stage will be stricter.
Although those tasked with making decisions at each stage may be granted extensions, beyond that, if they need more time, they would have to explain to a court the reason for that.
“What the workgroup is currently looking at is a much tighter timeline for every step of the way. Not just for the overall timeline, but also for each stage, we want to impose some timelines,” Mr Tong said.
This includes a six-month time limit for the Complaints Committee, which is likely to come with two more extensions.
MEDIATION EXPECTED TO PLAY BIGGER ROLE
Mediation, which can be applied to a “broad” 80 per cent of complaints that reach SMC, is one way to ensure that such strict timelines can be met, Mr Tong said.
He said that mediation can be used in cases that are, while valid, may not involve misconduct. They could instead be due to unhappiness with service or poor bedside manners.
Mr Tong said that the current process does not adequately scrutinise the complaints at an early stage to see if they are suitable for mediation. Instead, the claims are judged either to be thrown out or escalated to an independent disciplinary tribunal, which will start a formal inquiry.
“There is a broad spectrum in the middle where a lot more judgment can be used to look at the nature of the complaint, why this complaint arises, what’s the context of the patient’s unhappiness, and try and use that judgment to see whether we can funnel it to mediation,” he said.
There is an option for mediation in the current process, but without a time limit, mediation could take “years” after a complaint is made and find less traction, Mr Tong said.
“If I make a complaint and it is not resolved until a few years later, I think by that time, parties’ stance hardens. So you want to do mediation, you have to catch it early enough,” he said.
MAKING SURE RESOURCES DON’T GET “CLOGGED UP”
If these cases suitable for mediation are “taken out” of the system early, it means that resourcing downstream, especially for the disciplinary tribunal, does not get clogged up, he said.
Currently, of 155 complaints to the SMC on average annually, about 16 are referred to the disciplinary tribunal, which Mr Tong said is the “heaviest part of the resourcing”.
By putting in more layers of filters at the top, the number of cases that trickle down to the disciplinary tribunal, is likely to drop, he added.
The workgroup also recommended that a new disciplinary commission be formed. This commission, which will be independent of the SMC, will be responsible for constitution of each disciplinary tribunal and training the tribunal’s members, as well as members of the inquiry committee and Complaints Committee.
Currently, a disciplinary tribunal is chaired by a senior doctor with at least 20 years’ standing or a senior lawyer with no less than 15 years of experience.
The workgroup also recommended creating an in-house SMC prosecution unit to handle disciplinary tribunal cases to ensure that standards are applied consistently.
Currently, SMC hires private firms to handle prosecutions and different lawyers handle the cases each time, leading to inconsistent outcomes.
The workgroup is expected to submit its recommendations by the end of this year.
Editor’s note: An earlier version of this story stated that a legal committee will sit within the proposed inquiry committee. MOH has clarified that an external legal unit will advise the committee instead.