Hisham Didn’t Have A ‘Split Personality’ As Health DG, MMC President: Lawyers

Lawyers representing four FRCS Ed cardiothoracic surgery grads dispute MMC’s claim that Dr Noor Hisham Abdullah acted in his capacity as Health DG, not MMC president, in witnessing the MOUs. “An office bearer does not, in law, develop a split personality”.

KUALA LUMPUR, April 16 — Lawyers have disputed the Malaysian Medical Council’s (MMC) claim that Dr Noor Hisham Abdullah acted in his capacity as the Health director-general, not MMC president, in the establishment of the cardiothoracic surgery parallel pathway training in Malaysia.

Three memorandums of understanding (MOUs) involving the Royal College of Surgeons of Edinburgh (RCSEd) were signed in 2014 and 2018, two of which were witnessed by Dr Noor Hisham, but MMC claimed that it had never made nor authorised any endorsement of these MOUs executed by “third parties”.

“With regard to paragraph 4(a) of your letter, we are instructed to state that your client’s contentions therein are wholly incorrect and without merit as it is trite that an office bearer does not, in law, develop a split personality by reason of being vested with two or more offices,” said Steven Thiru, Jeremiah Rais, and Leah Samuel from Steven Thiru & Sudhar Partnership in a letter last February 15 to MMC’s legal counsel Kanesh Sundrum & Co. 

“In this connection, the involvement of TS Noor Hisham (the then Director-General of Health and ex-officio President of your client) in the execution of the various MOUs, as well as his public statements recognising the FRCS Ed Qualification, cannot be disassociated from his position as your client’s then President.” 

Steven Thiru & Sudhar Partnership was representing four graduates with the Fellowship of the Royal College of Surgeons of Edinburgh in Cardiothoracic Surgery (FRCS Ed) seeking registration on the National Specialist Register (NSR).

Three of them went on – with another fourth graduate – to file a judicial review application in the High Court here on March 20 to challenge the MMC’s rejection of their NSR specialist registration applications, after the regulatory body refused to recognise their FRCS Ed qualification from the Ministry of Health’s (MOH) parallel pathway programme with the overseas royal college.

Under the Medical Act 1971, the Health DG is the MMC president. 

Steven Thiru & Sudhar Partnership also highlighted Dr Noor Hisham’s press statement issued on August 27, 2014, after the signing of the first MOU between RCSEd, the Academy of Medicine of Malaysia (AMM), and the MOH to establish the cardiothoracic surgery parallel pathway programme in Malaysia.

In his statement, Dr Noor Hisham announced that the parallel pathway programme would “become an alternative pathway to the current Master of Surgery programme in producing more cardiothoracic surgeons in the country”.

“TS Noor Hisham’s conduct and/ or representations at the material time further bears significance in giving rise to our clients’ substantive legitimate expectation as he was also the then Registrar of Medical Practitioners (under S. 10(2) of the Medical Act [MA] 1971) and therefore bore the responsibility for the maintenance and custody of the Malaysian Medical Register (under S.11(2) MA),” said Steven Thiru & Sudhar Partnership in its February 15 letter.

The cardiothoracic surgery parallel pathway graduates’ legal counsel further asserted that Dr Noor HIsham (the then-MMC president) and Prof Dr Victor Lim Kok Eow (the-then chairman of MMC’s Medical Education Committee) had “implied and/ or ostensible authority” to make the various representations recognising the FRCS Ed qualification “on behalf of” MMC by virtue of their respective positions.

“Your client had at all material times been silent and/ or had otherwise failed to voice its objections to the representations made by TS Noor Hisham and/ or Dr Victor, and your client is accordingly stopped from denying the binding effect of such representations,” Steven Thiru & Sudhar Partnership told MMC’s lawyers.

“Crucially, and in direct contrast to your client’s current position, your client issued a press statement on 24.6.2021 to expressly recognise qualifications attained through ‘Parallel Pathways’ (e.g. the FRCS Ed Qualification) for purposes of NSR registration and to state that they are not subject to accreditation under the MQA Act.”

MMC’s Website Previously Contained Links To NSR Website With List Of Recognised Qualifications Including FRCS Ed

Steven Thiru & Sudhar Partnership rebutted MMC’s claim of ignorance of the contents of the NSR website, pointing out that the relevant section for the registration of specialists on MMC’s website (https://mmc.gov.my/registration/) had previously contained hyperlinks to the NSR website (https://nsr.org.my), even after the Medical (Amendment) Act 2012 came into force on July 1, 2017.

“These hyperlinks pertinently redirected users (i.e. the general public) to the List of Recognised Qualifications which included the FRCS Ed Qualification,” said the law firm.

The FRCS Ed cardiothoracic surgery graduates’ legal counsel cited a May 9, 2023 email by MMC’s Evaluation Committee for Specialists Medical Qualifications (ECSMQ) – which was comprised of MMC members, alongside representatives from both MOH and AMM, to date – sent from ECSMQ’s own email address, [email protected]

That email sent last May, according to Steven Thiru & Sudhar Partnership, alluded to the fact that “the Criteria and list of recognized specialist qualifications for specialties is available at the NSR MMC website https://nsr.org.my/Home.html” and attached the “2013 list of specialist qualifications” and “Proposed Edited List of Recognised Specialist Qualifications”.

Both of these documents, said the law firm, contained and listed FRCS Ed as a recognised qualification for the purposes of the registration of cardiothoracic surgery specialists on the NSR. 

Steven Thiru & Sudhar Partnership described MMC’s purported ignorance of the contents of the NSR website and/ or the List of Recognised Qualifications as a “disingenuous attempt by your client to exculpate itself of responsibility for its own representations and to suppress its prior recognition of the FRCS Ed Qualification”.

The FRCS Ed cardiothoracic surgery graduates’ lawyers also insisted that notwithstanding the Medical (Amendment) Act 2012 coming into force in 2017, the process of recognising qualifications for the registration of specialists on the NSR remained a “collaborative effort” between MMC, MOH, and AMM, as evidenced by the memberships of such representatives in the ECSMQ under MMC.

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