When using he alth services from medical facilities in Poland, we deal with various situations. When can we ask for help from the Patient Ombudsman? Julia Cynar, a pharmacy student at the Medical University of Poznań and an intern at the Rafał Piotr Janiszewski Advisory Office, explains more about the patient's rights.
Anna Tłustochowicz: What exactly can the Patient's Rights Ombudsman do for a patient? There is a lot of media coverage of parents raising millions to treat their children abroad. Can the Ombudsman help them?
Julia Cynar:It is beyond his remit. Here we are dealing with the design of the he alth care system. What is reimbursed and what is not - has been regulated in this system. The Ombudsman for Patients' Rights has, of course,the possibility of submitting legislative ideasand only this could possibly come into play, i.e. a proposal to modify the system so that the patient's basic right - the right to he alth services - would be preserved.
In this case, it is all about the availability of benefits, or rather the lack of it!
This is obviously a problem, for example, the lack of reimbursement of a specific drug, but the fact is also that fundraisers sometimes take place for purposes that must arouse reflection, e.g. for treatment abroad. In our system, such a possibility is provided for and the National He alth Fund finances it, but under certain conditions.
First of all, when the lack of such treatment endangers the patient's life.
Yes, and when it is not possible to obtain such a benefit in our country, the question arises whether in the case of fundraising such a condition has been met and why the parents organize a fundraiser.
Every now and then in the media there are texts with the title: “Scandal! I have an operation due in 10 years. " Such a patient can ask the Ombudsman for help?
The number of patients needing help is always greater than the system can handle. You have to accept the queues.
Establishing the order of providing services takes into accountthe clinical condition of a given patient.There are also privileged groups, incl. war veterans, pregnant women or organ donors and their benefits are due outside the queue.
And they, if they don't receive benefitsimmediately, can they ask the Patients' Ombudsman for help?
The regulations on privileged persons are quite old, fixed in the system, therefore there should be no irregularities. However, if a specific patient has a problem in enforcing their rights, they may turn to the Patient Ombudsman. Remember, however, thatthere are otherappeals institutions to which he can - and should - go first.
What?
For example, the director of a medical facility, the National He alth Fund, the field representative of the Patient Rights Ombudsman, and finally the Patient Rights Ombudsman, who, when answering a question, should deal with such a matter.
What other matters should the Patient Rights Ombudsman deal with?
Allmatters relating to the violation of broadly understood patient's rights . Unfortunately, Polish patients usually do not know them.
Let us list them briefly then.
The patient has the right to information about his or her he alth condition and may reserve to other people information about his or her he alth opinion may or may not be disclosed.
The patient has the right to respect for dignity and intimacy.
What does this mean?
For example, during the examination in the office, there should beonly people whose presence is necessary to provide the service and the patient.Nobody else.
In the media we read about women who gave birth and 15 medical students stood over them!
Such a woman should be asked to allow the presence of students who actually - especially in clinical hospitals - learn their profession this way. The patientshould be informed that she may not agree to such presenceand her will should be respected.
What if the woman did not consent to their presence? Complain?
Maybe.
What other rights does a Polish patient have?
First of all, the one from which we started the conversation, i.e.the right to he alth services corresponding to the current medical knowledge.The patient has the right to a transparent queuing procedure. If the service cannot be provided immediately, then the rules of determining the order of providing services must be transparent and known to patients.
The patient must know when he will receive the benefit!
The patient also has the right to expect that the doctor who is treating him, at his request, will consult another doctor, and the nurse - another nurse. On the other hand,in a situation of threat to he alth or life, the patient has the right to obtainbenefits right away . The Act on Patients' Rights also clearly states that the patient has the right to receive benefits related to childbirth.
You said that the patient needs to know when he will get the benefit. And what if he hears from the clinic at the clinic: "Please call me tomorrow"?
This is not legal. When the patient reports to the clinic,should obtain specific information about the date when he will have an appointment with the doctor.Of course, the person who answers the phone does not know the condition of the patient. Therefore, it can say, for example, that in urgent cases, the waiting time for a specialist is two weeks, and in stable cases it is one and a half years. If the patient is in a life-threatening condition, he should go to the Emergency Department.
What about medical secrets?
Of course, this is also the patient's right.The exclamation: "A man with a sick prostate is asked to come to his office" is definitely not right.Stories about the patient's state of he alth absolutely cannot take place.
When such a patient turns to the Patient Ombudsman, will he do it?
He will explain the circumstances of a specific case and check whether the procedures used in this medical entity properly protect against infringement of the patient's rights. Because if there is a custom there, for example, that this is how patients are invited to the office - and perhaps it is fixed in internal procedures - then it is a violation of the patient's rights.
Remember that the patient also has the right to consent and to refuse to provide him with he alth services.
The consent must be in writing?
Yes.Consent should be given in writingfor major procedures, operations that also involve certain risks, for less complex services consent may be given orally.
Does the patient have the right to be accompanied by a close person to the doctor?
Yes. If the patient needs it, for exampleparents or guardians have the right to be with him, of course.We also have "family births". It should be recognized that in a situation where the patient needs it, and is not prevented by the specificity of the service provided, such presence should be possible.
Remember that the patient also has the right to pain relief and die in a dignified manner.
If we are in pain and we are asking for a pill, we should get it, not be told that it "must hurt"?
There is no such thing as "must hurt."Hospitals are required to arrangepain relief procedures. Of course we should get a painkiller when we ask for it.
I also remind you thatthe patient has the right to medical records that are his property.
What else is the patient en titled to?
To object to a doctor's opinion or decision. A medical commission is then appointed to resolve the dispute. It is very important that webe aware of our rights and demand that they be respected ourselves.
Patient rights can also be found in display cases both in hospitals and clinics.
All he alth care facilities are requiredto display them in a visible place.Patients admitted to the ward should familiarize themselves with their rights and this should be marked in their documentation.
When a patient is in hospital and feels that his rights are being violated there, can he call the Ombudsman and expect an intervention?
In the first place, he should report his comments to the hospital management. If this does not help, the representative of the Ombudsman for Patients' Rights.Deficiencies can also be reported to the doctor's office.A telephone call to the Patient Ombudsman is of course also possible, but it is rather a last resort. It's about time! It is known that the hospital director will react faster than the Patient Rights Ombudsman, which is the central institution and receives complaints from all over the country.
What about medical errors? When a patient wants to go to court and fight for compensation, does the Ombudsman intervene in such a matter, help, e.g. provide a legal interpretation or monitor such a process?
Yes. The Ombudsman may join the case as a party. She will then support and represent the patient. Of course, the first thing he does ischecks entitywhere the error was supposed to have occurred, and the entity must respond to the allegations. If the Ombudsman finds that there has been an irregularity, he imposes a financial pen alty. In the event that the patient demands compensation, the Patient Ombudsman also helps to submit the application to the provincial committee.
And why not go to court?
Because that's the shortest way. Of courseyou can go to court , but the case will go on for longer there.
To sum up: The Patient Ombudsmancan report a whole range of issues , ranging from the fact that the patient could not say a prayer in the presence of the priest in the hospital room, to the innocent death of a person.The patient has different options for action!In the event of a medical malpractice inthere is also a possibility of a civil action, reporting the case to the prosecutor's office or the professional liability commission.
Such actions exclude the possibility of notifying the Patient Rights Ombudsman?
Absolutely not!
There is also a separate category, namely the Mental Hospital Patient Ombudsman.
This Ombudsman works within three neighboring provinces so that the psychiatric patient has a chance to exercise his rights, including the right to submit a request for a meeting with the Ombudsman, during which he will have freedom of expression. The regulations stipulate thatThe Ombudsman must appear within 7 working days.Remember that psychiatry is a sensitive area in which hospitalization takes place without the patient's consent and direct coercion measures are used.
Does the patient cost anything to report to the Patient Ombudsman?
Nothing. You can report to the Ombudsman free of charge. The application is not complicated:it is necessary to indicate the person reporting the matter, the patient concerned and describe the facts.The application is free of charge, and the Ombudsman can do various things with it: take the matter up , indicate to the applicant the legal remedies he is en titled to, transfer the case according to jurisdiction and not take the case. For example, if the Commissioner for Human Rights decides that a crime has occurred, he transfers the case to the prosecutor's office. What is very important: it always notifies the applicant of its decision.
Don't be afraid that we don't speak legal language? Can you describe the matter with your own affairs? Prosto?
Definitely yes!
Please also remember thatThe Ombudsman may refuse to disclose the patient's personal data to the medical facilityif it deems it necessary to protect the patient's rights.
If this is a permanent patient of this hospital and the staff could have advised him, knowing he was the one to complain?
For example.Then the Ombudsman can handle the case anonymously.So you don't have to be afraid. Finally, I would like to add that when the Patient's Rights Ombudsman has concerns about whether the patient's rights are respected in a given facility, because, for example, irregularities are reported in the media, then, of course, he has the option of taking the case ex officio.
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