Introduction
The demand for medical and healthcare products and services has significantly increased in recent years, and the quality of these products and services remains a key public concern. Practitioners of the medical and healthcare industries should maintain high integrity standards for ensuring service and product quality, as well as sustaining their goodwill, public trust and competitive edge in the market.
The Private Sector Integrity Centre (PSIC) offers anti-corruption and integrity training to help practitioners remain vigilant to corruption risks and uphold high integrity standards. We also provide corruption prevention advisory services and practical resources to help professions and companies strengthen safeguards and foster an ethical culture.
Bill was the regional manager of South East Asia in a European medical equipment manufacturer. He learnt that a medical equipment supplier in Chinese Mainland was planning to set up a company in Hong Kong to conduct bilateral business by purchasing European products through the suppliers in Hong Kong and selling wheelchairs and medical equipment made in China to South East Asia.
Bill invited the supplier to Hong Kong to have a look at the latest European medical facilities and the equipment used in hospitals in Hong Kong, as well as to get familiar with the local business environment.
Upon their arrival in Hong Kong, Bill only spent half a day visiting the hospitals with the two supplier representatives, but spent a whole week treating them to lavish meals and red wine at five star hotels and restaurants. Bill also arranged a tour to Macao, including a visit to a newly opened casino. Bill gave each of them HK$10,000 worth of casino tokens to "try their luck", claiming that it was a "trade practice" to show his hospitality to their clients. He also implied that he would offer them a handsome "red packet" if they purchase the medical equipment from his company.
According to the Prevention of Bribery Ordinance (POBO), free tours, “red packet” and casino tokens are all advantages. If the two representatives accepted these advantages from Bill in Hong Kong, both of them and Bill would be subject to the POBO, so that both the offeror and recipient would breach the law if they do not have the permission of their employers to receive the advantages.
They cannot use customary trade practice as an excuse because according to Section 19 of the POBO, it shall not be a defence to show that any such advantage is customary in any profession or trade, The court shall only make a judgement based on whether permission was given by the principal of the recipient.
Dr M, the Chief of Service of the Paediatric Department of a public hospital, has the approving authority for purchases not exceeding $100,000. His girlfriend Phoebe is a sales manager of a large medical equipment company.
Recently, David, the Department Operations Manager, recommended a replacement of a medical equipment and the sourcing was in progress. As Dr M knew that Phoebe was being pressured by her boss to secure more business for the company, he offered to help her. After going through the quotations obtained by David, Dr M found that the price quoted by Phoebe was not the lowest. He thus asked David to mark up the quotations of other companies so that he could secure the contract of the medical equipment to Phoebe’s company. In order to please Dr M, David agreed to the proposal.
David would violate Section 9(3) of the Prevention of Bribery Ordinance for manipulating quotation breakdown to deceive his employer i.e. the Hospital Authority (HA). Dr M, who instructed David to take part in the fictitious quotation plot might also be charged with an offence of conspiracy to defraud.
Dr M might face disciplinary action taken by the Medical Council of Hong Kong and his fitness to practise might be questioned.
At the same time, the HA would also take follow-up action against Dr M and David who might breach the HA’s code of conduct which requires the procurement of goods to be the best value for money in terms of price, quality, delivery time and service.
Also, Dr M should, as far as possible, avoid any actual and perceived conflict of interest. When a situation of conflict of interest cannot be avoided, he should as soon as possible declare all relevant details of such situation to his organisation, i.e. his relationship with the sales manager of the potential supplier.
Dr E is a consultant ophthalmologist in a public hospital who is often involved in the procurement of expensive medical equipment for his department. The procurement department of the hospital will seek Dr E’s views while drafting the specifications and in the course of purchase. He has a strong influence on the final selection of supplier through his assessment on the performance of the equipment.
During the procurement of equipment for oculoplastics, Billy, the sales director of a potential supplier, asked Dr E to comment favourably on the equipment produced by his company. He proposed to pay for the passage and accommodation for Dr E to visit the company’s laboratory in New York and take the convenience to attend an important medical conference there. After the trip, Dr E recommended the hospital to offer the contract to Billy’s company.
Dr E would violate Section 4 of the Prevention of Bribery Ordinance as he accepted an advantage i.e. the sponsorship for visiting the company's laboratory and attending a conference without the permission of his employer, and in return recommended the medical equipment of Billy’s company to the hospital. Billy would also commit an offence of corruption for offering the bribe to Dr E.
Dr E might breach Section 15.1 of the Code of Professional Conduct issued by the Medical Council of Hong Kong (Oct 2022) which specifies that doctors should avoid accepting pecuniary inducement from commercial firms that might compromise the independent exercise of their professional judgement.
According to the Hospital Authority's (HA) guidelines on acceptance of donation and sponsorship, overseas site visit relating to the selection of medical equipment before or during tendering exercises should be funded by the HA and should not be sponsored by any of the potential vendors. In any case, HA employees should not solicit or accept, directly or indirectly, any advantage or gift which would, or might reasonably be seen to, compromise their integrity or judgement or influence the discharge or non-discharge of their duties and responsibilities.
Shortly after starting his private practice, Dr C was approached by Ms WONG, the proprietor of a medical laboratory, who requested for the referral of all his patients to her. Ms WONG suggested that an arrangement could be made for a sum to be offered to Dr C by the laboratory for each patient referred. She emphasised that it was in no way unfair to the patients since they had to do the tests somewhere in any case. She also said that a number of other doctors in the same building had already made such arrangement with her.
Prior to the referral of patients to Ms WONG‘s laboratory, their agreement was brought to light by the nurse of Dr C’s clinic and the case was then reported to the ICAC.
A principal and agent relationship exists between Dr C and his patients. As such, Dr C would breach Section 9 of the Prevention of Bribery Ordinance (POBO) by accepting rebates from Ms WONG for referring his patients to her laboratory if Dr C did not have the permission from his patients.
Although the “under-the-table” dealing was not carried out by Dr C and Ms WONG, they would still be liable to prosecution. Under the POBO, both parties can be found guilty of an offence when the agreement on solicitation and acceptance of advantages have been reached even though the purpose of bribery has not been carried out.
Dr C might also violate Section 14.1 of the Code of Professional Conduct issued by the Medical Council of Hong Kong (Oct 2022) which prohibits doctors from receiving rebates from diagnostic laboratories for referring patients.
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