Key Benefits:
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BILL OF LAW No. 516 /XII
Law consolidating the legislation on the rights and duties of the utent of the
health services
The present text aims to present in a clear and integrated manner the rights and
duties of the utent of health services. For such, and departing from the XIV Base of the Law of
Basics of Health, Law No. 48/90 of August 24, incorporate in it the standards and
constant principles of the following diplomas:
(a) Law No. 14/85, of July 6-Monitoring of the pregnant woman during the
labor;
b) Law No. 33/2009, of July 14-Right of monitoring of users of the
Urgency services of the National Health Service (SNS);
c) Law No. 106/2009, of September 14-Family monitoring in
hospital internment;
d) Law No. 41/2007 of August 24-Letter of the Rights of Access to Care
of Health by the users of the National Health Service (SNS).
Thus, a single text has been created on this matter, which respects the principles
enshrined in the prevailing laws and that they contest the three laws on the " right of
follow-up "and the law approving the terms to which it must obey the" letter of the
rights of access to health care by SNS users ". The fifth diploma, the
Law No. 27/99 of May 3, which created the " special program of access to care of
health ", is hereby revoked expressly for having concluded that it was already tacitly.
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In Chapters II and IV it is intended to fill the XIV Base of Law No. 48/90, 24 of
august, which elenates the rights and duties of the utent of health services, following the
order of enunciation of the Base.
Chapter III has a distinct approach. Listening to the "follow up" of the
utterance of health services is developed sparsely in different diplomas,
it is understood that its consistent treatment mandates the creation of a general part, containing
the common rules by "follow-up in the urgencies", " follow-up of the woman
pregnant during childbirth "and" follow-up in hospital internment of children,
people with disabilities or in addictive situation ", referring after some
from the its specificities.
Already Chapter V deals exclusively with the charter of access rights.
By proceeding to this consolidation of the framework of rights and duties of the utent of services
of health, do not introduce any changes of substance. However, in some cases,
refreshes the terminology: attest to the example of " decide to receive ... the provision of
care ", listed in the paragraph b) of paragraph 1 of the Base XIV of Law No 48/90 that passed the
" consent declared in a free and enlightened manner " in Article 3 (1) of this
project, because it is the expression used in recent diplomas (vd. n Article 14 (1) of the
Law No. 32/2006 of July 26-PMA). On the other hand the " Inspectorate-General of the
Activities of Health " goes on to be referred to with the current designation of " Inspectorate-General
of the Activities in Health " .
Given that it is not applicable legislation only within the scope of the Service
National Health (SNS) is looking for a neutral language that can be used from
generic mode and remains, for reasons of harmonization, where possible, the term
"utterance of health services", accompanying the Health Bases Act: for example
"patient" in Article 2 (2) and "sick" in Article 5 of Law No 33/2009 passed the
"utent", in Art. 13 (1) and 1 (1) of this project.
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Please note that the said Act makes mention of the "health system" (para. a) of the No. 1 of the Base
XIV) and not to SNS. However, current legislation does, at times, make express references
only to SNS which, because it is the subject of substance, are not changed. Refused, only,
as exceptions, the provisions of Article 12 of this project that extends the exercise of the right
of follow-up of the pregnant woman to all health establishments, being that
currently only is planned in the "public health establishments".
See also the provisions of articles 13 and 14 of this project, on the rights and
limits of the right of follow-up. In these articles are set, as general rules,
currently planned for the follow-up in the SNS urgencies, which so if
extend to all. It is a uniformity, as all the accompaniments have
specific constraints.
Finally, it stands out that the approval of this new diploma implies revocation
express of the five laws previously mentioned and which is taken into account the
existing legislation, proceeding to remissions whenever this represents a gain in
clarity, never leaving to mention the subjects covered.
Thus, under the provisions of Article 156 (b) of the Constitution of the Republic and
of point (b) of Article 4 (1) of the Rules of the Assembly of the Republic, the
Undersigned deputies present the following Law Project:
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Chapter I
General Disposition
Article 1.
Object
1-A This Act is aimed at the consolidation of the rights and duties of the utner of the services of
health, concretizing the XIV Base of Law No. 48/90, of August 24, and safeguarding
the specificities of the National Health Service (SNS).
2-A This Law defines the terms to which it must obey the Charter of Access Rights
to Health Care, by the utent of the SNS, hereinafter referred to by the Charter of the
Access Rights, the approval of which is incumbent on the member of the Government responsible
by the area of health.
Chapter II
Rights of the utent of health services
Article 2.
Right of choice
1-The utterance of health services has a right to choose the services and providers of
health care, in the measure of existing resources.
2-The right to the protection of health is exercised by taking into account the rules of
organization of health services.
Article 3.
Consent or refusal
1-The consent or refusal of the provision of the provision of health care must be
declared in a free and enlightened manner, unless special provision of the law.
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2-The utterance of the health services may, at any time of the provision of the
health care, revoke consent.
Article 4.
Adequacy of the provision of health care
1-The utterance of health services is entitled to receive, with readiness, or in a period
of time considered clinically acceptable, depending on the cases, the care of
health that you need.
2-The utterance of health services is entitled to the provision of health care more
suitable and technically more correct.
3-Health care must be provided humanely and with respect for the utent.
Article 5.
Personal data and protection of private life
1-The utterance of health services is the holder of the rights to the protection of personal data and to the
reservation of private life.
2-Is applicable to data treatments in the area of health Article 5 of Law No 67/98,
of October 26, guaranteeing, specifically, that the data collected are the
adequate, pertinent and not excessive for the purposes pursued.
3-The utent of health services is a holder of the right of access to personal data
collected and may require the rectification of inaccurate information and the inclusion of
total or partially omission information pursuant to Article 11 of the Law n.
67/98, of October 26.
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Article 6.
Secrecy
1-The utterance of health services has the right to secrecy about your personal data.
2-Health professionals are obliged to the duty of secrecy regarding the facts
of having knowledge in the performance of their duties, unless you have the law that you have
to the contrary or court decision that would impose its disclosure.
Article 7.
Right to information
1-The utterance of the health services has the right to be informed by the provider of the
health care about your situation, the possible alternatives of treatment and the
likely evolution of its state.
2-A information must be transmitted in an accessible, objective, complete and
intelligible.
Article 8.
Spiritual and religious assistance
1-The utterance of health services is entitled to religious assistance, regardless
of the religion that professes.
2-To the churches or religious communities, legally recognized, are ensured
conditions permitting the free exercise of spiritual and religious assistance to the
users admitted to SNS health establishments, who request it, in the
terms of the Decree-Law No. 253/2009 of September 23.
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Article 9.
Complaints and complaints
1-The utterer of health services is entitled to complain and complain in the
health establishments, under the law, as well as receiving compensation for
damage suffered.
2-Claims and complaints can be submitted in book of claims or from
avulso mode, being mandatory the answer, under the law.
3-Health services, suppliers of goods or services of health and the
health operators are required to own claims book, which can be
filled by who to request it.
Article 10.
Right of association
1-The utterance of health services shall be entitled to constitute entities that represent it and
that they defend their interests.
2-The utterance of health services may constitute entities that collaborate with the
health system, particularly in the form of associations for promotion and
defence of health or groups of friends of health establishments.
Article 11.
Minors and unable
The law shall provide for the conditions under which the legal representatives of the minors and incapable
may exercise the rights that fit them, specifically that of refusing assistance,
with observance of the constitutional principles.
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Chapter III
Monitoring of the utent of health services
Section I
General rules for monitoring the utent of health services
Article 12.
Right to follow-up
1-In the SNS emergency services, everyone is recognized and guaranteed the right to
follow-up by a person per se indicated, and this should be provided
information at admission by the service.
2-It is recognized to the pregnant woman interned in health establishment, the
right of follow up during all stages of the labor, by
any person per se chosen.
3-The right of follow-up is recognised familiar to children admitted to
health establishment, as well as to persons with disabilities, to persons in
status of dependency and people with incurable disease in advanced condition and
in a final state of life.
Article 13.
Companion
1-In cases where the clinical situation does not allow the utent to freely choose the
accompanying, the services should promote the right to follow-up,
it may for this purpose to request the demonstration of the kinship or the relationship
with the utent, invoked by the accompanist.
2-A The nature of the kinship or the relationship referred to in the preceding paragraph shall not be
invoked to prevent follow-up.
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3-When the interned person is not accompanied, the administration of the
health establishment should diligenate to be provided to you the
personalized listening necessary and appropriate to the situation.
Article 14.
Limits to the right of follow-up
1-It is not allowed to accompany or attend surgical interventions and other
exams or treatments that, by their nature, can see their effectiveness and
fix impaired by the presence of the companion, except if for such a
given authorization expressed by the practitioner responsible, without prejudice to the willing
in Article 17 (1) and (2).
2-The monitoring cannot compromise the conditions and technical requirements to
that must obey the provision of medical care.
3-In the cases provided for in the previous figures, it is incumbent on the health professional
responsible for the provision of health care to inform and explain to the
chaperone the motifs preventing the continuity of the follow-up.
Article 15.
Rights and duties of the accompanying person
1-The accompanying person is entitled to be informed properly and in time
reasonable about the situation of the patient, in the different stages of the care, with the
following exceptions:
a) Indication expressed as opposed to the patient;
b) Matter reserved by clinical secrecy.
2-The chaperone must behave with urbanity and respect and abide by the
instructions and indications, duly substantiated, of the professionals of
service.
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3-In the case of violation of the duty of urbanity, disobedience or disrespect, the
services may prevent the accompanying person from remaining with the patient and
determine your departure from the service, and may be, in its replacement, indicated
another companion pursuant to Art. 13 (1).
Section II
Follow-up of the pregnant woman during childbirth
Article 16.
Conditions of the monitoring
1-The right to follow up can be exercised regardless of the period of the
day or night in which the labor of labor occurs.
2-To the extent necessary to comply with the provisions of this Law, the accompanying person
will not be subjected to the hospital regulations of visits or to their
condiments, being, specifically, exempt from paying the respect fee.
Article 17.
Conditions of exercise
1-The follow-up can excecionally not take effect when, in situations
serious clinics, for discourteous and expressly determined by the physician
obstetrician.
2-The monitoring may not be exercised in the units where the facilities do not
are consenting to the presence of the accompanying person and with the guarantee of
privacy invoked by other parturients.
3-In the cases provided for in the previous figures those interested should be
correctly informed of the respects reasons by the responsible staff.
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Article 18.
Cooperation between the accompanist and the services
The necessary measures are adopted to guarantee the cooperation between the pregnant woman, the
companion and the services, and they shall, in particular, provide information
suitable over the course of childbirth, as well as on the clinically necessary actions.
Section III
Follow-up in hospital internment
Article 19.
Family follow up of interned child
1-A child, aged up to the age of 18, interned in health establishment has
right to the permanent monitoring of the father and the mother, or of person who the
replace.
2-A child under the age of 16 years of age may designate the accompanying person, or
even prescinding it, without prejudice to the application of Article 23.
3-The exercise of monitoring is free of charge, not the establishment of health
require any retribution and the internship, or its legal representative, must be
informed of this right in the act of admission.
4-In cases where the interned child is a carrier of communicable disease and in which
contact with others constitutes a risk to public health the right to
follow-up may cease or be limited, by written referral from the clinical
responsible.
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Article 20.
Family monitoring of persons with disabilities or in a situation of
dependency
1-People with disabilities or in addictive situation, with incurable disease
in advanced state and the people in a final state of life, admitted to
establishment of health, are entitled to the permanent monitoring of
ascending, descending, spouse, or equated and, in the absence or impediment
of these or by their will, of person per se designated.
2-It is applicable to the family monitoring of the persons identified in the number
previous to the provisions of Article 19 (3) and 4.
Article 21.
Conditions of the monitoring
1-Permanent family monitoring is exercised in the period of the day or the
night, with respect for the instructions and technical rules regarding the care of
health applicable and by the remaining standards set in respect of regulation
hospital.
2-It is vehement to the accompanying person to attend surgical interventions to which the person
internothing is submitted, as well as to treatments in which your presence is
detrimental to the correction and effectiveness of the same, except if for this is given
authorization by the responsible practitioner.
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Article 22.
Cooperation between the accompanist and the services
1-Health professionals must provide the accompaniment to the convenient
information and guidance so that this one can, if so understand, under the
supervision of those, collaborate in the provision of care to the interned person.
2-The accompanying person shall comply with the instructions which, pursuant to this Law,
are given by the health professionals.
Article 23.
Meals
The companion of the person interned as long as it is exempt from the fee payment
moderator in access to health benefits under the SNS, is entitled to meal
free of charge, in the health establishment, if you stay in the institution six hours a day, and
where ascertaining one of the following conditions:
a) The interned person finds himself in danger of life;
b) The interned person finds himself in the postoperative period and up to 48 hours later
of the intervention;
c) When the accompanying person is a mother and is breastfeeding the interned child;
d) When the person interned is isolated for reasons of medical criterion-
surgical;
e) When the accompanying person resides at a distance of more than 30 km from the place where
it situates the health establishment where the internment stems.
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Chapter IV
Duties of the utent of health services
Article 24.
Duties of the utent of health services
1-The utterance of health services must respect the rights of other users, well
as those of the health professionals with whom to relish.
2-The utterance of health services must abide by the rules of organization and
operation of services and health establishments.
3-The utterance of health services should collaborate with health professionals in
all the aspements regarding your situation.
4-The utterance of health services must pay the charges deriving from the provision
of health care, when appropriate.
Chapter V
From the Charter of Access Rights to Health Care by the Utner of the Service
National of Health
Article 25.
Objective and content
1-A The Charter of Access Rights aims to ensure the provision of health care by the
SNS and by the entities convenor in time deemed clinically acceptable
for the health condition of each SNS utner under the present law .
2-A Letter of Access Rights defines:
a) The maximum guaranteed response times;
b) The right of the utent to information about these times.
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3-A Letter of Access Rights is published annually in annex to the portaria that fixed
the maximum guaranteed times.
4-A Letter of Access Rights is disclosed in the health portal and compulsorily
affixed to places of easy access and visibility in all establishments in the
SNS, as well as in all those who have convinced the provision of care of
health to its users.
Article 26.
Maximum guaranteed response times
1-For the purposes of the preceding article, the member of the Government responsible for the
area of health establishes, by portaria, the maximum guaranteed response times
for all kind of benefits without an urgent nature, particularly ambulatory
of health centres, home care, external hospital consultations, means
complementary to diagnostic and therapeutic and scheduled surgery.
2-Gradually, the maximum response times guaranteed by type of benefit are
discriminated against by pathology or groups of pathology.
3-Each establishment of the SNS, taking as a reference the porterie referred to in paragraph 1,
fixed annually, within the maximum limits set at the national level, its
response times guaranteed by type of benefit and by pathology or group of
pathologies, which must appear in the flat respects of activities and contracts-
program.
Article 27.
Information to the utan
In such a way as to guarantee the right of the utterance to the information, provided for in Article 25. º of the present
law, the establishments of the SNS and the conventionalized sector are obliged to:
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a) Affix in places of easy access and consultation by the utente the updated information
relative to maximum response times guaranteed by pathology or groups of
pathologies, for the various types of benefits;
b) To inform the utent in the marking act, upon registration or in own printed form,
on the maximum guaranteed response time for provision of the care of
which needs;
c) Inform the utent, whenever it is necessary to trigger the mechanism of
referrals between the SNS establishments, about the maximum time of
guaranteed response to be provided to you with respect to your care in the
establishment of reference, in the terms set out in the preceding paragraph;
d) Informing the utente, whenever the capacity for response of establishments
of the SNS is exhausted and it is necessary to proceed to the referration for the
private sector health establishments, under the terms set out in paragraph (b);
e) Keep available on your Internet site updated information on the
maximum guaranteed response times in the various modalities of provision
of care;
f) Publish and disclose, by March 31 of each year, a circumstantial report
on access to the care they provide, which will be audited, random and
annually, by the Inspectorate-General of Activities in Health.
Article 28.
Complaint
It is recognized to the utent the right to complain to the Health Regulatory Entity
(ERS), in the applicable legal terms, if the maximum guaranteed times are not
fulfilled.
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Article 29.
Sanctionatory regime
The sanctionatory regime by infringement of the provisions of this chapter is stated in the Decree-Law
n. 127/2009, of May 27.
Article 30.
Evaluation
1-The member of the Government responsible for the area of health presents to the Assembly of
Republic, until May 31, a report on the situation of the access of the Portuguese
to health care in the SNS establishments and convenor in the framework of the
health system, as well as of evaluation of the application of this Law, concerning the
previous year.
2-Anually the permanent specialist committee of the Assembly of the Republic with
specific competence in the area of health elabora, publishes and disseminates an opinion
on the forecast report in the previous number.
Chapter VI
Final provisions
Article 31.
Adaptation of SNS emergency services to the right of follow-up
1-SNS establishments that have emergency service must
proceed to the necessary changes in the installations, organisation and operation
of the respected emergency services, in such a way as to enable the utent to
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enjoy the right of follow-up without causing any injury to normal
functioning of those services.
2-The right to follow up on emergency services must be enshrined
in the regulation of the respective health institution, which it shall define with
clarity and stringency the respective standards and conditions of application.
Article 32.
Adaptation of public health establishments to the right to follow up
of the pregnant woman
1-Hospital administrations should consider in their plans the modification
of the facilities and conditions of organization of the services, so as to best
adapt existing units to the presence of the pregnant companion,
notably through the creation of appropriate facilities where the
labor, in such a way as to ensure their privacy.
2-All health establishments who have internships and services
of obstetrics should enable, in the most appropriate conditions, compliance
of the right of follow-up of pregnant women.
Article 33.
Repeal standard and production of effects
1-The following laws are repealed:
a) Law No. 14/85 of July 6;
b) Law No. 27/99 of May 3;
c) Law No. 41/2007 of August 24;
d) Law No. 33/2009 of July 14;
e) Law No. 106/2009 of September 14.
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2-Keep in force the regulations passed pursuant to the laws referred to
in the previous number.
Palace of Saint Benedict, February 14, 2014
THE DEPUTIES,