Singapore Medical Council v Wee Teong Boo: Disciplinary Tribunal Appeal for Inappropriate Prescription of Medication

The Singapore Medical Council appealed against the sentence imposed by a disciplinary tribunal on Dr. Wee Teong Boo for 20 charges of professional misconduct under the Medical Registration Act, involving inappropriate prescription of codeine-containing cough mixtures and benzodiazepines, as well as inadequate record-keeping. The Court of Three Judges, comprising Sundaresh Menon CJ, Judith Prakash JCA, and Steven Chong JCA, allowed the appeal on 27 February 2023, ordering Dr. Wee to be struck off the Register of Medical Practitioners, finding the original sentence manifestly inadequate.

1. Case Overview

1.1 Court

Court of Three Judges

1.2 Outcome

Appeal Allowed

1.3 Case Type

Regulatory

1.4 Judgment Type

Grounds of Decision

1.5 Jurisdiction

Singapore

1.6 Description

Appeal against disciplinary tribunal's sentence for inappropriate prescription of medication and inadequate record-keeping. The court found the sentence manifestly inadequate and ordered the doctor to be struck off the register.

1.7 Decision Date

2 July 2023

2. Parties and Outcomes

Party Name	Role	Type	Outcome	Outcome Type	Counsels
Singapore Medical Council	Appellant	Statutory Board	Appeal Allowed	Won	Kronenburg Edmund Jerome of Braddell Brothers LLP Sim Wei Min Stephanie of Braddell Brothers LLP Nicole Lee Man Ruo of Braddell Brothers LLP Thng Yu Ting Angelia of Braddell Brothers LLP
Wee Teong Boo	Respondent	Individual	Struck off the Register of Medical Practitioners	Lost	Chooi Jing Yen of Eugene Thuraisingam LLP Johannes Hadi of Eugene Thuraisingam LLP Low Wei Qi Hilary of Eugene Thuraisingam LLP

3. Judges

Judge Name	Title	Delivered Judgment
Sundaresh Menon	Chief Justice	No
Judith Prakash	Justice of the Court of Appeal	Yes
Steven Chong	Justice of the Court of Appeal	No

4. Counsels

Counsel Name	Organization
Kronenburg Edmund Jerome	Braddell Brothers LLP
Sim Wei Min Stephanie	Braddell Brothers LLP
Nicole Lee Man Ruo	Braddell Brothers LLP
Thng Yu Ting Angelia	Braddell Brothers LLP
Chooi Jing Yen	Eugene Thuraisingam LLP
Johannes Hadi	Eugene Thuraisingam LLP
Low Wei Qi Hilary	Eugene Thuraisingam LLP

4. Facts

Dr. Wee pleaded guilty to 20 charges of professional misconduct.
The charges included inappropriate prescription of codeine-containing cough mixtures and benzodiazepines.
Dr. Wee also faced charges for failing to keep adequate medical records.
Dr. Wee prescribed medication without a clear clinical basis.
Dr. Wee was aware or ought to have been aware that some patients had drug dependency issues.
The Disciplinary Tribunal (DT) initially sentenced Dr. Wee to a 20-month suspension.
The Singapore Medical Council (SMC) appealed against the sentence, arguing it was manifestly inadequate.

5. Formal Citations

Singapore Medical Council v Wee Teong Boo, Originating Application No 4 of 2022, [2023] SGHC 180

6. Timeline

Date	Event
1977-04-26	Dr. Wee registered as a medical practitioner.
2000-10-09	Ministry of Health issued letter on Sale and Supply of Cough Mixtures Containing Codeine.
2008-10-14	Ministry of Health issued Administrative Guidelines on the Prescribing of Benzodiazepines and Other Hypnotics.
2009-01-02	Dr. Wee consulted by P9.
2009-10-29	Dr. Wee consulted by P10.
2011-10-11	Dr. Wee consulted by P5.
2011-12-02	Dr. Wee consulted by P4.
2013-08-20	Dr. Wee consulted by P3.
2013-11-07	Dr. Wee consulted by P2.
2014-06-22	Dr. Wee consulted by P1.
2014-12-14	Dr. Wee consulted by P15.
2015-09-28	Dr. Wee consulted by P13.
2016-02-22	Dr. Wee consulted by P11.
2016-10-28	SMC received complaint from the Ministry of Health.
2018-04-25	SMC issued a Notice of Complaint to Dr. Wee.
2018-06-20	Dr. Wee sent his Letter of Explanation to the SMC.
2021-02-05	Dr Eng Soo Kiang's medical expert report was issued.
2021-02-09	SMC served a Notice of Inquiry on Dr. Wee.
2021-06-24	Dr Ng Beng Yeong's report was issued.
2022-11-10	First hearing date.
2023-02-27	Appeal allowed; Dr. Wee ordered to be struck off the Register of Medical Practitioners.
2023-07-03	Reasons for decision issued.

7. Legal Issues

Professional Misconduct
- Outcome: The court found that Dr. Wee's actions constituted professional misconduct and ordered him to be struck off the register.
- Category: Substantive
- Sub-Issues:
  - Inappropriate Prescription of Medication
  - Inadequate Record Keeping
  - Breach of Medical Ethics
  - Abuse of Privileges as a Medical Practitioner
Appropriateness of Sentence
- Outcome: The court found the original sentence manifestly inadequate and increased the sanction to striking off the register.
- Category: Procedural
- Sub-Issues:
  - Manifest Inadequacy of Sentence
  - Application of Sentencing Framework
  - Consideration of Mitigating and Aggravating Factors
  - Delay in Prosecution
Culpability Assessment
- Outcome: The court determined that Dr. Wee's culpability was high due to his deliberate actions and disregard for patient well-being.
- Category: Substantive
- Sub-Issues:
  - Degree of Blameworthiness
  - Abuse of Trust
  - Disregard for Patient Well-being
  - Lack of Clinical Basis for Prescriptions

8. Remedies Sought

Striking off from the Register of Medical Practitioners
Increased Sentence

9. Cause of Actions

Professional Misconduct
Serious Negligence

10. Practice Areas

Professional Regulation
Healthcare Law
Medical Malpractice

11. Industries

Healthcare

12. Cited Cases

Case Name	Court	Affirmed	Citation	Jurisdiction	Significance
Wong Meng Hang v Singapore Medical Council and other matters	Court of Appeal	Yes	[2019] 3 SLR 526	Singapore	Cited for the sentencing framework for disciplinary proceedings against medical practitioners, including the evaluation of harm and culpability.
In the Matter of Dr AAN	Singapore Medical Council Disciplinary Committee	Yes	[2009] SMCDC 2	Singapore	Cited as an example where striking off was warranted for a doctor deliberately and improperly prescribing and selling controlled medicines.
In the Matter of Dr Ho Thong Chew	Singapore Medical Council Disciplinary Tribunal	Yes	[2014] SMCDT 12	Singapore	Cited as an example where striking off was warranted for a doctor deliberately and improperly prescribing and selling controlled medicines.
Singapore Medical Council v Dr Tang Yen Ho Andrew	Singapore Medical Council Disciplinary Tribunal	Yes	[2019] SMCDT 8	Singapore	Cited by the respondent to argue that striking off would be too harsh, but distinguished by the court due to different facts.
Chng Yew Chin v Public Prosecutor	High Court	Yes	[2006] 4 SLR(R) 124	Singapore	Cited for the principle that judges should draw logical inferences from the facts before them.
Edwin s/o Suse Nathen v Public Prosecutor	High Court	Yes	[2013] 4 SLR 1139	Singapore	Cited for the principle that the absence of an aggravating factor is neutral and not mitigating.

13. Applicable Rules

Rule Name
No applicable rules

14. Applicable Statutes

Statute Name	Jurisdiction
Medical Registration Act (Cap 174, 2014 Rev Ed)	Singapore
s 53(1)(d) of the Medical Registration Act (Cap 174, 2014 Rev Ed)	Singapore
s 53(2) of the Medical Registration Act (Cap 174, 2014 Rev Ed)	Singapore
s 53(2)(b) of the Medical Registration Act (Cap 174, 2014 Rev Ed)	Singapore

15. Key Terms and Keywords

15.1 Key Terms

Professional Misconduct
Inappropriate Prescription
Codeine
Benzodiazepines
Medical Records
Disciplinary Tribunal
Sentencing Framework
Culpability
Harm
Drug Dependency
Medical Registration Act
Register of Medical Practitioners

15.2 Keywords

Medical Disciplinary Tribunal
Inappropriate Prescription
Codeine
Benzodiazepines
Professional Misconduct
Singapore Medical Council
Medical Registration Act

17. Areas of Law

Area Name	Relevance Score
Professional conduct	90
Disciplinary Proceedings	80
Administrative Law	60
Medical Malpractice	50
Healthcare Law	40
Medical Ethics	30

16. Subjects

Medical Law
Professional Discipline
Health Law
Regulatory Offences