Integrity in Practice - A Practical Guide for Medical Practitioners on Corruption Prevention

Gift, regardless of its monetary value, is a kind of advantage under the Prevention of Bribery Ordinance (POBO). According to Section 9 of the POBO, if a doctor of a medical group, without the approval of the medical group, solicits or accepts any advantage as an inducement to or reward for an act related to his official position shall be guilty of an offence. Doctors should therefore refrain from accepting gifts from patients for avoiding any possible contravention of the POBO or accusation of unfairness and favouritism.

Where a gift is offered out of a genuine courtesy motive and cannot be declined owing to protocol reasons or the need to avoid causing offence or embarrassment, private doctors should promptly report and dispose of the gifts in accordance with the relevant guidelines set out by their respective employers and consult the delegated authority of the medical group in case of doubt.

Under the Prevention of Bribery Ordinance (POBO), discounts, coupons or samples with monetary value are considered as advantages. As a general rule, private doctors should not accept advantages from commercial organisations having business dealings for avoiding possible contravention of the POBO, causing embarrassment or bringing their organisations into disrepute. They should also refer to the relevant guidelines on acceptance of advantages set out by their respective employers and consult the delegated authority in case of doubt. In case samples of new drugs have to be received in support of research or for clinical trial, doctors must comply with the guidelines and obtain permission from their respective employers accordingly.

According to Section 9 of the POBO, if an agent, i.e. the doctor, solicits or accepts any advantage without the approval of his principal, i.e., the medical group, as an inducement to or reward for an act related to the affairs or business of his principal, he shall be guilty of an offence.

Under the Prevention of Bribery Ordinance (POBO), food or drink for consumption on the occasion where it is provided and any other entertainment connected with such provision are considered as entertainment. Entertainment is not an advantage under the POBO and yet doctors must observe the relevant policy and internal guidelines on acceptance of entertainment set out by their respective employers, i.e. the private hospitals, and consult the delegated authority of their employers if in doubt.

As a general rule, accepting entertainment will not violate any laws or regulations if there is a genuine need (e.g. for liaison and research purposes) to do so. However, private doctors should not accept lavish, or unreasonably generous or frequent entertainment offered by work-related parties for avoiding conflict of interest, causing disrepute to their respective organisations or placing themselves in a position of obligation.

Sponsorship for attending overseas conference is considered as a kind of advantage. Doctors should refer to the policy and relevant guidelines of respective private hospitals and exercise their judgment in deciding whether to accept such sponsorship or not. They should not accept the offer of sponsorship if the acceptance would put themselves in a position of obligation to the offerors, lead to embarrassment in performing their duties or adversely affect the reputation of the hospital concerned. They should consult the delegated authority in their organisation if in doubt.

According to Section 9 of the Prevention of Bribery Ordinance, it will be an offence for both the offeror and recipient if the sponsorship, which covers the free passage, accommodation and other expenses, is offered to a doctor personally as an inducement to or reward for his showing favour to the medical equipment or pharmaceutical company in his official capacity.

Doctors have a responsibility to protect patients' information from improper or inadvertent disclosure. They should comply with the Personal Data (Privacy) Ordinance and the Code of Professional Conduct of the Medical Council of Hong Kong that requires doctors to obtain patient's prior consent before disclosing medical information to any third party unless permitted by laws.

Besides, doctors serving in private hospitals or medical groups are obliged to comply with relevant policies and guidelines on handling and protecting confidential information laid down by respective hospitals / medical groups. In any case, they must not accept any advantage offered to them by patients' relatives or any third party for abusing their official position, otherwise they might breach Section 9 of the Prevention of Bribery Ordinance. The offeror will also breach the law.

Referral of patients by doctors to medical service providers in which they have financial interest is a conflict of interest situation. This may constitute a criminal offence if bribery, falsified documents or other fraudulent means are used to conceal the conflict.

As a general rule, doctors should always place their patients' interest ahead of their private interests and avoid conflict of interest for safeguarding their trustworthiness and integrity. They should also observe the guidelines of their employers on conflict of interest and make conscious effort to avoid or declare if a conflict of interest situation occurs. Besides, they should refer to the Code of Professional Conduct of the Medical Council of Hong Kong that provides principles and rules of good communication and information dissemination to their patients.

To ensure a fair and competitive process for the tendering, the doctor should not divulge any privileged information of his hospital to any parties and refrain from giving advice and assistance to his relative in connection with the tendering exercise as this will give his relative an unfair advantage over other bidders. He may refer his relative's enquiry to the appropriate subject officer to be dealt with in accordance with the normal procedures.

If the doctor is involved in tendering exercise in which his relative may participate, he should declare to his hospital the potential or actual conflict of interest according to the procedures laid down in the hospital's code of conduct in order to avoid possible accusation of favouritism or even corruption.

Doctors employed by private hospitals or medical groups should be conversant with the policy or internal guidelines of their employers on acceptance of advantages for proper disposal or obtaining written permission from the designated approving authority for acceptance of gifts in their official capacity. As a general rule, they should remind their subordinates to observe the relevant guidelines and should not accept advantages from patients for avoiding conflict of interest or bringing their hospital or medical group into disrepute or embarrassing the employers. Unless being formally authorised, senior doctors are not in a position to grant permission to their subordinates or other junior staff to accept gifts from patients.

Nevertheless, senior staff with supervisory duties should lead by example and ensure that any advice given to their subordinates are aligned with the requirements and standards stated in the guidelines. They should also alert subordinates that since gift coupons are considered a kind of advantage under the Prevention of Bribery Ordinance (POBO), acceptance of them as an inducement to or reward for abusing their authority would constitute a POBO offence.

If a doctor or his subordinate suspects that he is being offered a bribe, he should decline the offer and report, either directly or through their respective organisation to the ICAC at the first practicable opportunity.

Doctors of private hospitals should follow the standing procedure of their respective hospitals in referring corruption suspicion to the ICAC. In any case, confidentiality and prompt action are of paramount importance in referring the allegations. In case of doubt, please contact the ICAC by dialing the 24-hour hotline 25 266 366 or contacting any of the ICAC Regional Offices.