It has been reported that in recent years, some doctors have, on the requests of their patients, issued sick leave certificates to them even when they were not ill, or issued sick leave certificates of a duration longer than necessary. However, the Medical Council of Hong Kong (MCHK) has often found it hard to gather evidence sufficient to prove that the sick leave certificates were issued abusively. Some members of the legal profession have pointed out that MCHK should cooperate with the Police and refer to the Police for investigation those serious cases in which sick leave certificates are suspected to have been issued abusively. In this connection, will the Government inform this Council:
(1) whether, in the past five years, the Police conducted any investigation into suspected cases of abusive issuance of sick leave certificates; if they did, of the number of such cases and, among them, the number of cases in which prosecution was not instituted due to insufficient evidence and the number of convicted cases; of the penalties generally imposed on the convicted doctors and patients, and among the convicted doctors, of the number of those whose names were removed from the registers by MCHK;
(2) whether the Police conduct any evidence gathering work at present on complaint cases against doctors about abusive issuance of sick leave certificates; if they do, whether they have encountered any difficulty; if so, of the details;
(3) whether, in the past five years, the Police deployed police officers to disguise as patients for gathering evidence; if they did, of the number of such operations; if not, whether the Police have other means to gather evidence; if they do, of the details;
(4) given that some private clinics, in particular Chinese medicine clinics, still keep patient records manually at present, making it time-consuming and cumbersome to check the records of sick leave certificates issued by the doctors concerned, whether the authorities have grasped the current situation of private clinics using computers to keep patient records; whether the authorities have measures to encourage doctors to keep all patient records using computers, including records of issuance of sick leave certificates to patients; if they do, of the details; if not, the reasons for that;
(5) whether it knows if MCHK has implemented any measure in recent years to enhance the professional conduct of doctors; if MCHK has, of the details; and
(6) whether it knows if MCHK will consider imposing heavier punishments on doctors who issue sick leave certificates abusively in order to enhance the deterrent effect; if MCHK will, of the details; if not, the reasons for that?
(1) to (3) Abusive issuance of sick leave certificates may constitute criminal offences such as deception and conspiracy to defraud. The Police does not maintain breakdown of such cases. However, it will follow up and conduct investigations in accordance with the law if criminal element is involved. Members of the public are advised by the Police not to defy the law.
(4) Medical practitioners registered in Hong Kong should comply with the Code of Professional Conduct for the Guidance of Registered Medical Practitioners promulgated by the Medical Council of Hong Kong (MCHK). According to the code, doctors have the responsibility to maintain systematic, true, adequate, clear and contemporaneous medical records. Medical records refer to the formal documentation maintained by a doctor on his patients’ medical history, physical findings, investigations, treatment, and clinical progress. It may be handwritten, printed, or electronically generated. The code does not regulate how private doctors maintain their patients’ medical records.
(5) and (6) The MCHK handles complaints against registered medical practitioners in accordance with the Medical Registration Ordinance and the Medical Practitioners (Registration and Disciplinary Procedure) Regulation. Upon receiving a complaint concerning the professional conduct or misconduct of a registered medical practitioner, or any information relating to the conviction of a registered medical practitioner of any offence punishable with imprisonment, the MCHK will deal with the case in accordance with the aforesaid ordinance and regulation. If suspected criminal elements are detected in the course of investigation, the MCHK will refer the case to the relevant law enforcement agencies for follow-up.
The Code of Professional Conduct for the Guidance of Registered Medical Practitioners promulgated by the MCHK provides general guidance for medical practitioners on the issuance of sick leave certificates. The code stipulates that a sick leave certificate can only be issued after proper medical consultation of the patient by the doctor, and the attendance date and issue date must be truly stated in the certificate, so as in the case of issuing sick leave certificates for ratification of sick leave. Doctors are required to issue certificates on the basis that the truth of the contents can be accepted without question, and they should not include in the certificates statements which they have not taken appropriate steps to verify. Any doctor who, in his professional capacity, issues a certificate or a similar document which contains untrue or misleading statements or which is improper will be liable to disciplinary proceedings.
In the past five years (2009-2013), two doctors were convicted for issuing misleading / false medical certificates and their names were removed from the registers after investigation and inquiries by the MCHK.