Guidelines on Disability Duration for Specific Injuries for Doctors

3 Mr Louis Ng Kok Kwang asked the Minister for Health whether the Ministry will consider issuing guidelines on disability duration for specific injuries for the use of doctors issuing medical leave and light duties for injured workers returning to work.

The Senior Minister of State for Health (Dr Lam Pin Min) (for the Minister for Health): Mr Speaker, in assessing the need for a medical certificate and its duration, both medical conditions and non medical circumstances need to be considered. These include the type and severity of the medical condition or injury; time needed for the treatment, rehabilitation and recovery; and work requirements and workplace conditions. The circumstances vary widely among different persons, making it difficult to come up with prescriptive guidelines.

The attending doctor should use his or her professional judgement, and when in doubt, consult fellow peers on what is needed to help the patient recover from a medical condition or injury.

To guide this, the SMC revised the Ethical Code which came into effect in 2017. This provides broad guidelines that medical certificates must be issued to patients on proper medical grounds arrived at through good clinical assessment, and doctors must not take into consideration extraneous factors such as who pays for the consultation, what benefits the patients may receive or what employers’ preferences may be. Also, when certifying that patients are fit to return to work but with limitations on their level of activity at work, doctors must first ensure that the patients’ work conditions allow this and, to the best of their ability, ensure that appropriate light duties are in fact available to the patients at their place of work.

MOH will study if it is necessary to formulate specific guidance in particular settings and seek inputs from the professional bodies.

Mr Louis Ng Kok Kwang (Nee Soon): I thank the Senior Minister of State for the reply. I just wanted to check the last part. He said that MOH is going to study this issue. Is it going to conduct a review on whether we can set up more specific guidelines, rather than the broad guidelines we have in our code now?

Secondly, I am asking this in relation to the recent case where the doctor issued two days of light duty for the worker that had a broken collar bone. So, how does MOH ensure that the appropriate number of medical leave or light duty is issued after a surgery or after a work-related accident?

Dr Lam Pin Min: Mr Speaker, as alluded to in my reply, there are already existing broad guidelines issued by SMC in their ethical code which gives some guidance to doctors on what is expected of them. With regard to whether we will come up with any specific guidance, this is an area where we will consult professional bodies to study whether it is feasible or practical to even do so. However, if the professional bodies think that there may be scope to provide some kind of guidance for certain types of injury, we will take their advice into consideration.

With regards to Mr Louis Ng's other question about the duration of Medical Certificates (MCs), this question had also been raised in the last parliamentary sitting by the Member, where a question was posed to MOM about whether MOM will be studying ways to better support the injured workers. MOM has already given the reply that they are currently reviewing it and will be conducting public consultation on this issue.