The health of the nation is the primary concern of this Government, and in this regard, the Ministry of Health has a responsibility to promote the interests and well-being of patients of health care facilities in Trinidad and Tobago.
Patients must always come first, and the Patient’s Charter is designed to direct the delivery of quality services to the public – both paying and non-paying.
The launch of the first ever Patient’s Charter in this Country, is a significant development in the thrust towards achieving a health service comparable with the best in the world.
It signals the introduction of national standards for the delivery of health care, which will essentially impact on the quality of services and the efficiency of health care facilities.
The Patient’s Charter entitles every patient to equal access to a consistently high standard of care, and protects every patient’s civil and religious liberties, including the right to independent personal decisions and knowledge of available choices. It signifies the Ministry’s commitment to the availability of quality health care to all persons on the basis of clinical need, and regardless of the ability to pay.
For years the health care system in this country has been plagued by many inefficiencies. Several steps are being taken to upgrade the quality of services and to meet the demands of the growing population.
The Patient’s Charter is one such initiative on the Ministry’s agenda to successfully transform the National Health Service, provide improved services and a better quality of life for all our citizens.
Honourable Minister of Health
Message from the Permanent Secretary
The Patient’s Charter of Rights and Obligations is being published to promote citizen’s awareness on his/her rights and obligations as it relates to health care in Trinidad and Tobago.
It also signals Government’s broader intention to allow consumers of public services to contribute to the development of the standards for the services provided.
This collaborative and patient-responsive philosophy equally ensures that the quality of care improves on a continuous basis and underscores the Ministry’s commitment to Quality.
MESSAGE FROM THE CHIEF MEDICAL OFFICER
The Patient’s Charter makes provision for the Health Sector to:
- Listen to and act on your views
- Set clear standards and revise as necessary
- Provide services that meet the organization’s standards
This booklet sets out the rights and obligations of every member of the public and outlines how you can help the sector to make further improvements.
For the purpose of this document ‘the patient’ is defined as a person who presents for diagnosis or treatment related to your physical or mental status, at a hospital/health facility established under the Regional Health Authorities Act No.5 of 1994 or established under the Private Hospitals Act 2 of 1960. ‘Rights’ mean that which all patients should receive; and ‘obligations’ refer to the responsibilities of the patient.
We look forward to working with you to ensure continuing improvement.
Dr. Rohit Doon
Chief Medical Officer
CHARTER OF PATIENT’S RIGHTS AND OBLIGATIONS
1. Access to Treatment
1.1 Every individual, including minors, the homeless and persons with disabilities, should be given impartial access to treatment or available lodging or appropriate medical and personal care based on individual needs, without considering his/her race, religion, gender, national origin, or social class.
1.2 The right is limited where the service is not reimbursable by public sector or private resources.
2.1 You have the right to receive respectful treatment from providers of health care at all times and under all circumstances, including the right to be informed on the approximate time frame of any mandatory medical procedure.
2.2 The right to fulfill your civic duty if your clinical condition permits.
3. Privacy and Confidentiality
You have a right to privacy with respect to your person and to information, such as is manifested in the following rights:
3.1 The right to refuse to speak to or to see someone, including visitors and persons officially related to the hospital, but not involved directly in your treatment.
3.2 The right to be examined in installations designed to ensure privacy, visual and auditory isolation. This includes the right to request that a person of the same sex be present during certain parts of a medical examination or during treatment or procedures done by a professional of the opposite sex, as well as, the right not to remain exposed for more than is necessary for carrying out the procedure for which you were requested to undress.
3.3 The right to expect such privacy during toileting or bathing and other activities of personal hygiene, except as needed for patient safety or assistance.
3.4 The right to expect that every consultation or mention of your case is made discreetly and that there are no people present who are not directly involved in your treatment, without your consent.
3.5 The right to have your medical file read only by those directly involved in your treatment or those who supervise its quality, and by other persons only with your prior written authorization or that of your legal representative.
3.6 The right to expect that all communication and records pertaining to your treatment, including the provision for payment, is treated confidentially.
3.7 The right to be provided with the isolation and protection that are considered necessary for your personal and biological safety.
4. Personal Safety/Security
4.1 You have the right to expect reasonable security to the extent that the practices and installations of the health facility allow.
4.2 You have the right to be assured that your personal property will be secured.
4.3 You have the right to expect care that does not compromise or is not detrimental to your safety or health.
5. Freedom From Abuse
5.1 You shall be protected from mental, sexual and physical abuse or the intentional and non-therapeutic infliction of physical pain or injury, or any persistent course of conduct intended to produce mental or emotional distress.
5.2 You shall be free from non-therapeutic chemical and physical restraints, except in fully documented emergencies, or as authorized in writing after examination by a patient’s physician/authorized officer for a specified and limited period of time, and only when necessary to protect you from self-injury or injuring others.
5.3 Minors, homeless and disabled persons are appropriately protected.
You have the right to know the identity and the professional position of the individuals who are providing you with services, as well as the right to know which physician or health professional is principally in charge of your treatment. Included here is your right to know whether there is some professional relationship among the individuals treating you, as well as the relationship to other health or educational institutions involved in your treatment.
7.1 You have the right to receive from the professional responsible for the coordination of your care the complete current information on your diagnosis, treatment alternatives, risks and prognosis. That information should be communicated to you in such a way that you can be expected to understand. When it is not considered medically advisable to give this information to you, that information will be made available to an authorized individual.
7.2 You have the right to know the investigations conducted, the results of these investigations and have them explained.
8.1 You have the right to access people other than hospital personnel, through visitors and through oral and written communication. When you do not speak or understand the predominant language of the community, you should have access to an interpreter. This is of particular importance when those language barriers affect your treatment/care plan.
8.2 You can expect your health facility to display information on the Patient’s Charter.
9.1 You have the right to be informed about and to participate in the decisions related to your health and treatment. Whenever possible, this should be based on a clear and concise explanation of your condition and of all the implicit technical procedures, including the possibilities of any risk of death or serious reactions and of problems related to your recovery and a satisfactory outcome.
9.2 You should not be subjected to any procedure without your voluntary, informed consent, or that of your legally authorized representative. When there are medical alternatives for your treatment you should be informed at all times.
9.3 You have the right to know who is responsible for authorizing and carrying out the procedures or the treatment.
9.4 Your participation in clinical training programmes for the purpose of obtaining information, or for the purpose of research should be by informed consent.
9.5 You should be informed of the aims, methods anticipated, benefits and potential risks of any research study that would affect your health or treatment and any discomfort it may entail. In addition, you have the right to refuse to participate in such activities.
Under petition and at your own expense, you have the right to consult with a specialist and get from him/her a second opinion on a major diagnostic or therapeutic procedure proposed.
11. Refusal of Treatment
11.1 You can refuse treatment. When the refusal of treatment by you or your legally authorized representative interferes with the provision of adequate treatment according
to professional standards, the relationship with you may be terminated with reasonable prior advance notice.
11.2 You have the right to refuse treatment or care from a provider who you believe is intoxicated or under the influence of other substance.
11.3 In cases where you are incapable of understanding the circumstances but have not been adjudicated incompetent by competent authority eg. The Judiciary, or when legal requirements limit the right to refuse treatment, the conditions and circumstances shall be fully documented by the attending physician in your medical record.
12. Respect for Culture and Religion
12.1 You have the right to manifestation of your cultural and/or religious expressions while admitted, as long as they do not interfere with the normal activities of the health facility and do not interfere with other patients interests.
12.2 Also you have the right to wear any symbolic or religious objects provided they do not interfere with the procedures for diagnosis or treatment.
12.3 You also have the right to request at any time, the presence of a representative from your religious denomination, provided they do not interfere with prescribed treatment.
You have the right to file a complaint when you consider your right infringed. You also have the right to have this complaint investigated by the designated officer and the results communicated to you within ten (10) days.
You or your authorized representative has the right to access a copy of your records.
15. Participation in Planning Treatment
15.1 You have the right to participate in the planning of your health care.
15.2 The right includes the opportunity to discuss treatment and alternatives with individual care givers and participate in formal case conferences.
15.3 You have the right to include a family member or other chosen representative in such conferences.
16. Notification of Family Members
If you are brought to a facility unconscious or comatose or is unable to communicate, the facility shall make reasonable efforts to contact a family member or person designated as the person to contact in an emergency. For the purpose of this paragraph “reasonable efforts” include:
- examining the personal effects of the patient;
- Examining the medical records of the patient in the possession of the facility.
17. Continuity of Care
You have the right to be cared for with reasonable regularity and continuity of staff assignment as far as facility policy allows.
18. Medical and Nursing Services
18.1 You can expect to receive medical and nursing care from professionals registered, enrolled or listed by the regulatory councils.
18.2 You shall receive care from these providers which is in compliance with the regulations governing their profession.
19. Primary Health Services
19.1 You can expect extended hours of service at some health centres and twenty four (24) hour service at District Health Facilities
19.2 You can expect some x-rays and laboratory tests to be done at the District Health Facilities
19.3 You can expect specialist clinics to be offered at some of the District Health Facilities
19.4 You can expect a visit from your health visitor, district nurse or midwife when necessary
19.5 You shall be provided with health promotion information
20. General Practitioner
In addition to the rights stated at 2, 3,4,5,6,7,9,10,12 and15
20.1 You have the right to receive information about the services your General Practitioner (private physician) provides.
20.2 You have the right to receive a health check (examination) in keeping with approved clinical protocols
21. Pharmacy Services
21.1 You shall receive medication in well-labeled containers and given clear instructions.
21.2.You shall expect that medicines dispensed for children will be provided in child proof containers.
21.3 You shall receive information on safe storage of medicines in the home.
21.4 You shall receive information on safe disposal of expired medicines.
21.5 You have the right to knowledge of the cost of your prescription(s) before deciding to purchase the prescribed items
21.6 You have the right to view the expiration date of all medication before purchase
21.7 You have the right to refuse expired drugs
21.8 You have the right to retain any attached literature of medications purchased
21.9 You have the right to information on contra indications for all medications
21.10 You have the right to be dispensed the prescribed brand of drug. If this is not available, you have the right to confer with your medical practitioner on any substitution.
22.1 You shall receive Ophthalmology Care from providers in the health system.
22.2 You can expect your care to include screening advice, eye examinations, investigations and prescriptions for appropriate treatment.
22.3 You shall be informed of any indication that medical treatment or further investigation is necessary and referral to an appropriate practitioner.
23. Dental Services
You shall expect to receive care from Dentists/ Dental Auxiliaries registered by the Dental Council to Practice in Trinidad and Tobago.
1.Supply of Information
1.1 You are responsible for providing according to your best understanding, precise and complete information on your current complaints, previous diseases, hospitalizations, drugs, and other matters related to your health.
1.2 You have the responsibility to report any unexpected change in your condition to the responsible professional.
1.3 You are also responsible for reporting whether you understand clearly the course of action contemplated and what is expected of you.
2. Compliance with Instructions
2.1 You are responsible for following the plan of treatment recommended by the professional mainly responsible for your care. This can include following the instructions of nurses and other personnel associated with your care.
2.2 You are responsible for keeping your appointments and, when this is impossible for any reason, for notifying the responsible health facility professional.
2.3 Your are responsible for communicating whether or not you understand the course of action to be undertaken in treatment.
3. Refusal of Treatment
You are responsible for your actions, if you refuse to receive treatment or follow the instructions of the practitioner.
4. Regulations and Statutes of the Hospital/Health Facility
4.1 You are responsible for observing hospital regulations and statutes that relate to the treatment and the behaviour of the patient.
4.2 You are responsible for complying with facility regulations regarding Visiting at the institution
5. Respect and Considerations
5.1 You are responsible for being considerate of the rights of other patients and the personnel of the health facility.
5.2 You/significant other are responsible for helping to control noise, and the number of visitors.
5.3 You are responsible for respecting the property of other persons and of the hospital, health centre, nursing home or other health facility.
6. Financial Obligations
If you assume financial obligation for your health care, then it is his/her responsibility to see that this is settled in due time.
HOW YOU CAN HELP THE HEALTH SERVICE
We have explained to you your rights and obligations when accessing care at health facilities.
We expect that you will use the services in a responsible manner, letting us know about your experiences. You can help us by remembering to:
- Give Customer Relations Officers or patient representatives your comments and suggestions so that we can improve services wherever possible (See pg. 15 for names & nos).
- Communicate your complaints to the Customer Relations or Complaints Officers and expect a response.
- Let us know as soon as possible if you cannot keep an appointment (this will help us to see someone else instead)
- Tell your doctor, nurse, pharmacist and other care provider or records officer if you have changed your name, address or telephone number.
Thank you for helping us to help you.
Director, Health Services Quality Management