Doc suspended over inadequate MCs for foreign worker
SINGAPORE — Migrant-worker advocacy groups on Wednesday (May 11) welcomed a landmark six-month suspension of a doctor for granting insufficient hospitalisation leave to an injured construction worker and inappropriately certifying him to be fit for light work. But such cases continue to occur, they said.
The Humanitarian Organisation for Migration Economics (Home), which had lodged the complaint in 2011 with the Singapore Medical Council (SMC) on the worker’s case, still sees 15 to 30 cases of insufficient medical leave a year, said executive director Jolovan Wham on Wednesday.
About one in three work injury cases seen by HealthServe involves doctors not issuing appropriate medical certificates (MC), said its communications manager Nhaca Le Schulze.
Transient Workers Count Too (TWC2) does not track numbers of such cases due to resource constraints, but still sees “quite a large number of people who are given (a) very short number of MC days”, said executive committee member Debbie Fordyce. TWC2 sees over 100 new injury cases each month.
All three non-governmental organisations said they were heartened and encouraged by the court decision to convict orthopaedic surgeon Wong Him Choon of professional misconduct.
A disciplinary tribunal had acquitted Dr Wong on the basis that medical watchdog Singapore Medical Council (SMC) had not proven beyond reasonable doubt that Dr Wong’s departure from the “applicable standard of conduct was intentional and deliberate”.
The SMC then filed an appeal to the Court of Three Judges, which hears appeals against disciplinary tribunal decisions. The Court dismissed the acquittal and suspended Dr Wong from practice for six months. This was longer than the four months that SMC had pushed for.
According to a press release issued by the SMC on Tuesday, the judges said Dr Wong, from Raffles Orthopaedic Centre at Raffles Hospital, had considered irrelevant factors in issuing the medical certificate and had disregarded his patient’s well-being.
The SMC’s expert deemed that the foreign worker’s hand and forearm fractures, suffered in a construction site accident, warranted two weeks’ medical leave by a conservative standard.
But after operating on the unnamed patient in the wee hours of Sept 4, 2011, Dr Wong had issued two days’ MC and certified him fit for light duties for a month after that.
The worker experienced pain and went to Changi General Hospital a week later, and was given hospitalisation leave from Sept 11 to 30, 2011. It was only during a scheduled appointment on Oct 5 that year that Dr Wong issued a backdated MC from Sept 6 to Nov 20, 2011.
For years, NGOs have encountered injured workers given insufficient leave by doctors, mainly from private hospitals. When the workers sought treatment at public hospitals, they were given significantly more medical leave for the same injuries.
The complaints even prompted the Manpower and Health ministries to remind all doctors in 2013 to give injured workers medical leave “commensurate with the nature and severity of the workers’ injury”.
According to HOME, the practice stemmed from “unethical benefits” employers gained under a previous rule that required employers to report workplace accidents if medical leave given was for three or more consecutive days.
The “loophole” was changed after advocacy by NGOs, it said. Employers also gain from the unethical practice via maintenance of their safety records.
“This results in an unethical and symbiotic relationship between the employer and the doctor as employers are willing to pay a premium for treatment if it means net savings and benefits accrued at the expense of their workers’ well-being, and the doctors are assured a steady flow of patients from companies from the various industries that rely heavily on foreign labour,” said HOME.
Ms Fordyce said TWC2 now sees about three clinics that seem to be granting inadequate medical leave to injured foreign workers. “It’s a small number of doctors and clinics, and I don’t want it, in any way, to suggest that this is happening among a large group of doctors,” she said.
Granting workers adequate medical leave helps tide some over while they wait for work-injury compensation claims to be resolved, as the law mandates that workers must be paid while on medical leave.
Mr Wham said Home has filed about 10 complaints of this nature to the SMC in the last five years — about half of these cases are ongoing — and will be filing about three to four more. In Dr Wong’s case, Mr Wham said he attended one disciplinary tribunal hearing and provided the MCs given by Dr Wong and Changi General Hospital. The worker returned to China sometime in late 2011 or early 2012, he said.
On the significance of the landmark case, HealthServe’s Ms Le Schulze said: “We are extremely encouraged … and hope that this conviction will deter doctors from putting the desires of companies over the health and well-being of their patients.”