MEDICAL DOCTORS

MEDICAL DOCTORS

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(Maintaining public confidence): **

24.

Mr Low Thia Khiang asked the Minister for Health how does his Ministry ensure that medical doctors uphold a high standard of medical ethics as well as a sense of professional responsibility, so as to maintain public confidence in the medical profession.

Mr Khaw Boon Wan: My Ministry and I view issues of medical ethics and professionalism seriously. As the Member rightly pointed out, a high standard of medical ethics and professionalism is key to maintaining public confidence in the medical profession.

By and large, our doctors are professional and ethical. Singaporeans have respect for our doctors. Every year, we commission a private survey company to interview a large sample of our patients. Singaporeans have consistently rated our doctors’ performance as "excellent". While questions on ethics were not specifically asked in the survey, the patients must have been sufficiently satisfied with the doctors’ professional and ethical standard, to give them an excellent overall rating.

Achieving such an outcome requires a comprehensive approach. First, we start with the stringent selection of medical students. Our medical schools put their candidates through rigorous interviews and written assessments on ethical and moral issues. They also have access to character references submitted by the candidates’ past teachers and headmasters.

Second, medical students undergo programmes to learn about medical ethics and professionalism both in classrooms as well as in real-life case discussions. Teaching and research in medical ethics and professionalism was further strengthened with the establishment of the NUS Centre for Biomedical Ethics headed by a renowned medical ethicist.

Third, the teaching and learning of medical ethics and professionalism continues after graduation during clinical training. All doctors on specialist training undergo a compulsory Medical Ethics course before they can exit as accredited specialists in Singapore.

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Fourth, all new doctors who are eligible for full registration take the Physicians Pledge, a solemn oath, in the presence of the Singapore Medical Council (SMC). By taking the Pledge, new doctors re-affirm their professional responsibilities to patients and the need to uphold high professional and ethical standards as they embark on their medical careers.

Fifth, in the hospitals and clinics, senior doctors and clinician mentors coach through personal examples, as they show the young doctors how they address professional issues that arise in their daily interactions with patients in the wards.

Sixth, SMC has an established set of Ethical Code and Ethical Guidelines on all matters concerning the doctors’ professional conduct. On specific controversial issues, the National Medical Ethics Committee set up by the MOH provide further guidance on how doctors should carry out their duties and responsibilities.

Finally, the Medical Registration Act (MRA) enables the public to lodge formal complaints to the SMC about doctors who misconduct themselves ethically or professionally. The SMC will convene a Complaints Committee to investigate each complaint. If justified, the Complaints Committee will refer the matter to a Disciplinary Committee for a formal hearing. If found guilty, appropriate punishment will be meted out to the errant doctor, including suspension or deregistration. The SMC publishes the findings of the disciplinary proceedings. To further safeguard public interest, anyone who is dissatisfied with the findings may appeal to the Minister for Health, whose decision will then be final.

I will soon come to this House to propose several amendments to the MRA to further improve and streamline the Council's existing disciplinary processes. The intent is to empower the Council with a wider array of approaches to deal with ethical and professionalism issues arising amongst medical practitioners in Singapore.

Singapore Medicine is not perfect, but it is generally well regarded for its high clinical and ethical standard. There will be some black sheep in the profession, unfortunately. When there is sufficient evidence, we never hesitate to take appropriate action against them. This way, we protect the reputation of the profession and safeguard the health and safety of all Singaporeans.

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