30 October 2018

The Ministry of Health (“MOH”) and Singapore Medical Council (“SMC”) conducted a public consultation on proposed amendments to the Medical Registration Act (“MRA”) from 28 September 2018 to 26 October 2018.  The proposed amendments to the MRA aim to improve the disciplinary proceedings for both the public and doctors.

Set out below are the key proposed amendments to the MRA:

  • Appointing an independent Appeals Committee (“AC”) to consider appeals against decisions of the Complaints Committee (“CC”): The proposed amendment will provide for an independent AC comprising a medical doctor, a legal professional and a distinguished lay person to consider appeals against the CC’s decisions. Currently, such appeals against the CC’s decisions are made to the Minister for Health (“Minister”). The proposed AC may by majority vote, make orders including affirming the CC’s decision, overturning the CC’s decision and substituting it with its own decision, directing the CC to conduct further investigations, and referring the matter to a Disciplinary Tribunal (“DT”).
  • Excluding SMC members from the DT: It is proposed that the current practices of (i) excluding SMC members from taking up appointments as chairmen or members of DTs; and (ii) appointing a legal professional to every DT, be formalised.
  • Streamlining appeals against the DT’s decision: It is proposed that the current provision in the MRA that allows for complainants to apply to a Review Committee for a direction that the SMC appeal against the DT’s decision be removed. However, the complainant is not left without a remedy as the complainant can still appeal directly to the SMC, which will consider the request before making its final decision whether to appeal the DT’s decision. If a complainant disagrees with the SMC’s decision not to appeal the DT’s decision, the complainant can institute judicial review proceedings against the SMC’s decision. The complainant may also file a civil suit against the doctor regardless of the SMC’s decision whether to appeal. 
  • Staying the operation of the DT’s orders: The current MRA provides that a DT’s orders will only be stayed if the respondent doctor appeals to the High Court against the DT’s decision. The proposed amendment provides that the DT’s orders will additionally be stayed if the SMC appeals to the High Court against the decisions of the DT. Further, the proposed amendment grants the DT power to decide that its orders take effect immediately notwithstanding an appeal, if this is necessary in the interests of patient safety or is in the best interests of the doctor. 
  • Removing the minimum suspension period of three months, and developing more appropriate and consistent sentencing guidelines: The SMC will be appointing a Sentencing Guidelines Committee to develop sentencing guidelines to aid DTs in deciding the appropriate sentences. In line with the establishment of the sentencing guidelines, it is proposed that a DT be allowed to suspend the registration of a doctor for a period which is lesser than the current minimum of three months.
  • Widening the pool of potential CC chairpersons: Currently, the chairperson of a CC has to be a member of the Complaints Panel who is also an SMC member. The proposed amendment allows doctors who are members of the Complaints Panel but are not SMC members to be appointed as CC Chairpersons. 
  • Allowing the CC to reach an agreement on appropriate measures with a doctor whose ability to practise has been affected by health issues: There is a proposal to remove the need for a Health Committee inquiry if the CC and doctor agree on the appropriate measures to be taken in relation to complaints regarding the doctor’s physical or mental fitness to practise.

Reference materials

The following materials are available on the MOH website www.moh.gov.sg:

 

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