LCQ1: Regulation of high-risk medical procedures
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     Following is a question by the Hon Vincent Fang Kang and a reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (June 19):

Question:

     Last year, a beauty salon referred a number of its customers to undergo high-risk medical procedures performed by medical practitioners, and such procedures caused one death and three persons in serious illness. The incident prompted the Government to set up a working group to differentiate between medical procedures and beauty services. It has been learnt that the Government plans to define certain procedures currently carried out in beauty salons as medical procedures, and prohibit such procedures from being performed in beauty salons again.  In future, beauticians who have received the relevant recognised training will no longer be allowed to perform such procedures, and only registered medical practitioners will be allowed to do so. However, some members of the beauty industry have relayed to me that, in the past decade, most of the cosmetic procedures or plastic surgery involved in serious incidents were performed by registered medical practitioners or those who had been suspended from practice. In this connection, will the Government inform this Council:

(a) of the number of serious incidents relating to cosmetic procedures or plastic surgery in the past three years and, among them, the respective numbers of those in which the procedures or operations concerned were performed by beauticians, registered medical practitioners or those medical practitioners who had been suspended from practice, as well as whether they were penalised; the respective numbers of persons who were hospitalised, became permanently disabled or died as a result of such incidents, the procedures or operations involved in such incidents, as well as the types of premises where such incidents occurred;

(b) of the number of private medical practitioners penalised in the past three years by the Medical Council of Hong Kong for contravention of the requirements under the Professional Code of Conduct and, among them, the number of those who were penalised because of their involvement in the incidents mentioned in (a); the reasons for penalising them and the details of the penalties; whether the authorities monitor if the medical practitioners, who have been suspended from practice, continue their practice during the suspension period; and

(c) whether at present the authorities have required that medical practitioners must have received specialised training before performing procedures or operations such as injection of weight-loss drugs, augmentation mammoplasty, removal of eye bags, laser facial depigmentation or dermabrasion; if so, of the details; if not, the reasons for that?

Reply:

President,

     Regarding the incident in October 2012 causing one death and serious sickness of three other patients resulting from high-risk medical procedures, the Department of Health (DH) took immediate follow-up actions upon receiving report from the Hospital Authority (HA) and found that the incident involved a beauty services company and a laboratory processing health products for advanced therapies. As the Police is conducting criminal investigation into the case, we are not in a position to provide details of the incident so as not to prejudice the legal proceedings that may be involved in the future.

     To enhance the safety of beauty services, the DH, the Customs and Excise Department (C&ED) and the Consumer Council have strengthened co-operation since October 2012 to protect consumer interests. Such efforts include public education on how to select safe beauty services. The DH has stepped up screening of advertisements of beauty services and established an information exchange mechanism with the Consumer Council to analyse complaints for follow-up actions. It will also conduct proactive inspection of beauty salons and where necessary, take enforcement actions against beauty services companies suspected of allowing non-qualified persons to provide high-risk medical treatments to customers.

     We agree that there is a need to review the regulatory framework of high-risk medical procedures for better protection of public health. The Working Group on Differentiation between Medical Procedures and Beauty Services, which is chaired by the Director of Health and includes representatives from relevant medical specialties, the beauty industry and consumer groups, is set up under the Steering Committee on Review of the Regulation of Private Healthcare Facilities to differentiate high-risk medical procedures from low-risk, non-invasive beauty services, and make recommendations on procedures which should be conducted only by medical practitioners.

     My reply to the three-part question raised by the Hon Vincent Fang is as follows:

(a) The DH does not keep statistics or information on incidents related to cosmetic procedures or plastic surgical operations.  However, according to the information gathered under the above-mentioned information exchange mechanism established by the DH and the Consumer Council, there were 48 complaints on adverse events related to beauty procedures performed at beauty parlours as at June 10, 2013. Of these cases, seven involved medical practitioners, 36 were not performed by medical practitioners, and for the remaining five, there is no information on who performed the procedures. Among all these cases, 40 involved the use of energy-emitting apparatus (such as laser machine) and/or performance of invasive procedures.

(b) In the past three years, a total of 77 medical practitioners were subject to disciplinary inquiries of the Medical Council of Hong Kong (MCHK). Among them, 69 were found guilty of professional misconduct and were subject to disciplinary sanctions. None of them was involved in serious incidents relating to cosmetic procedures or plastic surgical operations. All medical practitioners subject to disciplinary inquiries, except two, were not practising in the public sector when the incidents occurred.

     The nature and circumstances of each inquiry case are different, and some may involve more than one charge. The MCHK will record in the judgment details of the case, as well as the disciplinary punishments imposed for each charge and their justifications. Judgments will be uploaded in full to the MCHK's website after completion of the disciplinary proceedings for public information.

     Any person who continues to practise medicine during the period when his name is removed from the General Register of the medical practitioners commits an offence and is liable to a fine and imprisonment.

(c) Professional conduct of registered medical practitioners is regulated by the MCHK. They shall comply with the Code of Professional Conduct for the Guidance of Registered Medical Practitioners issued by the MCHK. In general, medical practitioners must act in patients' best interests and take the patients' needs into consideration when performing clinical treatment. They must also possess the relevant knowledge and skills. Before any treatment is offered, the medical practitioner should explain clearly to the patient the treatment procedures and risks involved, and seek the consent of the patient. If a patient is dissatisfied with the professional conduct of a medical practitioner, he may lodge a complaint to the MCHK.

     A registered medical practitioner who wishes to become a specialist must satisfy the requirements set out in section 20K of the Medical Registration Ordinance (Cap. 161). He should be a Fellow of the Hong Kong Academy of Medicine and have satisfied the continuing medical education requirements, or possesses equivalent professional standards. He should also have the approval of the MCHK for inclusion of his name under the relevant specialty in the Specialist Register. Any person who claims to be a specialist without the approval for registration as a specialist commits an offence and is liable to a fine and imprisonment.

     Moreover, the Hospital Accreditation Programme, in which a number of public and private hospitals in Hong Kong have participated, also requires hospitals to implement a credentialing system so as to ensure that their medical practitioners possess the qualifications and competency necessary for delivering certain medical procedures.

Ends/Wednesday, June 19, 2013
Issued at HKT 14:21

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