A Hospital Authority director on Monday said holding senior managers to account for any medical blunders at public hospitals won't mean that lower-ranked staff involved will be off the hook.

Bosses have pledged to improve governance and spell out the responsibility of staff of all ranks, after a special committee submitted 31 recommendations following a three-month review.

As part of the reform, the authority said it will develop a framework to strengthen the accountability of senior staff.

Michael Wong, the authority's director of quality and safety, said a reform committee will look at a reward and penalty system.

"Senior management under the accountability framework include hospital chief executives and department heads. Although they're the ones who'll mainly be held responsible, it doesn't mean that no other colleagues should take responsibility," Wong told an RTHK programme.

"Those overseeing hospital wards have their corresponding responsibilities, which will be evaluated during the employees' annual appraisals."

The authority's chairman, Henry Fan, previously said authorities might freeze the pay of senior managers for blunders, but firing employees might not be an option due to a manpower crunch faced by the public healthcare sector.

Alex Lam, from Hong Kong Patients' Voices, said Fan's comment gives a bad impression.

"If there's no dismissal mechanism when an employee makes a grave mistake, it seems to be like a 'get-out-of-jail free card', which says the employee can keep their job regardless of their mistake, and at worst, may only have their salary frozen," Lam said.