Good afternoon!
Dear Yerlan Zhakanovich,
dear deputies,
colleagues!
In order to implement the instructions of the Head of State aimed at improving the status of medical workers, protecting the rights of patients and improving the quality of medical care, a draft law "On amendments and additions to some legislative acts of the Republic of Kazakhstan on health issues" has been developed.
As you know, Article 270 of the Code "On the Health of the People and the Healthcare System" legislatively establishes the right to insurance of professional liability of medical workers in case of harm to the life and (or) health of the patient when they provide medical care.
In order to implement the legal and financial protection of medical workers and the guaranteed rights of patients to compensation for harm, it is necessary to gradually introduce a system of insurance of professional liability of medical workers, which will improve the quality of medical care.
During the work on the draft law, the Ministry analyzed various models of insurance of professional liability of medical workers.
In international practice, a system of compulsory professional liability insurance is used to protect health workers by creating foundations and associations (Sweden, Canada, Denmark), as well as through private markets (USA, Germany, Japan, Turkey). The obligation to insure their professional responsibility is assigned to medical workers or health care organizations.
Based on the above international experience, an adapted market model of insurance (through existing insurance companies, pre-trial settlement of the conflict) according to the models of the USA, Germany, Japan and Turkey is proposed as the optimal mechanism for insuring professional liability of medical workers, taking into account the development of Kazakhstan society.
Patient support services are being created in medical organizations.
For reference: To date, about 700 patient support services have been created in the country.
According to this model, consideration of the complaint will be carried out by a special commission with the involvement of experts and interested parties using elements of mediation, as well as with the involvement of specialized medical associations. At this stage, the issue can be settled in the Ministry of Defense itself.
If the patient does not agree with the decision of the Service, the complaint can be considered in the territorial division of the Medical and Pharmaceutical Control Committee to provide an expert opinion. In case of a positive result, the materials on the complaint, including the conclusion of the forensic medical examination, will be transferred to the insurance company where the medical organization was insured.
Payment of compensation for the damage caused to the patient will be made by the insurance company. In case of refusal of payment and dissatisfaction, the patient has the right to go to court.
The amount of the insurance premium will be determined taking into account the degree of responsibility of the medical worker on the basis of approved actuarial calculations, depending on the degree of risk.
Based on the above, the Ministry proposes a developed adapted model of imputed insurance of professional liability of medical workers through existing insurance companies, with the maximum amount of financial liability of the insurer, with financing through the tariffs of medical services, where the employer acts as the policyholder, and the medical organization enters into a collective agreement with the insurance company.
Dear deputies! professional liability insurance of medical workers is a new institution in the field of healthcare aimed at reducing the legal and professional risks of medical workers, which exposed the main problems of the industry during the covid-19 pandemic, such as professional burnout, outflow of medical personnel, high responsibility to the patient, insufficient wages, low security, an increase in the number of complaints and low status professions. In this regard, we believe that it is necessary to adopt this Law.
Protection of medical workers.
The Ministry of Health, within the framework of the Draft Law, proposed norms for the humanization of criminal offenses for improper performance of professional duties by a medical or pharmaceutical worker and to reduce the sanctions measures of Article 317 of the Criminal Code of the Republic of Kazakhstan.
In 2018 – 2020, 14 123 appeals were received from individuals and legal entities, of which about 300 cases are opened annually for improper performance of professional duties in relation to medical workers under Article 317 of the Criminal Code, often for surgical specialists with a risk of death (obstetricians and gynecologists - 14 people, surgeons – 14, traumatologists – 8, anesthesiologists - 6).
The bill proposes to reduce the size of the fine and the term of arrest for unintentional infliction of moderate and severe harm to health, in case of severe harm to health or death of the patient, "deprivation of liberty" should be replaced with "restriction of freedom" with a revision of the terms of punishments.
For reference:
In neighboring CIS countries, norms on improper performance of professional duties by a medical or pharmaceutical worker are provided for in the Criminal Codes of Ukraine (Article 140), Belarus (Article 162). Along with Kazakhstan, an independent chapter on medical offenses is available only in the Criminal Code of Kyrgyzstan.
In Russia, the criminal law does not contain a special norm for these crimes and, in general, for medical crimes. The chapter on crimes against the person provides for liability for an act committed as a result of improper performance by a person of his professional duties.
The Ministry of Health has repeatedly made attempts to humanize punishment, taking into account the opinion of the medical community.
The bill is also aimed at improving the status and social support of medical workers, awarding them honorary titles and continuing to increase the salaries of medical workers in 2023.
Dear deputies!
Expected results from the adoption of the bill:
The proposed model of insurance of professional liability of medical workers and the humanization of punishments for improper performance of professional duties is primarily aimed at protecting the rights of citizens, at compensation for harm to health and life when receiving medical services, as well as at legal and financial protection of medical workers, reducing the outflow of highly qualified specialists from the industry whose activities are associated with socially useful risk when helping a patient. All this is aimed at raising the status and respect for the medical profession, as well as to attract the younger generation to the healthcare sector.
Dear Yerlan Zhakanuly, dear deputies, we hope for fruitful work and support of our bill in the Parliament aimed at improving the status of medical workers, protecting the rights of patients and improving the quality of medical care.
Thank you for your attention!