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Parliamentary Group

DRAFT LAW NO. 273 / X

LETTER OF THE RIGHTS OF ACCESS TO HEALTH CARE BY USERS OF THE

NATIONAL HEALTH SERVICE

Exhibition of reasons

The wait for health care is a phenomenon present in most of the countries

european, whatever their model of health organization, funding and

of provision of services.

The existence of waiting lists is not in itself a negative element, resulting from

a high number of factors that determine their existence and magnitude, both

closely related to supply, demand and the degree of self-regulation among them.

The purpose of the waiting lists is to serve as an instrument for the planning of the

activities of health services. Although they do not have to necessarily mean

a mismanagement, lose their operational value if the volume of waiting patients is

very high and if the waiting time prolong itself beyond an acceptable limit.

To prevent this situation it imposes itself on adjusting supply to demand through implementation

of a set of integrated measures, among which they avulate, (a) improvement of the system

of information on waiting lists, (b) homogenisation of patient records, (c)

analysis and publication of the data on lists and waiting times, by type of provider, (d)

development of specific policies related to the remuneration system

of the providers. In this perspective, the fixation of guaranteed response times should not

be viewed as a case-by-case and isolated measure, but as an integrator element

of a set of actions for the better if they manage the waiting lists.

Since 1990, some European countries have been taking steps to respond to

this problematic. The Netherlands has established guaranteed response times by means of

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designated standards Treeknorms , drawn up by hospitals, insurers and providers

in such a way as to ensure the provision of care within reasonable waiting times, " always

that it is possible ". Norway, excepting urgent cases, guarantees patients a

consultation within 30 days of the date of contact with the health service, with

assessment of needs in care and health and the information of the date of its

provision. Finland guarantees a 3-day wait for a consultation at the centres of

health and from 3 a to 7 days in the hospitals. In this country, the Act on Status and Rights of Patients

assures the utente the right to have knowledge of the waiting time for a consultation or

treatment. Denmark has established as a milestone the 60 days for the realization of the

scheduled surgical interventions, not urgent, and the patient may choose another

health establishment if this deadline is not guaranteed by the hospital where it is

enrolled. In Sweden vigorous maximum wait times of 3 months for 12

surgical procedures. For 2004 a Ireland has set a maximum waiting time of 3

months for ambulatory consultations. The UK has set for 2005 times

maximum waiting 6 months for surgical interventions, 3 months for the

external consultations of the hospitals and 2 days for a general practitioners consultation.

In Portugal, since 1995 it has been produced vary legislation on this

matter, being to highlight Law No. 27/99 of May 3, which among other provisions,

defines the concept of the waiting list, consigna to the retrieval programs of the lists

of waiting for an additional and own budget allocation, never less than 1% of the

annual budget of the SNS and obliges the Ministry of Health to report periodically to

Assembly of the Republic on the situation of access to health care.

Regarding surgery have not been verified significant and sustained progress

in this matter, and there are currently more than two hundred thousand cases in

wait. As for the other type of care-consultations, complementary means of

diagnosis and therapy and internment-the available information is dispersed and

fragmented, not allowing to have a comprehensive and rigorous view of the situation, incidentally

recognized by the Ministry of Health in the National Health Plan (2004-2010).

Health Basics Act defines the rights of users of health services (Base

XIV), among which it integrates by one side the right to be treated with preparedness and by

another the right to be informed about your situation and possible alternatives of

treatment. However, the mere legal allocation of rights of nothing serves if in practice

no means are found to ensure that they are complied with. The purpose of the present

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draft law is to provide users of the health services of those means with regard to the

access to health care.

Thus, in the applicable constitutional and regimental terms, the Deputes and the

Deputies from the Parliamentary Group of the Left Bloc present the following

Draft Law:

Article 1º

Subject

The present diploma approves the Charter of Access Rights to health care by the

users of the National Health Service.

Article 2º

Definition and Content

1-A Charter of Access Rights to health care by SNS users visa

guarantee the provision of the generality of care by the National Health Service in

time considered clinically acceptable for the health condition of each utent, in the

terms of this diploma.

2-A Charter of Access Rights to health care by SNS users

will contain:

a) the maximum guaranteed response times;

b) the right of users to the strict information on the functioning of the

health establishments, as well as the obligations of health establishments to

o ensure it;

c) the right of users to make use of the Health Regulatory Entity for safeguarding the

your rights.

3-A Charter of Access Rights to health care by SNS users, it is

published annually in annex to the Portaria setting the maximum guaranteed times.

4-A Charter of Access Rights to health care by SNS users, it is

disclosed to SNS users, and compulsorily affixed to all

establishments.

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5-The establishments affix it to the Charter of Access Rights to the care of

health by SNS users, the relation of the response times of the respective

establishment.

Article 3º

Maximum guaranteed response times

1-For the purposes of the provisions of the preceding Article, until June 30 of each year, the Ministry

of the Health will make it publish, to invigorate from January 1 of the following year, in the

establishments of the SNS, a Portaria containing the maximum response times

guaranteed, duly substantiated, for all kind of benefits without a character of

urgency, inter alia, ambulatory of health centres, home care,

external hospital consultations, complementary means of diagnosis and therapy,

internment and scheduled surgery.

2-Each establishment of the National Health Service (SNS), taking as

reference to Portaria referred to in the preceding paragraph, shall annually fix its times of

guaranteed response, which should appear in the respective activities plan and

budget-program.

Article 4º

Information for users

In such a way as to ensure the right of users to the strict information about their

operation, and for the purposes of Article 2º, the SNS establishments are obliged to:

a) Apfix in places of easy access and consultation by users the updated information

on the guaranteed response times for the various types of benefits;

b) Informing users in the act of marking, upon registration or own printed, on

the guaranteed time of response to receive the care you need;

c) Informing the users, whenever it is necessary to actuate the mechanism of

referrals between the SNS establishments, about the guaranteed response time

to be provided for you with the respective care in the reference establishment, in the

terms set out in the preceding paragraph;

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d) Informing the users, whenever the responsiveness of the establishments of the

SNS is sold out and it is necessary to proceed to referration for the establishments

of private sector health, under the terms set out in paragraph (b);

e) Keep available on your website updated information on the times of

guaranteed response in the various arrangements for the provision of care;

f) Publish and disseminate, annually, a circumstantial report on access to

care it provides, which will be audited, randomized and annually, by a commission

external and idonea to this effect, contracted by the Ministry of Health, through

public contest.

Article 5º

Complaint

It is recognized for users the right to complain to the Health Regulatory Entity

(ERS), in accordance with paragraph 2 (a) of Article 6º of the Decree Law No. 309/2003 of 10

of December, requiring redress of the possible damage caused by the delay, always

that do not come up with the deadlines for listening within the time of response

guaranteed for your health condition.

Article 6º

Infringements and sanctions

1-Constitui counterordinance:

a) the non-definition by the health establishments of their own times of repurposing

guaranteed, following the publication of the Portaria of the Ministry of Health, in the terms

of Article 3º (º2),

b) the non-compliance by the health establishments of the response times

guaranteed;

c) the failure to comply with the information obligations of users provided for in Article 4º.

2-Will be punished with a fine of between 1000 and 5000 euros, ducts which constitute

counter-ordinance pursuant to points (a) and (b) of the preceding paragraph.

3-Will be punished with a fine of between 1000 and 2500 euros, the mains that constitute

counterordinance pursuant to paragraph 1 (c).

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4-A negligence is punishable by being, in these cases, reduced to half the values of the

fines set in the previous figures.

5-Compete to the Health Regulatory Entity, the application of the corresponding fines

to the counter-ordinations provided for by this diploma, applying, with the necessary

amendments, Articles 45º to 50º of Decree-Law 309/2003 of December 10.

Article 7º

Evaluation

1-The Ministry of Health will present to the Assembly of the Republic, until June 30 of

each year, a report on the situation of the Portuguese's access to the care of

health and evaluation of the application of this Law and the portaries therein provided for by the

establishments of the SNS, in the previous year.

2-Anually the permanent specialized Commission of the Assembly of the Republic with

specific competence in the area of health, elabora, publishes and disseminates an opinion on the

report of the Ministry of Health referred to in the previous point.

Article 8º

Entry into force

The present diploma comes into force with the approval of the State Budget for the

year subsequent to that of its publication in Journal of the Republic.

Assembly of the Republic, June 7, 2006

The Deputies and Deputies of the Left Bloc