MEDICAL AND DENTAL PROFESSIONS BOARD

GUIDELINES FOR GOOD PRACTICE IN MEDICINE, DENTISTRY AND THE MEDICAL SCIENCES

NATIONAL PATIENTS’ RIGHTS CHARTER

BOOKLET 13

PRETORIA JULY 2002

1

NATIONAL PATIENTS’ RIGHTS CHARTER

PREAMBLE

The  Department  of  Health,  in  consultation  with  various  other  bodies,  developed  a  National Patients’ Rights Charter.  The Medical and Dental Professions Board at the time also submitted input into the different drafts that were circulated for comments.

The document contained herein was launched by the Minister of Health and agreed to by the Board.  It has since been included in the Board’s Handbook for Interns, Accredited facilities and Health Authorities.

The Board takes this opportunity to make the National Patients’ Rights Charter available to all practitioners provided for by the Board as part of its series of Booklets on Guidelines for Good Practice in Medicine, Dentistry and Medical Sciences.

NATIONAL PATIENTS’ RIGHTS CHARTER

1            INTRODUCTION

1.1         For many decades the vast majority of the South African population has experienced either a denial or violation of fundamental human rights, including rights to health care services.

1.2         To ensure the realisation of the right of access to health care services as guaranteed in the Constitution of the Republic of South Africa, 1996 (Act No. 109 of 1996), the Department of Health is committed to upholding, promoting and protecting this right and, therefore, proclaims this PATIENTS’ RIGHTS CHARTER as a  common standard for achieving the realisation of this right.

2            PATIENTS’ RIGHTS

2.1         HEALTHY AND SAFE ENVIRONMENT

Everyone has the right to a healthy and safe environment that will ensure their physical and mental health or well-being, including adequate water supply, sanitation and waste disposal, as well as protection from all forms of environmental danger, such as pollution, ecological degradation or infection.

2.2         PARTICIPATION IN DECISION-MAKING

Every citizen has the right to participate in the development of health policies, whereas everyone has the right to participate in decision-making on matters affecting one’s own health.

2.3         ACCESS TO HEALTH CARE

Everyone has the right to access to health care services that include -

2

a.           receiving  timely  emergency care at  any  health  care  facility  that  is  open, regardless of one’s ability to pay;

b.           treatment and rehabilitation that must be made known to the patient to enable the patient to understand such treatment or rehabilitation and the consequences thereof;

c.           provision for special needs in the case of newborn infants, children, pregnant women, the aged, disabled persons, patients in pain, persons living with HIV or AIDS patients;

d.           counselling without discrimination, coercion or violence on matters such as reproductive health, cancer or HIV/AIDS;

e.           palliative care that is affordable and effective in cases of incurable or terminal illness;

f.            a positive disposition displayed by health care providers that demonstrates courtesy, human dignity, patience, empathy and tolerance;

g.           health information that includes information on the availability of health services and how best to use such services, and such information shall be in the language understood by the patient.

2.4         KNOWLEDGE OF ONE’S HEALTH INSURANCE/MEDICAL AID SCHEME

A member of a health insurance or medical aid scheme is entitled to information about that health insurance or medical aid scheme and to challenge, where necessary, the decision of such health insurance or medical aid scheme relating to the member.

2.5         CHOICE OF HEALTH SERVICES

Everyone has a right to choose a particular health care provider for services or a particular health facility for treatment, provided that such choice shall not be contrary to the ethical standards applicable to such health care provider or facility.

2.6         TREATED BY A NAMED HEALTH CARE PROVIDER

Everyone has a right to know the person that is providing health care and, therefore, must be attended to by only clearly identified health care providers.

2.7         CONFIDENTIALITY AND PRIVACY

Information concerning one’s health, including information concerning treatment may only be disclosed with informed consent, except when required in terms of any law or any order of court.

2.8         INFORMED CONSENT

Everyone has the right to be given full and accurate information about the nature of one’s illnesses, diagnostic procedures, the proposed treatment and the costs involved.

2.9         REFUSAL OF TREATMENT

A person may refuse treatment and such refusal shall be verbal or in writing, provided that such refusal does not endanger the health of others.

3

2.10       A SECOND OPINION

Everyone has the right on request to be referred for a second opinion to a health provider of one’s choice.

2.11       CONTINUITY OF CARE

No one shall be abandoned by a health care professional who or a health facility which initially took responsibility for one’s health.

2.12       COMPLAINTS ABOUT HEALTH SERVICES

Everyone has the right to complain about health care services, to have such complaints investigated and to receive a full response on such investigation.

3            RESPONSIBILITIES OF THE PATIENT

Every patient or client has the following responsibilities:

3.1         To take care of his or her own health.

3.2         To care for and protect the environment.

3.3         To respect the rights of other patients and health care providers.

3.4         To utilise the health care system properly and not to abuse it.

3.5         To know his or her local health services and what they offer.

3.6         To provide health care providers with relevant and accurate information for diagnostic, treatment, rehabilitation or counselling purposes.

3.7         To advise health care providers of his or her wishes with regard to his or her death.

3.8         To comply with the prescribed treatment or rehabilitation procedures.

3.9         To enquire about the related costs of treatment and/or rehabilitation and to arrange for payment.

3.10       To take care of the health records in his or her possession.

GUIDELINES FOR GOOD PRACTICE IN THE HEALTH CARE PROFESSIONS
GUIDELINES ON THE KEEPING OF PATIENT RECORDS

OWNERSHIP OF RECORDS

10.1       In the case of state institutions, where records e.g radiographs are the property of the institution, original records and images should be retained by the institution. Copies must however, be made available to the patient (or referring practitioner) on request for which a reasonable fee may be charged in terms of the Promotion of Access to Information Act (Act No. 2 of 2000);

10.2       In cases where patients are required to pay for records and images (e.g. private patients or patients in private hospitals) such patients must be allowed to retain such records – unless the health care practitioners deem it necessary to retain such records for purpose of monitoring treatment for a given period. Should the patient however require the records and / or images to further or protect an interest (e.g. such as consulting with another practitioner) he or she must be allowed to obtain the originals for these purposes.

10.3       As the ownership of records in a multi-disciplinary practice depends on the legal structure of the practice, the governing body of such multi-disciplinary practice should ensure that these guidelines and the provisions of the Promotion of the Access to Information Act relating to health records are adhered to. The Act requires public institutions to appoint information officers to administer access to information, and similar provisions apply to private bodies.

10.4       Should a health care practitioner in private practice (both in a single practice and in a partnership) pass away, his or her estate, which includes the records, will be administered by the executor of the estate:

10.4.1    Should a practice be taken over by another health care practitioner, the executor shall carry over the records to the new health care professional.   The new health care practitioner is obliged to take reasonable steps to inform all patients regarding the change in ownership and that the patient could remain with the new health care practitioner or could request that his or her records be transferred to another health care practitioner of his or her choice.

10.4.2    Should the practice not be taken over by another health care practitioner the executor should inform all patients in writing accordingly and transfer those records to other health care practitioners as requested by individual patients.  The remaining files should be kept in safe keeping by the executor for a period of at least twelve (12) months with full authority to further deal with the files as he or she may deem appropriate – provided the provisions of the rules on professional confidentiality are observed.

10.4.3    It should be noted that certain partnership agreements may make specific provision for the management of a deceased partner’s share in the partnership after the death of a partner and such management would include dealing with patient records.

10.5       If health care practitioners in private practice decide to close their practice for whatever reason they shall within three months of closure inform all their patients in writing that:

10.5.1            The practice is being closed as from a specific date;

10.5.2    Requests may be made that records are transferred to other health care practitioners of their choice;

10.5.3    After the date concerned, the records will be kept in safe-keeping for a period of at least twelve (12) months by an identified health care practitioner or health institution with full authority to deal with the files as he or she may deem appropriate, provided the provisions of the rules on professional confidentiality  are observed.

If you would like us to send you the complete guidelines please email us at info@plwc.org.za