Why Parliament must pass the Patients’ Rights Bill now

Surgeons operate a child at Arua Regional Referral Hospital. Under the proposed law, patients and doctors share the decision-making responsibility.

What you need to know:

Purpose. As the architect of the Bill (Mr Milton Muwuma- Kigulu South) explained to the House, there is a need for a law to prohibit discrimination in healthcare delivery, safeguarding the right of patients to confidentiality; and requiring informed consent to be obtained from patients undergoing treatment.

There is a seething debate in Parliament on whether our country needs a law on patients’ rights and responsibilities. The Uganda National Health Consumers’ Organisation, an organisation that has championed the rights-based approach to healthcare, started this very important debate and a group of concerned MPs later picked up the issue. The debate deepened on the day the MPs applied for leave of the House to table the new Bill titled: The Patient’s Rights and Responsibilities Bill, 2015.

The proposed law is a major step towards emancipation of patients whose rights have been trampled on by some health practitioners. The proposed law empowers patients to give feedback (both positive and negative) or comments, or raise concerns or complaints about the health care they received.

Far from the untruths being hawked by some MPs and health practitioners, the new Bill does not in any way seek to hunt down health workers, the objective is forthright: to empower health consumers to demand high quality healthcare; to promote the rights of patients and to improve the quality of life of all Ugandans in line with “inherent dignity” and the equal and unalienable rights of all members of the human family.
Under the proposed law, patients and doctors share the decision-making responsibility. So, the right to health also means that we need to have our health workers well paid, facilitated, accommodated, facilitated to work in an environment that protects the rights of patients.

Who is to blame?
Some blame the misconduct of some health workers on the meagre pay and overload in health facilities, but I blame the lack of a law that spells out the rights of patients and the responsibilities of care providers. The ugly truth is that hounding and harassment of patients, especially the pregnant mothers, is one of the dirty little secrets of nursing.

The scandal of abusive nurses is the rotten meat of a sick health sector. This tacit problem in the heath sector needs to be publicly acknowledged, and just as publicly discussed before damning the proposed law, because it’s embarrassing the health profession. Some doctors can also be insolent and careless. Egotistical doctors even insult nurses and patients with impunity. It’s even worse for latter.

The agony is that the poor patients don’t fight back against the people who put them in the corner. They are powerless to the extent that even when wrong procedures are done, they have no recourse. The overwhelmed and angry nurses take their frustration out on the rest of us stuck in the corner with them, or on anyone — like mothers and interns — they perceive as being less powerful than they are. It’s a daily heartbreak in our health facilities.

Objective of the law
Though for many years, common medical practice meant that physicians made decisions for their patients, many countries have enacted separate laws to ensure that patients receive treatment consistent with the dignity and respect they deserve as human beings. Far from persecuting reckless medical workers and careless hospital administrators, the new law seeks to provide, at minimum, equitable access to quality medical care, ensuring patients’ privacy and the confidentiality of their medical information, informing patients and obtaining their consent before employing a medical intervention, and providing a safe clinical environment.

As the architect of the Bill (Mr Milton Muwuma- Kigulu South) explained to the House, there is a need for a law to prohibit discrimination in health care delivery, safeguarding the right of patients to confidentiality; and requiring informed consent to be obtained from patients undergoing treatment as well as giving full information to patients about the risks involved with medical procedures and medication undertaken.

Nonetheless, the success of the new law requires more than convincing the antagonists to the proposed piece of legislation the doctors and health facilities; it requires educating Ugandans about what they should expect from their governments and their health care providers—about the kind of treatment and respect they are owed. Ugandans, then, can have an important part to play in elevating the standard of care when their own expectations of that care are raised.

Needed reforms
First, if government has decided to watch as patients’ rights are being violated left and centre, then, Parliament should lead the way in coming up with another piece of legislation on health insurance. Attempts by the government to introduce the National Health Insurance Scheme for the citizens have failed because of lack of seriousness. The new team at Ministry of Health should either resuscitate this urgent matter or be whipped by the health committee. Ugandans have to wait for this law for far too long. It should follow the patients’ rights Bill.

Secondly, it’s a shame that the government policy of providing free health services at public facilities is still running but over the years it has been recognised that much as the policy is for free health services, in reality, because of corruption, the free services are either inadequate or absent. Some Ugandans have been forced to sell their property or to acquire loans from loan sharks to address their health needs.

It’s important that we remind those against the proposed patients’ rights Bill that “power belongs to the people”. It is the responsibility of MPs and Parliament, to ensure that this power remains with them and makes sense to Ugandans. The power is delegated to Parliament must be used for purposes that promote public good. Therefore, Parliament should use the power to allocate resources without fear or favour and fix the ambiguities in the limping sectors of our economy.

It’s the job of Parliament to ensure that patients receive treatment consistent with the dignity and respect they are owed as human beings. According to World Health Organisation, there is a growing international consensus that all patients have a fundamental right to privacy, to the confidentiality of their medical information, to consent to or to refuse treatment, and to be informed about relevant risk to them of medical procedures. This is mainly the thinking behind the enactment of the patients’ rights Bill.