Appropriate use of my money? I think not!

This was the headline news in the Today paper this morning.

The long arm of ethics
Why holding Shorvon accountable is important to the S'pore Medical Council

Tor Ching Li
chingli@mediacorp.com.sg

WHEN he came to Singapore in 2000 as chief of the National Neuroscience Institute (NNI), Professor Simon Shorvon was acknowledged as one of the world's leading authorities on epilepsy.

Today, his reputation is in tatters, his research is on hold and the 58-year-old is talking of "early retirement" as the Singapore Medical Council (SMC) and its team of lawyers has followed him all the way to Britain to make sure he answers for his actions.

The vigour with which SMC has pursued the Shorvon case — even beyond Singapore's borders — has surprised legal circles, but the council says it had no choice.

What's more, as Singapore becomes a biomedical hub, the SMC says that if any foreign doctor breaches ethics here, he won't get away merely by fleeing Singapore. It will pursue him wherever he goes, taking up the matter through its foreign counterparts.

The Shorvon case shows how determined it is to make this point.

Given a $10-million grant here to conduct research on Parkinson's Disease and other conditions, he used some patients as unwitting guinea pigs. Their medication was changed without their knowledge. In some cases, they were told to ignore the regular prescriptions from their neurologists.

The NNI sacked him in 2003. He was struck off the Singapore medical register and made to pay a $10,000 fine and foot the SMC's $175,000 legal costs. As Prof Shorvon moved back to England, the SMC informed its counterpart, Britain's General Medical Council (GMC), of its findings.

If this was routine, the SMC's resoluteness to hold the former NNI chief accountable became clear after this point.

As GMC prepared for a public inquiry into Prof Shorvon's conduct here, the SMC and its solicitors made two trips to London to assist them.

It discussed options including video-conferencing or sending doctors and patients from Singapore to London for the inquiry.

In September last year, the GMC decided to drop the inquiry as its independent expert, Prof A C Williams, felt that Prof Shorvon's offences here were "of a relatively minor nature".

Far from letting matters rest, the SMC appealed against GMC's move in the British High Courts.

It has hired Queen's Counsel David Pannick to present its case there. And apart from pointing out inaccuracies in Prof Williams' report presented in a two-day hearing this week, Mr Pannick has spelt out the SMC's stand: It feels that Prof Shorvon has a strong case to answer, and he should answer it.

Dr Lau Hong Choon, SMC's executive secretary, told Today that GMC's cancellation called into question the "integrity and independence of the SMC's findings against Prof Shorvon".

SMC president Prof R Nambiar said that Prof Shorvon's ethical lapses were "serious", and the standards to be upheld as "internationally established principles of medical practice and research and must be strictly complied with in all research projects".

Prof Shorvon has said that the SMC has no right to contest the decision of Britain's GMC, and told The Straits Times that his reputation, career and salary progression would be seriously compromised if the GMC continued to inquire into his conduct in Singapore.

Between 1997 and 2003, he received grants worth $21.5 million. He has received no grants since 2003.

But Dr Lau said there was a bigger issue involved.

"The SMC has an interest in upholding Singapore's reputation as a place where foreign doctors can practice medicine and conduct biomedical research, in a framework of internationally well-accepted ethical standards," he said.

"Foreign doctors may practise medicine or conduct medical research in Singapore. However, if medical ethics are breached and patients are harmed, they should expect to face disciplinary proceedings before the SMC.

"If these doctors leave Singapore in a bid to avoid such disciplinary proceedings, the SMC will pursue the matter through its foreign counterparts," he added.

Still, criminal lawyer Bajwa Singh commented that the SMC's move was unusual.

"It is unusual for the SMC, or for any other professional body in Singapore, to pursue a matter outside the jurisdiction of Singapore," said Mr Singh.

"One reason for not pursuing is that our bodies usually have no standing to take action in a foreign jurisdiction — though in this case they do seem to, or they would not have filed for action. On the other hand, the obvious rationale for taking action is for a matter of public interest and duty."

The British High Court will come to a decision before Dec 22. The legal costs will then be decided between the SMC — which is funded by registration fees of doctors in Singapore — and the GMC depending on outcome. Should the SMC fail in this appeal, there are two other tiers of appeal — to the Court of Appeal and subsequently the House of Lords.

Can someone explain to me why the money I pay for my medical registration fees is being used to hire a Queen's Counsel in the UK to prosecute Prof Shovron?

Anyone?