PROFIT GUARANTEES OF SPECIALIST CLINIC PRACTICES

Mr Choo Wee Khiang asked the Minister for Health whether his Ministry is aware that some specialist doctors have agreed to give specific profit guarantees to a listed company that is proposing to purchase their specialist clinic practices, and what will be the adverse impact such an arrangement will have on the standard of medical practice.

Mr Yeo Cheow Tong: My Ministry is aware that four specialist doctors have given specific profit guarantees to a listed company that purchased their medical practices. The profit guarantee does not contravene any existing legislation covering healthcare establishments or practices, and the parties do not require the approval of my Ministry for the transaction. However, my Ministry is very concerned with any commercial transaction or arrangement which can lead to a lowering of our high professional and ethical standards of medical practice.

The media reported last week that the council of the Singapore Medical Association (SMA) has circulated a resolution on the issue of profit guarantees to its members. The resolution states that:

`Medical practitioners who are involved directly or indirectly in the provision of medical services associated with profit guarantees, whether imposed upon or voluntarily undertaken by them, are putting themselves at increased risk of unethical behaviour arising from patients' interests no longer always being their first consideration.'

SMA's position is that the financial imperative imposed by profit guarantees is incompatible with the Singapore Medical Council's Physician's Pledge and the ethical principles subscribed to by the doctors. The SMA President said that the association is concerned that such commercial arrangements will compromise the doctor-patient relationship which puts the patient's interest first. The Singapore Medical Council (SMC) is in full agreement with SMA's resolution.

My Ministry supports the strong stand taken by the SMA and SMC. A high standard of ethical behaviour by the medical profession is at the heart of good medical care. In the provision of medical care, the patient's interest must always come first.

We must remember that the doctor-patient relationship is different from other consumer-provider transactions, where the consumer has sufficient knowledge of the service or product to make an informed choice. It is therefore vital in a doctor-patient relationship that the doctor remains professionally independent to do what he believes is best for the patient, free from the influence of any non-professional consideration that may potentially be in conflict with the patients' best interests. Doctors who enter into business arrangements must be circumspect and avoid any situation or arrangement which would potentially compromise their professional independence and their patients' interests.

To ensure that high professional and ethical standards of medical practice are maintained in Singapore, my Ministry will scrutinise more closely and conduct more intensive medical audits on those medical establishments which are at greater risk of compromise of professional or ethical standards. This will help ensure that high professional and ethical standards of medical practice are maintained in Singapore. Let me assure the House that MOH will not hesitate to act decisively to uphold high professional and ethical standards of medical practice, by bringing errant doctors to SMC for investigation and disciplinary action whenever such action is warranted.