ABU DHABI // The cases of doctors accused of malpractice, negligence or misconduct are being judged in the US, following a decision by the health authority to outsource the disciplinary process to guarantee a neutral process. The Health Authority Abu Dhabi (HAAD) has disclosed that it began sending cases abroad at the start of the year after overhauling its compliance division, which includes the complaints section.
Since January, about 20 serious cases have been exported for a ruling. The HAAD has not released the outcomes. Adjudication is being carried out by three US companies that specialise in medical complaints. Although HAAD has not named the companies, which liaise with lawyers, insurance companies and medical professionals to reach their verdicts, it revealed that one organisation had the services of more than 350 consultants.
The companies forward their recommendations to HAAD, which can then decide to revoke a doctor's licence or take other action. One benefit of the system, according to the authority, is that cases are dealt with relatively quickly. Verdicts usually take between three and 10 days to reach Abu Dhabi, it says, whereas previously cases dragged on for much longer. "Before we did this we were having a lot of problems and issues when it came to bringing a committee together," said Khalid Fulad, the director of the Health System Compliance division at HAAD. "There was not a big enough pool to form a neutral, unbiased group."
Previously all complaints, including the most serious, were dealt with by ad hoc committees of hospital consultants and specialists from the emirate, brought together by HAAD. Mr Fulad said the authority changed the procedure after deciding there were not enough neutral professionals to make unbiased decisions on the more complicated and serious complaints. He introduced the new procedure when he took over the department in January and says it has been a great success.
"The main reason for doing this is we need to make sure we are taking the best action based on the correct decision when it comes to these serious complaints," he said. "We want reliable, solid decisions and we know we can get these from the States." Timing had also been a problem. "It was difficult getting a committee together as different members had different priorities and were not always available," said Mr Fulad.
"This is a very quick and efficient process which suits everyone. We are dealing with very experienced companies who are independent, thorough and quick." Some doctors, however, expressed reservations. "I don't see why they need to send these cases for review to the United States," said one doctor with the Gulf Diagnostic Centre Hospital. "There are different practices in every country." A doctor with the Ghanem Medical Clinic said: "There are competent people here who can do this. It would be better. They would be closer to the situation and can understand the context of the complaint."
However, a third health professional, working at the Ahalia Hospital, said: "It's OK by me. It sounds good - as long as everyone can respect the decisions made." Mr Fulad said the system was designed to introduce greater accountability and reduce conflicts of interest. HAAD also hoped it gave the public more confidence in those regulating the providers of medical care. "This increases accountability for the providers. We would urge anyone who has a complaint, be it against a public or private facility, to come to us. It is a very good way of monitoring the health service and we want to know if some providers are not doing their job properly.
"This was why HAAD was created. We do not do day-to-day management or operation of facilities, we oversee the hospitals, create policies and implement these, then check they are being followed." This year HAAD also launched its Customer Care Centre campaign, displaying posters in hospitals and clinics in the emirate. Patients with queries or complaints are invited to call 800-800. "At the moment the number of complaints is going up, which is what we expected," Mr Fulad said. "We want to know everything that is going on in the health service."
Since January, there have been more than 300 complaints against public and private facilities. The vast majority referred to service-related incidents and a small proportion were complaints about alleged clinical negligence. @Email:munderwood@thenational.ae * With additional reporting by Suleman Din