LCQ20: Fraudulent COVID-19 Vaccination Medical Exemption Certificates

     Following is a question by Dr the Hon Priscilla Leung and a written reply by the Secretary for Health, Professor Lo Chung-mau, in the Legislative Council today (October 26):
     Recently, seven private doctors have been arrested by the Police for suspected abuse in the issuance of COVID-19 Vaccination Medical Exemption Certificates (Exemption Certificates). It has been reported that these doctors issued a total of over 25 000 Exemption Certificates, which accounted for more than half of all the valid Exemption Certificates. In this connection, will the Government inform this Council:
(1) given that the Police have referred the cases to the Medical Council of Hong Kong (MCHK) for follow-up, whether it knows if MCHK will consider striking off the register the names of the doctors concerned;
(2) as it has been reported that the Police are investigating those persons who were issued with an Exemption Certificate by the doctors concerned, whether the Police have examined such persons' medical records to ascertain if they deliberately provided false information in order to be issued with an Exemption Certificate; and
(3) given that the "Electronic Health Record Sharing System" (known as "eHealth") has recorded the seven doctors concerned having issued a large number of Exemption Certificates within half a year, whether the relevant government officers noticed such irregularities through the eHealth and reported such irregularities at an early stage; if so, of the details; if not, the reasons for that?
     Based on overseas and local scientific evidence and real-world experience, it is proven that most people are suitable for receiving the CoronaVac and Comirnaty vaccines currently provided in Hong Kong. Both vaccines are able to reduce the risks of severe illness and death arising from COVID-19 infection in a safe and efficacious manner.
     Doctors are allowed to issue COVID-19 Vaccination Medical Exemption Certificates (Exemption Certificates) under the arrangement of the Vaccine Pass simply to cater for an extremely small number of people who are unsuitable for receiving the vaccine due to health reasons. That said, the fact is that these individuals are actually being exposed to a higher risk for not having been vaccinated. Therefore, the Department of Health (DH) has issued to doctors detailed guidelines listing the medical reasons for being not suitable for vaccination. Doctors should only issue the Exemption Certificate after verifying that the person concerned is not suitable to receive the two vaccines provided in Hong Kong.
     In consultation with the Security Bureau, my reply to the question raised by Dr the Hon Priscilla Leung is as follows:
(1) The Health Bureau and the DH have referred the relevant private doctors suspected to have abused the issuance of Exemption Certificates to the Medical Council of Hong Kong (Medical Council) for follow-up on the professional discipline of the doctors concerned.
     The Medical Council is established under the Medical Registration Ordinance (Cap. 161, Laws of Hong Kong) (Ordinance) and is empowered to handle professional discipline of doctors in Hong Kong. Section 26 of the Code of Professional Conduct for the Guidance of Registered Medical Practitioners issued by the Medical Council stipulates that doctors are required to issue reports and certificates on the basis that the truth of the contents can be accepted without question. Doctors are expected to exercise care in issuing certificates and similar documents, and should not include in them statements which they have not taken appropriate steps to verify. Any doctor who in his professional capacity gives any certificate or similar document containing statements which are untrue, misleading or otherwise improper renders himself liable to disciplinary proceedings. The Medical Council will handle the cases in accordance with the Ordinance and its subsidiary legislation E, the Medical Practitioners (Registration and Disciplinary Procedure) Regulation.
(2) Since March this year, the Police have taken enforcement actions in relation to seven private doctors who have allegedly abused the issuance of Exemption Certificates.
     Police arrested 39 people in relation to the cases thus far, including six doctors, seven staff members and 26 patients.  They are suspected to have committed the offences of making a false instrument, conspiracy to defraud and conspiracy to make a false instrument. Two of the doctors are charged with three counts of access to computer with dishonest intent and two counts of conspiracy to defraud respectively. One doctor is currently wanted by the Police.
     Police’s investigation is ongoing and will maintain close liaison with relevant departments. In investigating if persons issued with Exemption Certificates by the doctors involved in the cases may be in violation of the law, Police will holistically consider the circumstances of each individual case and examine all relevant evidence.
(3) Under the arrangement of the Vaccine Pass, a person who is medically unsuitable for receiving the two COVID-19 vaccines provided in Hong Kong is required to obtain an Exemption Certificate issued by a registered doctor.
     In the early stage of the implementation of the Exemption Certificate arrangement, a transitional period was provided so that private doctors could have sufficient time to register for the eHealth system and make preparations to issue Exemption Certificates electronically. Both non-electronic and electronic versions of the Exemption Certificate were accepted during the transitional period. Subsequently, in early May, in order to monitor the issuance of Exemption Certificates in a more systematic manner, all Exemption Certificates must be issued electronically via the eHealth system or the Hospital Authority’s computer system. The Exemption Certificates issued via the aforementioned computer systems will be presented in paper form with an encrypted QR code.
     After switching fully to the electronic version, the Government can have a better grasp of the issuance situation, pattern, circulation and holders of Exemption Certificates, etc. through the eHealth system. The relevant information can assist the Government in conducting risk analysis and taking follow-up actions, including some recent enforcement actions.
     The Chief Executive in Council passed the Prevention and Control of Disease (Vaccine Pass) (Amendment) Regulation 2022 (Amendment Regulation) on October 25, empowering the Secretary for Health to declare specified Exemption Certificates as invalidated under situations specified in the Amendment Regulation.
     We will continue to enhance the monitoring mechanism and closely monitor the issuance of Exemption Certificates by doctors. If any irregularities, contravention of the Code of Professional Conduct for the Guidance of Registered Medical Practitioners or criminal acts are found, the Government will firmly follow up, and will consider invoking the powers mentioned above to declare the relevant Exemption Certificate as invalidated. We will also pass the relevant information to the Medical Council and enforcement departments for follow-up as appropriate.

Ends/Wednesday, October 26, 2022
Issued at HKT 15:15