The National Assembly is expected to consider a draft law next month that would establish a committee to monitor and regulate doctors, marking a major step in holding those working in the private health care sector accountable for their actions.
The draft law, which was passed by the Council of Ministers a month ago, would create a board that would have the power to question and punish doctors who are accused of malpractice or breaching a medical code of conduct. In serious cases, the board would be able to prevent a doctor from practicing.
Doctors would have to register with the board or they would not be able to practice in the country. The board would be the first to receive a complaint against a doctor. Currently, someone who wants to complain about a doctor has to go to the courts.
Health experts say the law is an important step in monitoring the private health sector, which is currently unregulated. It was only recently that private doctors were asked to register with the Ministry of Health. Before, they had to ask only the municipality in their area for permission to open the clinic.
“It [the law] will make doctors obey the law and have morals in carrying out their work,” said Health Minister Dr Hong Sun Huot, who supports the law’s passage.
He also said the law could stop the practice of doctors who sell their rights to open a clinic to others who are not qualified to practice medicine.
Dr Nhem Sokhan, who has been practicing for five years, said Cambodia badly needs a law to regulate the private sector.
“It would cut down on the number of doctors who don’t have the skills to practice,” he said.
Maurits van Pelt, head of the Medecins Sans Frontieres office in Cambodia, said the unregulated private health care sector is one of the core obstacles to improving the system.
“Doctors in Cambodia exploit the ignorance of the people,” he said. “They recommend treatment that is expensive and unnecessary to create a market for themselves.”
Stephan Rousseau, executive director of the health care NGO umbrella organization Medicam, said the board would give doctors an incentive to report each other’s mistakes.
“If a doctor is losing money because of corrupt competition, they can say, ‘Hey, I’m losing business because of you,’ and report the other guy to the board.”
In the past, ministry officials said they did not have the resources or the legal support to regulate the private sector. It was unclear where the funding for the board would come from.
According to a Ministry of Health report released in February, “low quality public health services…cause Cambodian patients to self medicate or to seek care from the expensive and unregulated private sector, with dubious quality.”
Many private doctors also work in the public health sector. Because public health care doctors earn only $10 to $20 a month, many of them open private clinics.
Another key component to improving the health care system is to increase the salaries of those working in the public sector. “In exchange for the increase, you could ask for competent work and set up sanctions for bad behavior,” van Pelt said.
Cambodian doctors should be proud to work in the public service. Now they don’t have self-respect.”
