Top 10 Questions Related to SMC Best Left Unanswered for 2012

Before we know it, November has come and 2012 is drawing to a close. 2012 had its usual own share of the inexplicable and the unanswered. But this hobbit thinks it’s time to be positive and believe 2013 will be better than 2012. Perhaps in 2013, we will know understand why 2012 went the way it did, especially with regard to what’s happened to SMC. Maybe someone would produce a TV series similar “X-files” in the future and answer some of these questions. But for now, let’s keep these 10 questions unanswered for 2012:


Question 1 Did MOH investigate other such cases? If it did, why did it only refer these two cases to SMC?


The recent SMC press release implied that that SMC only decided on the 2 aesthetic cases (the cases involving Dr Low Chai Ling and Dr Georgia Lee) because these two cases were initiated under the old law whereby SMC could only investigate cases where there had been complaints by other parties. It could not investigate other cases if there were no complaints. However, with the new law, SMC could initiate investigations even when there are no complaints. This is true. However, the abovementioned 2 cases were complaints initiated by MOH. So the unanswered question is – are these two cases the only ones brought by MOH to SMC? And if so, why did MOH only bring two cases to SMC and not others?


Question 2 What is the definition of “legally embarrassing” work? 


Only when we know what clearly constitutes an embarrassment, can we then try our level best to prevent this from happening again.


Question 3 Should SMC pay for the regulatory work of its most frequent user, the rather “better” funded Ministry of Health? 


The SMC is supposed to be self-funded by doctors’ subscriptions. Yet the largest user of SMC is the MOH. Can we actually know the cases that were referred by MOH constitute what percentage of the total caseload handled by SMC? And if MOH is the “chief complainant” and not aggrieved individual patients, should not MOH share in the cost of running SMC? Why should doctors fund MOH’s regulatory actions? MOH has a budget of billions, SMC only a few millions. By the way, this hobbit knows of no other country in the Anglophone or developed world where the most frequent user of a medical council are the authorities themselves. This hobbit would be happy to know if there are other similar countries.


Question 4 Can someone please explain why there are two Executive Secretaries instead of one?


The Medical Registration Act (Section 10) clearly states the SMC may appoint  “an executive secretary”. Now there are two. Have things improved after there were two executive secretaries?


Question 5 What is the main mission of SMC’s lawyers? 


What is the main mission of SMC’s lawyers? Is it to secure justice or to secure a conviction? Is payment in-line with the mission? A senior lawyer highlighted the main difference between a DPP and a lawyer at a SMA talk held recently. He said a DPP’s main mission is to ensure justice, not to secure a conviction. A lawyer’s main intention is to win the case for his client.


Question 6 Can SMC use government legal officers instead of private sector lawyers?


In the case of the Medical Council of Hong Kong, a Government Counsel of the Department of Justice is responsible for presenting evidence to substantiate charges in the prosecution process. Can we do likewise, use an officer from the government legal service? Why does SMC use lawyers from law firms instead? Are there very compelling reasons to continue this practice?


Question 7 Why were there 10,000 votes for no one?


In the recent SMC elections, about 14,000 votes were cast in total for the five candidates that stood for election. There are about 8000 SMC fully-registered doctors who had 3 votes each. In other words, a grand total of some 24,000 votes could have been cast on human candidates, but only 14,000 were so. That means doctors who could vote chose to cast 10,000 votes (41% of all votes) for “00” i.e. “nobody”. That’s 10,000 votes worth of food for thought. All of the candidates had very good if not sterling CVs. And yet, the most popular “candidate” by far was “00”. If we don’t call this a crisis, this hobbit doesn’t know what is. It may not be long before the figure of 41% goes beyond 50%. (No doubt, instead of genuine reform to ensure credibility and competence, some twit will now contemplate removing the option of “00” to prevent further embarrassment). And by the way, there is no ‘collective action’ here, as some people are wont to say. 8,000 doctors cast 10,000 votes on nobody without any coordination by anyone.


Question 8 Why are there so many SMC members from the local medical schools?


The composition of the SMC can go up to a maximum of 25 members: -12 elected members and 13 appointed ones. Of the 13 appointed ones, one of them is the DMS and another four members are nominated by the two local medical schools (i.e. four ‘allocated’ seats, two from each medical school). There are currently only 24 members because one seat reserved for Duke-NUS GMS is vacant. That leaves SMC with another eight appointed members. As if though the medical schools are not already sufficiently represented by the four allocated seats, of these remaining eight, three appointed members are again from the local medical school. Why is there this phenomenon whereby so many appointed members are staff of the local medical schools (Excluding the DMS, there are still 7 out of 24, assuming Duke-NUS GMS fills its 2nd seat soon – as it should)?


Question 9 Why so few GPs on the SMC?


Contrast this to the sad situation of GP representation on the SMC. There must be about 2000 GPs in Singapore. Yet there are only 2 GPs on the SMC, and both are elected members. It is true that some things are beyond anyone’s control, which includes getting GPs to run for SMC, let alone getting them elected. But surely of the eight appointed members that need not come from the local medical schools, at least one or two can be GPs?


Question 10 Why are SMC members (unpaid) volunteers?


It’s 2012 going on to 2013. Nothing much is free anymore, other than parking at the government mortuaries and columbariums. So the recent SMC press release about SMC disciplinary committee members being volunteers probably cuts no ice with either the public or doctors. Being unpaid is no excuse for doing something that is legally embarrassing, especially when the lawyers representing all parties at SMC hearings are still being paid and the job of SMC is so important. So maybe we should start paying our SMC members a decent honorarium for their work. If reservists can get reimbursed their civilian salaries, why not our SMC members as well? SMC can probably still balance the books, if it used legal officers instead of lawyers and cases referred to SMC by MOH are funded by MOH instead of SMC. The SMC needs to get the job done, and if it needs “reimbursed” volunteerism, so be it.


p.s. There will probably be no long posting in December. This hobbit is also going on an unexpected journey 😉

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