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The Medical Error Compensation Bill: We Call It Good because It Is Good

 The Medical Error Compensation Bill: We Call It Good because It Is Good

1 June 2010

A draft of the Medical Malpractice Health-Compensation Bill, which the Ministry of Public Health had sponsored and presented before the Council of Ministers, was forwarded to House of Representatives in June of 2010.

The Bill was met with vehement protests from a number of physician groups who claimed the Bill would lead to more lawsuits that would make it virtually impossible for them to function.

The National Health Commission Office, as the Secretariat for the National Commission on Health Workforce and as the Secretariat for the National Health Assembly, has been monitoring this issue closely and concur that the Bill is indeed very good. The key points of the bill can be summarized as follows:

One. It intends to be a social safety net for patients facing undesirable effects of improper medical treatment received at either public or private hospitals in an appropriate and speedy manner.

Two. The Bill is not aimed at bringing an action against physicians or their medical facilities, either in a civil or criminal form. Indeed, once we have a system in place to bring quick and effective relief to patients suffering impairment, the number of cases preferred against medical practitioners will decrease correspondingly. Furthermore, should the case arise in which a criminal action is brought against a doctor who is then found guilty in a court of law, Section 45 of the Bill provides a means for the court to lessen the penalty or to impose no sentence at all. This provision of the Bill is entirely favorable to the doctor.

Three. The Medical Compensation Fund is supported financially by the National Health Security Scheme, the Civil-Servants’ Medical-Benefits Scheme and the Social-Security Scheme. It may also collect additional funds from hospitals to help provide universal coverage for all Thai citizens.

A seven-year period of providing compensation for medical impairment as required by Section 41 of the National Health Security Act has drawn an annual expenditure of only one-to-two hundred million baht.

This funding does not involve a large amount of money, nor does it threaten to drive the health-care system into bankruptcy. The Fund will be managed by the Department of Health Service Support of the Ministry of Public Health. There is no one individual or group of persons who will be in a position to exploit the system for personal gain as some may suspect.

Four. Four steering committees comprising members of diverse backgrounds govern the disbursing of the funds. Specifically, they oversee (1) the policy and direction in which the funding is applied; (2) the initial compensation for health impairment; (3) the appropriateness of the compensation to the impairment suffered: and (4) the appeal process available to the patient suffering impairment caused by medical error.

The members of each committee comprise a variety of qualified people, among whom there is always the possibility of disagreement from time to time. The issues involved are subject to negotiation and adjustment through an extensive legislative process during which both the House of Representatives and the Senate convene a total of six times to review, debate and finally decide their final outcomes.

Five. The Bill provides an opportunity for patient and doctor to engage in dialogue on a voluntary basis and with complete openness. Thus, unresolved matters that each side has privately held against the other can be brought out into the open and resolved, with the result that the relationship of patient to doctor will be profoundly enhanced. This provision follows the concept that underlies the building of a humanized health-care system. It is truly a wonderful feature of the Bill.

Six. A system is being set up to analyze and understand the causes and effects of past experiences of patients who had suffered unfavorable outcomes from their medical treatment. The purpose of this study will be to enhance the future quality and safety of patient care. It will hopefully obviate the supposed need on the part of doctors to conceal or misrepresent any misdirected patient diagnosis, treatment and-or prognosis out of fear of being sued in court, as is all too often the case today.

When the National Health Assembly convened in December 2008, it brought together upwards of a thousand participants from every constituency nationwide. When a consensus was taken on the current legislation, they gave their full support to the principles embodied within its provisions, confident that the bill would be an effective device in harmonizing the activity of the National Health-Care System. Participants urged the Government and Parliament to act speedily in passing the Bill into law. Consensus was strong enough to spur the government into action, but resistance to the measure was sufficiently strong to bring the Government’s action to a halt. So, all we can do now is to wait and see what the Parliament decides to do with the bill as currently drafted. Such as it is, it can only benefit the people in general and physicians in particular.

    Seeing that the Bill as currently drafted is good, I can only conclude that it is indeed good. I can characterize it in no other way.

 Amphon Jindawatthana
Secretary General
National Health Commission