Separate laws required to safeguard both patients, doctors: Experts

Separate laws are required to protect both patients and healthcare providers in the face of incidents of medical negligence, assaults on doctors and hospital vandalism, say experts. 

The current healthcare landscape in Bangladesh is marred by several issues, including a lack of trust between patients and doctors and disruptions in healthcare services.

Since 2015, efforts have been underway in the country towards legislation on healthcare and protection issues. Although drafts were prepared in 2015, 2018 and 2023 during the tenure of the previous government, they never reached completion.

After the interim government assumed responsibility, the draft of the "Healthcare and Protection Ordinance 2024" was published on the website for public feedback.

The experts say the proposed healthcare protection law fails to address the safety of either patients or doctors. It is an updated version of the "Medical Practice and Private Clinics and Laboratories (Regulation) Ordinance" of 1982, they note.

The ordinance lacks focus on safeguarding both patients and doctors, say the experts. Separate legislation is needed to ensure the protection of patients and medical professionals, they say.

Syed Abdul Hamid, a professor at the Institute of Health Economics of the University of Dhaka, told TBS that a protocol-based service is essential to ensure patient safety.

For instance, he said, there should be a checklist specifying the necessary tests before a patient undergoes surgery, a list of equipment required for the operation, verification of whether the equipment is sterilised and a checklist for post-operative treatments.

"Additionally, there should be a system to ensure that nurses administer medication correctly, with a checklist to monitor this. These protocols must be explicitly included in the law, Hamid stressed.

Moreover, he said, patients should have a system enabling them to file complaints either with the hospital or the government.

Hamid went on to say, "Healthcare providers and doctors' security must also be ensured. A system should be in place to prevent any physical assault on doctors or vandalism of hospital property. In cases of intentional or unintentional errors by doctors, appropriate action should be taken under separate laws rather than through criminal law.

"The Healthcare and Protection Ordinance 2024 is a regulatory law for hospital management. It cannot ensure patients' safety or the security of doctors and healthcare providers. Separate legislation will be required to address these issues."

On the night of 16 December, Azizur Rahman, a man taken to Green Life Hospital on Green Road in the capital, passed away in the ICU an hour later. Following his death, Azizur's family accused the hospital of medical negligence.

Dr Sajib Nazrul, who treated Azizur in the emergency department, is currently in jail in connection with the case filed by the family.

Meanwhile, on 24 November, Firoza Begum, a resident of Jhapa village in Monirampur upazila, at a press conference at the Jashore Press Club accused Dr Abu Bakkar Siddique of Keshabpur Modern Hospital of negligence and malpractice.

Firoza Begum claimed that during her daughter Joly's C-section, her uterus was cut, and due to negligence, the newborn died.

Dr Abdun Noor Tushar, adviser of the Foundation for Doctors' Safety, Rights and Responsibilities, believes that separate laws for patients and doctors are necessary to address issues like the complaints of patients as well as the imprisonment and penalties faced by doctors.

"The draft of the Healthcare Protection Act 2024 must be scrapped and new laws should be formulated separately for patients and doctors. Additionally, a distinct law should be established for hospital management," he said.

Dr Tushar noted that government hospitals in Bangladesh receive three times more patients than their capacity to handle them with the available doctors. To alleviate this pressure, he said, a referral system must be introduced so that not all patients crowd medical colleges.

He further stated that awareness about various diseases needs to be increased. "Patients should be educated on which illnesses can be managed at home, which require consultation with a general practitioner and which necessitate hospital visits."

The Ministry of Health must enhance its campaigns to raise this awareness among the public, Dr Tushar said.

Muzaherul Huq, a member of the Health Sector Reform Commission, said whenever a patient files a complaint about medical negligence or malpractice, it must be thoroughly investigated.

"If hospital doctors or staff are found responsible, appropriate action should be taken. We will provide recommendations on measures that doctors can adopt to ensure patients' safety and restore trust in the healthcare system," he said.