5 November 2007
Port Louis — The Institute for Consumer Protection welcomes the Ministry's initiative to initiate consultations in view of the formulation of a Patients' Charter. We will fully support this initiative in view of the implementation of the Charter at the earliest possible.
A Patients' Charter should, according to us, respond fundamentally to patients' rights to basic health care, information, choice and right to obtain redress. These are, in fact, four of the eight basic Consumer Rights, as enshrined in the UN Guidelines for Consumer Protection.
General Comments
1. Limitation to public sector.
We fail to understand why this Charter should be limited to the public sector only, as specified by the Ministry during the last consultation meeting. The Medical Council Act provides for patients having recourse to the public or private health institutions for the same right to obtain redress against medical practitioners in cases of alleged medical negligence.
We are of opinion that patients who have recourse to the private health institutions should have the same rights as those who attend public health institutions, more so, since they are paying for the services provided.
Furthermore, in view of the setting up of a Nursing Council, we believe that it would not be convenient to limit the powers of the Council exclusively to nurses working in the public sector.
Hence we suggest it is specifically mentioned that this Patients' Charter concerns all patients, indiscriminately.
2. Special provisions for pregnant women.
Pregnant women should not be considered as sick patients, but patients with special needs, unless they suffer from some medical conditions. Yet they need medical attention before, during and after delivery.
We are of opinion that special provisions should be made for pregnant women attending antenatal care. We are of opinion that pregnant women have the right to information and choice. They also have the right for better comfort and privacy, while attending antenatal care, in order not to increase stress.
3. Special provisions for Breastfeeding mothers.
In accordance with the Baby Friendly Hospital Initiative, hospitals should have a written breastfeeding policy. Hence, mothers may expect that medical staff will abide by their choice to breastfeed their babies or not. New mothers have the right to be informed about the benefits of breastfeeding.
4. Right to privacy.
In addition to patients' right to confidentiality of information, as provided for in paragraph 4, we aver that patients also have the right to privacy. We recall, for example, the indication on a patient's card of the fact of his/being seen by a psychiatrist may cause the patient to be stigmatized.
5. Children should not be treated as miniature adults.
i) Studies have proved that most children are subject to varying degrees of trauma after a stay in hospital. Although this is inevitable, health institutions should adopt measures to reduce the effects of hospitalization on children to the lowest acceptable level.
We aver that there is a need for the formulation of Health Care Policy in respect of children. We suggest the following basic recommendations for this policy:
i) child shall not be taken to hospital unnecessarily, nor be kept there for any longer than necessary, parental access to children should not be limited and facilities for rooming-in should be provided.
All staff should be psychologically trained in the management of children.
ii) Furthermore, we are of opinion that children should not be hospitalized in the company of adults, as is the case actually in orthopaedic wards.
iii) Rooming-in facilities should be provided to breastfeeding mothers. This applies to infants who are treated as in-patients for some medical conditions.
Parents of children below ten years should have access to their children any time during the day.
iv) Mothers who choose to accompany their infants during the latter's hospitalization should be provided adequate comfort and facilities. This will reduce stress.
v) Most up-to-date pediatricians place communications as a major issue. In line with these trends, we urge policy-makers to provide facilities where doctors can respond to parents' queries.
6. Compliance to the WHO-UNICEF International Code of Marketing of Breastmilk Substitutes.
Breastfeeding mothers and babies have the right to be protected from harassment and marketing gimmicks of formula-milk importers and distributors.
7. Right to adequate comfort.
We are of the view that patients have the right to a change of bedsheets daily.
8. Right to comfort while eating.
Presently patients have to sit on their beds holding their plates in their hands to eat. This is a most uncomfortable situation. We suggest that patients should have the right to a movable table to take food.
Comments on the proposed document
We agree with all the provisions, except for the following provisions for which we are making some comments and suggestions.
Paragraph 2. to know about health services
The right to be informed seems more appropriate than to know.
Paragraph 9. to a brief, factual written report regarding their medical condition.
While we concede that some patients may abuse of this provision to have investigations on their medical conditions effected in public hospitals and then have recourse to private practice, yet the limitation of this right to only a "brief factual report, may aggrieve some patients. We recall, for example, patients having suffered from injuries during a road accident. Such consumers may need a complete medical report in order to claim for compensation from insurance companies.
We therefore suggest that this provision should provide for a balance whereby patients are not deprived of their right to information, while others cannot make an abuse of it for having recourse to private health care institutions.
Institute for Consumer Protection
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