charter of rights and responsibilities - shcc.org.pk · pmdc pakistan medical & dental council...
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Directorate of Complaint SHCC 1
Charter of Rights and Responsibilities
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Directorate of Complaint SHCC 2
א� א��ي�2345 ��01/.-,+
SHCC Sindh Healthcare Commission 6�7�8�9:
PMDC Pakistan Medical & Dental Council ;<���=>�?��@A�BCD
HCSP Healthcare Service Provider E��FGH�I���J�K�5�7�8 L
HCE Healthcare Establishment � MNO PQR STU V2W
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SHCC Sindh Healthcare Commission ���6�7�8�9: ����� ئ��� �� � �
PMDC Pakistan Medical & Dental Council ���;<���=>�?��@A�BCD ـ�ـ� پا��ـ�ـان �ـ�ـ��ـ�ـ� � ��ـ
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Directorate of Complaint SHCC 3
DEFINITIONS
Healthcare Establishment: means a hospital, diagnostic cen-ter, medical clinics, nursing home, maternity home, dental clinic, ho-meopathic clinic, Tibb clin-ic,Hajama clinic, acupuncture, physiotherapy clinic, pharmacy or any system of treatment. (a) Wholly or partly used for
providing healthcare services; and
(b) Declared by the Government, by an order published in the official Gazette, as a healthcare establishment;
Healthcare Services: means ser-vices provided for diagnosis, treatment or care of persons suf-fering from any physical or men-tal disease, injury or disability in-cluding procedures that are simi-lar to forms of medical, dental or surgical care but are not provided in connection with a medical con-dition and includes any other ser-vice notified by Government. Healthcare Service Provider: means an owner, manager or in-charge of a healthcare establish-ment and includes a person regis-tered by the Pakistan Medical Dental Council, National Council for Tibb and Homeopathy or Nursing Council, pharmacy ser-vice provider.
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Directorate of Complaint SHCC 4
EXECUTIVE SUMMARY
Sindh Healthcare Commission
(SHCC) has developed this charter to
ensure the rights of Healthcare Ser-
vice Providers (HCSP). This charter
is essential to make sure that whatev-
er, and whenever care is provided it
is of high quality and is safe. The
HCSP Charter will be reviewed an-
nually or on a need basis, as deemed
appropriate by SHCC, in view of its
experiences, through a consultative
process involving patients, healthcare
service providers, healthcare estab-
lishments, related professionals, staff
and other stakeholder groups.
These rights and responsibilities
are intended to be used as a tool that
healthcare service providers refer to,
and for them to know what their
rights and responsibilities are while
functioning in the provision of
healthcare services in Sindh. It also
focuses on a Patient Centered ap-
proach and promotes participation by
patients and HCSPs as well as HCEs.
It also empowers healthcare estab-
lishments to feel secure and safe in
performing their function and topro-
vide quality healthcare services in
Sindh with protection of property,
without fear of harassment/ violence.
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Directorate of Complaint SHCC 5
Rights are legal, social, ethical principles of freedom or
entitlement, which are the fundamental normative rules about what is allowed topeople or owed to people, according to the legal system.“Health for All” is a pri-mary goal of the Government of Sindh and to regulate healthcare it has established the Sindh Healthcare Commission (SHCC). The SHCC will strive to make provision for: Improvement, Access, Equity, and Quality of healthcare service;to ban quack-ery in all its forms, and provision of ancil-lary matters. The prime organization regis-tering doctors and dentists is Pakistan Med-ical & Dental Council (PMDC). PMDC, along with other regulatory authori-ties,have defined the patients, service pro-viders/ healthcare establishments’ rights in their code of ethics.These rights and re-sponsibilities are essential to make sure that quality healthcare is provided.
GUIDING PRINCIPLES
There are three guiding principles which describes how this Charter of Healthcare Service Providers’ (HCSPs) rights and responsibilities applies in the-healthcare delivery system in Sindh. 1. Everyone has the right to be able to
access healthcare and this right is essential for the Charter to be mean-ingful.
2. The Sindh Government is committed to international agreements like the Sustainable Development Goals (SDGs) etc. about human rights which recognize everyone’s right to have the highest possible standard of physical and mental health.
3. Sindh consists of people from differ-ent cultures and way of life, and the Charter acknowledges and respects these differences.
RIGHTS OF HEALTHCARE PRO-VIDER (HCSP)
1. ACCESS A. Rights: Every healthcare service provider has equal right to access healthcare services, equal benefit to law,with no discrimination.
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Directorate of Complaint SHCC 6
• Have right to equal treatment and
equal benefit of the law in all applica-tions by and in dealings with theGov-ernment, private sector and others.
• Not to be unfairly discriminated
against by any patient, medical scheme, medical faculty or school, government, employer or any other person or institution on the basis of their race, religion, belief, gender, origin or on any other ground.
• Freedom of religion, belief and opin-
ion,HCSPs have the right to reasonable work space as per their religious beliefs, short of undue hardship to others.
• Access to housing, especially where
healthcare providers are fulfilling training requirements, community service, or contributing to alleviate the plight in rural areas.
B. Responsibilities: Healthcare service provider’s respon-sibilities are:
• Not to unreasonably refuse a patients’ ac-
cess to healthcare, especially where there are no public health facilities available.
• Healthcare providers may not refuse
emergency treatment to patients. Healthcare providers have a responsibility to assist in realizing the right of access to healthcare, which may include issuing prescriptions and ensuring access to the best available treatment.
• To treat all his/her patients equally and pro-
vide them with the same level of concern irrespective of age, color, disability or illness, gender, marriage, maternity, religion or be-lief, nationality, politics or social status.
• Although a healthcare service provider
has the right to choose his/her patients, such choices may never amount to unfair discrimination and emergency treatment may never be refused.
• Healthcare providers have the duty not to
harass patients, colleagues or others on the basis of sex, gender, sexual orientation, race or any group characteristic.
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Directorate of Complaint SHCC 7
• To respect the religion, beliefs and
opinions of their patients, even if it
differs from their own, and not to
force any patient or colleague to pre-
scribe to any religious practice, belief
or opinion.
• Healthcare providers have the responsi-
bility to respect the clinical independ-
ence of their colleagues and not to suc-
cumb to pressures of dual loyalty.
• To take care of official residence (if)
provided to them, and not to refuse
housing (to let or to sell) to any per-
son based on a prohibited ground of
discrimination.
2. SAFETY & PROTECTION A. Rights: Healthcare service provider (HCSPs) have equal right to life, safety and freedom.
• HCSPs have the right to not be placed
in disproportionately life-threatening
situations.
• HCSPs have the right not to be har-
assed by any patient, other HCSP/ co-
worker or management /employer.
• Have the right to physical autonomy
and the right to be free from violence.
• Have the right to a safe environment,
especially where harmful medical equip-
ment, medicines or devices are used.
There should be appropriate systems in
place for medico-legal work, such as
cases of rape, domestic violence, abuse,
assault, drunken driving, etc.
• Have right to an environment that is
not harmful to their health or wellbe-
ing, including appropriate manage-
ment of stressful situations and super-
vision/ assistance of junior healthcare
providers.
• Right to social security, including
aspects such as social health insur-
ance: this includes access to insurance
and social assistance. Social security
institutions have to remunerate
healthcare providers fairly and timely.
• �u�Y�� �� ��� ����`�� Hij � �� �¥f� ë����� �������¾h�Hij ��¦����B��Í�"���H�½�&���¼½�u��ÝÞ� �Hñf�´�����v�q�� �R
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Directorate of Complaint SHCC 8
B. Responsibilities: Healthcare service providers’ respon-sibilities are:
• To protect life, within the confines of a patient’s right to physical autonomy and decision-making power.
• To ensure that patients are not sub-jected to cruel, inhuman or degrading punishment or treatment and to report instances where such occur, especial-ly within the spheres of prison, deten-tion, etc, as well as abuse of children and the elderly.
• To ensure that medical waste is dis-posedoff appropriately and safely, and that appropriate protocols are followed in terms of infectious disease control.
• To inform their patients of the harm-ful effects of medicines and how to store and use it properly.
• To adopt practices with good and ra-tional practices for prescribed drugs.
• To ensure that medical reports are fair and accurate, and that only particulars that are authorized by law are disclosed to insurance and assistance agencies.
3. RESPECT AND DIGNITY
Healthcare service providers (HCSP) have the right to be shown respect, dignity and consideration. A. Rights: Right to be treated by patients, carers, other HCSP/co-workers and employers, with dignity and respect.
• Have the right to not face violent or aggressivebehavior by patients, their carers, other HCSP/co-workers and employers.
• To work in an environment that is not hos-tile in terms of sex, gender, sexual orienta-tion or (presumed) race or ethnicity.
• Healthcare providers have the right to post-exposure prophylactics in cases of occupational exposure.
• To be paid a fair remuneration for services rendered and not to have any unlawful interference with these and other property rights.
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Directorate of Complaint SHCC 9
• Have the right to not be taxed more or
targeted exclusively based on their
assumed financial status.
• The right to their own language and
culture and the adherence thereto, as
far as is practicable, which includes
the right to converse in the language
of one’s choice, where practicable.
• Not to be arrested, detained or ac-
cused healthcare providers have the
right not to be forced to take part in
any unlawful (bodily) search or sei-
zure and have the right to enquire as
to the status of the subject brought to
them.
B. Responsibilities:
Healthcare service providers’ respon-sibilities are:
• To demonstrate dignity, patience,
empathy, tolerance and courtesy
while dealing with patients and co-
workers.
• To treat patients and co-workers with
respect and dignity, irrespective of
age, disability, gender, marriage,
pregnancy, maternity, race, religion,
socio-economic status, cultural be-
liefs, colour, caste or creed.
• To treat in privacy and with dignity
and respect the patients religious and
cultural beliefs throughout the dura-
tion of care including, but not limited
to, taking the medical history, exami-
nation, or adopting any other course
of action.
• To pay their dues, fairly remunerate
their own employees and respect the
property of others.
• To assist in the realization of the right
of access to healthcare of all arrested,
detained and accused persons and to
bring to the attention of the authori-
ties, or inspecting judge, any irregu-
larities or needs of the inmates in rela-
tion to healthcare.
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Directorate of Complaint SHCC 10
4. INFORMATION
Healthcare service providers have the right to give and to receive information A. Rights:
• Right to get accurate and complete
personal contact details of patients
i.efull name, age, complete postal
address, contact numbers etc, and the
HCSP should beinformed by the pa-
tient of any changes in given infor-
mation.
• Right toget complete and accurate
information about the patient’s health
including present health condition,
previous medical history, medica-
tions, hospital stays, herbal/
homeopathic and other traditional
remedies used, and any other matter
related to the patient’s health.
• Right to access information held by
the state and any other person or pri-
vate institution, company or organiza-
tion regarding one’s own/patient’s
health.
• Right to freedom of expression and
speech, within limitations set by rele-
vant regulations/laws.
• Right to express themselves and their
opinions without victimisation.
Healthcare providers have the right to
notify their patients of their services
according to the rules.
• Right to have their justifiable disputes
heard in a court of law or other appro-
priate forum. Healthcare providers
who act as witnesses in cases have the
right to be fairly remunerated for their
services.
B. Responsibilities:
Healthcare service provider’s respon-sibilities are:
• To provide access to information re-
quested by their patients and to ensure
that health data is stored safely and
not sold or passed on without the pa-
tient’s informed consent.
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Directorate of Complaint SHCC 11
• To give information in a way that is
easily understood, using the appropri-ate medium and language.
• Healthcare providers may only with-
hold information on the limited grounds listed by the Pakistan Right to Information Act 2013.
• Not to practice hate speech or to use
expressions that are harmful to others or is aimed at inciting harm or violence.
• Healthcare providers have a responsi-
bility to listen to their patients and take their views into consideration.
• Healthcare providers have the respon-
sibility not to advertise in an unpro-fessional- or comparative-manner.
• To assist in legal proceedings when
called upon as expert witnesses.
• Healthcare providers have a particular
responsibility in relation to crimes such as child abuse, domestic vio-lence and abuse of the elderly.
4. PARTICIPATION
Healthcare service providers (HCSP) have the right to participate in the collabo-rative process of decision making, occupa-tion and trade, fair labour practices and political choices. A. Rights:
• Have the right to take an active part in
discussions and decisions about his/
her healthcare and treatment.
• Have the right to Freedom of Assem-
bly,demonstration, picketing, and to
present petitions, without victimization.
• Have the right to Freedom of Trade,
occupation and profession, within the
limits set by the Government and the law
in general, including choices in relation
to specialization where positions exist.
• It is the inalienableright of HCSPs to
take part in economic endeavours, fair
labour practices, including the right to
lodge disputes including fair dispen-
sations of overtime, leave and work-
ing conditions.
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Directorate of Complaint SHCC 12
• The right to have their grievances
taken up at appropriate forums.
• HCSP have the right to be assisted in dis-
ciplinary enquiries, to state their side of
the case and to an impartial chairperson.
• Have the right to make political
choices and participate in political
activities, to freedom of association,
which includes the right to voluntarily
form, join and participate in any asso-
ciation or to disassociate.
• Have the right to access and to partic-
ipate in career development activities,
education and training.
B. Responsibilities:
Healthcare service provider’s respon-sibilities are:
• To exercise their rights to assembly,
demonstration, picketing and petitions
to such an extent that it does not af-
fect the healthcare of their patients.
• Not to exercise his/her association in
such a manner that it discriminates
against any other person, amounts to
supporting any scheme providing per-
verse incentives or to a denial or exclu-
sion of the rights or benefits potentially
due to other HCSPs or others.
• To ensure that they exercise their oc-
cupation within the limits set by the
law. This also means that economic
endeavours should not amount to per-
verse activities or to partake in activi-
ties that undermine the best possible
patient care.
• To fulfil their employment duties. The
heads of facilities have the responsi-
bility to facilitate and harmonise the
employment rights of healthcare pro-
viders employed by them.
• To practice medicine in such a way as
not to endanger the lives of their pa-
tients.
• To ensure that patient’s partake in any
type of medical research with their
full and informed consent.
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Directorate of Complaint SHCC 13
• To ensure that any political affiliation
and activities does not interfere with his/
her duties to provide good patient care.
• To ensure that s/he informed their
employer about the latest develop-
ments in their fields and take part in
educational and career development
activities organized by their organiza-
tion/employer.
6. PRIVACY
Healthcare Service Providers have the right to privacy and confidentiality. A. Rights:
• Have the right to personal privacy and
privacy of information.This includes
protection of personal information,
communication, family and property.
• Have the right to freedom of movement
and residence, which includes not being
subjected to unreasonable limitations in
terms of where healthcare service pro-
viders must live and work.
B. Responsibilities:
Healthcare service provider’s respon-sibilities are:
• To protect the privacy and confidenti-
ality of his/her patients and to only disclose healthcare, treatment, diag-nostic and other health information with the patient’s informed and writ-ten consent or when authorized by law or a court to do so.
• The healthcare establishment or
healthcare provider to ensure that incases of children and females in the immediate post Anesthesia phase, a female staff shall be present until a family member or carer can join the patient.
• Freedom of movement and resi-
dence;not to interfere with the rights of movement and residence of others and to, as far as possible, accommo-date patients whose residence may cause difficulty in accessing health care.
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Directorate of Complaint SHCC 14
7. FEEDBACK AND COMMENT
Healthcare service providers have the right to feedback and comment on the con-duct of any patient, Co-worker or manage-ment/ employer. A. Rights
• Have the right to pass on any feed-
back, suggestions and raise concerns or complaints to the employer, SHCC or any regulatory or law enforcing agency,as deemed necessary, without any fear of retribution/revenge and harassment by patients, co-workers, management/employer.
• Have the right to be aware of proce-
dures of complaints and resolution of disputes and conflicts.
• Have the right to be given information
on how to give feedback and com-ment or raise concerns about the health services and care.
• Have the right to seek compensation
if the HCSP has been harmed/harassed by patients, co-workers, management/ employer.
B. Responsibilities
Healthcare service provider’s respon-sibilities are:
• To provide both positive and negative
feedback about the care and treatment or about the health services in general.
• To withhold from initiating or partici-
pating in fraudulent healthcare and to report unethical behavior of patients, co-workers, other healthcare provid-ers, or the practices management of the healthcare establishment to the appropriate authorities.
• To raise any concerns about the safety,
effectiveness or cleanliness of services that may affect the health of himself/herself, patients and family/ society.
• To discuss any misunderstandings/
lack of understanding, regarding healthcare services, procedures, rules and policies of healthcare establish-ment through the appropriate meth-ods/ channels.
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