Replies to LegCo questions

LCQ22: Professional indemnities insurance cover by private practitioners

Following is a question by the Hon James Tien and a written reply by the Secretary for Health, Welfare and Food, Dr York Chow, in the Legislative Council today (January 26):

Question:

It has been reported that, as only a minority of private practitioners of Western medicine and Chinese medicine have taken out professional indemnities insurance cover, there is no full protection of patients' rights. In this connection, will the Government inform this Council:

(a) whether it knows the respective numbers of private practitioners of Western medicine and Chinese medicine who have taken out professional indemnities insurance cover, as well as the percentages of such practitioners among all the practitioners in their respective sectors;

(b) whether it has assessed the causes of the above practitioners not taking out insurance cover and how patients' rights have been affected; and

Reply:

Professional Indemnity Insurance (PII) is not mandatory for medical practitioners (MPs) and Chinese medicine practitioners (CMPs). Nonetheless, a majority of MPs are covered by PII either through arrangements with their employers or through individual arrangements. Compared with MPs, the PII take-up rate of CMPs is lower.

For MPs employed by the Government, their liability for damages arising from the actions in the performance of their duties is covered by Government. For MPs working in the Hospital Authority (HA), a master policy is in place to cover liabilities arising from their medical practice in the course of their employment. For MPs in the private sector, nearly all of those who take out PII through individual arrangements participate in a PII scheme managed by the Medical Protection Society (MPS)�]*1�^ through the Medical Association. Some MPs in the public sector may also participate in this PII scheme. There are also other commercially operated schemes arranged by the Hong Kong Public Doctors' Association and Hong Kong Doctors Union.

For CMPs, Malpractice Liability Insurance Proposals are provided by some insurance companies. As for CMPs working in the three CM Clinics at HA hospitals, medical liability insurance is provided by the concerned NGOs, which are employers of these CMPs.

(a) As at July 1, 2004, over 8,000 MPs have participated in the PII scheme managed by the MPS, which constitute about 80 per cent of registered MPs in Hong Kong. It should however be noted that not all registered MPs are engaged in patient service or clinical care, some are in administrative and research work which does not involve interface with patients. According to the Medical Association, nearly all MPs who are in relatively high risk practices have already taken out PII.

At the moment, about 100 CMPs have taken out PII, representing about two per cent of the total registered CMPs in Hong Kong. It should be noted that statutory regulation of CMPs has only been in operation for six years, and the profession is at the early stage of formal development. Moreover, CM is often perceived to be less intrusive in Hong Kong with patients managed on an out-patient basis for less serious or acute conditions.

(b) The Administration fully appreciates the need to protect the interests of the public against medical malpractice and negligence. Regardless of whether a MP/CMP has insurance cover, they will have tortious liability if they are found to be negligent. We do not have statistics on medical practitioners who do not have insurance cover and fail to pay off compensation to patients as damages for medical incidents, and therefore have not made an assessment on the impact of such lack of insurance cover.

(c) The taking out of PII is a voluntary act to protect the practitioners. Every practitioner would assess the risks involved in providing his service before coming to a decision on whether or not to obtain cover. It would be difficult to assess the reasons why some practitioners decide not to obtain cover when they all have tortious liability if they are found negligent.

The Hong Kong Medical Council�]*2�^ (HKMC) has discussed and examined the need for all MPs to take out PII before, and supports that all MPs, particularly those who provide patient service, should do so. On the request of Government, the Council revisited the issue in 2004 and issued a strong recommendation to all MPs, particularly those who are practising clinical medicine directly or indirectly, to take out PII.

In relation to CMPs, the DH continues to play a facilitating role in encouraging them to take PIIs. DH briefed the insurance industry in June 2004 on the latest development in the regulation of CM in Hong Kong and encouraged insurance brokers to provide assistance to CMPs associations. The Chinese Medicine Council will also continue to encourage CMPs to take out PIIs, and provide appropriate assistance.

Notes:

�]*1�^ MPS is not an insurance company but a mutual medical protection society operating in over 40 countries by subscriptions. In case of a negligence claim, members of the MPS will be provided with complete indemnity against legal costs and damages awarded on a discretionary basis according to the track record of the members.

�]*2�^ The HK Medical Council is the regulatory body established under the Medical Registration Ordinance (Cap. 161) to assure and promote quality in the medical profession in order to protect patients, foster ethical conduct, and develop and maintain high professional standards.

Ends/Wednesday, January 26, 2005

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