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Paediatrics in Hong Kong: the high price of risk

13 March 2019

Growing risk and rising claims continue to affect paediatrics, an area of clinical practice already renowned for its inherent riskiness. Dr Ming Teoh, head of medical services (Asia) at Medical Protection, looks at the numerous factors driving these changes


For doctors in Hong Kong, it remains a fact that the last ten years have seen increasingly higher levels of complaints, regulatory cases and claims. This is especially true for paediatricians who treat infants in the early neonatal period.

It is a highly complex medicolegal area, where clinicians have a greater risk of being involved in high-value litigation, involving injuries of the utmost severity. By the very nature of the injuries that can result, they are often the very largest of claims. This article looks at our data to explore what is driving this risk growth.

Claims – growing in value and frequency

Solicitors are litigating birth-injury claims more aggressively, and the general damages and long-term care costs they pursue for their clients continue to rise. Our data shows that between 2008 and 2017, the number of claims reported against paediatric members in Hong Kong increased an average 8% per year over the ten-year period, compared to 1% for the medical pool as a whole. During that same period, the number of cases (involving incidents other than claims, such as complaints, MCHK inquiries, inquests) opened on behalf of paediatric members increased 56%.

Claims involving birth injuries are some of the highest value claims we see. To date, the highest value paediatric claim Medical Protection settled on behalf of a paediatric member in Hong Kong was over $51 million, and we are currently assisting on individual cases each valued between $26m and $65m.

Why is this happening?

A major cause of the increasing cost of such claims is the natural delay in when they are reported to us. The average delay between incident date and the date of a claim arising is 2.2 years in Hong Kong, with a further delay of 1.4 years on average until it is resolved and an outcome achieved.

However, between 2008 and 2017, only 52% of paediatric claims in Hong Kong were reported within the first two years of an incident occurring. In fact, the remaining 48% were reported three to six years after the incident date.

As a result of these delays, many factors can intervene to impact on the final cost of a claim, such as changes in the law, increases in the cost of care and improved life expectancy.

Fighting your corner

Thanks to our six decades of experience in Hong Kong, we know that we must monitor these changes carefully and look at the overall trends across five or ten years, so we can capture a clear and comprehensive picture of the environment.

We must set subscription rates that collect sufficient funds to meet the costs of claims and assistance that could arise in the future. This is to ensure that we are here to protect members against the potentially harmful costs of litigation, as well as the other challenges they might face throughout their careers.

Your subscription

Unfortunately, continued escalation in the paediatric claims environment has an impact on members’ subscription rates. This is because we must anticipate and price for the full potential costs of these high-value paediatric claims falling in future, so that we are able to provide the right level of defence and support you may need should the worst happen.

We strongly believe that prevention is better than cure. As a member of Medical Protection, you have access to a wealth of online resources on our website and e-learning platform, PRISM – to help you act now to safeguard your future practice.