By Dr Amon Aruho
My attention has been drawn to the fact that however much the National Health Insurance bill is highly supported by government and a certificate of financial implication has already been issued by the Ministry of Finance, it is bound to encounter hiccups, unless Parliament passes the Patients’ Rights and Responsibility Bill into law.
The Patients’ Rights and Responsibility Bill is not in the good books of government and this is premised on the vehement resistance it received from government by the Minister of State for Health Hon Sarah Opendi, when it was presented on the floor of Parliament by Hon. Paul Kamba.
The Minister of Health Hon. Ruth Aceng during the National Health Care Quality Improvement Conference in Kampala, retaliated the same that the proposed Patients bill is not required because it does not address Health Workers’ rights and will worsen the situation of Health care in Uganda by way of endless litigation against Health Workers.
Both the Patients’ Rights and Responsibility Bill and the National Health Insurance Bill are before parliament health committee and public scrutiny as it is required by law before passing them into acts of parliament.
This article enumerates why the National Health Insurance Scheme can work better in pursuit of quality universal health care for all Ugandans if the Patients’ Rights Bill is also passed into law as a check and balance, more so for redress and accountability, where the health care providers under the Scheme fall below standard, or if the Medical Malpractice and Patients’ rights violated.
Both laws envisage realization of universal health care in Uganda hence giving life to objective XIV, XX of National Objective and Directive Principle of State Policy and article 8A of the Constitution of Uganda that allude to the state to take all measures possible to ensure the provision of basic medical care services to the population.
Article 8A of the Uganda constitution as amended further postulates that parliament shall make a law that will envisage the provision of basic medical services to all the People of Uganda.
The National Health Insurance Bill provides for contributory mechanism where by the scheme will pool resources where the rich subsidize the treatment of the poor and the healthy will subsidize the treatment of the sick, young and elderly.
All this is towards progressive realization of universal health coverage and the right to health as provided in various international instruments that Uganda has ratified to.
The Patients’ Rights and Responsibility Bill provides for the best interest of patients as they access Medical services both in private and public health facilities, the proposed bill underscores rights of patients and their responsibilities towards health workers.
The proposed bill further seeks to empower health consumers to; demand high quality health care, promote the rights of patients, improve the quality of life of all Ugandans in line with inherent dignity and provides responsibilities patients owe health workers.
The right to health is not expressly provided in the constitution of Uganda and neither is it provided for in any act of parliament; it’s mentioned in the national objectives found in the preamble of the constitution but justifiability of these objectives has been a subject of debate and courts have held that they are non-justifiable.
However, although other commentators have thought otherwise, it is up to judicial activism of the Presiding judicial officer to find them justifiable as there is no law expressly providing for that.
However the situation will be different if the Patients’ rights bill is passed into law because the right to health will be derived from that law and duty bearers including the Health insurance Scheme shall be held accountable with authority of that law.
The Minister of Health Dr Ruth Aceng further argued that the Patients’ Rights Bill does not address the rights of Health workers and Patients’ rights are already Provided for in Ministry of Health’s Patient Charter of 2009. But it is my submission that rights of Health Workers are already provided for in the employment act of Uganda and its regulations thereto.
The Proposed Patients bill envisages Responsibilities of Patients towards Health Workers hence addressing some of the rights of Health workers.
The minister went ahead to say that some patients have assaulted health workers; this I do not dispute but there are laws providing for redress in case of being assaulted, like the penal code, civil procedure act, to mention but a few.
However, for violation of Patients’ Rights there is no distinct law providing for redress in case of such violation because the Patients’ charter mentioned by the minister is just persuasive and not legally binding and therefore it’s not justifiable and enforceable in courts of law in Uganda.
I so submit that the proposed Patients’ Bill provides for high quality health care, Standards and redress to be sought in case there is a fall in standard and violation of Patients’ Rights as we may experience this when the National Health Scheme has been operationalized, hence serving as a compliment and check to the National Health Insurance Scheme.
Otherwise, if this proposed Bill is not passed into law, we may not differ so much from the current Public Health care system that government realized has not been effective towards Progressive realization of right to Health and universal Health Care.
In light of the National Health Insurance Scheme, we need the force of law of the Proposed Patients’ Bill to ensure justifiability of the right to health, respect for Patients’ Rights, check and balance of the National Health Insurance Scheme.
We also need to be mindful and live to the fact that Uganda is a signatory to various regional and international instruments that provide for the right to Health hence both these Bills domesticate our international obligations.
It’s my considered Opinion that the passing of both these laws will create a leverage in ensuring high quality and safe medical care given to Ugandans through the Health insurance scheme and this being accounted for through the Patients’ Rights Law, which in turn will avert the recurrent Medical Malpractices that have sprung up within both the private and public health facilities and both Patients and Health workers can seek redress in case of violation of their rights.
Finally I appeal to all stakeholders to appreciate the fact that the success of the Health Insurance Scheme will to a big extent depend on quality and safety of health care services offered and the satisfaction of all Ugandans as they receive such services.
Such satisfaction is derived from redress and accountability that are well provided for in the Patients’ law.
Dr Aruho Amon is a Dentist/Advocate high court of Uganda, a Medical Legal Advocate with Enforcement of patients and health workers rights. (EPHWOR)PHD Candidate Medical Law University of Kwazulu Natal Durban. draruhoamon@gmail.com
