Tweet
ARMENIAN OMBUDSMAN ON PROBLEMS IN HEALTHCARE FIELD
news.am
March 27, 2012 | 15:05
YEREVAN.- Armenia's human rights defender Karen Andreasyan issued a
report on the activities of Ministry of Health in 2011. The following
shortcomings and positive developments are identified.
Shortcomings and problems identified
As a result of changes in the appropriate Government decision, the
threat of importing counterfeit medicines and pharmaceutical drugs
has increased, however the Ministry hasn't foreseen any additional
mechanisms to reduce the threat, to increase control in this direction
in the pharmaceutical market. Moreover, the Ministry does not want to
prevent the counterfeit drug distribution, it even does not conduct
statistics of detection and punishment of such crimes.
Medical institutions have authorities to release from co-payment or
apply a lower threshold co-payment based on the patient's degree
of solvency, which is decided by those institutions based on the
patient's or his/her relative's application. Certain criteria for such
decisions are not clearly prescribed by the legislation, as a result
of which in some cases differentiated and subjective approaches were
demonstrated by the medical institutions. Allowance and existence of
such approaches cause corruption risks.
The concept "medical error" is not defined by the legislation. That is
why negligence is not distinguished from the medical error, which in
its tern makes difficult to evaluate the case. Currently the medical
error is defined by various commissions without clear criteria, as a
result of which doctors are unfairly exposed to liability or unfairly
avoid it.
Though, the free in-patient care certificate program and a child's
health profile for 7 years old children has been installed since
1st January, 2011, in certain cases parents, having a certificate
defined for free medical care of a 7 years old child, had to make
extra payments to certain doctors.
The Ministry didin't provide the Ombudsman with information on how
many night-time monitoring it had conducted in medical institutions
and how many cases of human rights violations were revealed as a
result. Lack of the statistics or its non-provision significantly
reduces the public confidence towards efficiency of appropriate
supervisory functions of the Ministry.
Examination of complaints addressed to the Defender in the respect of
non-provision or improper provision of medical aid in the framework
of the Government order shows that people, being included in lists
of /special/ groups receiving free medical aid and service ensured
by state, were registered in an appropriate institution for receiving
such aid or had a certificate given by the Ministry of Health; however,
medical institutions refused to carry out their treatment or did not
provide them with a proper medical aid. In certain cases, as a result
of a change of a medical center, a citizen was deprived of the right
to surgery in the framework of the Government order. In some cases,
a disrespectful attitude was demonstrated towards patients receiving
treatment in the framework of the Government order.
Positive developments
Since 1st January the free in-patient care certificate program and
a child's health profile for 7 years old children has been installed.
Since May 2011, the medical examination and treatment, if necessary,
of young people of 14 pre-conscription-age -is free of charge.
The quality of emergency medical service has been improved. 38 rural
and urban medical institutions received 88 modern ambulance cars, GPS
unified new system of call acceptance has been launched with operation
of a unified dispatcher center. As a result, speed of responding to
calls increased by 2 times. Salaries of medical staff raised for 1.5
up to 2 times.
Shadow business in health system was reduced by installment of the
co-payment program, 439.6 million AMD - formerly in shadow circulation
- was put in the state budget. Taxes from medical institutions-
paid to the state budget - increased by 39% or 735 million AMD,
salaries of medical staff, involved in the program of "co-payment",
were raised for 1.2 up to 2.3 times.
Armavir, Ijevan, Hrazdan, Ararat and Goris medical centers were
staffed with modern technics and equipments, 20 new aid stations were
constructed and 30 community aid stations - repaired.
Provision of various certificates (not stipulated by law) by clinics
to citizens was terminated.
In 2011 the RA Ministry of Health received 78 written complaint
regarding activities/inactivities/ of healthcare centers' officers;
147 complaints were received by the "Hot Line". For elimination of the
revealed violations appropriate measures were taken. The Ministry's
response to the complaints and taken measures are assessed positive.
Website of the Ministry of Health and easiness of access to its
information are positively assessed.
news.am
March 27, 2012 | 15:05
YEREVAN.- Armenia's human rights defender Karen Andreasyan issued a
report on the activities of Ministry of Health in 2011. The following
shortcomings and positive developments are identified.
Shortcomings and problems identified
As a result of changes in the appropriate Government decision, the
threat of importing counterfeit medicines and pharmaceutical drugs
has increased, however the Ministry hasn't foreseen any additional
mechanisms to reduce the threat, to increase control in this direction
in the pharmaceutical market. Moreover, the Ministry does not want to
prevent the counterfeit drug distribution, it even does not conduct
statistics of detection and punishment of such crimes.
Medical institutions have authorities to release from co-payment or
apply a lower threshold co-payment based on the patient's degree
of solvency, which is decided by those institutions based on the
patient's or his/her relative's application. Certain criteria for such
decisions are not clearly prescribed by the legislation, as a result
of which in some cases differentiated and subjective approaches were
demonstrated by the medical institutions. Allowance and existence of
such approaches cause corruption risks.
The concept "medical error" is not defined by the legislation. That is
why negligence is not distinguished from the medical error, which in
its tern makes difficult to evaluate the case. Currently the medical
error is defined by various commissions without clear criteria, as a
result of which doctors are unfairly exposed to liability or unfairly
avoid it.
Though, the free in-patient care certificate program and a child's
health profile for 7 years old children has been installed since
1st January, 2011, in certain cases parents, having a certificate
defined for free medical care of a 7 years old child, had to make
extra payments to certain doctors.
The Ministry didin't provide the Ombudsman with information on how
many night-time monitoring it had conducted in medical institutions
and how many cases of human rights violations were revealed as a
result. Lack of the statistics or its non-provision significantly
reduces the public confidence towards efficiency of appropriate
supervisory functions of the Ministry.
Examination of complaints addressed to the Defender in the respect of
non-provision or improper provision of medical aid in the framework
of the Government order shows that people, being included in lists
of /special/ groups receiving free medical aid and service ensured
by state, were registered in an appropriate institution for receiving
such aid or had a certificate given by the Ministry of Health; however,
medical institutions refused to carry out their treatment or did not
provide them with a proper medical aid. In certain cases, as a result
of a change of a medical center, a citizen was deprived of the right
to surgery in the framework of the Government order. In some cases,
a disrespectful attitude was demonstrated towards patients receiving
treatment in the framework of the Government order.
Positive developments
Since 1st January the free in-patient care certificate program and
a child's health profile for 7 years old children has been installed.
Since May 2011, the medical examination and treatment, if necessary,
of young people of 14 pre-conscription-age -is free of charge.
The quality of emergency medical service has been improved. 38 rural
and urban medical institutions received 88 modern ambulance cars, GPS
unified new system of call acceptance has been launched with operation
of a unified dispatcher center. As a result, speed of responding to
calls increased by 2 times. Salaries of medical staff raised for 1.5
up to 2 times.
Shadow business in health system was reduced by installment of the
co-payment program, 439.6 million AMD - formerly in shadow circulation
- was put in the state budget. Taxes from medical institutions-
paid to the state budget - increased by 39% or 735 million AMD,
salaries of medical staff, involved in the program of "co-payment",
were raised for 1.2 up to 2.3 times.
Armavir, Ijevan, Hrazdan, Ararat and Goris medical centers were
staffed with modern technics and equipments, 20 new aid stations were
constructed and 30 community aid stations - repaired.
Provision of various certificates (not stipulated by law) by clinics
to citizens was terminated.
In 2011 the RA Ministry of Health received 78 written complaint
regarding activities/inactivities/ of healthcare centers' officers;
147 complaints were received by the "Hot Line". For elimination of the
revealed violations appropriate measures were taken. The Ministry's
response to the complaints and taken measures are assessed positive.
Website of the Ministry of Health and easiness of access to its
information are positively assessed.