National Assembly Delegate of Nghe An: Medical practitioners need to publicly disclose their benefits to pharmaceutical companies for supervision.

This is the exchange of Mr. Hoang Minh Hieu - Standing Member of the Law Committee of the National Assembly, delegate of Nghe An delegation after studying the experience of many countries in promulgating laws on medical examination and treatment to avoid conflicts of interest between medical practitioners and patients when giving comments on the Draft Law on Medical Examination and Treatment (amended).

On the morning of June 13, continuing the 3rd session, at Dien Hong Hall, National Assembly House, under the direction of Permanent Vice Chairman of the National Assembly Tran Thanh Man, the National Assembly discussed in the hall the draft Law on Medical Examination and Treatment (amended). Photo: Quochoi.vn

Speaking at the discussion on the content of the Draft Law, the delegate of Nghe An, Mr. Hoang Minh Hieu - Standing Member of the Law Committee of the National Assembly, cited that during this session of the National Assembly, on June 3, Lao Dong Newspaper reported that in a prescription given at a hospital in Hanoi, a patient had to spend more than 4.8 million VND on functional foods while only having to spend 400,000 VND on treatment drugs.

The article also reported that because the prescriptions at this hospital are often so expensive, many patients have had to leave the hospital. Unfortunately, this is just one of many cases where patients have suffered losses when going to the doctor. “In the past, the public has heard many cases where patients had to pay a lot of money for unnecessary tests; were not given clear explanations about the results of the examination and treatment, and were not even given explanations when errors occurred during the examination and treatment process,” said delegate Hoang Minh Hieu.

The Executive Presidium chaired the meeting. Photo: Quang Khanh

According to him, one of the fundamental reasons for this situation is that we have not fully recognized the legal relationship between patients and medical practitioners. In this relationship, patients are always in a weak position, completely dependent on the information, knowledge, professional skills and ethics of medical practitioners. Therefore, in principle, the law on medical examination and treatment must set out very specific regulations to protect the rights and interests of patients.

However, through studying the Draft Law on Medical Examination and Treatment, the delegate of Nghe An delegation found that the draft only mentioned the relationship between patients and practitioners, focusing on some provisions in Section 1, Chapter II on the rights of patients (including 6 articles) and corresponding provisions on the obligations of practitioners in Article 37.

“These regulations are both lacking and only stop at general regulations on rights and obligations, without specific mechanisms to ensure that patients can exercise their rights. Obviously, if they stop at such regulations, the Draft Law has not resolved the practical problems raised, and has not achieved the goal of this law amendment of “taking patients as the center” as determined in the Government's Submission”, said delegate Hoang Minh Hieu.

Based on that analysis, he recommended that the Drafting Committee continue to thoroughly summarize the practice to fully supplement the regulations on the relationship between patients and medical practitioners with the nature of the trust relationship between patients and medical practitioners. Accordingly, the Draft Law needs to affirm that in this relationship, practitioners must perform medical examination and treatment for the maximum benefit of patients.

National Assembly Permanent Vice Chairman Tran Thanh Man chaired the discussion session on the morning of June 13. Photo: Quang Khanh

Going into details, to clarify this trust relationship, the delegate of Nghe An delegation suggested that the Draft Law should supplement regulations on the responsibilities of medical practitioners towards patients from three perspectives: One is the responsibility in medical examination and treatment; two is the responsibility to keep patient information confidential; and three is the responsibility to avoid conflicts of interest.

Accordingly, first of all, regarding the responsibility for medical examination and treatment; in addition to the contents stipulated in Articles 8 and 11 of the draft, the delegate said that it is necessary to clearly stipulate that practitioners are required to inform patients about the advantages and disadvantages; risks and side effects of treatment methods; explain other treatment methods if any; and not just stop at the current general provisions of the draft which are to advise and provide information on medical examination and treatment methods.

At the same time, it is necessary to affirm that this responsibility must be carried out continuously during the examination and treatment process, especially when there are new developments in the patient's health status. This ensures that the patient clearly understands his or her health status and understands the progress of the examination and treatment results that the doctor has performed. This is one of the contents that the law on examination and treatment in many countries is very interested in. The law on examination and treatment in some countries also stipulates very specifically the content of responsibility at each time during the examination and treatment process that doctors need to perform for patients.

Regarding the responsibility to protect patients' personal information, the Draft Law has quite complete regulations on this content in Clause 2, Article 3; Clauses 3 and 4, Article 9; Clause 5, Article 38. This is one of the advantages of this Draft Law.

However, according to the delegate, Article 92 of the Draft Law only mentions that this information will be aggregated in the information system on medical examination and treatment management centrally managed by the Ministry of Health; the entire content of the Draft Law does not have any article or clause clearly regulating the authority to access and use data of this system. Therefore, to ensure the principle of protecting patients' personal information, Mr. Hoang Minh Hieu suggested that the Draft Law needs to clarify this content.

Regarding the responsibility to avoid conflicts of interest, according to the delegate of Nghe An, this is an important content in contributing to limiting expensive prescriptions as mentioned in the above example, but has not received due attention in the Draft Law.

According to the laws of many countries, to avoid conflicts of interest, medical practitioners must publicly disclose their relationships with organizations and individuals related to medical examination and treatment, such as pharmaceutical companies, units providing testing and diagnostic services, medical research facilities, etc., to be monitored during their practice. This information can be made public on the website of the medical examination and treatment facility and must be notified to patients.

Delegate Hoang Minh Hieu - Nghe An Delegation, Standing Member of the National Assembly's Law Committee, speaks at the discussion on the Draft Law on Medical Examination and Treatment (amended). Photo: Quang Khanh

The laws of some countries such as Korea even clearly stipulate a number of specific cases prohibiting practitioners from enjoying material benefits from pharmaceutical companies, drug research and development facilities, medical equipment, etc. in various forms to ensure maximum benefits for patients.

“The above is just one of the issues raised for this Draft Law. Through the recent Covid-19 pandemic, the interest of voters and people of all walks of life in the Draft Law on Medical Examination and Treatment is very great. Therefore, we suggest that the Drafting Committee should continue to invest more time and effort to perfect the contents of the Draft Law, especially the provisions related to the rights and interests of patients, clarifying the image of patients in this Draft Law; truly making it convenient for people to participate in medical examination and treatment”, delegate Hoang Minh Hieu emphasized at the end of his discussion./.