The Nation Newspaper

Tag: Healthcare

  • Restitution and patients’ rights in healthcare (1)

    The World Health Organisation (WHO) recommends that every country should have a doctor (physician) to patient ration of 1:600. However, according to recent reports in the press, quoting the country’s chief physician (Minister of Health), the doctor to patient ration in Nigeria is about 1:4000, considering that Nigeria’s population stands at about 200million.

    There are some reports also, allegedly quoting the Labour Minister, that Nigeria has no shortage of doctors. Based on these alleged official declarations, let us take a brief look at the facts. Based on the WHO recommendation above, it thus means that Nigeria needs about 330,000 doctors at a minimum to meets its needs. However, Nigeria has no fewer than 90,000 doctors and just about half of which are in active practice. According to the Health minister, 50 per cent of these are distributed around Lagos and Abuja axis.

    Yet, Nigeria ranks among the top 10 poorest healthcare systems and in the top end of worst human capital development in the world. The indexes are frightening. Despite these, doctors that are based in Nigeria are doing their best to meet the monumental challenges that they face each day. Even at this, the confidence of an average Nigeria in the health system is weak, thus necessitating the wealthy to seek healthcare services abroad. They spend over US$1 billion yearly abroad.

    That said, the topic for today is patients’ rights even in the midst of the weak healthcare system. Healthcare service providers are providing services to the consumers. Therefore, healthcare clients or patients are consumers too. These consumers fall within the Consumer Protection Act. The patients have rights, responsibilities, duties and privileges just as the service providers themselves. All of these are enshrined in Nigeria’s legal system. It’s disheartening though that clinical injuries that are negligently caused are also rising with lethal consequences for all concerned. But there is good news: patients are becoming more aware of their rights and healthcare providers are becoming more conscious of their responsibilities.

    The law forbids abuse. Patients should not abuse the legal provisions that exist to protect them to the detriment of the medical profession. With this in mind, I will set out the provision of the law that specifically relates to patients’ rights as stated in the National Health Act of 2014.  Just as for doctors, nurses, pharmacists, physiotherapists, psychologists and all healthcare professionals are subject to the law and not just the doctors alone. Apart from the code of conducts that regulates the respective healthcare professionals, which also provides safeguards for patients, consumers of healthcare service are also protected under the National Health Care Act of 2014. I have copied verbatim here, such, rights and safeguards under sections 23-28 of the National Healthcare Act 2014. Let us call these provisions our own Nigerian “Patients’ Bill of Rights.”

    Section 23 (1) every health care provider shall give user relevant information pertaining to his state of health and necessary treatment relating thereto including: (a) The user’s health status except in circumstances where there is substantial evidence that the disclosure of the users health status would be contrary to the best interests of the user; (b) The range of diagnostic procedures and treatment options generally available to the user; (c) The benefits, risks, costs and consequences generally associated with each option; and (d) The user’s right to refuse health services and explain the implications, risks, obligations of such refusal.

    (2) The health care provider concerned shall, where possible, inform the user in a language that the user understands and in a manner which takes into account the user’s level of literacy. According to Section 24, the federal ministry, every state ministry of health, every local government health authority and every private health care provider shall ensure that appropriate, adequate and comprehensive information is disseminated and displayed at facility level on the health services for which they are responsible, which shall include: (a) The types of health services available; (b) The organisation of health services; (c) Operating schedules and timetables of visits; (d) Procedures for laying complaints; and (e) The rights and duties of users and health care providers.

    According to Section 25, subject to applicable archiving legislation, the person in charge of a health establishment shall ensure that a health record containing such information as may be prescribed is created and available at that health establishment for every user of health services.

     

    • If you have any question or clarification on this article, please contact me: 07087733114 or website: www.the-hospitals.com.

     

    • Culled in part, from the book: ‘Personal Injury & Clinical Negligence: Consumer Rights & Provider’s Responsibilities’ by Joel Akande

  • Affordable healthcare for Makoko residents

    The Therapists Without Borders Foundation (TWBF) at the weekend visited Makoko to provide therapeutic services, personal hygiene training, and distribute materials that will promote personal hygiene to the people.

    The visit was part of events lined up to mark the Occupational Therapy and Autism Awareness month worldwide.

    Over 50 women between the ages of 15 and 70 benefitted from this outreach. Volunteers and workers of the organisation had one-on-one lectures with residents on the benefits of personal hygiene.

    Items distributed include foodstuff, toiletries (sanitary pad, soap, tooth brush, and paste, antiseptic solution, tissue paper, and antibacterial detergent).

    Founder of TWBF Dr Tosin Emmanuel said the outreach was the first of several programs the foundation has lined up to mark the Occupational Therapy and Autism Awareness month, celebrated worldwide every April.

    Emmanuel said she decided to take this outreach to Makoko area because “It is important to educate this community due to the decreased level of hygiene within their environment which increases the spread of diseases.

    “We targeted women and young girls because we believe that educating these women about the importance of proper personal hygiene will boost their self-confidence and esteem and also increase their knowledge on ways to reduce the spread of diseases within their homes and community.”

    Emmanuel was also concerned about the women’s inaccessibility to cheap medical care, and called on government and well-meaning Nigerians to partner the foundation and help these people get better access to medical care. “Due to the concerns of the women in the community about the cost of their medical services, TWBF will partner the nearby Aiyetoro Health Centre to assist with their primary check-up and immunisations in the future,” she added.

  • Healthcare fund for Lassa fever treatment coming, says Fed Govt

    SUCCOUR is underway for patients with confirmed cases of Lassa fever as the Federal Government plans to introduce a funding mechanism to cater for them, the Director-General of the Nigeria Centre for Disease Control (NCDC), Dr Chikwe Ihekweazu, said yesterday.

    Ihekweazu, who dropped the hint in chat with the New Agency of Nigeria (NAN) in Abuja, explained that the aim of the healthcare fund was to ensure that money does not become a hindrance for patients in accessing Lassa fever treatment.

    He said: “We are making plans through the Basic Primary Healthcare Provision Fund, the new funding instituted by the federal government, to cover the cost of treatment of confirmed cases of Lassa fever patients.

    “A process is ongoing on how to manage this and it is at the heart of discussion at all levels of government at the moment. The aim is to make sure that ability to pay is not a barrier to accessing the treatment for public health diseases such as Lassa fever.”

    According to him, efforts are being made by the government through the NCDC to reduce the burden of treatment on patients, pending the take- off of the healthcare fund.

    Ihekweazu explained: “We from the Federal Government level have made sure that the core treatment costs are covered; of course when you are admitted in a hospital there are other costs accrued to you.

    “What we have been doing with the Teaching Hospitals is to make sure that such cost is reduced to the barest minimum. In some cases we are able to treat patients absolutely free, in other cases they still have to pay.

    “What we have ensured in all the treatment centres in Nigeria is that no patient has ever been turned away because of his or her inability to pay and no patient has been detained in any hospital for not being able to pay.

    “So, eventually, either upfront or at the end of that treatment period, we ensure that everyone gets the treatment.”

    The NCDC chief said: “You don’t need to be wealthy to keep your environment clean, so, the key thing is to get the messages out in all Nigerian languages that this is what you need to do to prevent the disease. Prevention is so much cheaper than cure because the illness can kill. This is a big financial burden for government.”

  • Niger Assembly passes state contributory healthcare bill

    The Niger House of Assembly has passed the state contributory healthcare bill aimed at ensuring easy access to quality and affordable healthcare services.

    The passage was followed by the adoption of the report of the House Joint Committee on Health, Finance, Labour and productivity at the plenary in Minna.

    Presenting the report of the Committee, Honorable John Bahago, said the intendment if the Bill is to ensure the people have access to affordable and quality healthcare services in the state.

    He added that the scheme would reduce the out of pocket expenditure of the people and make healthcare affordable to all by protecting families from financial hardship of huge medical bills.

    “The number one factor that is a barrier to accessing affordable quality healthcare towards achieving universal health coverage is financial problems and associated high out of pocket expenditure. This Scheme will limit the inflationary rise in the cost of health are services and generate a pool of resources to carter for both formal and informal sector.

    “The Committee noted that Niger is among the three states of Anyia and Osun selected in the country to pilot the programe and further observed that the federal government of Nigeria has made it mandatory for all states in the federation to establish a Health contributory scheme to enable them access the Basic Healthcare Provision Fund.”

    The Speaker of the Assembly, Honorable Marafa Ahmed after effecting all alterations into the Bill stated that the passage of the bill would help transform the health sector in the state and directed the Clerk to forward clean copies of the bill to the governor for assent.

  • Osun gets $20m to fix healthcare

    The Osun State government will get $20 million to fix healthcare facilities, the Minister of Health, Prof. Isaac Adewole, said yesterday.

    Adewole broke the news when he hosted Governor Gboyega Oyetola in his office in Abuja, the nation’s capital.

    The money is the earning of the state from the World Bank-supported Saving One Million Lives (SOML) programme for result initiative.

    The programme is aimed at giving incentives based on the achievement of results (health outcomes) and helping to drive institutional processes needed to achieve results.

    It also seeks to catalyse change in the way health business is done by focussing on results and governance.

    The programme is financed through the $500 million International Development Association (IDA) credit to the Federal Government over four years for distribution to states on the basis of performance.

    States are assessed based on the implementation of a number of maternal and child healthcare indicators, which determine what is earned.

    Oyetola said Osun State would use the money to fix 332 of the over 900 primary health centres (PHC) in the state.

    This will be on the basis of one PHC per ward, to bring healthcare to the doorstep of the people at the grassroots, the governor said.

    Oyetola, who is the chairman of the committee on healthcare, which he constituted after his inauguration, said he took charge “to put my eyes on the ball and ensure that the 332 PHCs go into full operation within the shortest possible time”.

    The governor said he was prioritising healthcare because “a healthy state is a wealthy state”.

    That is why healthcare and education are critical indices of the Human Capital Development (HCD), he added.

    Oyetola hailed the minister for supporting Osun State and for his ambition when he was bidding for the position.

    The governor added that he was looking forward to actualising the planned upgrading of the Wesley Guild Hospital in Ilesa to a Federal Medical Centre (FMC).

    The Permanent Secretary in the Federal Ministry of Health, Abdulaziz Abdullahi, and other top officials, including Dr. Ibrahim Kana, the Programme Manager of SOML, who made a presentation of the Osun State Healthcare indices, attended the meeting.

    Also yesterday, Oyetola hosted the Deputy Head of Mission, Finnish Embassy, Otto Stenius, and Trade and Investment Development attache, Ms Suri Laakson, at the Osun House in the Federal Capital Territory (FCT).

    The envoy promised to support the planned agriculture exhibition of the state government.

    Oyetola urged developed countries to support developing countries to empower their people.

    “It is in the best interest of the developed countries to assist developing counties to prevent migration, which is now in a very high rate,” he said.

    He canvassed the idea of Public–Private-Partnership (PPP) as a business model, saying: “Government has no business in business.”

  • Experts unveil roadmap for healthcare

    Healthcare professionals and medical students have drawn a roadmap on how to achieve sustainable development in the sector.

    The experts were among the 600 participants, including medical students, healthcare professionals, non-governmental organisations, policy makers, research and experts from 11 countries who attended the Federation of African Medical Students Association’s (FAMSA) 32nd General Assembly at the University of Ibadan, the Oyo State capital.

    Participants rose from the meeting with a pledge to play active roles in structuring healthcare in Africa.

    UI College of Medicine Provost, Professor Oluwabunmi Olapade- Olaopa described the Assembly as the largest gathering of medical students and professionals.

    The conference, with the theme: “Repositioning healthcare in Africa for sustainable development,” provided an opportunity for experts to build on the Millennium Development goals programmes of the United Nations and other development partners in 2015, he said.

    He said the assembly adopted the 17 Sustainable Development Goals (SDGs) to serve as a universal call to action to end poverty; protect the planet and ensure that all people enjoy peace and prosperity.

    The assembly, he added, provided another opportunity to latch on three SDGs specific to health, which was aproposed solution that brought together young minds as well as professionals and other stakeholders in both public and private sectors from across Africa to discuss ideas and initiate steps towards the goals.

    In his welcome address, patron and chair of the advisory board, Professor Akinyinka Omigbodun said the assembly provided opportunity for experts at the five-day conference through various plenary sessions, workshops,and scientific presentations to examine topics including infectious diseases in Africa. Also delivering the keynote address,   the regional director, World Health Organisation(WHO), Dr. Clement Lugala, examined issues bordering on the burden of non-communicable diseases and the younger generation.

  • Making primary healthcare work

    A 400-Level medical student of the Imo State University (IMSU), Ekenedirichukwu Ahaneku, was selected by the United Nations Children’s Fund (UNICEF) to participate in a global Primary Healthcare summit in Astana, Kazakhstan. At the event, Ekenedirichukwu, a CAMPUSLIFE reporter, led discussion around impediments to youth participation in primary healthcare delivery. CHUKWUEBUKA OSUJI (400-Level Library and Information Science) and NOEL OSUJI (300-Level Medicine and Surgery) report.

    Youth groups and students working for the realisation of Primary Health Care (PHC) across the world gathered at Astana, Kazakhstan for a three-day global health conference focusing on building partnership to achieving Universal Health Coverage (UHC) and Sustainable Development Goals (SDGs).

    The event, organised by World Health Organisation (WHO) and the United Nations International Children’s Emergency Fund (UNICEF), was held to commemorate the 40th anniversary of an international declaration in Alma-Ata, Kazakhstan, which recognised the importance of primary healthcare. Nigeria’s Ministry of Health also supported the programme.

    Health professionals, including the WHO Director-General, Dr Tadros Ghebreyesus, Kazakhstani Minister of Health Salidat Kairbekova, attended the event with representatives of health ministers of signatory countries and health organisations.

    Participants discussed ways to redesign some of the concepts and original principles of primary healthcare. The event served gave signatory governments opportunity to renew their commitments towards achieving universal health coverage.

    The conference featured a session tagged: Youth pre-conference, aimed at showcasing youth engagement in PHC, their challenges and barriers impeding the realisation of primary healthcare in their respective communities.

    Participants in the side discussion engaged private healthcare providers about the roles of the youth in realising the visions of PHC through policymaking, practice and strategic implementation of global policies. They also discussed how they could leverage opportunities to bring about change.

    A 400-Level Medicine and Surgery student of Imo State University (IMSU), Ekenedirichukwu Ahaneku, who represented Nigeria at the conference, led the discussion during youth preparatory workshop tagged: Our future, our health, held on the first day as part of the conference session.

    During the plenary attended by 30 youth representatives, Ekenedirichukwu addressed the poor level of youth engagement in primary health care.

    Ekenedirichukwu, a primary healthcare volunteer and member of Nigerian Red Cross Society, is the Executive Director of Blas Innovative Minds, a social enterprise that has objectives to educate and improve capacity healthcare workers.

    The discussants resolved that there was need for incentives that would facilitate greater participation of youths in primary healthcare delivery across the world. Their resolutions were added to the recommendations issued by the organisers at the end of the summit.

    On the second day, the event featured general sessions, which focused on revitalising primary healthcare to achieve universal health coverage and how the government can take revolutionary approach to advancing the course.

    Participants agreed that a large number of countries, especially the third world countries, had done little to improve access to primary healthcare in line with the global target.

    Ghebreyesus described the level of achievement of PHC in developing countries as “appalling” and “sad”, while admonishing government representatives to seek ways through which their countries could improve access to healthcare for people at the lowest rung of society, who cannot afford expensive services in private hospitals.

    On the third day, the discussion focused on actions that should be taken towards the actualisation of accessible and effective healthcare and leveraging viable economic policies that would encourage investment in healthcare. The participating medical students had an opportunity to have one-on-one engagement with the WHO Director-General and Kazakhstani Minister of Health to discuss their resolutions at the youth workshop as well as prevalent issues affecting primary healthcare in their communities.

    After the plenaries ended, the participants gathered for social show in which they displayed their cultures. They also visited some primary healthcare organisations in Astana, Kazakhstani national museum, and some heritage sites. The event ended with a dinner at the Astana Opera.

    Ekenedirichukwu, who is also a CAMPUSLIFE reporter, described the event as “inspirational”, saying he learnt tips to make him improve his capacity to bringing about change in the way primary healthcare is delivered to Nigerians.

    He said: “My activities have always been directed towards the promotion of primary healthcare. This fetched me the opportunity to attend the conference. My attendance was fully sponsored by UNICEF and I see this as a rare opportunity. I will continue to champion the implementation of Astana Declaration in Nigeria in order to ensure that young people contribute to the promotion of primary healthcare.”

  • Consumer Protection: Healthcare as case study

    Note: These excerpts culled from the book: “Personal Injury & Clinical Negligence: Consumer Rights & Provider’s Responsibilities” which will be published in this column in the coming weeks was granted with the kind permission of the publisher, Strategic Insight Publishing.  The author of the book is Dr. Joel Akande. The book being sold in Nigeria for N2500, went on sale worldwide on 4 September 2018.

     

    Continue from last week…

    In this week, we conclude the excerpts from the above book. The remaining discussion continues in the book: “Personal Injury & Clinical Negligence: Consumer Rights & Provider’s Responsibilities”

     

    Continuation of a “Contract”

    What makes an agreement a contract?  There are five parts to a contract and we shall go through each of them in turn.

    Offer; Acceptance; Consideration; Intention to create legal relations; Capacity;

     

    Offer:

     

    Whatever business or profession a person or party may be in, they have something to offer or intend to offer purchasers or consumers of the goods of services. Take food vendor for example. A food seller places his/her ware in his/her shop looking for a buyer: This process is an offer. A medical doctor who opens a clinic is surely offering his or her skill to members of the public just as a taxi driver on the road is offering his service to intending rider.  This same explanation applies to a pharmacist, a dentist, a nurse who tells the world that he or she is available and offering to the intending clients his professional skills. The offer is nothing until the rest of the elements of contract kick in. A government, a mechanic, an electrician, etc offers their respective services to potential takers just as manufacturers of goods do.

     

    Acceptance:

     

    A hungry man who walks into the food store and knows that the food is on offer asks to be served. He asks for the price of what is on offer. He goes ahead and takes the food. In addition, a woman who boards a bus clearly has indicated or agreed to abide by the offer that had been made on the commuting. Similarly, a patient walks in to a clinic, asks for the fees charged, and proceeds to  undertake  the treatment or professional services on offer. All of these individuals have accepted the offer that the respective providers have made to the world.

     

    Consideration:

     

    Consideration is the value that is exchanged between the party making the offer (offeror) and the party that accepted the offer (offeree). This value may be money and or any other value defined by the parties to the contract. In other words as they say: nothing goes for nothing. There must be something returned in exchange for what you got.  The value or consideration may be a ride from say Lagos to Ibadan in exchange for helping you clean your house in place of paying N5000 for the job.

    In case of healthcare,  the consideration is usually a monetary exchange between the offeree (patient, service user or client) and offeror (the healthcare practitioner).

    Where there is no consideration, there is in general no contract. In cases of voluntary services as we shall see later, the law of contract still applies even though, clearly, it seems  there is no element of consideration. The consideration in volunteering is the satisfaction that the giver of service receives that he or she is doing some good even to his own hurt (altruism). Sadly, many people in Nigeria expects clinicians to fall into the class of altruism even though the doctors and allied workers have personal and business needs to meet.

    Intention to create legal relations:

    A contract may not be valid without the intention of the parties to enter into the contract. Examples: A person who does not intend to eat in an eatery but was forced to eat cannot reasonably be expected to pay for the food he had no intention of consuming. Similarly, a child under 18years who accompanied his mother on a tour cannot be expected to pay the fare, as the child as we shall see below, had no intention of going on the bus.  This is in fact the basis on which a child, except as in a case law called Gillick doctrine cannot consent for a medical treatment without an adult doing so on his or her behalf. Children cannot enter into a binding contract.

     

    Capacity:

     

    As a rule, a child cannot enter into a contract as we have mentioned. The reasoning behind this is both a matter of responsibility and maturity. Under the law, a child may not have the mental capacity to form a contract.

    A similar principle applies to mentally disabled people, confused persons such as the elderly and very physically ill persons who are unable to understand what is presented to him or her.  This doctrine has a practical application in healthcare. A child under 16 years except as in the case of Gillick, may not consent to treatment and hence cannot enter into a contract. The principle carries greater weight in employment of juveniles. Except as the law may allow, any contractual arrangement with a child that subjects the child to labour is obviously an abuse. We have a lot of such in Nigeria. Yet these children have no room or legitimacy to enforce their rights.

    In this week, we conclude the excerpts from the above book. The remaining discussion continues in the book: “Personal Injury & Clinical Negligence:  Consumer  Rights & Provider’s Responsibilities.” Our appreciation  to Strategic Insight Publishing for permission to use parts of the book on our health pages.

  • Consumer Protection: Healthcare as a case study

    Note: These excerpts culled from the book: “Personal Injury & Clinical Negligence: Consumer Rights & Provider’s Responsibilities” which will be published in this column in the coming weeks was granted with the kind permission of the publisher, Strategic Insight Publishing.  The author of the book is Dr. Joel Akande. The book being sold in Nigeria for N2500, went on sale worldwide on 4 September 2018.

     

    Continue from last week…

    Regulatory Authorities: Based on these legal hierarchies as explained above, individual professional members are allowed to practice their professions and be regulated by their respective regulatory authorities as empowered under their Acts as made by the National Assembly.

    Therefore, a typical clinician (say a medical doctor) is subject to the General Law (Criminal Code/Penal Code, respective Business Laws etc), the Industrial Sectional Law (National Health Act), and specific Professional Law ( such as Medical and Dental Practitioners Act) and finally for doctors, the MDCN acting under Medical and Dental Practitioners Act, enacted the Codes of Conduct for doctors. Similar operation of the law operates in Nursing, Pharmacy, Physiotherapy, Psychology, and Nutrition and for Laboratory Professionals.

    Now, for the reasons already mentioned and again for convenience, the healthcare industry will be used to illustrate issues of personal injury though the underlying principles of duty of care are applicable to an array of human endeavours.  The list of federal agencies and regulators where complaints may be lodged in the event of injury or be joined as co-defendants in litigations are listed at the end of the book.

     

    Law of contract as relates to healthcare

    Healthcare practitioners, like everyone else, are free to enter into a contract (otherwise called agreement) or exit a contract /agreement as the case may be. We encounter contract everywhere we turn either such contract is written down or implied. Contract can both be written in part and implied in part. Example of both written and implied contract is marriage between couples. Drivers on the roads have an implied “contract” to behave and drive carefully and not injure anyone whilst the driver uses the roads. Food sellers have implied contract not to harm consumers by the food that they sell. The government has a written contract (via the constitution and other enacted laws) to treat the citizens right and to defend the nation. Teachers have a contact with schools. Employees have a contract with their employers. We have a social contract with each other in the society to maintain the peace. Contract can be written or spoken or be implied depending on the circumstances that gave rise to such a contact as well as the intention of the parties to the contact.

    The law of contract in the common law jurisdiction, of which Nigeria is an integral part, is essentially a result of the jurisprudence (reasoning) of the judges. However, in some cases as in the United Kingdom, a specific Act of Parliament may exist to address some contract issues. This is the case as in Sales of Goods Act, 1979. (The Sale of Goods Act 1979 has now been replaced by the Consumer Rights Act 2015). Except as may be inferred from a specific legislation, the law of contract that is discussed in this book relates essentially to the Common Law reasoning of the Court.

    It is not my intention to turn the reader of this book into a lawyer overnight. Law of contract is larger and deeper than can be contained in the next few pages. The essential point to be made is that a contract exists between healthcare practitioners and their clients or patients or service users. Contract exists between service or product providers and the consumers of such products or services. Contact exists between manufactures, distributors and final consumers even though the contact may not be visible physically in most occasions: in the least, such contracts are enshrined in general law governing the people.

    A contract is simply by definition, an agreement between the entities or individuals or parties that intend to form the contract with the intention that each party will perform his or her part of the agreement and failing, the court may compel performance or award restitution to an injured party or the victim of failed contract.

    Let us also look at what other thinkers and writers have said of the definition of contract. American Restatement (2nd) of the law of Contract 1978 defines contract as “… a promise or set of promises for the breach of which the law gives a remedy or the performance of which the law in some way recognizes as a duty.”

    Let us take another look at the definition of contract: by Yerokun: “a contract as a promise or set of promises, which the law will enforce. Contract is mainly concerned with relation between persons, which the law will recognize and enforce where one of parties fails to perform his part of the bargain.”

    In the past centuries, many writers and courts placed much emphasis in respect of contract, on the need for a ‘meeting of minds’ or ‘consensus ad idem’ for the creation of contracts. This dependence on actual intention was a manifestation of laissez-faire philosophies and a belief in unencumbered freedom of contract. This particular approach to the making of contracts has now largely been jettisoned, though its effect can still be noticed in certain rules. In general, what matters in modern times is not what meaning a party actually intended to express by his words or conduct, but what meaning a reasonable person in the other contracting party’s position would have assumed him to be conveying. This process is known as ‘objective interpretation’.  This particular “objective interpretation” is very relevant in healthcare when a service user walks into a hospital with say bleeding from the head. Clearly, the patient is already saying loud and clear that he or she wants a treatment for his or her bleeding. Continue next week…

  • Consumer Protection: Healthcare as a case study (4)

    Note: The excerpts culled from the book: “Personal Injury & Clinical Negligence: Consumer Rights & Provider’s Responsibilities” which will be published in this column in the coming weeks was granted with the kind permission of the publisher, Strategic Insight Publishing.  The author of the book is Dr. Joel Akande. The book being sold in Nigeria for N2500, went on sale worldwide on 4 September 2018.

     

    Continue from last week…

    As the reader may have observed, the book has to do with Personal Injury, the bulk of the content deals with clinically related matters. Personal injury encompasses events that in part, are clinical and in part non-clinically related matters but issues that involve negligence resulting in injury in any area of human endeavour.  Falls on the road due to faults of the local government and or the contractor that made the road are examples. Slips on a wet floor at a shopping mall resulting in a broken arm of the victim, road traffic accidents and the likes that cause the victims to suffer harm are examples, which, at the outset, are non-clinical personal injury matters.

    Finally, I wish to state that this book is not written exclusively for the professionals. In writing this book, I have medical doctors, nurses, physiotherapists, laboratory scientists, pharmacists, occupational therapists and all other healthcare practitioners in mind. Further, the target audience includes lawyers, government agencies, professional regulators and indeed victims of personal injuries, clinical malpractice and the general public.. The consumer of any product or service be it on the street or via the internet are my focus. With this complex array of readers in mind, the approach that I have taken in writing this book is to present the book in a readable and to a large extent, jargon-free medical and legal language.

     

    The basics

    Now, let us deal with the basics.

    Introduction  and  Definition:  Medicolegal is the forensic examination of medical practice or as is very often the case, legal scrutiny of an alleged medical malpractice. Medicolegal is the discipline and service area that combines the practice and knowledge of law and medicine. Actual practice may also extend to cases that originally did not involve doctors such as road traffic accidents, whiplash injuries, falls in private or public places that is due to the fault of someone else. All of these constitute personal injuries. As the name implies, medicolegal is the meeting point of law and medicine, incorporating the reasoning of judges in arriving at the judgement for a case (jurisprudence) involving a claim against a medical practice or against a clinician. The person may be a nurse, doctor, physiotherapist or anyone that has a specific role to play in the care of a patient under the care of the specific practice. I hope the reader has taken note that contrary to what appears as the popular belief, medicolegal pursuit is not about medical doctors or dentists.

    The Health Sector within Larger Economy: The healthcare sector is part of the larger economy of a country. The larger or the national economy  being  the   umbrella  consisting of farming, retail, health, military and  so  forth  are  classed  as manufacturing and service sectors. Each industrial sector is regulated or is supposed to be regulated. Also, everyone in the same country be it a biological individual, unincorporated business or  body corporate (incorporated body or business) is subject to the general laws that govern the country, aimed at peaceful co-existence of all as well as preventing injuries by one person or party against the other (i.e the law seeks the welfare of persons). Such general laws may be laws regulating human conduct against assault, financial fraud and so forth.

    The Law: Each of the professions such as accountancy, engineering, healthcare is also subject to their own particular sets of laws that regulate them. Similarly, each sub-part that makes up the particular industrial sector is also subject to its own regulatory rules. Let us now cite some examples:  The Criminal Code has provisions in respect of assault. There are laws, which regulate health services and delivery in the country. Within the  health sector, the National Assembly makes the law for the establishment and regulation of medical practice,  nursing  practice,  physiotherapy practice, laboratory practice and so forth. Their respective regulatory bodies (such as Nursing and Midwifery  Council of Nigeria, Pharmacists Council of Nigeria and Medical and Dental  Council of Nigeria are empowered  and set up by the appropriate/applicable laws to regulate the education, training and practice of the respective members and professions).