There have been many serious complaints hurled at the medical profession in the local media recently. Subsequently, there were calls from health authorities to bar camera handphones and journalists from hospitals, and dissatisfied patients were advised not to complain to the press. It was also concluded that "most of the complaints were due to mis-communication" and complaints should be correctly channeled to Malaysian Medical Council (MMC) for action.

Section 1.1 of the Code of Professional Conduct (adopted by the MMC since 1986) does layout a few commendable standards of professional responsibility but it also states that 'The Council is not ordinarily concerned with errors in diagnosis or treatment, or with the kind of matters which give rise to action in the civil courts for negligence'.

If the MMC s primary duty is to protect the public, how can it then disregard complaints on medical errors in diagnosis or treatment? Would not making correct diagnosis and administering proper medical treatment and care be part of a doctor's professional duty? Is this an effective disciplinary mechanism to safeguard the public?

Complaints of medical errors or negligence may be routinely brushed off by the medical profession as being mere 'allegations' or 'perceptions' until and unless the complainants can successfully prove otherwise. The medical and legal profession may know only too well, in most instances, how impossible a task this may be. Victims of medical errors or negligence and their loved ones not only suffer the pain and trauma caused by an adverse medical event but they further face the arduous task of having to prove their legitimate cases.

Proving medical errors or negligence may be impossible due to, among others, the difficulty in obtaining expert opinion; the difficulty in having these experts to testify; the possibility of cover-ups; the possibility of fabrication of medical reports and records; the application of the Bolam test by the civil court in cases concerning medical negligence; the lack of specialist lawyers to defend victims of medical errors or negligence; the high cost of litigation; the lengthy court process; and the lack of pertinent details in the consent forms (for surgery).

Also, can the ordinary layperson be expected to take on mighty and powerful medical establishments, insurers or medical-defence unions/organisations? Private hospitals may even easily disclaim any responsibility or liability in the event of a claim of negligence with the said consultant is at all material times an independent contractor and is not an employee of although patients may not be promptly informed of this during registrations, consultations or even admissions.

In conclusion, just as the medical profession has the ability to save lives so does it have the ability to inadvertently cause serious harm to patients. A major 2003 health care study conducted in the US suggests that the average adverse patient outcome rate may be 20% with a mortality rate of 14%. The study also suggests that this figure may be significantly underestimated because the majority of such cases go unreported.

According to press reports, Malaysia had a total of 65.7 million patients in 2003. Sympathy alone from the MMC may not suffice to save lives but it must be complemented with, among others, strong and effective mechanisms to safeguard the public. To achieve this, the following 'holistic' measures need to be urgently implemented:

Compelling the Malaysian Medical Council to be accountable to Parliament.

Establishing an Independent Medical/Healthcare Complaints and Misconduct

Commission to look into all complaints concerning health care speedily, effectively, fairly and transparently.

Reviewing and reforming of all existing laws pertaining to health care including the MMC s Code of Professional Conduct, Medical Act 1971, Medical Regulations 1974 and the Private Healthcare Facilities And Services Act 1998. In addition, any unfair provisions in the Civil Law Act 1956 must also be reviewed to ensure that victims of medical or personal injury are adequately compensated.

Establishing a royal commission of inquiry to enquire on all aspects of the health care system including the quality and standard of medical education and treatment and to make the appropriate findings and recommendations.