Singapore

SMC looking into mandatory insurance for private doctors

The Singapore Medical Council (SMC), together with the Ministry of Health, is studying a proposal on making insurance coverage compulsory for all doctors.

Such cover protects doctors against any claims by patients should things go wrong. It also protects patients as they will be indemnified if the problem was caused by the doctor.

It covers not only the cost of court cases, but also any reimbursement that might have to be made to patients or their families. The doctor also has the option to settle rather than fight a case.

Although the majority of doctors do buy such insurance coverage, not all do so since it is not obligatory and the cost of premiums can be high. Insurance that covers doctors who do procedures deemed to be "high risk" costs tens of thousands of dollars a year.

These procedures include aesthetic surgery, neurosurgery and bariatric surgery, where the size of the stomach is reduced to combat obesity.

It was a case of bariatric surgery gone wrong that recently highlighted the fact that not all doctors are insured or sufficiently insured.

The private-sector surgeon who carried out bariatric surgery on an obese patient was not insured for that procedure, although he had insurance for general surgery.

Something went wrong, and the patient ended up in intensive care for several weeks, required several corrective operations and chalked up hospital bills of close to $500,000.

The patient wanted to sue the surgeon, but found that the surgeon was not covered by his insurer, and did not have much money to pay him should he win the case.

They settled for a public apology and a payment of $200,000, half of which is to be paid in monthly instalments of $3,000.

When the story ran in The Straits Times last month, the SMC said the law does allow it to require proper insurance coverage as a condition to allow doctors to practise, but it has not exercised that right.

'NOT EXERCISED'

Its spokesman said: "Section 36(7) of the Medical Registration Act allows the SMC, with the Minister's approval, to require that doctors take out and maintain insurance when applying for the grant or renewal of their practising certificates. The SMC has not exercised this at present."

But, the SMC "is currently working with the Ministry of Health to look into the proposal of mandating insurance for doctors".

Should the SMC decide to make having proper insurance coverage a requirement, the change will affect only the more than 4,000 doctors in private practice, since all doctors in the public service are covered by the institutions that employ them.

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