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 4 of the POBO, if a public servant, including both doctors employed by the Government and the Hospital Authority (HA), solicits or accepts any advantage as an inducement to or reward for an act related to their official position shall be guilty of an offence. Public doctors should therefore refrain from accepting gifts from patients for avoiding any possible contravention of Section 4 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, public doctors should report and dispose of the gifts in accordance with the relevant circulars / guidelines set out by their respective employers and consult the delegated authority in case of doubt.

Under the Prevention of Bribery Ordinance (POBO), discounts, coupons or samples with monetary value are considered as advantages. Public doctors should not accept advantages from commercial organisations having business dealings with their respective organisations for avoiding possible contravention of the POBO, causing embarrassment or bringing their organisations into disrepute. They should also refer to the relevant circulars / 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, public doctors must comply with the regulations and guidelines and obtain permission from their respective organisations accordingly.

According to Section 4 of the POBO, a public servant, including public doctors serving in both the Government and the Hospital Authority, 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. For doctors employed by the Government, they should also comply with the Acceptance of Advantages (Chief Executive's Permission) Notice for not contravening Section 3 of the POBO.

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, public doctors must observe the relevant circulars / guidelines on acceptance of entertainment set out by their respective employers, i.e. the Government or the Hospital Authority, and consult the delegated authority in their organisations if in doubt.

As a general rule, accepting entertainment will not violate any laws or regulations if there is a genuine need to do so. However, public doctors should not accept lavish, or unreasonably generous or frequent entertainment offered by work-related parties for avoiding conflict of interest, leading to the embarrassment of themselves in the discharge of their duties, causing disrepute to their respective organisations or placing themselves in a position of obligation.

Acceptance of donations to hospitals may contribute towards the enhancement of patient services and care. However, before considering donation offer to public hospitals, especially those from commercial organisatsions, the doctors concerned should refer to and follow the policies and guidelines on acceptance of donation set out by the Hospital Authority (HA) in order to avoid possible (actual or perceived) conflict of interest situations or bringing the doctors themselves or the HA into disrepute. The doctor should refer the donation offer to the responsible department of the hospital to ensure proper segregation of duties in handling donations.

They should also observe relevant principles laid down in the Code of Professional Conduct of the Medical Council of Hong Kong as appropriate.

Sponsorship for attending overseas conference is a kind of advantage. The Government and the Hospital Authority (HA) have set out policies and guidelines on acceptance of sponsorship by staff. Public doctors should refer to these policies and guidelines and exercise their judgment in deciding whether to accept such sponsorship or not. For instance, they should not accept the offer of sponsorship if the acceptance would put them in a position of obligation to the offerors, lead to embarrassment in performing their duties or adversely affect the reputation of the HA or the hospital. They should consult the delegated authority in their respective organisations if in doubt.

According to Section 4 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 as they owe a common law duty of confidentiality to patients. They also need to comply with the Personal Data (Privacy) Ordinance and the Code of Professional Conduct of the Medical Council of Hong Kong which requires doctors to obtain patient's prior consent before disclosing medical information to any third party unless permitted by laws.

Besides, they are obliged to comply with relevant policies and guidelines on handling and protecting confidential information laid down by their employers, i.e. the Government and the Hospital Authority. In any case, they must decline any advantage offered to them by patients' relatives or any third party for abusing their official position, otherwise they might breach Section 4 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. Public doctors may also commit the common law offence of Misconduct in Public Office if the involved conflict of interest is wilful and serious.

As a general rule, public doctors should always place the public duties they served and their patients' interest ahead of their private interests and avoid conflict of interest for safeguarding their trustworthiness and integrity. Public doctors should also observe the guidelines of the Government or the Hospital Authority 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 the tendering exercise in which his relative may participate, he should declare to his hospital the potential or actual conflict of interest according to the relevant guidelines of the Hospital Authority in order to avoid possible accusation of favouritism or even corruption.

Doctors employed by the Hospital Authority (HA) should obtain prior permission from the designated approving authority for acceptance of gifts in their official capacity, for example the Hospital Chief Executive. Senior doctors should remind their subordinates to observe the relevant circulars / guidelines and should not accept any advantages from patients for avoiding conflict of interest or bringing their hospital into disrepute or embarrassing the HA. 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 circulars / 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 organisations to the ICAC at the first practicable opportunity.

Public doctors or their subordinates should follow the standing procedures of the Government or the Hospital Authority 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.