Farirai Machivenyika
Senior Reporter
A Bill has been gazetted to upgrade the Health Services Act, the law that ensures the provision of comprehensive hospital services in Zimbabwe by laying down the admission and fee criteria for Government hospitals.
It also sets out the criteria for licensing private hospitals.
The Health Services Amendment Bill gazetted on Friday and shortly to be introduced in Parliament, brings the Act into line with the Constitution, especially in the Declaration of Rights where the right to health care for all citizens and permanent residents is entrenched along with the rights of children, rights of the elderly, rights of the disabled and rights of war veterans where medical services are a factor.
The Act recognises that some rights, such as access to emergency life-saving treatment, can be promulgated now with no real qualification, while other rights, such as medical services for the elderly or war veterans will be added to the list where the Health Minister can make regulations so these can be increased progressively as resources become available.
A fairly large block of the proposed amendment deals with patient rights, making these very explicit and not open to much argument, with adult patients having the absolute right to be fully informed and consulted over their condition and treatment, having the right to refuse treatment, and needing to give their written approval for any experimental treatment.
There is an ordered list of relatives, starting with a spouse and working down, who can give approval when a patient is unconscious, along with a provision for someone else to be appointed in advance as the approver.
Medical staff faced with a life-threatening emergency and unable to find someone to approve treatment will be able to go ahead, at least to keep the patient alive.
Emergency treatment has been carefully defined for the first time in Zimbabwean law as "treatment which is necessary to treat or reduce a life-threatening but reversible deterioration in a person's health status that causes an immediate risk to a person's life or long-term health and it continues to be emergency treatment until the condition of the person has stabilised or has been reversed to a particular extent'.
The definition is needed because the Act will, for the first time, make emergency treatment a right.
And emergency treatment is usually almost instant treatment, even where relatives cannot be found. At the same time private hospitals will be required if they are the one nearest to accept an emergency patient for up to 48 hours for stabilisation while arrangements are made for a transfer to a Government hospital, and with fees sorted out later if they are recoverable. There is also a clause requiring a private hospital able to offer a special service not available at a Government hospital.
Rights of children receiving medical treatment are made explicit, with parents and guardians being unable when the law comes into force to prevent or forbid their children from being given necessary medical treatment. Adults have the right to refuse treatment, and that will be entrenched in the proposed law although the adult must be made aware of the consequences of refusal, but children must receive the treatment.
The Act already allows the Health Minister to make hospital care regulations over a range of issues. The Amendment proposes to extend this list by including regulations in nine new categories:
Sign up for free AllAfrica Newsletters
Get the latest in African news delivered straight to your inbox
The basic health care to be afforded to persons with chronic illnesses and veterans of the War of Liberation; the basic health care and medical assistance to be afforded to persons over the age of 70; medical, psychological and functional treatment to be accessed by persons with disabilities; emergency medical treatment; reproductive health care; ensuring health care services of minor children are not prejudiced by the moral and religious beliefs of the parents and guardians; the basic health care packages which shall be available at Government primary health care centres, district, general, provincial, central and quinary hospitals for specialist services; minimum standards to prevent unauthorised access to patients' records; and the establishment and composition of a national consultative health forum.
Choosing the path of permitting regulations rather than fixing these factors in statute law means that the Minister of Health can amend them easily and frequently as resources become available to upgrade.
