It is most admirable for Parliamentary Secretary for Health, Chris Fearne, to come out with a consultation document on a patient’s charter, the absence of which has been felt for long now. It is fine to have first-class hospitals and clinics, but what ultimately counts most is the standard of service given by healthcare providers. It is towards improving such standard that the government is now planning to introduce a patient’s charter.
Evidently, however extensive a patient’s charter may be, it will be meaningless if it is not rigorously followed at all levels of the health service. Experience has shown that standards in work practices tend to deteriorate in places where there is no adequate supervision and control. This applies to the health care service provided in both the public and private health sectors, as many can well testify for themselves. Just to take one example, it is not the first time that people in private care homes complain that the service provided is below that advertised. A patient’s charter sets out not just rights but responsibilities too, which is as it should be, for many people tend to think only about their rights, caring very little for the rights of others.
The charter is structured around eight main principles: health protection; access; information; participation and informed consent; privacy and confidentiality; dignity and respect; safe healthcare; and comments and complaints. In the introduction to the charter, Dr Fearne points out that, considering that “this is the first national patient’s charter and that in a number of fields, there is an element of catching up to do, it is envisaged that the targets set out shall be fully achieved within one year from its publication”.
As matters stand today, this sounds a bit ambitious, and in any case, some of the requirements have to be observed on an ongoing basis. Take, for instance, the fifth and sixth principles – privacy and confidentiality, and dignity and respect. The rights contemplated in both these principles have to be followed at all times, and therefore have no timeframes or targets. The issue over privacy has been a priority concern, especially at the main hospital, for quite some time, particularly in times when, due to lack of sufficient space, patients are left to be treated in corridors, stripping them of their dignity.
The relevant provision in the proposed charter says: “ One has the right to expect that one’s privacy is respected when receiving healthcare according to the different circumstances.” The way patients are sometimes treated, particular the elderly in State hospitals or homes, is shameful. However much this issue has been discussed over the years, the practice persists, clearly showing that there is no adequate control in the places where this happens.
The practice highlights also lack of adequate professional training, for no truly professional carer is likely to treat patients degradingly.
The relevant provision in the proposed charter reads: “One has the right to be treated as an individual. One should expect that the healthcare provider demonstrates dignity, patience, empathy, tolerance, and courtesy.”
Particularly important of course is the undertaking being proposed that, “if a predetermined maximum acceptable waiting time is not respected”, a patient would have the right to seek “healthcare through a local private healthcare provider or in another European country for state or private treatment, in accordance with the Maltese Cross-Border Healthcare Regulations, under the Health Act”.
This obviously places greater pressure and responsibilities on the hospital authorities to ensure that timeframes are respected, as it should be, insofar as this is humanly possible.