The Gambia’s Health Services, described by one presidential candidate as a “death trap,” is frequently making unfavorable news headlines, often relating to tragic incidents of maternal mortality, or non-availability of essential medical equipment or consumables, leading to hardship and sometimes loss of life.
What is not often stated, is that behind the headlines are mostly decent, well trained and hardworking individuals, who are doing all their best in a poorly managed system that has fallen far short of patients’ expectations.
The constant reporting (thanks to social media), of unfavorable headlines about inadequacies of the healthcare system has put the authorities on the defensive. Their response has largely been politically convenient knee-jerk reactions that are minimally effective in the overall healthcare improvement strategy.
Clearly, what is needed, and apparently now recognised by the authorities, is a major health care reform that must have as its core objectives: a) Improving the general quality of healthcare delivery. b) Broadening access to healthcare services c) Lowering the cost of healthcare to be reasonably affordable by the greatest majority of the population.
It is acknowledged that each of these objectives incorporate multiple issues that need to be adequately studied and smartly implemented.
The responsibility for designing policies that will bring about comprehensive healthcare reform, and create a conducive environment for public/private participation falls on the government.
In formulating any such policy, a binding patient’s bill of rights/charter should form a key part, for successful implementation. This becomes pertinent, given our healthcare care environment, where any and every minimally qualified, uncertified, or unregistered person can set up a healthcare establishment, and openly entice the vulnerable sick, using questionable advertising techniques, and making unrealistic claims that may sometimes fall under the category of medical fraud.
A patient’s bill of rights must assert a minimum level care to be provided at each healthcare establishment that will be commensurate with the standards expected of their operating license. It must state expressly that patients must be treated confidentially, with dignity, and professionalism; and that includes appropriate assessment and management of patients’ complaints.
Normally included in any patient’s rights bill are requirements that the patient must be informed of the testing, diagnosis, treatment, and prognosis related to his/her condition, and must be given a chance to accept or refuse participation. In addition, any bill must make it mandatory that the patient be informed, and must give consent to participate in any Medical Research that will be part of their management.
The bill of rights should protect the patient from unrealistic and unprofessional cure-all claims by individuals and establishments that do not appear to fall under any sort of regulation, and yet purport to provide consequential complex medical maneuvers.
To make it work, a patient’s bill of Rights must establish a receptive and accommodating Ombudsman-like body that can listen to, and take up the complaints of long-suffering patients left distraught, and financially bankrupted by a system that appears to look after the professions rather than welfare of the sick.
The rights bill should be patient focused, while at the same time recognize the selfless sacrifice of the professionals providing the services.
A patient’s bill of rights will raise the overall standards of care, improve relations between care providers, and patients. It should provide an acceptable non-litigation method of addressing medical grievances between contesting parties.
The author is a Biomedical Scientist and Healthcare Specialist at Health Screen Diagnostic Laboratories, Brusubi