Parliament is charged with a duty to make law, make budget allocations and carry out the oversight role on public expenditure among others. This makes Mps gate keepers of the citizens right to health care; they have government’s wish list for the health sector. It is from this wish list that citizens can enjoy improved healthcare settings.
The Patient rights and responsibilities law seeks to give legal force to scores of international commitments, basic medical services, access to health services, the patient charter, Universal health coverage, provide an accountability mechanism come the National health Insurance Scheme framework.
Entrenching patient responsibilities
The bill enjoins patients to: seek real time health care; take full responsibility while seeking health care; follow the course of medical or healthcare; furnish health provider the requisite full information about their health, pay up medical or health services financial obligations, respect health workers, hospital property, comply with visitation guidelines; give feedback, file complaints about reactions or the failure to respond to treatment to the healthcare giver or health unit so as to mitigate harm.
Entrenching Patient Rights
Patient rights to access healthcare; emergency healthcare; not to be detained at health facility for non payment; seeking second opinion, non discrimination, knowing indentify of health worker, access to medical records, right to Health Information; right to be referred after getting first aid to a health facility that can better manage health services sought; Refuse treatment, right to safe healthcare settings and attendant exceptions are the subject of the proposed law.
Protection of health workers from retaliation
Section 28 of the patient rights and responsibilities Bill protects health workers while operating within the framework the patient rights and responsibilities Bill. The proposed law does not seek to pit health facility owners against their employees but rather empower health workers to expose wrongs or errors that health units are involved in that fail making healthcare settings safer for patients.
Evidence shows that health worker’s as defenders of patient rights can suffer from violations although this is beyond the welfare concerns that are well covered in article 40 of the 1995 Constitution of Uganda as amended, the Employment Act of 2006, Workers' Compensation Act, 2000 (No. 8 of 2000) (Cap.225) this speaks to Employment accident and occupational disease benefit and the Occupational Safety and Health Act, 2006. Sad to note, health workers have not put these laws to test and I implore them to strengthen their workers or trade unions to lobby for the improvement of their welfare needs and also support fellow members get better pay.
It must also be known to all and sundry that the law shall protect health workers from any errors that happen in good faith and promotes the best interests of the patient in any health care setting. To that end, none of us is any the wiser about falling sick or being subjected to this state of healthcare.
I therefore implore all gate keepers of Uganda’s health sector to operate within the dictates of the rights based approach because patient rights is here to state and patients have become more vigilant than ever before.
Call to fast track enabling Legislative proposals
The parliament of Uganda has on its radar proposed laws that if past shall facilitate the implementation of the patient rights and responsibilities Bill, 2018 and these include:
The Uganda National Health Laboratory Services Bill, 2016 which is at first reading: seeks to establish an autonomous body, to provide for the purpose and functions of Uganda National Health Laboratory Services, to establish a board, its composition and functions of the board, to provide for the employees of Uganda National Health Laboratory. According to the Ministry of Health, health seekers in government hospitals at 70 % come for laboratory services.
The mental Health Bill of 2014 seeks to repeal the mental treatment Act of 1964 and operationalise the national health policy which identifies the mental health services as an essential aspect of health.
The National health insurance Bill of 2014 is awaiting cabinet approval to be table for first reading. A recent study (2008) by WHO revealed that Ugandans spend 22 percent of their earnings on health care, and six percent of the poorest who have the highest number of health bills have to sell their assets to meet medical bills. The National Social Health Insurance Scheme was expected to take off in July 2007, but was tabled before the Parliament of Uganda in March 2009. The National Health Insurance Fund (NHIF) failed to make it to through the parliament because of resistance from employers, trade unions and worker representatives. They were sceptical about the government’s ability to guarantee efficient service delivery given the poor state of health facilities in the country.
The National Health Insurance Fund is for all residents in Uganda. The initial plan is to cover around 2 million employed Ugandans (6% of the population) including 300,000 government workers and then transition to cover other voluntary members. The first phase of implementation will cover formal sector employees equal to six percent of the population. The premium for formal sector employees
is 8 percent of the employee's salary. Employers will be responsible for paying 4 percent, and the employee will be responsible for paying the remaining 4 percent.
In conclusion The benefits of implementing a Rights Based Approach to programming, budget allocation, health service provision among others cultivates smooth working relations of all players of the health sector and does not hound health workers acting in good faith but holds the tormentors liable for their actions acting in bad faith.