OVERVIEW OF THE BOARD
&
THE NATIONAL PATIENT’S RIGHTS CHARTER
DURING THE
43RD KMA SCIENTIFIC CONFERENCE
NOBLE CONFERENCE CENTRE, ELDORET
ON 23RD APRIL, 2015
PROF. GEORGE MAGOHA
CHAIRMAN
MEDICAL PRACTITIONERS AND DENTISTS BOARD
LEGAL FOUNDATION
• The Board is established under Section 4 of the Medical
Practitioners and Dentists Act Cap. 253.
• The Act was enacted by Parliament in 1977 and
became operational on 1st January 1978.
• The Mandate of the Board is to regulate the training,
practice of Medicine & Dentistry as well as healthcare
standards in Health Institutions and clinics in the country
COMPOSITION
COMPOSITION OF THE BOARD
• The Chairman appointed by the Cabinet Secretary of Health;
• The Director of Medical Services/ Registrar;
• A Deputy Director of Medical Services nominated by the Cabinet
Secretary of Health;
• Four medical practitioners nominated by the Cabinet Secretary of
Health;
• Five medical practitioners and two dentists elected by the votes of
all medical and dental practitioners;
• Three representatives from Medical and Dental Schools in Kenya
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BOARD’S SECRETARIAT
The Board has an established secretariat headed by the Chief
Executive Officer.
Departments:
 Administration
 Finance
 Registration and Licensing
 Legal Services
 Standards and Compliance
 ICT
The staff establishment is 45 but currently only 21 officers are in
place.
Recruitment, training and capacity building on progress.
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FUNCTIONS OF THE BOARD
•
•
•
•
•
•
•
•
•
Education & Training
– Approval of Medical & Dental Schools, Core Curricula, Conduct Examination and CPD
Registration
– Medical, Dental practitioners and Health Institutions
Licensing
– Medical & Dental Practitioners, Foreign Doctors, Health Institutions and Clinics
Inspections
– Medical/ Dentals Schools, Internship Centers, Health facilities
Disciplinary
– Preliminary Inquiry Committee (National), Professional Conduct Committee (County) and
Tribunal(National)
Database
– maintaining a database of all registered and licensed medical & dental practitioners &
health institutions
Advisory-Ministry of Health and other government agencies
Collaboration & Partnership
– International, Regional and Local agencies – IAMRA,General Medical Council-UK,
AMCOA, EAC & National Boards/Councils , Professional Associations like KMA, KMPDU
– Donor Agencies –University of Nairobi, CDC/Emory Project, IFC/WorldBank, FunzoKenya
among others
Monitoring & Evaluation- Performance contracting
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NATIONAL PATIENT’S RIGHTS
CHARTER
 The development of the Kenya National Patient’s Charter was
necessitated by the dynamics of medical practice and constitutional
dispensation and the review of other enabling legislation relevant to
health
 The Patient’s Charter meant to inform clients and patients of their
rights and responsibilities.
 Empowering them to demand quality services from health care
providers
 It provides guidelines for conflict resolutions arising between patients
and health care providers.
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NATIONAL PATIENT’S RIGHTS
CHARTER
• Defines and
responsibilities
mechanisms.
explains
and
the patients’ rights,
dispute
resolution
• The rights outlined herein are anchored in the
Constitution of Kenya 2010 and in particular
Articles 19, 20(5), 21(2), 22(1), 26, 43(1)(2), 46,
53(1)(c) and 70.
Continued….
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PATIENT’S RIGHTS
1. Right to access health care
Include: promotive, preventive, curative, reproductive, rehabilitative
and palliative care.
2. Right to receive emergency treatment in any health facility.
In emergency situations, irrespective of the patient’s ability to pay,
treatment to stabilize the patient’s condition shall be provided.
3.
Right to be informed all the provisions of one’s Medical
Scheme/Health Insurance Policy.
Anyone who is enjoying the provisions of a medical cover (insured) is
entitled to know all the privileges accorded and also entitled to
challenge, where and if necessary, the contents and decisions of the
medical scheme and health insurance policy.
NATIContinued….
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PATIENT’S RIGHTS
4. Right to choose a health care provider
Shall not be unduly restricted by third parties so long as the provider of choice is
qualified, registered, retained and in current good standing with the Regulatory
Authority to provide
5. Right to the highest attainable quality of Health care products and services
6.
Right to refuse treatment.
Documented and witnessed, should not endanger the life of patient or others and
patient is of sound mind.
7. Right to confidentiality
Even after death. Disclosure allowed in public interest or by law.
8. Right to informed consent to treatment
Nature of one’s illness, diagnostic procedures, proposed treatment, alternative
treatment and the costs involved except in emergency cases.
The decision shall be made willingly and free from duress.
9.
Right to information
Full and accurate information on their health and health care.
Continued….
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10. Right to be treated with respect and dignity
11. Right to a second medical opinion
In regards to diagnosis, procedures, treatment and/or medication
from any other qualified health professional of one’s choice.
12. Right to complain
to relevant authorities, such complaint should be investigated and
receive a response from the authority within a reasonable time that
does not exceed twelve months. Where there is a delay, the relevant
authority shall provide the reasons.
13.Right to insurance coverage without discrimination on the basis of
age, pregnancy, disability, illness including mental disorders.
14.Right to donate his or her organs and/or any other arrangements /
wishes upon ones demise.
Continued….
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PATIENT’S RESPONSIBILITIES
Every patient has a responsibility to:
1. Take care of his/her health by adopting a healthy lifestyle;
2.
Protect,
care
and
provide
healthy
lifestyle
for
a
minor
(parent/guardian)
3. Adopt a positive attitude towards their health and life;
4. Protect the environment;
5. Respect the rights of others and not to endanger their life and health.
6.Give health care providers relevant, accurate information to facilitate
diagnosis, treatment, rehabilitation and/or counseling while being
truthful and honest on past health care;
7. Take care of the health records in his or her possession and avail
produce them if and when required by the health care provider;
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8.Keep scheduled appointments, observe time and if not possible,
communicate to the health care provider;
9. Follow instructions, adhere to and not abuse or misuse prescribed medication
or treatment and/or rehabilitation requirements.
10. Enquire about costs of treatment and rehabilitation and to make appropriate
arrangements for payments;
11. Be aware of the available health care services in his or her locality and to
make informed choices while utilizing such services responsibly;
12. Inform the health care providers, where necessary, when one wishes to
donate his or her organs and/or any other arrangements / wishes upon ones
demise;
13. Make decisions on health care services where a adult patient is not
competent to do so. Next of kin and guardian shall accord protection and
care to the patient.
Continued….
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DISPUTE RESOLUTION
Disputes may arise from the following areas:
1) Patient and health care provider;
2) Patient and financier/insurer;
3) Patient and the employer, and
4) Patient and Regulatory Body.
The patient may lodge the dispute directly with the Health Care
Provider. The provider may resolve the dispute amicably,
formulate an internal inquiry, establish a committee and/or
internal body to consider it and thereafter take make
appropriate steps which resolves the complaint conclusively to
the satisfaction of all the concerned parties.
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The patient may opt to lodge the compliant with the relevant
Regulatory Authority or body as set out by the applicable Statutes,
which includes;
(i) The Public Health Act, Chapter 242 of the Laws of Kenya;
(ii) The Medical Practitioners & Dentists Board Act, Chapter 253 of t he
Laws of Kenya;
(iii) The Pharmacy & Poisons Board, Chapter 244 of the Laws of Kenya;
(iv)The Nursing Council of Kenya;
(v) The Clinical Officers Council;
(vi) The Kenya Medical, Laboratory, Technician and Technologists Board;
(vii) The Radiation Protection Board;
(viii)The Nutritionists and Dietician Institute,
(ix) The Consumer Protection Act, and
(x) The Public Health Officers and Technicians Act, 2013
Continued….
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DISPUTE RESOLUTION AT THE MEDICAL
PRACTITIONERS AND DENTIST BOARD
Legal provisions
The disciplinary powers are conferred upon the Board by Section 20 of
the Medical Practitioners and Dentists Act. Cap 253 laws of Kenya as
read together with the Medical Practitioners and Dentists ( Disciplinary
Proceedings) (Procedure) Rules under the Act.
Under section 23 (b) of Cap. 253 the Minister/ Cabinet Secretary in
consultation with the Board can make rules to provide for the
procedure to be followed by the Board in an inquiry under Section 20
Health services are determined by the following factors; history, culture,
geography, economic empowerment, political persuasion, spatial
distribution and a host of other unique factors. The practice of
medicine is an indispensable service to the public.
Medical malpractice cases have been there since mid-nineteenth
century. There has been a periodic rise due to public awareness.
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MEDICAL MALPRACTICE
Definition:
 “professional negligence by an act or omission of a health care
provider in which the treatment provided falls below the accepted
standards of practice in the medical community and causes injury or
death to the patient”.
 Standards and regulations for medical malpractice vary by
country and jurisdictions;
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Type of conduct raising disciplinary
inquiry
Termination of pregnancy- the Laws of Kenya do not permit termination of pregnancy
which is only allowed in a few exceptions.
2.
Gender reassignment- is not permitted on demand.
3.
In-vitro Fertilization (IVF) and assisted reproduction-patients in need of IVF should
always be referred to an IVF accredited center.
4.
Sex selection- it is unethical for practitioners to engage in such a practice, to support
or to encourage sex selection.
5.
Abuse of professional confidence- practitioner shall not disclose to a third party
information which has been obtained in confidence from the patient or patient’s
guardian. However; there are exceptions to this rule
6.
Abuse of relationships between practitioners and patients:- health practitioners are
privileged people who gain confidential information by virtue of their position of trust.
7.
Abuse of financial opportunities- practitioners should adhere to consumer rights as
provided for in Article 46 of the Constitution.
8.
Advertising, canvassing and related professional offences
9.
Conduct negatively affecting the reputation of the profession
10. Medical errors which include: mis-diagnosis, failure to diagnose, Wrong treatment/
medication, Emergency room errors, Surgical errors, Patient abandonment, Transfer
without proper instruction, Lack of consent, lack of informed consent, Dental errors ,
Psychiatric malpractice
1.
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COMPLAINTS
 The Board may receive complaints from the following: Patients or their relatives /Advocates,
 Aggrieved members of the public,
 Director of Medical services,
 Health institutions,
 Professional bodies/ Associations,
 Office of the Ombudsman,
 Media etc.
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DISPUTE HANDLING MECHANISMS
A. PRELIMINARY INQUIRY COMMITTEE
1. Conduct inquiries into the complaints submitted to it under these
Rules and make appropriate recommends to the Board.
2. Ensure that the necessary administrative and evidential
arrangements have been met so as to facilitate the Board to
effectively undertake an inquiry under rule 6;
3. Promote mediation and arbitration between the parties and refer
matters to such mediator or arbitrator as the parties may in writing
agree; and
4. At its own liberty, record and adopt mediation agreements or
compromise between the parties on the terms agreed and
thereafter inform the chairperson.
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DISPUTE HANDLING MECHANISMS
B) PROFESSIONAL CONDUCT COMMITTEE (“PCC”)
1. Conduct inquiries into the complaints within such counties as the
Board may specify and make appropriate recommendations to
the Board;
2. Ensure that the necessary administrative and evidential
arrangements have been met so as to facilitate the Board to
effectively undertake an inquiry under rule 6;
3. Convene sittings in respective counties to determine complaints;
4. Promote arbitration between the parties and refer matters to such
arbitrator as the parties may in writing agree.
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DISPUTE HANDLING MECHANISMS
C. TRIBUNAL
• The Full Board exercising judicial or quasi judicial functions to
determine disciplinary matters is known as a Tribunal
• Board members act as the jury.
• The Tribunal hears matters referred to it by the Preliminary Inquiry
Committee and the Professional Conduct Committee.
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Penalties under
Preliminary Inquiry Committee (PIC) and Professional
Conduct Committee (PCC)
a. To admonish a doctor, dentist or the institution and conclude the
case.
b. Make an order compelling a medical practitioner or dentists to undergo
continuous professional development of not more than fifty points.
c. Suspend the licence of a medical institution for a period of not more than six
months.
d. Make an order for the closure of an institution pending the compliance by
that institution, of a conduction or requirement under the licence issued to it
under the Act;
e. Make such further recommendations as the committee deems fit;
f. Levy reasonable costs of the proceedings from the parties
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PENALTIES UNDER
THE TRIBUNAL
a) Admonish a doctor, dentist or institution and conclude the case.
b) To place the doctor or dentist under probation( the Board may at its
own discretion direct the doctor or dentist to be supervised during the probation
period which does not exceed six (6) months.
c) To order for the payment of costs for the Board’s sitting(s) to be paid by the
medical or dental practitioner or the institution on such terms as shall be
deemed fit in the circumstances;
d) To direct the suspension of a doctor’s or dentist’s registration or licence for a
period not exceeding twelve (12) months
e) To direct removal from the register;
f) To suspend licenses for medical institutions for up to six (6) months
g) To order the closure of medical/ dental institution until compliance with
requirements of operating licenses.
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