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Healthcare: Patients' Rights Exercise Compromised

6m SPP APV 2014The newest survey of the Provincial Protector of Citizens - Ombudsman (PPCO) conducted on the first six months of work of the patients' rights protection advisors in the local self-government units in the Autonomous Province of Vojvodina (APV) indicates that patients' rights exercise is compromised, primarily by their lack of competence and healthcare related legal expertise.

One of the most concerning data is that all advisors, except one, have already been employed with the local self-government prior to their appointment to their present post. This means that their new appointment only added healthcare issues to the list of their daily legal professionals' activities, without providing them with sufficient training or knowledge in this highly expert field. Most of them have attended a one-day's training, while four of them had no training whatsoever. This raises serious suspicion regarding the fulfillment of the proscribed condition that such an advisor must have substantial knowledge and expertise in handling healthcare related legal issues.

From December 2013 till May 2014, the advisors filed 236 complaints relating mostly to primary healthcare centers and general hospitals. Most patients complained orally (i.e. with no written track of their complaints) about the behavior of the nurses, organization of the healthcare service and its quality, as well as about the doctors' behavior and very limited possibilities to schedule appointments. The advisors established that patients' right had been violated in 39 percent of the cases. In spite of this figure, the fact that none of the advisors initiated formal proceedings to provide for the exercise of actual rights or to sanction professional misdemeanor with the relevant authorities is a serious cause of concern.

The PPCO supports the establishment and work of these advisors handling patients' complaints and invites them to process them more formally, esp. as related to the kind of rights being complained about, whether the violation really happened and the way the complaint related issue has been resolved. It is also crucial to bear in mind that the total lack of legal regulation concerning mandatory filing and recordkeeping of patients' complaints was one of the major operational faults of the advisors' institutional predecessor, aka the patients' rights protector.

Long-term experience in patients' rights protection and developments in healthcare related rights, as well as new legislation in this field providing a basis for establishing an efficient mechanism for their protection and development, were all an impetus for the PPCO to research the ways, conditions, results and problems in the work of the patients' rights protection advisors. Mandated to act pro-actively, the PPCO has drawn conclusions and formulated recommendations and communicated them to all national authorities in charge and other relevant actors to improve on both the position of the advisors and the healthcare clients' rights exercise in general.