WESTERN SAMOA

MEDICAL PRACTITIONERS 

INDEX

Medical Practitioners Act 1975

Regulations:
Medical Practitioners (Fees and Forms) Regulations 1971

ANALYSIS

Title

PART I
PRELIMINARY AND ADMINISTRATION

1. Short title
2. Interpretation
3. Dissolution of Medical and Dental Council
4. Establishment of Medical Council
5. Terms of office of appointed members
6. Extraordinary vacancies
7. Meetings
8. Secretary
9. Remuneration and allowances of Council members

PART II
QUALIFICATIONS AND REGISTRATION

10. Registers to be kept by Secretary
11. Qualifications and registration of medical practitioners
12. Provisional registration
13. Applications for registration
14. Applications to be considered by Council
15. Decisions of Council
16. Temporary practising certificates
17. Certificates of practice
18. Additional degrees, etc., to be entered in register
19. Person registered to notify change of name or address
20. Correction of registers
21. Inspection of registers

PART III
SUSPENSION, DISCIPLINE, APPEALS AND RE-REGISTRATION

22. Suspension of registration for disability
23. Disciplinary powers of Council
24. Appeals from decisions of Council
25. Re-registration

PART IV 
EMPLOYMENT, PRACTICE AND OFFENCES

26. Only registered persons to be employed
27. Penalty for wrongfully procuring registration
28. Penalty for wrongfully using title of medical practitioner
29. Right of persons to sue for fees
30 Other persons not to sue for fees
31 Act not to affect Government claims, chemists, etc.

PART V
MISCELLANEOUS

32 Certificate of Secretary to be evidence
33. Funds of Council
34. Regulations
35. Repeal

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THE MEDICAL PRACTITIONERS ACT 1975
No. 15

An Act to consolidate and of otherwise amend the law relating to medical practitioners, to establish the Medical Council, to prescribe the qualifications required by persons for the practice of medicine and surgery in Western Samoa and to provide for the registration and disciplinary control of such persons.

[23 December 1975]

PART I

PRELIMINARY AND ADMINISTRATION

1. Short title - This Act may be cited as the Medical Practitioners Act 1975.

As to the sale, packing and possession of poisons by medical practitioners see ss. 11, 12 and 24 of the Poisons Act 1968.

2. Interpretation - In this Act, unless the context otherwise requires,-

"Council" means the Medical Council as established by this Act:

"Department" means the Department of Health:

"Director" means the Director of Health:

"Hospital" means a hospital or other institution controlled or maintained by the Department:

"Judge" means a Judge of the Supreme Court:

"Medical practitioner" means medical practitioner qualified and registered under this Act:

"Minister" means the Minister of Health:

"Prescribed" means prescribed by regulations:

"Registration" includes provisional registration:

"Regulations" means regulations made under this Act.

“Medical practitioner”: See the definition in s.2 of the Births and Deaths Registration Ordinance 1961.
See also s.6 of the Coroners Ordinance 1959.

3. Dissolution of Medical and Dental Council - The Council called the Medical and Dental Council, which was established by section 3, of the Medical and Dental Practitioners Act 1966, is hereby dissolved.

4. Establishment of Medical Council - (1) There is hereby established a Council to be called the Medical Council.

(2) The following persons shall be members of the Medical Council for all its business-

(a) The Director, who shall be Chairman of the Council;

(b) A medical practitioner to be appointed by the Head of State, acting on the advice of Cabinet, who shall be Deputy Chairman of the Council;

(c) A medical practitioner to be appointed by the Head of State, acting on the advice of Cabinet who is in private practice as a medical practitioner in Western Samoa or who is a retired medical practitioner ordinarily resident in Western Samoa;

(d) Two medical practitioners to be appointed by the Head of State, acting on the advice of Cabinet , being persons who have been nominated for such appointment by the Western Samoa Medical Association Incorporated; and

(e) A barrister or solicitor in the office of the Attorney-General who is for the' time being nominated in writing for the purpose by the Attorney-General.

(3) No vacancy in the membership of the Council shall affect its powers.

As to the appointment of a medical practitioner to the Pharmaceutical Committee, see s. 3 (1) (a) of the Pharmacy Act 1976.

5. Terms of office of appointed members - (1) Subject to the other provisions of this Act, the appointed members of the Council shall be appointed for a term of 3 years, but may from time to time be reappointed.

(2) Every appointed member, unless he sooner vacates his office otherwise than by effluxion of time, shall continue in office until his successor comes, into office, notwithstanding than the term for which he was appointed may have expired.

6. Extraordinary vacancies- (1) Any appointed member may at any time be removed from office by the Head of State, acting on the advice of Cabinet, for disability, inefficiency, bankruptcy, neglect of duty, misconduct or permanent departure from Western Samoa proved to the satisfaction of Cabinet, or may at any time resign his office by written notice addressed to the Secretary.

(2) The office of any appointed member shall become vacant if he dies or resigns or is removed from office, and thereupon the vacancy shall be treated as an extraordinary vacancy and shall be filled in the manner in which the original appointment to the vacant office was made.

(3) Every person appointed to fill an extraordinary vacancy shall be appointed for the residue of the term for which the vacating member was appointed.

7. Meetings - (1) Meetings of the Council shall be called by the Secretary, on a requisition in writing from at least 3 members or from the Chairman.

(2) The quorum for any meeting of the Council shall be 4 members.

(3) Every question before a meeting of the Council shall be determined by a majority of the votes of the members present at that meeting but the chairman of that meeting shall have a deliberative vote, and, in the case of an equality of votes, shall also have a casting vote.

(4) Except as otherwise provided in this Act or in any regulations, the Council may regulate its procedure as it thinks fit.

8. Secretary - (1) There shall be a Secretary to the Council who is a registered medical practitioner.

(2) The office of Secretary to the Council may be held in conjunction with any other office in the Department.

9. Remuneration and allowances of Council members - There may be paid, out of the funds of the Council:

(a) To each member of the Council, at a rate to be approved by Cabinet, travelling expenses reasonably incurred by him in the performance of his duties as a member of the Council; and

(b) To any member of the Council, so long as he is not a full time salaried officer or employee of the Government, such sum as may from time to time be approved by Cabinet in respect of each day or part of a day that he spends on the business of the Council.

PART II

QUALIFICATIONS AND REGISTRATION

10. Registers to be kept by Secretary - (1) The Secretary shall set up and keep the following registers, namely:

(a) A register of medical practitioners;

(b) A register of provisionally registered medical practitioners;

(c) A register of persons who are temporarily registered under section 16;

(d) A register of persons who are appointed by the Public Service Commission in accordance with section 26 to the staff of any hospital to carry out duties for which registration is required under this Act.

(2) The Secretary shall enter in each appropriate register the full names, addresses and professional qualifications of every person registered under this Act, together with such other particulars as may from time to time be prescribed, or be directed by the Council.

11. Qualifications and registration of medical practitioners - (1) After the expiration of the period of 3 months following the commencement of this Act, no person shall practise medicine or surgery in Western Samoa unless-

(a) He is registered as a medical practitioner under this Act and is the holder of a current practising certificate issued under section 17; or

(b) Being provisionally registered under this Act and being the holder of a current practising certificate issued under section 17, he practises medicine or surgery in accordance with subsection (2) of section 12; or

(c) He, practises medicine or surgery in accordance with a current temporary practising certificate issued to him under section 16; or

(d) He practises medicine or surgery in a hospital in accordance with subsection (1) of section 26

(2) Every person shall be entitled to registration as a medical practitioner under this Act who satisfies the Council-

(a) That he is of good character and reputation;

(b) That he has such qualifications and practical experience as are for the time being prescribed by the Council by notice published in the Gazette and in the Savali.

(3) Every person, who immediately prior to the commencement of this Act was the holder of a practising certificate under subsection (1) or subsection (2) of section 10 of the Medical and Dental Practitioners Act 1966, shall ipso facto be entitled to be registered as a medical practitioner under this Act.

12 Provisional registration - (1) Any person who lacks practical experience in medicine or surgery but who otherwise would be qualified for registration under the preceding section hereof; may be granted provisional registration by the Council under this section.

(2) Any person registered as a medical practitioner provisionally under this section may be employed or permitted to practise medicine or surgery in an approved hospital for such period as the Council shall consider necessary to enable such person to acquire the practical experience requisite for registration under the preceding section of this Act.

13. Applications for registration - (1) Every application under this Act for registration or provisional registration shall be made in writing to the Secretary in the prescribed form and shall be accompanied by-

(a) Two current references as to the applicants good character and reputation, given by medical practitioners of good standing (whether in Western Samoa or elsewhere); and

(b) Evidence to the satisfaction of the Council of the applicant's qualifications and practical experience; and

(c) The prescribed fee.

(2) No entry of the name of any person shall be made in any register kept under this Act except pursuant to a direction of the Council.

14. Applications to be considered by the Council - (1) At its first meeting after any application for registration has been submitted to the Secretary, or as soon thereafter as may be practicable, the Council shall consider the application and shall give such directions to the Secretary in respect thereof as it thinks fit and as is by this Act authorised.

(2) Before giving any such direction the Council may if it thinks fit examine on oath the person making the application or any person objecting to the application or any other person, with respect to the application, and for the purposes of any such examination the Chairman may administer an oath to any person appearing before a meeting of the Council.

(3) The Council may if it thinks fit require any person to verify by statutory declaration any statement made by him with respect to any application before the Council or with respect to any objection thereto.

15. Decisions of Council - (1) If the Council after considering any such application is of the opinion that the applicant is entitled to be registered in the manner specified in the application or in any other manner it shall so direct and the Secretary shall thereupon register the applicant in the manner directed and shall notify him accordingly in writing.

(2) If the Council after considering any such application is of opinion that the applicant is not entitled to be registered in the manner specified in the application or in any other manner it shall so direct and the Secretary shall thereupon refuse to register the applicant in any manner and shall notify him accordingly in writing.

16. Temporary practising certificates - (1) Notwithstanding anything to the contrary in this Act, the Council or the Director of Health, acting with the written concurrence of any 2 members of the Council, may issue to a person who has applied for registration under this Act a temporary certificate of permission to practice or surgery or both, as the case may be, which shall entitle the person, pending the consideration of his application by the Council, to practice in accordance with the certificate, to the extent to which he would be entitled if he had been registered in the manner specified in the certificate, and, while the certificate remains in force, he shall be deemed to be so registered.

(2) No such certificate shall in any case remain in force for a longer period than 3 months from the date of issue.

(3) The Council may at any time cancel any temporary certificate granted under this section and the certificate shall thereupon lapse, and there shall be no appeal from any such cancellation.

17. Certificates of practice - (1) Every person who is registered or provisionally registered under this Act shall be entitled to receive a certificate of such registration in the prescribed from under the hand of the Secretary.

(2) Every person who is registered or provisionally registered under, this Act, and whose registration is not for the time being suspended, shall in every year on payment of the prescribed fee be entitled to receive a practising certificate for that year under the hand of the Secretary.

(3) Every practising certificate shall be in the prescribed, form and shall expire with the 31st day of December in the year for which it is issued.

(4) The Council may prescribe by notice published in the Gazette and in the Savali the length of practical experience that is necessary before a registered medical practitioner may set up practice in a private capacity.

(5) No person shall practise medicine or surgery in a private capacity in Western Samoa unless-

(a) He is registered as a medical practitioner under this Act; and

(b) He is the holder of a current practising certificate under this section; and

(c) He has the necessary practical experience required by subsection (4) of this section; and,

(d) The practicing certificate is endorsed on its face by the Council that the holder is entitled to practice medicine or surgery in Western Samoa in a private capacity.

18. Additional degrees, etc., to be entered in register- (1) Any person registered under this Act who obtains any approved degree, diploma, certificate or licence other than that by virtue of which he is registered, may apply to the Secretary to amend the register so far as it relates to the qualifications of that person; and on any such application the Council, if satisfied that the applicant is entitled to the degree, diploma, certificate or licence in respect of which the application is made and that it is one of a kind approved by the Council for the purposes of this section, shall direct the Secretary to amend the register accordingly, and the Secretary shall thereupon insert in the register particulars of the degree, diploma, certificate or licence.

(2) It may be a condition of the approval by the Council for the purpose of this section of any degree, diploma, certificate or licence that the course of education or examination therefore shall be such as is approved or required by the Council.

(3) Any approval or requirement for the purposes of this section may at any time be revoked by the Council.

19. Person registered to notify change of name or address - (1) Every person registered under this Act who at any time changes his name or address as appearing on any register shall, within 3 months thereafter, send to the Secretary a notice of his new name or address.

(2) Thereupon the Secretary shall alter the register accordingly.

20. Correction of registers - (1) If any, person has been registered under this Act by reason of any false or fraudulent representation or declaration, made either orally or in writing, or if any person not, entitled to be registered under this Act has been so registered, the Council shall cause the name of that person to be removed from the register.

(2) Where it appears to the Council that the name of any person is incorrectly stated in, or has been incorrectly removed from, any register kept under this Act, the Council may correct the register accordingly.

(3) Upon receiving creditable notice of the death of any person registered under this Act, the Secretary shall remove the name of that person from the register.

(4) If any person registered under this Act applies to the Secretary to have his name removed from the register, the Secretary shall, if the Council so directs, remove the name from the register accordingly.

(5) On the corning into effect of any decision of the Council or a Judge under sections 22, 23 or 24 of this Act respectively, to remove the name of a person from the appropriate register or suspend his registration under this Act, the Secretary shall take action in accordance therewith.

21. Inspection of registers - Every register kept under this Act shall at all reasonable times be open to the public for inspection at the office of the Secretary at Apia, subject to payment of any prescribed fee.

PART III

SUSPENSION, DISCIPLINE, APPEALS AND RE-REGISTRATION

22. Suspension of registration for disability - (1) If the Council at any time is satisfied that any person who its registered in any register requires to be kept by this Act is unable, owing to mental or physical disability, to perform his professional duties satisfactorily, and that, because he may attempt to perform those duties, it is necessary in the public interest to prevent him from so doing, the Council may direct that the registration of that person be forthwith suspended.

(2) The Council may at any time, either on application by or on behalf of that person or of its own motion, revoke any such suspension.

(3) The Secretary, after noting each such suspension and revocation of suspension of a person in the appropriate register, shall notify him accordingly in writing.

23. Disciplinary ovary powers of Council - (1) If the Council is satisfied in respect of any person registered under this Act that that person, whether before or after he became registered,-

(a) Has been guilty of disgraceful conduct in a professional respect; or

(b) Has been guilty of professional misconduct as a medical practitioner,-

it may, in its discretion, either cause that person's name to be removed from the appropriate register, or suspend his registration under this Act for a period not exceeding 12 months, or impose a fine of such amount as it thinks fit not exceeding $100.

(2) The Council may, if it thinks fit, determine that the decision of the Council under this section  in relation to any person shall not come into effect until a notice of appeal is given under section 24 of this Act or if no such notice is given until the period within which such a notice many be given has expired.  If within that period such a notice is given, the decision of the Council shall not take effect unless and until it is confirmed by a Judge or the appeal is for any reason dismissed by a Judge:

Provided that in any such case the decision shall take effect from the date of the decision of the Judge hearing the appeal or from such other date as the Judge may fix.

(3) Before exercising its powers under subsections (1) and (2), the Council shall cause to be served on the person concerned a notice-

(a) Specifying the allegations against that person in sufficient detail to enable him to prepare adequately any defence that he may have to such allegations; and

(b) Specifying a time and place at which he may appear before the Council to answer the allegations being such as will give the person reasonable opportunity to prepare any defence that he may have; and

(c) Informing him that he may appear before the Council at the time and place appointed, either personally or by his legal adviser or other representative, and cross-examine any witnesses called against him, and call evidence and make submissions on his own behalf.

(4) Before exercising its powers under subsections (1) and (2), the Council shall hold a hearing in accordance with the terms of the Notice referred to in subsection (3).

(5) For the purposes of the hearing, the Council shall have the same powers and privileges as are conferred on a Commission of Inquiry by the Commissions of Inquiry Act 1964.

(6) Any hearing of any matter under this section may be adjourned by the Council from time to time and from place to place.

(7) Every monetary penalty imposed by the Council under this section shall be recoverable by the Council as a debt due to the Council.  If any such penalty is not paid within the time specified by the Council in that behalf, or within such extended time as the Council may allow, the Council may suspend the registration of the person liable for the payment of the penalty, until the penalty is paid.

(8) Whenever the Council shall exercise any authority under this section in the case of any employee of the Public Service, the Secretary shall forthwith in writing notify the Public Service Commission of the determination or decision of the Council.

As to false or misleading certificate under the Mental Health Ordinance 1961, see s.40 thereof.

24. Appeals from decisions of Council - (1) Every person who is dissatisfied with any determination or decision of the Council relating to an application by him for registration or to authorise him to practise in a private capacity or to the removal of his name from any register, or to the suspension of his registration, or to the refusal to revoke any such suspension, or to the imposition on him of any fine, may, within 28 days after notice of the decision has been communicated to him by the Secretary, give a notice of appeal to the Secretary, and to the Registrar of the Supreme Court.

(2) A Judge shall hear the appeal as soon as practicable, and may be inform, reverse of modify the decision of the Council, including the giving of any decision which the Council could have given under this Act.  The Judge's decision shall be final.

(3) On any appeal under this section, the Judge may make such order as to costs as he shall think fit.

25. Re-registration - (1) Where the registration of any person is refused or revoked by the Council or, on appeal, by a Judge, the Council shall not be obliged to consider any further application by that person for registration under this Act for a period of 2 years following such refusal or revocation or, subject to subsection (2), for such further period as the Council thinks fit; and in allowing such subsequent application, the Council may impose conditions precedent to registration to be undergone by the applicant.

(2) Any person aggrieved by a refusal of the Council to consider any such further application during such period may, within 28 days after notice of the refusal has been communicated to him by the Secretary, give a notice of appeal to the Secretary, and to the Registrar of the Supreme Court.

(3) A Judge shall hear any such appeal as soon as practicable, and may make such order on the application (including any order as to costs) as he thinks fit. The Judge's decision shall be final.

PART IV

EMPLOYMENT, PRACTICE AND OFFENCES

26. Only registered persons to be employed - Except with the approval of the Minister, given on a recommendation made by the Council on special grounds to be specified in the recommendation, the Public Service Commission shall not appoint any person to the staff of any hospital to carry out the duties of any class for which registration is provided under this Act unless the person is registered or provisionally registered under this Act in that class or is the holder of a temporary practising certificate for that class:

Provided that nothing in this section shall be construed to restrict the employment in any hospital of persons undergoing a course of education in medicine or surgery.

27. Penalty for wrongfully procuring registration - Every person who wilfully makes or causes to be made any false entry in or falsification of any register kept under this Act, or procures or attempts to procure himself or any other person to be registered under this Act by making or producing or causing to be mad or produced and false or fraudulent representation or declaration, either orally or in writing, commits an offence and is liable to imprisonment for a term not exceeding 6 months or to a fine not exceeding $500.

28. Penalty for wrongfully using title of medical practitioner - (1) Every person commits an offence against this Act who contravenes subsection (1) of section 11 or subsection (5) of section 17.

(2) Every person commits an offence against this Act who, not being qualified to be a medical practitioner by virtue of this Act or by virtue of any degree, diploma, licence, qualification, or registration obtained outside Western Samoa, describes himself or otherwise holds himself out as a medical practitioner.

(3) Nothing in subsection (2) shall be construed so as to entitle any person to practise medicine or surgery in Western Samoa in contravention of subsection (1) of section 11.

(4) Every person who commits an offence specified in subsection (1) or (2) shall be liable on conviction to imprisonment for a term not exceeding 3 months or to a fine not exceeding $200, and to a further fine not exceeding $20 for every day on which the offence has continued.

As to certificates under the Mental Health Ordinance 1961 by persons who are not medical practitioners, see s.40 thereof. 

29. Right of persons to sue for fees - Every person who is registered and authorised under this Act to practise medicine or surgery in a private capacity shall be entitled to sue in any Court for the recovery for any fee or other remuneration for professional service rendered by him.

30. Other persons not to sue for fees - No person shall be entitled to recover any fee or other remuneration in any Court of law in Western Samoa for any medical or surgical advice or attendance or treatment, or for the performance of any operation, or for any medicine which he has both prescribed and supplied, unless, at the time when the fee or other remuneration in respect of which the action is brought was incurred, he was a registered medical practitioner.

31. Act not to affect Government claims, chemists, etc. - (1) Nothing in this Act shall affect any right of the Government to charge fees or other remuneration for any medical or surgical advice or attendance or treatment, or for the performance of any operation, or for any medicine supplied, or for any care and nursing supplies, in or from any hospital.

(2) Nothing in this Act shall affect the lawful occupation, trade or business of any pharmaceutical chemist, or registered midwife, maternity nurse or nurse.

PART V

MISCELLANEOUS

32. Certificate of Secretary to be evidence - A certificate under the hand of the Secretary to the effect that any person was or was not registered under this Act in any specified register at any specified time or during any specified period, or as to any entry in any register kept under this Act, or as to any act or proceeding of the Council, shall, until the contrary is proved, be sufficient evidence of the matters therein certified.

33. Funds of Council - (1) The funds of the Council shall comprise-

(a) Such money as may from time to time be appropriated by the Legislative Assembly for the purpose; and

(b) Fees payable under this Act for registration, provisional registration, practising certificates, and temporary practising certificates; and

(c) All other money payable to the Council under this Act or otherwise.

(2) The funds of the Council shall be administered in the Department of Health.

As to audit of funds, the Audit Office is auditor of all statutory authorities; see W.S.R. 1976/21/14 reprinted in title Audit.

34. Regulations - (1) The Head of State, acting on the advice of Cabinet, may, from time to time, make all such regulations as may in his opinion be necessary or expedient for giving full effect to the provisions of this Act and for the due administration thereof.

(2) Without limiting the general power conferred by subsection (1) of this section, regulations may be made for all or any of the following purposes:

(a) Prescribing the form and contents of and the method of keeping the registers under this Act;

(b) Prescribing the subject-matter of examinations to be conducted by the Council;

(c) Prescribing the forms of applications, certificates, and other documents required under this Act, what notice (if any) shall be given of applications, the manner in which notices may be served, and the times when they shall be deemed to have been served;

(d) Prescribing the fees payable in respect of education, examination, applications for registration, registration and giving of certificates under this Act, in respect of any alteration of or addition to any register kept under this Act, in respect of inspections of any such register, and in respect of any other matters under this Act;

(e) Prescribing the procedure of the Council;

(f) Prescribing fines; not exceeding $50, for the breach of any regulations.

(3) No regulation made under this section shall be deemed to be invalid on the ground that it delegates to or confers on the Council or any other person or body any discretionary authority.

35. Repeal - The Medical and Dental Practitioners Act 1966 is hereby repealed.

The Medical Practitioners Act 1975 is administered in the Department of Health.

REGULATIONS APPLYING TO MEDICAL PRACTITIONERS 

Medical Practitioners (Fees and Forms) Regulations 1977 (W.S.R. 1977/10)

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the Medical Practitioners (Fees and Forms) Regulations 1977

HIS HIGHNESS, MALIETOA TANUMAFILI II, HEAD OF STATE 
At the Government House at Apia this 10th day of June 1977

PURSUANT to the Medical Practitioners Act 1975, the Head of State, acting on the advice of Cabinet, hereby makes the following regulations.

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ANALYSIS

l. Title and commencement
2. Interpretation
3. Registers
4. Application for registration
5. Certificate of registration
6. Certificate of provisional registration
7. Practising certificates
8. Fees
Schedules
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REGULATIONS

1. Title and commencement - (1) These regulations may be cited as the Medical Practitioners (Fees and Forms) Regulations 1977.

(2) These regulations shall come into force on the date on which they are made.

These Regulations were gazetted on 1 July 1977, W.S. Gazette 1977, Vol. VII, No. 7, p. 749.

2. Interpretation - In these regulations, unless the context otherwise requires,-

"Act" means the Medical Practitioners Act 1975;

"Council" means the Medical Council established by the Act;

"Registration" includes provisional registration;

"Secretary" means the Secretary to the Council.

3. Registers - (1) The Secretary shall set up and keep a separate register for each class of persons referred to in section 10 of the Act to be registered under the Act.

(2) Each such register, with the appropriate title and necessary modifications, shall be in Form 1 set out in the First Schedule.

4. Application for registration - Every application for registration shall be made in Form 2 set out in the First Schedule.

5. Certificate of registration - A certificate of registration under the Act shall be in Form 3 set out in the First Schedule.

6. Certificate of provisional registration - A Certificate of provisional registration under the Act shall be in Form 4 set out in the First Schedule.

7. Practising certificates - (1) A temporary practising certificate to be issued under section 16 of the Act shall be in Form 5 set out in the First Schedule.

(2) An annual practising certificate issued to any person who is provisionally registered under the Act shall be in Form 6 set out in the First Schedule.

(3) An annual practising certificate issued to any person who is registered under the Act shall be in Form 7 set out in the First Schedule:

Provided that where such a certificate is issued to a person practising medicine or surgery in a private capacity, the certificate shall be engrossed on its face as follows:

"And is entitled under this certificate to practise in a private capacity."

8. Fees - The fees prescribed in the Second Schedule shall be paid to the Council in respect off the matters specified in that Schedule.

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SCHEDULES

FIRST SCHEDULE

Regulation 3

Form 1

Register of Medical Practitioners

(or appropriate title for each class of persons referred to in section 10 of the Act)

Date of registration: ..........................................................................................................................
Name: ................................................................................................................................................
Address: ............................................................................................................................................
Qualifications: ……………………………………………………………………………………..
Date of issue of certificate of registration: .......................................................................................
Date of issue of annual practising certificate: ..................................................................................
Date of amendment of register: ........................................................................................................
Nature and particulars of amendment
(e.g., additional qualifications): ........................................................................................................
New address: .....................................................................................................................................
Date of correction of register: ...........................................................................................................
Nature and particulars of correction: ................................................................................................
(As appropriate) Transfer of register - Date:.........................................................................
New register: ........................................................................................................................
Date of suspension from register: .....................................................................................................
Grounds for suspension: ...................................................................................................................
Date of removal from register: .........................................................................................................
Grounds for removal: ........................................................................................................................
Date of re-registration: ......................................................................................................................

Form 2

Regulation 4

Application For Registration

(or provisional registration) under the Medical Practitioners Act 1975.

The Secretary,
Medical Council,
APIA.

Application is hereby made for registration (or provisional registration) (delete as appropriate) as a medical practitioner under the provisions of the Medical Practitioners Act 1975. I submit the following particulars:-

1. Full name: .........................................................................(Surname first - Block letters)
2. Address: ............................................................. Residence: ............................................
Work or practice: ..................................................................................................................
3. Date of birth: ............................................ Place of birth: ………………………………
4. Qualifications, conferring authority and year of issue of each degree, diploma, certificate. etc.: ……………………………………………………………………………
(State all qualifications)
5. History of work or practice since qualifying:
______________________________________________________________________________

Date
_______________

Place
From                                  To
______________________________________________________________________________
(Complete on separate sheet if space insufficient)

6. Reasons for being in Western Samoa: …………………………………………………………..
7. Countries where now registered as a medical practitioner:…………………………………….
……………………………………………………………………………………………………
8. I have not at any time been removed from any register of medical practitioners in any country where I am or have been registered. (If so removed, state the date and reasons for removal): ………………………………………………………………………………………………………
9. I enclose: (a) 2 current references as to my good character and reputation given by:
…………………………………………………………………………………………..… (Name)
………………………………………………………………………………….…… (Designation)
…………………………………………………………………………………………... (Address)
and, 
…………………………………………………………………………………………….. (Name)
………………………………………………………………………………………. (Designation)
…………………………………………………………………………..………………. (Address)
(b) the fee of $ ……………………………………………………………………………………...
I HEREBY CERTIFY that I am the person applying for registration (or provisional registration) as a medical practitioner in Western Samoa, and that I am the person named in the above degrees, diplomas, certificates, etc. (delete or add as appropriate), and that the information I have given above is true and correct.

DATED AT ……………………….this …………………day of …………………..19…………..
…………………………………………………….
(Signature of applicant)

NOTE: Under the Medical Practitioners Act 1975, the Council in its discretion may require evidence, other than those submitted, of the applicant’s qualifications and practical experience; and may examine on oath the applicant or any other person with respect to the application; or may require the applicant to verify by statutory declaration any statement made by him in his application.
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Form 3
Regulation 5
Certificate of Registration under The Medical Practitioners Act 1975

I HEREBY certify that ……………………………………………………….……… is registered
as a medical practitioner, h……………………………. name having been duly entered in the register of Medical Practitioners of Western Samoa on the ……………………………………….
day of ……………………………………..19………………
DATED at Apia this ……………………..day of ………………………….19…………………...
.……..………………………………….…..
(Secretary to the Medical Council)
Signature of holder: ………………………………..
……………………………………………………...
……………………………………………………...

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Form 4
Regulation 6

Certificate of Professional Registration under the Medical Practitioner Act 1975

I HEREBY certify that ……………………………..…………………………….. is provisionally 
registered as a medical practitioner, h…………………………….……….name having been duly 
entered in the register of Provisionally Registered Medical Practitioners of Western Samoa on the ………………………………day of ………………………………………. 19……………….
DATED at Apia this …………………………………day of……………………19……………...
………………………………………
(Secretary of the Medical Council)

Signature of holder: ………………………………
…………………………………………………….
…………………………………………………….

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Form 5
Regulation 7 (1)
Temporary Practising Certificate

(Issued under section 16 of the Medical Practitioners Act 1975)

I HEREBY certify that …………………………………… is entitled to practise
…………………………………….* in Western Samoa.
THIS certificate shall be valid for 3 months from the date of issue and is in force until the ……………... day of ……………………………………..19……...., unless before that date the abovenamed has been duly registered or this certificate has been cancelled.
ISSUED at Apia this………………………day of……………………..19……………….
.……………………………………
for: (Director of Health)
(The Medical Council)

(*Insert medicine, or surgery, or both)

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Form 6
Regulation 7 (2)

Annual Practising Certificate of Provisionally Registered Medical Practitioner

I HEREBY certify that …………………………………………………………… is provisionally registered as a medical practitioner in Western Samoa under the provisions of the Medical Practitioners Act 1975 and is entitled to practice ……………………………………………...…*
in the hospital at ………………………………. Until the 31st day of December 19………………

DATED at Apia this …………………. day of ……………………………………19……………
……………………………………………..
(Secretary to the Medical Council)
(*Insert medicine, or surgery, or both)

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Form 7
Regulation 7 (3)

Annual Practising Certificate Of 
Registered Medical Practitioner

I HEREBY certify that ……………………………………………… is registered as a medical practitioner in Western Samoa under the provisions of the Medical Practitioners Act 1975 and is entitled to practise…………………………………………..* until the 31st day of December 19……………….

DATED at Apia this ………………………... day of …………………………..19………………
…………………………………………..
(Secretary to the Medical Council)
(*Insert medicine, or surgery, or both)

SECOND SCHEDULE

Regulation 8

Fees
$
On application for registration ……………………………………………………….	10.00	
On application for provisional registration…………………………………………...	5.00	
For certificate of registration (whether provisional or full registration)……………………………………………………………..…………….	
2.00	
For annual practising certificate (whether registered or provisionally registered)…………………………………………………………………………….	
2.00	
For any inspection of any register.…………………………………………………...	1.00	

MALIETOA TANUMAFILI II
HEAD OF STATE

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