Medical board cracks whip with tougher penalties

BY PAUL WAFULA

Kenya: The medical watchdog has increased the number of penalties that errant doctors and institutions convicted for causing death can face as pressure for reforms in the sector gains momentum.

In a move to tighten the grip on negligent health professionals, the Medical Practitioners and Dentists Board (MPDB) has increased the number of penalties from three to eight.

The board will now cancel licences for medical institutions, order the payment of costs, adopt a mediation agreement or compromise between the complainant and the practitioner or the institution, deregister a doctor indefinitely or order closure of medical or dental institutions until compliance with the requirements of the operating licence.

A revised executive brief prepared by MPDB chief executive officer Daniel Yumbya, dated May 27 and made available to The Standard, reveals that the board will also have doctors on probation earn upto 50 points before being cleared.

Doctors are currently appraised every year on a continuous programme focusing on their area of specialisation or CPD (Continuing Professional Development). CPD is described as the education of physicians following completion of formal training. CPD consists of any educational activity which helps to maintain, develop or increase knowledge, problem-solving, technical skills or professional performance standards, all with the goal that physicians can provide better health care.

According to Mr Yumbya, the CPD programme awards points based on such issues as their practice, exams taken and seminars attended to improve their medical skills.

The minimum points a doctor needs upon assessment to keep their names on the register has now been set at 50. Until this revision, the board only would deal with errant doctors. Most liable medical institutions were not held to account. In addition, the trend made institutions less culpable for their staff. However, the suspension of hospitals will only last for a maximum of six months.

“At the conclusion of an inquiry in which a doctor or dentist or institution has been proven to have been guilty of professional misconduct, the committee shall by simple majority determine whether the complaint shall be referred to the Board or decide to suspend licences for medical institutions for up to six months,” the executive brief signed by Yumbya states.

The MPDB is the only professional body in the medical sector that wields disciplinary powers. In the past, the board has come under heavy criticism for the way it handled complaints on doctors and hospitals.

Health agreement

The revision comes at a time when The Standard has been running a medical campaign dubbed Bad Medicine: Campaign Against Medical Negligence, now in its third week, aimed at exposing the problems facing the sector and the need for reforms.

Issues plaguing the sector range from underfunding to overworked medical personnel.

The board can also adopt a mediation agreement between the complainant and the practitioner or the institution, as agreed. It can also ‘order the payment of costs for the committee’s sitting to be paid by the medical or dental practitioner or institution on such terms as shall be deemed just and fit in the circumstances.’

It has also laid out a provision in the new penalty schedule that would allow it to levy “reasonable costs or the proceedings from parties”. A negligent doctor will not just be sent back to medical school if convicted as has been the practice in the past, but will now be required to earn up to 50 points to be cleared.

Until these changes, the severest punishment that a doctor convicted for causing death in Kenya could face was a year’s deregistration, a penalty seen as a mere slap on the wrist for errant doctors.

“In such cases, this (removal from register) remains effective indefinitely unless and until a doctor or dentist makes a successful application for restoration of his or her name in the register. Suspensions and removal from the register shall be made by a two-thirds majority of the Board members in accordance with the Act,” Mr Yumbya says.

In the prior brief from the Board that was in operation until April 19, this year, there were only three penalties for a doctor found guilty of a criminal offence.

The Director of Public Prosecutions is supposed to institute charges against doctors found guilty by the Board. Cases of such nature are rare.

The first was to admonish the doctor or dentist and conclude the case at that stage, in response to complaints filed directly by patients or their representatives with the board. This penalty still exists and it is done by sending warning letters to practitioners. The decision is a simple majority.

The second penalty was to place a doctor or dentist on probation. This penalty comes with a requirement that the doctor sources for three persons of good standing and repute.

“At least one of whom shall be a professional colleague, to whom the board may apply for information, to be given in confidence, concerning his habits and conduct since the previous hearing,” the brief says.

The probation period, however, does not exceed six months, meaning that the doctor can go back to practicing in just half a year. Such a penalty was handed down last month after the medical tribunal sent back to class a doctor found guilty of causing a patient’s death.

Before the revision, the furthest the tribunal could go was the suspension of the errant doctor’s licence for a period not exceeding 12 months in what made Kenya’s killer doctors almost unstoppable. Moreover, doctors suspended for a one-year period could still be recalled before he or she served her term.

Available data shows that the board has so far received 718 cases out of which 380 cases, or 44 per cent of the cases lodged have been finalised.  The remaining cases are at various stages of investigations, with seven having been determined by the 15-member board tribunal.

Late last month, the board de-registered Dr William Omondi found guilty for leaving a ‘woman’s belly open’ and recommended for subsequent prosecution in a ruling that has sent shivers in the medical fraternity. The DPP’s office is yet to file charges in court.

The board has 7,726 registered medical and dental practitioners and another 2,732 private and faith based medical institutions that it regulates.