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Law Consolidating The Legislation On The Rights And Duties Of Users Of Health Services

Original Language Title: Lei consolidando a legislação em matéria de direitos e deveres do utente dos serviços de saúde

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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,