FOREIGN DOMESTIC MAIDS (Wrong pregnancy test results)

Mr Goh Choon Kang asked the Minister for Health how many doctors have been taken to task for providing to employers wrong pregnancy test results for foreign domestic maids from 1996 to date.

The Parliamentary Secretary to the Minister for Health (Mr Chan Soo Sen) (for the Minister for Health): From 1996 to date, the Singapore Medical Council has received a total of eight complaints from the Ministry of Manpower against doctors who failed to detect pregnancies in foreign domestic maids during their medical examination. And these eight cases occurred, one in 1996, three in 1998, one in 1999 and three this year.

Out of these eight complaints, the three that were lodged this year are still being investigated. The one lodged in 1999 has been referred to the Disciplinary Committee of the Singapore Medical Council for formal inquiry. For the remaining four cases, three had been dismissed as there was insufficient evidence to show that the doctors were guilty of professional misconduct, and only one doctor had been censured.

The number of missed diagnosis of pregnancy is very small compared to more than 100,000 foreign domestic maids working in Singapore. Nevertheless, the Singapore Medical Council has reminded doctors about the importance of such examination. My Ministry is also working with the Ministry of Manpower to study how the examination procedure could be improved so as to minimise the error.

Mr Goh Choon Kang: Sir, I would like to ask the Parliamentary Secretary: if such a wrong diagnosis has led to subsequent delivery of a child in the KK Hospital, should that doctor be asked to foot the bill?

Mr Chan Soo Sen: I have not heard of doctors footing the bills for such cases. Let us put it this way. A wrong diagnosis is possible because normally a pregnancy test is done by detecting a certain hormone in the urine. I believe it is called HCG, and if it is administered properly, the accuracy is about 98%. There is a possibility that the hormone could not be detected when she is in a very early stage of pregnancy. She may look physically normal and no hormone was detected under such circumstances. I do not really think the doctor ought to foot the bill. She ought to be responsible for her own decision.

Mr Goh Choon Kang: Sir, is it fair then to ask the employer to foot the bill?

Mr Chan Soo Sen: What has the employer got to do with the pregnancy?

Mr Goh Choon Kang: Sir, I have come across a case where the employer was asked to pay for the hospital bills on behalf of the maid.

Mr Chan Soo Sen: But the question is who asked the employer to pay for the bill.

Mr Goh Choon Kang: KK Hospital.

Mr Chan Soo Sen: It will be interesting if the Member could let me have the particulars of the case so that we could look into it.

Dr Lily Neo (Kreta Ayer-Tanglin): May I ask the Parliamentary Secretary whether it is correct to say that there were cases of false negative findings in patients not due to errant doctors but due to the deceitful acts of maids in adulterating urine samples and in using someone else's urine samples for examination.

Mr Chan Soo Sen: Mr Speaker, Sir, that is possible and that is why when we review the procedure, we will look into the possibility using the blood to test for pregnancy because HCG can be detected by a urine test. I was also advised that it can be detected through blood test and, for medical examination of foreign domestic maids, a blood test is already necessary to identify diseases like HIV and sexually transmitted diseases. So it is possible to incorporate the blood test for pregnancy. We understand, however, that the cost may be slightly higher. The cost per urine test, I was told, is about $1. The cost per blood test for pregnancy is about $3.35. We will look at it and put up a formal recommendation to the Ministry of Manpower later. By insisting on a blood test, the possibility of adulteration is much less because the doctor would probably have to draw the blood himself rather than leaving the maid to produce the urine and she could have carried that bottle of urine with her to the toilet before the test.

Dr Lily Neo: May I ask the Parliamentary Secretary: in a case of deceit by the maid, is the doctor still to be blamed or is the maid solely liable?

Mr Chan Soo Sen: I am quite sure that this would have been taken into consideration during the inquiry by the Singapore Medical Council. If the act is a deceitful one by the maid, I do not see the doctor being responsible for analysing the wrong sample, that is, obtaining the right result leading to the wrong outcome.

Dr Lily Neo: May I ask the Parliamentary Secretary whether his Ministry will inform all doctors on the need to verify work permits of maids for identification prior to consultation and certification in their clinics? Am I correct to say that there are employers who are reluctant to hand work permit passes to their maids? Therefore, the requirement for the Ministry to verify the identity of maids will help doctors enforce the correct procedure.

Mr Chan Soo Sen: I believe this is a question for the Ministry of Manpower. I stand to be corrected but this procedure for medical tests is a requirement to renew the work permit.