Right to Health
Towards Establishing the Right to Health and Healthcare
Nursing Homes and Hospitals:
- Setting up minimum decent standards and requirements for each type of unit; general specifications for general hospitals and nursing homes and special requirements for specialist care, example maternity homes, cardiac units, intensive care units etc. This should include physical standards of space requirements and hygiene, equipment requirements, human power requirements (adequate nurse: doctor and doctor: beds ratios) and their proper qualifications etc.
- Maintenance of proper medical and other records, which should be made available statutorily to patients and on demand to inspecting authorities.
- Setting up of a strict referral system for hospitalization and secondary and tertiary care.
- Fixing reasonable and standard hospital, professional and service charges.
- Filing of minimum data returns to the appropriate authorities for example data on notifiable diseases, detailed death and birth records, patient and treatment data, financial returns etc.
- Regular medical and prescription audits which must be reported to the appropriate authority.
- Regular inspection of the facility by the appropriate authority with stringent provisions for flouting norms and requirements.
- Periodical renewal of registration after a thorough audit of the facility.
Physicians and other medical practitioners:
- Ensuring that only properly qualified persons set up practice.
- Compulsory maintenance of patient records, including prescriptions, with regular audit by concerned authorities.
- Fixing of standard reasonable charges for fees and services.
- Regulating a proper geographical distribution.
- Filing appropriate data returns about patients and their treatment?? Provision for continuing medical education on a periodic basis with licence renewal dependent on its completion.
- Ensuring quality standards and qualified personnel.
- Standard reasonable charges for various diagnostic tests and procedures.
- Audit of tests and procedures to check their unnecessary use.
- Proper geographical distribution to prevent over concentration in certain areas.
Pharmaceutical industry and pharmacies:
- Allowing manufacture of only essential and rational drugs.
- Regulation of this industry must be switched to the Health Ministry from the Chemicals Ministry.
- Formulation of a National Formulary of generic drugs which must be used for prescribing by doctors and hospitals.
- Ensuring that pharmacies are run by pharmacists through regular inspection by the authorities.
- Pharmacies should accept only generic drug prescriptions and must retain a copy of the prescription for audit purposes
Health insurance and third party administration:
- Health insurance should be allowed only as a not-for-profit sector.
- National and social insurance must be under public authority.
- Premiums must be negotiated through a multi-stakeholder mechanism.
- Insurance coverage must be comprehensive.
- Insurance companies must directly settle claims with hospitals and physicians.
- Insurance data must be in public domain.
- Individual based exclusions should not be permitted.
- Insurance must also cover preventive and promotive healthcare, maternity, dentistry and ophthalmic services.