Editorial | Address the causes of Hong Kong medical blunders to bolster patient safety
Punishment must be accompanied by measures to address contributing factors at Hong Kong public hospitals such as staff shortages, overwork and long hours
The ultimate sanction against an individual held responsible for grave or repeated blunders in delivery of an essential service is dismissal or demotion. That may be especially so if the mistake or omission harms or risks harming someone. Hospital blunders involving patient safety would appear to be a case in point – except for a reality check from Hong Kong’s Hospital Authority chairman Henry Fan Hung-ling.
Fan said firing medical or management employees from the public health system was not really an option because of a manpower crunch. “If some frontline [medical] staff or management are found to be negligent, we cannot just sack them as we really do not have enough people to do the work.” Instead, he said, those involved in repeated blunders may have their pay frozen for a year.
This follows a review by a special committee after a string of medical blunders and equipment failures at public hospitals.
In a sense, the decision not to resort to dismissals is positive for patient safety. It makes it less likely that accountability may appear to have been served without addressing underlying issues that could have contributed, such as staff shortages, overwork and long hours, flawed procedures or inadequate training. Given that the public system serves most Hongkongers, that outcome strikes a balance.
Moreover, Fan noted that it was often unclear who should be held responsible for medical blunders and that the current system made it difficult to verify how the mistake occurred. Clarification of responsibilities would avoid blurring and dilution of individual accountability. It is also good that Fan will chair a high-level panel to implement the committee’s recommendations and explore ways to strengthen accountability and governance.
Hong Kong has a widely respected public health system, but like many of its overseas counterparts it continues to be plagued with staff shortages. The authority must redouble its efforts to address them with aggressive retention policies and by recruiting suitably qualified non-locally trained doctors and nurses.
