What Most Private-Practicing Doctors have to do under the Private Healthcare Facilities Ordinance (Cap. 633)?

The Private Healthcare Facilities Ordinance (Cap. 633) is the new law passed to regulate private healthcare facilities which include private hospitals, day procedure centers and clinics.  Nearly all private practicing doctors will be affected. 

Dated back to 2012, there was concern over the safety of procedures done in private clinics.  In October 2012, the Steering Committee on Review of Regulation of Private Healthcare Facilities, chaired by the Secretary for Food and Health, was established.  It was followed by a consultation period from December 2014 to March 2015.  In April 2016, a consultation report was published.  In June 2017, the Private Healthcare Facilities Bill was introduced into Legislative Council.  The Bill was then passed by Legco and it was Gazettal on November 30, 2018.  From 2019 onwards, there will be phased implementation of the new regime.  

The mode of regulation is through licensing.  Health services establishments listed in Schedule 9 to the Ordinance are to be regulated.  These include private hospitals, day procedure centers and clinics.  Private hospitals are premises with lodging.  Day procedure centers are premises without lodging, and providing “scheduled medical procedures” as listed in Schedule 3.  Clinics are premises without lodging and not providing “scheduled medical procedures”. 

Most of the private practicing doctors in Hong Kong practice in clinics.  Under the new law, clinics need to be licensed.  However, exemption arrangement is available for eligible small practice clinics.  Although the doctor needs to apply to the Director of Health for a letter of exemption, the requirements are less stringent than those for applying for a license.  The criteria are:

1. The clinic is operated by at most 5 registered medical practitioners, who are not under limited registration, as sole proprietor, partners or director of a company.
2. The sole proprietor/partner(s)/company director(s) have exclusive right to use the premises.
3. Only the sole proprietor/ partner(s)/ company director(s) can practice in the clinic.
4. Locums are exceptions.  They can work for each sole proprietor/ partner/ company director for less than 60 days in a calendar year; and less than 180 days per clinic in a calendar year.
5. Each registered medical practitioner (not under limited registration) can operate at most 3 exempted clinics.

  

We have to note than exemption is not automatic.  A doctor has to apply for a letter of exemption by providing proof to all of the above criteria.  Exempted clinics will not be subjected to the code of practice applicable to licensed clinics under the new regime.  For a clinic without exemption, it needs to apply for a license.  The license needs to be renewed.  There will be regular inspection.  And there are other requirements to fulfill such as the requirement of a chief medical executive. 

There are different arrangements for doctors who are with limited registration under Promulgations No. 3 and 4 of the Medical Council since 1995 and 2001 respectively; and who are practicing in clinics registered under the Medical Clinics Ordinance (Cap. 343).  Since Cap 343 will be repealed under the new regime, these clinics will be registered as “scheduled clinics” under Cap. 633.  The license will be valid for one year or less.  And these clinics will be subjected to the same code of practice as other licensed clinics. 

For all other private healthcare facilities, application for licenses is required.  A licensee has to be wholly responsible for the private healthcare facility’s operation.  Also, he has to appoint a chief medical executive.  The chief medical executive has to take charge of the private healthcare facility’s day-to-day administration.  There are requirements set for the chief medical executive, which are different for different types of private healthcare facilities.  For all private medical facilities, the chief medical executive has to be a registered medical practitioner.  One interesting point to note is that there is no offence under the new ordinance that targets at the chief medical executive specifically.  It is the licensee who is ultimately responsible for the operation of a private healthcare facility. 

There are regulatory measures to tackle with breaches of the law and licensing requirements.  A private healthcare facility service can be suspended.  A license can be cancelled.  To deter serious and intentional non-compliance, a licensee can be subjected to sanctions for certain contraventions.  For example, the maximum penalty for operating a private healthcare facility that is not licensed or exempted is a fine of $5 million and imprisonment for 5 years.  So, when the time comes, remember to apply for a license or a letter of exemption (and I am going to tell you when).  Another example is that for failing to comply with a suspension order to suspend a private healthcare facility, the maximum penalty is a fine of $1 million and imprisonment for 2 years. 

It is also statutory requirements to have complaints management system in place.  A licensee has to set up a complaints handling procedure at source.  Unresolved complaints will be handled according to a centralized mechanism.  A committee on Complaints against Private Healthcare Facilities will be set up. 

The above-mentioned licensing procedures will be implemented in phases.  For private hospitals, applications will commence in mid-2019.  Regulations are anticipated to take effect in early 2021.  For day procedure centers, applications are anticipated to commence in 2020.  The first batch is anticipated to take effect in early 2021.  For clinics, applications for licenses and letters of exemptions are anticipated to commence in 2021 at the earliest.  The anticipated date for measures to take effect is to be announced later.  

(Source: HKMA News March 2019)