Charter of Patients’ Rights and Responsibilities in India – by National Council for Clinical Establishments

medical
A Registered Medical Practitioner [RMP] is a person who is enrolled in the State Medical Register or the Indian Medical Register under the Indian Medical Council Act 1956.’ [IMC Act, 1956]

Charter of Patients’ Rights and Responsibilities

(As approved by National Council for Clinical Establishments)

As updated on 23rd August 2021

Ministry of Health and Family Welfare (MoHFW) had shared the Charter of Patients’ Rights recommended by National Human Rights Commission (NHRC) in 2019 with the Government of all States and Union Territories (UTs).  Health is a State subject, thus it is for the respective State/UT Government to adopt, implement and monitor the Charter of Patients’ Rights.  Further, it is also for the respective State/UT Government to display the Patients’ Rights Charter in public and private healthcare facilities as well as on their health department websites, allocate budget for promotion of Patients’ Rights Charter, set up grievance redressal mechanism for patients as recommended by NHRC advisory.

National Council for Clinical Establishments setup under the Clinical Establishments Act, 2010 in MoHFW has, in the year 2021, further updated the aforesaid Patients’ Rights Charter and included additional Patients’ Rights and shared the same with the States and UTs, where the Clinical Establishments Act is applicable.  The implementation of the provisions of the aforesaid Act and the updated Patients’ Rights Charter is within the remit of the respective State/UT Government, where the Act is applicable.

As on 08.02.2022, Ayushman Bharat Pradhan Mantri – Jan Arogya Yojana (AB PM-JAY) is implemented by 33 States/UTs.  A pan-India network of more than 25000 hospitals are empanelled under AB PM-JAY for providing healthcare services to the scheme’s beneficiaries.

National Health Authority (NHA) which is mandated to implement the AB PM-JAY, drafted the Patients’ Rights and Responsibilities Charter for hospital empanelled under this scheme. This was adopted from NHRC and international patient charters. Further, in May 2021, NHA issued a communication to various State Health Agencies (SHA) to ensure observance of Patients’ Rights Charter across all empanelled hospitals and to display it at prominent areas in the hospital premises. It was also suggested that the Patients’ Rights Charter booklet be made available with the Pradhan Mantri Arogya Mitra’s kiosk for AB PM-JAY beneficiaries.

NHA releases funds to the SHAs to undertake various beneficiary empowerment activities including Information, Education and Communication (IEC). These funds are intended to be utilized by SHAs for above purpose.


Law

TEXT of the Charter

Patients’ Rights: A patient and his/her representative has the following rights with respect to the clinical establishment-

i. To adequate relevant information about the nature, cause of illness, proposed investigations and care, expected results of treatment, possible complications and expected costs;

ii. To information on the Rates charged for each type of service provided and facilities available. Clinical Establishment shall display the same at a conspicuous place in the local as well as in English language.

iii. To access a copy of the case papers, patient records, investigation reports and detailed bill (itemized).

iv. To informed consent prior to specific tests/treatment (e.g. surgery, chemotherapy etc.)

v. To seek second opinion from an appropriate clinician of patients’ choice, with records and information being provided by the treating hospital.

vi. To confidentiality, human dignity and privacy during treatment.

vii. To have ensured presence of a female person, during physical examination of a female patient by a male practitioner.

viii. To non-discrimination about treatment and behaviour on the basis of HIV status

ix. To choose alternative treatment if options are available

x. Release of dead body of a patient cannot be denied for any reason by the hospitals.

xi . It was recommended that patient seeking transfer to another hospital/discharge from a hospital will have the responsibility to “settle the agreed upon payment”.

xii. It may be specified in the charter that no discrimination in treatment based upon his or his illness or conditions, including HIV status or other health condition, religion ethnicity, gender (including transgender), age, sexual orientation, linguistic or geographical/social origins.

xiii. Informed consent of patient should be taken before digitization of medical records.

Inclusion of Additional Charter of patients’ rights in minimum standards –

The National Council for Clinical Establishments approved for inclusion of the following additional patient rights, as per National Human Rights Commission (NHRC) Advisory, in the already approved list of patient rights as given above .

x i v . Right to care according to prescribed rates wherever relevant

x v. Right to choose source for obtaining medicines or tests

The hospitals especially corporate hospitals and other clinical establishments should not force the patients to purchase the medicines from the Hospital Pharmacies, and if they are able to get medicines from outside at lower price/cost, that should be acceptable.

Thus, No patient is forced to buy medications from hospital pharmacy. He can choose the pharmacy from where he wants to purchase the medicine. Similarly if the patient wants to get his tests done from outside, that may be accepted and facilitated by the hospitals or clinical establishments.

x v i . Right to protection and compensation for patients involved in clinical trials, as per Drugs and Cosmetics Act and other Government Guidelines.

x v i i . Right to protection and compensation for participants involved in biomedical and health research as per ICMR and other Government Guidelines.

x v i i i . Right to Patient Education

x i x . Right to be heard and seek redressal: Every Hospital shall have/establish a time bound Grievance redressal mechanism to address the grievances of the patients. A Grievance redressal officer will be identified by the hospital and his name and contact details will be displayed at a conspicuous place in local language and in English. The records of grievances received and remedial action taken will be maintained. The name and contact details of the district regis tering authority will also be displayed who may be contacted in case of non-redressal of the grievance of patients to their satisfaction.

x x . Right to proper referral and transfer, which is free from perverse commercial influences-

a. In case of referral by the hospital, the referring hospital will provide proper referral transport facility in the most appropriate vehicle/ambulance for transfer of patient to the nearest possible hospital where facilities for appropriate and timely management of the condition of the patient, are available.

b. Such transfer of patient will not be refused even if not referred by the treating hospital and even if the patient is leaving against medical advice (LAMA). The applicable reasonable charges may be levi ed by the Clinical Establishments for such transfers. However, in case of an emergency situation, such referral transport will be provided free of cost as far as possible and will not be refused for want of any payment.

c. State/UT Government may consider to define various charges for different types of ambulance for compliance by the hospitals and other clinical establishments. The Clinical Establishments will be required to display the rates of charges of ambulance(s)

d. The referring hospital shall provide a q ualified and trained person to monitor and manage the condition of the patient enroute till the patient is received by the referee hospital.

The information about the above additional rights should be widely disseminated by the Ministry and State Governments among Hospitals, doctors, patients and public so that everyone is aware that the rights exist.

Patients’ Responsibilities:

i. Provide all health related information

ii. Cooperate with Doctors during examination, treatment

iii. Follow all instructions

iv. Pay hospitals agreed fees on time
v. Respect dignity of doctors and other hospital staff

vi. Never resort to violence.


Note:-

1. The Patients’ Rights as listed from Serial no. (i) to (xiii) were disseminated to all States/UTs for adoption and implementation vide MoHFW letter dated 02.06.2019, as may be seen at weblink [http://clinicalestablishments.gov.in/WriteReadData/9901.pdf]

2. The Patients’ Rights as listed from Serial no. (xiv) to (xx) is the additional charter of patients’ rights, as approved by National Council for Clinical Establishments in its 12th meeting (Minutes issued on 23.08.2021) for inclusion in the Minimum Standards, in addition to the aforesaid Rights from (i to xiii).

3. The information about the above mentioned Patients’ Rights and responsibilities should be widely disseminated by the respective State/UT Government among hospitals, doctors, patients and General Public.


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