Charter Of Rights Of Access To Health Care By Users Of The National Health Service.

Original Language Title: Carta dos Direitos de Acesso aos Cuidados de Saúde pelos utentes do Serviço Nacional de Saúde.

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1 Group DRAFT law No. 273/X CHARTER of RIGHTS of ACCESS to HEALTH CARE by USERS of the NATIONAL HEALTH SERVICE explanatory memorandum to wait for health care is a phenomenon present in most European countries, whatever your health organization model, financing and provision of services. The existence of waiting lists is not in itself a negative element, resulting from a large number of factors that determine its existence and magnitude, both closely related to the supply, demand and the degree of self-regulation among them. The purpose of waiting lists is to serve as a tool for the planning of health service activities. Although they have not necessarily meant mismanagement, lose their operational value if the volume of patients on hold is very high and if the waiting time is prolonged beyond an acceptable threshold. To prevent this situation we need to adjust supply to demand through the implementation of a set of integrated measures, among which loom large, (a) improving the system of information on waiting lists, (b) homogenization of patients ' records, (c) analysis and publication of data on lists and waiting times, by type of service provider, (d) develop specific policies related to the system of remuneration of service providers. In this respect, guaranteed response times should not be viewed as a material and isolated, but as a system integrator a set of actions to better manage waiting lists. Since 1990 that some European countries have been taking measures to respond to this problem. The Netherlands has established guaranteed response times through 2 designated Treeknorms standards, drawn up by hospitals, insurance companies and service providers in order to ensure the provision of care within reasonable wait times, "whenever possible". The Norway, with the exception of urgent cases, ensures patients an appointment within 30 days from the date of contact with the health service, with assessment of needs in nursing and health and information of the date of their provision. The Finland guarantees a 3 days waiting for a query in health centres and 3 to 7 days in hospitals. In this country, the Act on Status and Rights of Patientes ensures the user the right to have knowledge of the waiting time for a consultation or treatment. The Denmark established as the 60 days to carry out the planned non-urgent surgeries, the patient may choose another health establishment if this deadline is not guaranteed by the hospital where you are registered. In Sweden there are times waiting 3 months maximum to 12 surgical procedures. For 2004 the Ireland has set a maximum wait time of 3 months for outpatient consultations. The United Kingdom established for 2005 maximum times 6 months waiting for surgical interventions, 3 months for external consultations for hospitals and 2 days to a general practitioner. In Portugal, since 1995 it has been produced various legislation on this matter, particularly law No. 27/99, of 3 may, which among other provisions, defines the concept of waiting list, records of recovery programmes waiting lists additional budget and own, never less than 1% of the annual budget for the NHS and obliges the Ministry of health to report periodically to Parliament on the State of access to health care. Regarding the surgery have been significant and sustained progress in this matter, and there are currently more than two hundred thousand cases on hold. As for the other type of care-consultation, complementary means of diagnosis and therapy and hospitalization-available information is dispersed and fragmented, not allowing to have a global vision and the situation, in fact recognized by the Ministry of health on the national health plan (2004-2010). The health framework law defines the rights of users of health services (XIV), which integrates the right to be treated promptly and on the other the right to be informed about your situation and possible treatment alternatives. However, the mere assignment of legal rights is no use if in practice are not found means to ensure its observance. The aim of this draft law 3 is to provide users of the health services of these means, with regard to access to health care.

Thus, in accordance with the rules applicable and constitutional, the Members and the Members of the parliamentary group of the Left block present the following draft law: article 1 subject-matter this Decree-Law approves the Charter of rights of access to health care by users of the national health service.

Article 2 definition and Contents 1-the Charter of rights of access to health care by users of the NHS aims to ensure the provision of most national health service care in time considered clinically acceptable to the health condition of each user, in accordance with the present law. 2 – the Charter of rights of access to health care by users of the NHS will contain: a) maximum guaranteed response times; (b)) the right of users to rigorous information on the functioning of health establishments, as well as the obligations of health establishments to ensure; c) the right of users to turn to health regulatory authority to safeguard their rights. 3-the Charter of rights of access to health care by users of the NHS, is published annually in annex to Ordinance fixing the maximum guaranteed times. 4-the Charter of rights of access to health care by users of the NHS, is disclosed to the users of the NHS, and necessarily posted in all establishments. 4 5-post establishments with the Bill of rights of access to health care by users of the NHS, the relationship of the response times of the respective establishment.

Article 3 maximum guaranteed response Times 1-for the purposes of the previous article, until 30 June of each year, the Ministry of health will publish, to take effect from 1 January of the following year, NHS establishments, an Ordinance containing the maximum guaranteed response times, duly reasoned, for all non-emergency benefits in particular, outpatient health centres, home care, hospital outpatient, complementary means of diagnosis and therapy, hospitalization and surgery. 2-establishment of the national health service (SNS), taking as a reference the Ordinance referred to in the preceding paragraph, shall determine annually their guaranteed response times, which should appear on the respective business plan and programme budget.

Article 4 Information to users in order to ensure the right of users to rigorous information about its operation, and for the purposes of article 2, the NHS establishments are required to: a) Post in places of easy access and consultation by users up-to-date information relating to guaranteed response times for the various types of benefits; b) Inform users at the time of booking, by registration or printed himself, on the response time guaranteed to get the care you need; c) Inform users, where it is necessary for activating the referral mechanism between NHS establishments, on the response time guaranteed to be provided their care in the establishment, pursuant to the preceding paragraph; 5 d) Inform users whenever the responsiveness of NHS establishments is exhausted and it is necessary to referral to health establishments in the private sector, as referred to in point (b)); and) Keep available at his website up-to-date information on guaranteed response times in the various modalities of care; f) Publish and disseminate, on an annual basis, a detailed report on the access to care it provides, which will be audited, random and annually by an external Commission and suitable for this purpose, employed by the Ministry of health, through public tender.

Article 5 complaint is recognized to users the right to complain to the health regulatory authority (LRA), in accordance with subparagraph (a)) of paragraph 2 of article 6 of Decree Law No. 309/2003 of 10 December, demanding compensation for damage caused by delay, whenever they don't see met the deadlines for service within the guaranteed response time to your health condition.

Article 6 infringements and sanctions

1 – Constitutes a misdemeanour: the) definition by health establishments of their own response times guaranteed, following the publication of the Ordinance of the Ministry of health, in accordance with paragraph 2 of article 3, b) non-compliance by establishments of health of guaranteed response times; c) failure to comply with information obligations of users provided for by article 4. 2-will be punished with a fine between 1000 and 5000 euros, constituting a misdemeanour pursuant to points (a)) and b) of the preceding paragraph. 3-will be punished with a fine between 1000 and 2500 euros, the conduct constituting an administrative offence under subparagraph (c)) of paragraph 1. 6 4-negligence is punishable, in these cases, reduced to half the values of fines laid down in the preceding paragraphs. 5-the health regulatory authority, the application of the fines corresponding to the offences provided for in this decree-law shall apply, with any necessary amendments, articles 45 to 50 of the Decree-Law 309/2003, of December 10.

Article 7 1 Review-the Ministry of health shall submit to the Assembly of the Republic, until 30 June of each year, a report on the situation of the Portuguese ' access to health care and of evaluating the implementation of this law and the Ordinances contained therein by the establishments of the SNS, in the previous year. 2-each year the Permanent Committee of the Assembly of the Republic with specific competence in the area of health, shall draw up, publish and disseminate an opinion on the report of the Ministry of health referred to in the previous point.

Article 8 entry into force the present law shall enter into force with the approval of the State budget for the year following that of its publication in the Official Gazette.

Assembly of the Republic, of 7 June 2006 The Members and members of left-wing Block