The report on delays in disciplinary proceedings against doctors highlights the problem encountered with medical negligence cases (Hard to get experts to testify, says SMC; Nov 1).

The Singapore Medical Council (SMC) deals with all the complaints against doctors, ranging from alcoholism to medical negligence.

The problem arises when unhappy patients make use of the SMC to get a free opinion regarding their treatment or its complications by bringing up the complicated issue of medical negligence.

In Singapore, the aggrieved patient may reject the SMC's decision and proceed to court or even appeal to the Health Minister to order a reassessment.

All these scenarios have occurred in Singapore in recent memory.

The difficulty in getting experts to testify occurs because the "expert" realises that he may encounter a similar problem in his own practice. He would then become a defendant and be judged by others.

This happens most frequently in obstetrics where complications can be sudden and unexpected.

The expert may be asked if he has himself had the complication under discussion.

If he answers "never", he is not an expert; but if he says "many times", his expertise is also in doubt and his credibility and reputation tarnished.

It would take a very bold and confident person to agree to be labelled an expert witness, as the courts are adversarial arenas.

My suggestion is to let the SMC continue to preside over all cases, except where there is a suggestion of negligence. These patients should be advised to proceed to the courts.

After the court verdict, the SMC could decide if any penalty should be imposed. The entire process is then streamlined and avoids the embarrassment such as when the the court ordered the SMC to pay the costs of a case a few years ago.

Chew Shing Chai (Dr)