Will aware patients ask the right questions?

Namrata Devikar
Saturday, 22 September 2018

On August 30, the Ministry of Health and Family Welfare placed the draft of ‘Charter of Patient Rights’ in the public domain for suggestions. However, the discussion and much needed debate on the charter lost its way just like other debates on one common point of disagreement.

WHAT’S THE AIM OF THE CHARTER?
One unique aspect of this Charter is that it is prepared by the National Human Rights Commission (NHRC). The preamble of the Charter states that the Charter is formed on the lines of “growing consensus at international level that all patients must enjoy certain basic rights.” In its preamble, NHRC also underlines the need for the Charter highlighting that it is important at this point as “at the present juncture India does not have a dedicated regulator like other countries and existing regulations in the interest of patients, governing the healthcare delivery system is on the anvil.”

The preamble of the Charter states that it should serve as a guidance to healthcare providers to actively engage with patients’ rights and to create general awareness and educate citizens regarding the same.

WHAT THE CHARTER STATES
Doctors, healthcare providers and many patients have expressed support to most of the points included in the Charter as it talks about patients’ privacy, confidentiality and right to choose source for obtaining medicines or tests. As earlier, many cases of overcharging have come forth, this will give patients the right to buy medicines and get tests done at a facility of their own choice, rather than one prescribed by the doctor.

Speaking about the in-house tests being conducted, Dr Abhijit Vaidya, Head of Arogya Sena said it is important for patients to decide where to do the tests. “In many cases it is seen that the test reports from outside hospital are incorrect. Though the choice of doing the test and buying medicines should be of the patient, they must also be aware of the false reports they may get outside the hospital,” said Dr Vaidya. 

The Charter also extends the right to transparency in rates and care according to prescribed rates helping patients to seek expensive devices and implants at rates fixed by National Pharmaceutical Pricing Authority (NPPA) and other relevant authorities.

The right to emergency medical care ensures that emergency care should be extended to the patients without demanding payment and irrespective of the patient’s paying capacity. The onus of this has been given to the hospital management to ensure provision of such care through its doctors and staff.

WHAT IS THE DISCUSSION IN PUBLIC DOMAIN ABOUT?
Social media and other public platforms have successfully focused the discussion on only one clause in the charter, ‘Right to discharge of patient or receive body of deceased from hospital’. The clause states the patient or the body of the patient cannot be detained at the hospital on procedural grounds including non-payment or dispute regarding payment of hospital charges against wishes of the caretakers. Speaking on this Dr Arun Gadre, member of Alliance of Doctors for Ethical Healthcare (ADEH) said the clause should be amended. “There should be no confinement of the patient or the body of the patient by the hospital. However, there is a need to add a sub-clause where the patients or family of the deceased are also held responsible and made to clear the payments later. In my personal experience, if the clause remains unchanged then the small hospitals may suffer a lot as many patients do not turn up to clear the bills. Also, many hospitals will be forced to take deposits from patients as fear may loom about non-payment of bills later,” said Gadre.

RIGHT QUESTIONS TO BE ASKED
The Charter’s Preamble clearly states that it should serve as a guidance to healthcare providers to actively engage with patients’ rights and to create general awareness and educate citizens regarding the same. The Preamble of the Charter clearly states that the focus of the Charter is in awareness of the patients regarding their own rights. Hence the timing of the Charter is apt as over the past few years we have witnessed innumerable headlines about the rising cost of healthcare and unfathomable bills from private healthcare providers. Many health experts have provided evidence that many families in India after a major health setback are pushed below poverty line.  Now that the patient knows and understands his rights, the authorities should not be shocked if one might ask why they need to choose a private hospital over a public one even for the most basic treatment?

To this question, the present ruling party or the previous ones, will not be able to give a concrete answer as government after government has consecutively reduced the funds for public healthcare. Leaving the patients only with the option of choosing a private player who has a primary agenda of making profits.

A patient’s charter is much needed in this time, but the government should not run away from its primary responsibility of providing free and quality healthcare to all at minimal prices at the government hospitals.

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