Банкеръ Weekly



He who requests or gets payment or another kind of reward for medical assistance he has provided, when this is not regulated by the law, is to be sanctioned to pay up to BGN500 for a first violation or up to BGN1,000 for a second one, if he is not subject to a graver sanction. A repeated violation is a reason for suspending this person's qualification. Monetary sanctions of this kind will be introduced by the new bill on patient's rights proposed by members of the Democrats for Strong Bulgaria group. The bill was put forward in Parliament by the MP associate professor Vassil Panitsa and is waiting for a date for discussion.
At present, the rights (and obligations) of patients are treated in the biggest details in section II of chapter three of the Health Act. The act became valid on January 1, 2005, but obviously does not satisfy the interests of the legal experts. The same issues are also treated in a number of other acts and regulations including in the National Framework Agreement. Patients' rights are even mentioned in the Constitution (art. 52). Besides, Bulgaria ratified international documents in the field - the Universal Declaration of Human Rights, the European Social Chart, etc. However, in most of the developed countries there are also special laws in this sphere.
The texts in the Health Act are not concrete enough and do not provide the necessary protection to patients, the group claims. Falling in the hands of a doctor, dentist or in a medical institution, one is defenceless. He is not competent to judge to what extent what they do to him is right and whether or not the procedures are necessary indeed. This alone is a sufficient reason to ask that patients' rights be defined clearly and protected by a law, Dr. Stoicho Katsarov, former deputy minister of healthcare, explained. He added that today ill people are doomed to be dissatisfied and complain, but there are no mechanisms that enable them to influence the development of the healthcare system.
The makers of the bill aim at achieving effective protection of the rights of patients. The document also defines some initial rights and terms such as the so called information agreement which exists even now but does not fulfil its task at all. According to Dr. Katsarov, When a patient is accepted in a hospital, he is given a model form valid for everybody in the country. It reads that you may not pay if the treatment is covered by the healthcare fund. This is not enough. None of the doctors knows 300 articles of the framework agreement by heart, not to mention the patients. So they are not aware of what they are signing under. We hold the view that the informed agreement should relate to the concrete person and the concrete disease. It should provide information about the diagnosis, the alternatives of the treatment applied, the risks and the possible consequences. And not just inform in principle how treatment is done in the respective hospital.
The two types of commissions planned by the bill are expected to provoke discussions, too. The first of them are dedicated to the rights of patients and will include two doctors, a psychologist or a social worker, a representative of the religious community. As well as the chairmen of the commissions, they will be appointed by the respective regional governors. These commissions will have to occupy with appeals filed by patients as well as with solution of ethical problems. Investigation commissions may be established at the regional healthcare centres to make inspections after warnings to local structures of the healthcare ministry or appeals of the respective commissions on patients' rights.
In order for a really modern act to be created, the latest European trend should be taken into account - the patient should be treated as consumer, former minister of healthcare Dr. Ilko Semerdzhiev said. At the same time, relations between a doctor and an ill person should be built on a basis that allows them not to bother about money. Moreover, Dr. Semerdzhiev proposed that catalogues be introduced in hospitals (like those existing in pharmacies) in which the types and prices of medical services would be described. This will make it easier for patients to have a choice.
According to the authors of the bill, the rights of patients do not depend on the way the healthcare system is financed. They are able and should exercise their rights regardless of the fact whether or not they have paid healthcare insurance. This is why the bill formulates universal rules, the Democrats for Strong Bulgaria members underlined.
It should be noted that a Bill on Protection of the Patient was put forward to the 39th National Assembly in September 2002 by Krustyo Petkov and Emilia Maslarova (Coalition for Bulgaria). On August 25, 2005 associate professor Atanas Shterev proposed a Bill on the Rights and Obligations of Patients on behalf of the National Movement Simeon II. However, both bills made no progress and are still in the position of permanent discussion.

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