You have had a problem with your doctor, your pharmacist or your dentist and you have reported it, it is better not to be in a hurry. “Over the period 2015-2023, the total processing time for a file by the health professions and patients’ rights monitoring commission (CSPSDP) is well over three years. This duration even reaches four years for decisions handed down in 2023.” This is what the Court of Auditors was able to observe after studying the functioning of the CSPSDP. Requested in November 2023 by State Councilor Pierre Maudet, in charge of Health, the supervisory authority issued a rather harsh opinion this Thursday regarding the efficiency of the CSPSDP over the last eight years.
Created in 2006, the CSPSDP is the body to which any patient can contact to complain or even denounce a health professional, whether a simple practitioner, a specialist or a veterinarian. Made up of 20 members – including a number of doctors – it has the power to take disciplinary sanctions (warning, reprimand and fine of up to 20,000 francs) and to propose a temporary or permanent withdrawal of the right to practice which must be issued by the Department of Health.
“For obvious reasons of medical confidentiality, we did not investigate a particular case,” immediately points out the titular magistrate, Isabelle Terrier, in reference to the case of the gynecologist which caused a lot of noise. “We have also not addressed issues related to governance but we are focused on efficiency.” And the observation is clear: “Just by looking at the deadlines, we see that the work of the CSPSDP is not efficient.”
By breaking down the different stages, the Court realized, for example, that “on average more than 540 days elapse between the decision-making of the subcommittee and the presentation of the file, including the drafting of a draft decision, in plenary”. Thanks to the stabilization of two lawyers, “the stock of files awaiting drafting of a decision has increased from nearly 90 in 2014 to around twenty to date”. However, the bottleneck is found elsewhere in the process.
Another important point according to Isabelle Terrier: “The commission does not publish an annual report. There is no catalog of decisions taken.” It is therefore difficult to rely on case law. “In the absence of a reference document, the question of fair treatment arises. The only one who remembers the files and therefore has an overview is the director. Everything depends on one person,” laments the magistrate.
The Court finally notes “the director is often forced to supplement the work of her colleagues” and that “the human resources of the registry are insufficient”. Recalling that the work of the Court of Auditors focused on the question of deadlines, she concluded: “We would not rule out continuing our work on governance.”
Pierre Maudet announces reinforcements
It is with a certain satisfaction that Pierre Maudet must have read the opinion of the Court of Auditors. “It corroborates my hypotheses. These findings are now supported and documented and allow me to move forward with the expected changes, with objectivity and realism,” reacts the State Councilor. To remedy the problems raised, he announced that he wanted to strengthen the resources of the CSPSDP from January 2025; and improve “coordination with the cantonal doctor service which was too absent from the procedures”. And added: “I will also accelerate the deployment of new case processing software, as recommended by the Court.”
In the eyes of Pierre Maudet, “it seems obvious that we must gain transparency in the monitoring and communication of the situations handled, for the sake of setting an example and out of respect for the complainants.” Finally, he wishes to “facilitate the exchange of information with neighboring cantons to prevent sanctions taken in Geneva from being applied there”. With a view to the reorganization of the CSPDSP, the law should be amended.
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