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Mediation in Healthcare


Dr Ludwig TSOI

Specialist in Emergency Medicine
Accredited Mediator (General and Family)


Mediation is nothing new. It is a process to settle disputes between people. Recently, it has gained traction in the legal field as an alternative resolution to settle legal disputes. And hence, many organizations around the world have organized training courses to equip people with the knowledge and skills to get this done. 

Hong Kong has followed suit in this regard. The past two decades have witnessed the growth of the number of mediators, the number of disputes settled by mediation and the passing and enactment of the Mediation Ordinance in 2012 and 2013. 

What is mediation?

In simple terms, mediation is a structured process in which one or more mediators assist the disagreeing parties to identify issues in dispute; explore and generate options; communicate with one another; and to reach an agreement regarding the resolution of the dispute. In the local setting, if one person wants to file a lawsuit against another person or party, his legal counsel will advise him to seek mediation first according to the practice direction 31. Practice direction 31 is part of the Civil Justice Reform, it stipulates that the court encourages the use of mediation to settle disputes, if someone refuses to participate in mediation without good reasons, the court could make any adverse costs order against the party. The practice direction together with the Mediation Ordinance has facilitated the local legal community to turn more civil cases to use mediation as an alternative to legal proceedings.

Is mediation relevant to healthcare sector?

If you look around, medical blunders and mishaps made a lot of headlines in recent years. Some of the incidents might be related to the system, some to training and some to miscommunication. Since mediation provides a platform for disagreeing parties to communicate, it could serve to resolve at least part of the disputes. And from my personal experience, at least 80% of the complaints arising out of healthcare is due to poor communication at the front door. By instituting a systemic training on communication to the frontline staff, many complaints may be stopped at the outset. Furthermore, even when a patient or his family files a complaint, the complaint could be handled with the techniques taught in the mediation training. Although at present, attending the mediation training course is not a prerequisite for the post of Patient Relation Officer, having such a qualification is an edge. If the complaint has eventually escalated to the court, the hospital can still use mediation to resolve the case with the patient. 

The way forward

There are still some roadblocks in settling disputes with patients amicably using alternative measures, one being the financing. Singapore is ahead of Hong Kong in this regard. E.g. there are subsidized schemes jointly developed with key industry partners for disputes in private education, media freelancers, intellectual property, tenancy, healthcare and sports. We look forward to similar schemes in Hong Kong to push the boundaries of the application of mediation. 

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