Public health experts and rights activists have said that health services in the country have become commercial in the absence of exhaustive law, and the people are impoverished while seeking treatment. They demanded speedy enactment of a comprehensive legislation for health.
Speaking at a webinar, they said that although various institutions and facilities have increased in the healthcare sector, the reforms and development of laws and policies have not been done accordingly.
They also said that the healthcare centers in the country are losing public trust due to various reasons, including legal constraints, lack of monitoring, and lack of Standard Operating Procedures (SOP). As a result, medical negligence has become a regular phenomenon and the incidents of medical negligence are on the rise, they added.
Center for Law and Policy Affairs-CLPA and Save the Environment Movement (Poba) jointly organised the webinar on Tuesday.
Presenting an article at the event, Syed Mahbubul Alam, an expert on public health and environment policy; said that although the public health issue, control of communicable and non-communicable diseases, and health management are related to about 45 laws, it is not possible to identify the standard and non-standard due to loopholes in the laws and policies. Speedy enactment of comprehensive legislation is a must to check medical negligence and ensure better healthcare for people, he opined.
Moderated by Aminul Islam Bakul, the meeting was addressed, among others, by Professor Firoz Ahmed, president of Doctors for Health and Environment; Mejbah Suman, general secretary of POBA; Samia Afrin, public health specialist at Naripokkho; Dr. Fakhrul Islam Khaled, an associate professor at Bangabandhu Sheikh Mujib Medical University (BSMMU); Dr. Mahbubur Rahman Rafi, an associate professor at BSMMU; Barrister Nishat Mahmud, member secretary of Public Health Lawyers Network; Dr. Rashid E Mahbub, an expert on public health; Md Bazlur Rahman Tarafder, an associate professor at Dhaka International University (DIU), Dr. Saqlain Russell form BIRDEM; Aminul Islam Rintu from Development Activities of Society (DAS); and Hamidul Islam Hillol from BNTTP.
In the article, Syed Mahbubul Alam mentioned that some provisions in ‘The Medical Practice and Private Clinics and Laboratories (Regulation) Ordinance, 1982’, ‘Consumers’ Right Protection Act’, The Penal Code, 1860 cover the health protection issue. None of these laws are exhaustive. In such a situation, it is necessary to enact a specific law to ensure the protection of individuals, institutions and healthcare recipients and to ensure the responsibility of the institutions, he added.
He recommended inclusion of internationally recognised medical negligence issues in the law. It is suggested that the responsibility and duties of the hospital/medical aid institutions, doctors, nurses, medical assistants, equipment suppliers, patients, and patient attendants should be specified to identify medical negligence. Otherwise the liability of medical negligence will fall only on the doctors, he said.
Speakers of the event specified the establishment and management of public hospitals in the law, as well as making provision for the government to give special benefits to public hospitals if needed, hospital authorities in patient protection and medical negligence, specifying the responsibilities of suppliers of food, medicine goods, materials in health care, to reduce medical expenses.
They recommended the formation of health protection committees, provision of administrative fines by the health department, formation of healthcare courts like environment court-drug court and empowering ordinary citizens to easily file complaints and cases.
The speakers also said that enactment of a comprehensive health protection law is now a public demand. This law should ensure that everyone's rights are protected, while at the same time those who violate rights and neglect their responsibilities have the opportunity to face accountability.
A comprehensive law defining medical negligence and setting compensation standards is vital also for preventing untoward incidents in healthcare sector as lack of specific law and proper way of taking legal action often lead to violence.
Although the ‘Consumers’ Right Protection Act, 2009’, ‘Bangladesh Medical and Dental Council Act, 2010’ and ‘The Penal Code 1860’ provide for some remedies, victims are not seen to complain in line with these laws due to loopholes.
Against this backdrop, the Law Commission had prepared a draft of a proposed law. The proposed law has been gathering dust in the offices concerned for a couple of years. In 2017, the Law Commission prepared the draft.
The draft of the proposed law incorporated 65 clauses in it. There are 14 sections in the draft law. The proposed law defines various types of negligence by doctors, medical institutions and other concerned. Besides, there are several provisions in the draft law according to the nature of negligence.
The proposed law touches the issues-- the negligence in the performance of proper duty by doctor; giving wrong treatment; misdiagnosis; providing wrong medication; removal of wrong organ; providing false or exaggerated reports; unnecessary delay in providing medical treatment in case of emergency; giving unnecessary pathological and diagnostic tests; prescribing unnecessary and repeatedly dispensing the same drugs from different companies; unnecessary out-of-scope treatment; not following prescribed treatment protocols; performed by a nurse, midwife, ward-boy or other person rather than a physician; and giving less or more medicine than required.
The negligence of hospitals and clinics have also been brought under the ambit of crime. That is, not regularly supervising all matters related to the patient’s treatment; not keeping adequate medical equipment; not storing all information regarding the opinions, orders and comments of trained and experienced nurses, doctors regarding the patient's treatment; failure to maintain all types of emergency medicine; failure to maintain necessary surgical equipment including autoclave; not taking effective measures to prevent hospital-acquired infections; every health facility that does not have its own waste management of international standards.
The proposed law includes the formatin of ‘Healthcare Dispute Resolution Tribunals’, the procedures of these tribunals and the formation of health care-related complaints, investigations, and appeal commissions in order to assess the damage caused and determine and recover its compensation.
