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Patients’ Rights in Poland. Magda Bojarska Institute for Patient‘s Rights & Health Education Workshop on patients‘ rights in cross-border health care Budapest, February 2009. Institute for Patient‘s Rights & Health Education. Founded in 2004 by Father Arkadiusz Nowak Mission
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Patients’ Rights in Poland Magda Bojarska Institute for Patient‘s Rights & Health Education Workshop on patients‘ rights in cross-border health care Budapest, February 2009
Institute for Patient‘s Rights & Health Education • Founded in 2004 by Father Arkadiusz Nowak • Mission – promote patiens’ rights, - integrate patient movement • Activities: • Webportal directed to patients – www.prawapacjenta.eu • Legal advise for patients • Conferences, public debates, advocacy of patients’ rights • Public actions & campaigns • Project „Patients’ Academy” – 2-years educational programme for 120 leaders of patient associations (sponsored by EFPIA & PhRMA)
Patients’ Rights in Poland Polish Constitution: Art. 68 - Everyone has a right to protection of health and a right of equal access to health services financed from public sources; Art. 38 – Life of a person is protected by law; Art. 18 and art. 40 – Privacy and dignity of a person is protected by law; Art. 51 – Personal data of a person are protected by law;
Polish legislation related to Patients’ Rights • Act on Health Care establishments • Act on Health Care services refunded with public funds • Acts on Doctor’s and Nurse’s profession • Laws on Doctors’ and Nurses’ Chambers
Charter of Patients’ Rights • Adopted by the government in 1998 • Based on international and Polish legislation • Does not have legal power of a law, it is only a cathalogue of patients’ rights • Contains 11 articles.
Charter of Patients’ Rights A patient is explicitly entitled to: - equal access to the health services financed from public sources; - proper and clear information on own health status, necessary diagnostic and treatment procedures, health risks and prognosis - consent or refuse treatment - access to own medical record & documentation - respect of physical and mental integrity - confidentiality of all health data and personal data - contact and care of close / relatives - religious support / pastoral care - die in peace and respect - complaint and compensation
Problems • Theright to equalaccess to the health services financedwith public funds - granted • Theright to receiveinmediatetreatmentinsituation of serious life or health thread - granted • Theright to choiceamongavailabletreatmentmethods – limited by the State budget • Theright to freechoice of service provider – formallygranted • Theright to choosemoreexpensivetreatmentordiagnosticmethod and coverthedifference – not granted • Maximumwaiting time for health services „guaranteed” – „lists of patientswaiting” depending on localcapacities • Theright of secondopinion – conditioned by doctor’sassent
Medical documentation • Access have: - Doctors, nurses and othermedicalprofessionals (includingadministrativestaff) - Patient & the person authorised • In case of death – a proxy - a person authorised by a patient / closeones/ relatives – not formallyregulated New law on patientrights & patients’ rights ombudsman – limitstheright of access to medicaldocumentationincase of death of a patientonly to personsformallyauthorised by a patient (not yetinforce) • Medicaldocumentationshould betranslated to Polish – the law on thePolishlanguage
Enforcement of patients’ rights • The law on patients’ rights & patients’ rights ombudsman – enacted by theParliamentin 2008 - vetoed by thePresident (togetherwiththewholebunch of health care-relatedactsproposed by thegovernment) • will hopefully be votedagainin 2009 and enforcedin 2010 • Institute for Patient’sRightsactivelyparticipatedinlegislativeprocess The law: Enforcespatients’ rights and introducesnew body responsible for patients’ rightsimplementation and observation – thePatients’ Rights Ombudsman. Atpresent – PR advocatesinhospitals – paid by NFZ - PR Office attheMinistry
Quality standards in HC • Quality standards are regulated only in anestesiology • Internal system of quality management in HC – TQM • External system – ISO 9000 • Acreditation by the Centre for Monitoring of HC Quality
Cross border HC • National HC Fund (NFZ) refunds cost of medical services for Polish citizens only in case of emergency. • The cost of planned procedures or diagnostics is covered by NFZ only if these procedures are not available in Poland. • The Supreme Administrative court issued a ruling that an excessive pending time for treatment can be treated as „unavailability” of this treatment in Poland.