A healthcare provider can exploit his patient through breach of contract, medical negligence that could give rise to tortious liability, violation of some specific fundamental rights or violation of the patient’s rights under the National Health Act 2014. A healthcare provider can be punished when he/she commits any action under the aforementioned through specific disciplinary mechanisms set aside by the law.
Globally, the health care system is governed by ethical principles guiding the professional conduct of different professions within the coordinated body of health care delivery. Those ethical principles regulate service delivery in every profession and safeguard the well-being of the patients handled by those professionals within the scope of their professional practice.
Nigeria, with no exception, has its own healthcare system encompassing three delivery levels, ranging from primary, secondary and tertiary healthcare. Each level has personnel that are professionally trained in the various fields of health practice to take care of patients according to their expertise and professional boundaries.
The relationship between a healthcare provider and his patients from a legal perspective is contractual. The healthcare provider owes his patient a duty of care, and the patient owes the healthcare provider a token as payment for the service rendered. A contract is known to be an agreement between two or more parties that is legally binding, but in some cases, the relationship between the health care provider and the patient is not mutual, as the patient might not be in the right state of mind to make decisions. Regardless, the relationship is contractual, as implied by law.
In every contractual relationship between parties, there is a legal obligation that is to be fulfilled. Failure to fulfil the obligation will be regarded as a breach of contract. Breach of contract, according to law, generally attracts damages and, in some exceptions, can attract restitution, quantum meruit or specific performance, as the case may be. Inadequate knowledge of the law leads to the exploitation of many patients by some healthcare providers, which usually slides without punishing the offenders.
A healthcare provider can exploit his patient through breach of contract, medical negligence that could give rise to tortious liability, violation of some specific fundamental rights or violation of the patient’s rights under the National Health Act 2014. A healthcare provider can be punished when he/she commits any action under the aforementioned through specific disciplinary mechanisms set aside by the law.
The disciplinary mechanisms could be a civil or tortious liability, where the offender will be required to pay for damages by the court; criminal liability, where the offender will be punished based on the intensity of his crime according to the penal code of the state; and professional punishment can be served by the professional body that the offender belongs to by demotion, revoking of license or dismissal as the case may be.
There are instances where the management of a health facility could be held responsible for an accident that occurred to the patient in the facility—it is referred to as “Occupier’s liability” in law. In this regard, the accident must be a result of the negligence of the management, caused by failure to provide something necessary in which its absence resulted in the accident, or there may be a lack of maintenance of some equipment or devices that might have led to an accident.
Vicarious liability is also a situation where the management of a health facility can be held responsible for an act committed by their employee. When a patient is maltreated in a health facility by any member of staff, be it a violation of the right, tortuous act or breach of contract, the patient can sue the whole management of the facility in court for justice to prevail.
Any health consumer in Nigeria that once in a while visits a health facility to patronise health care services should know his rights as stipulated under the National Health Act 2014.
Part III of the National Health Act 2014 (Rights and obligation of users and health care personnel) encompasses eleven sections, starting from section 20 to section 30. Eight of those sections (sections 20, 23, 24, 25, 26, 27, 29 and 30) directly state the right of patients in relation to the health care provider.
Section 20 is about “emergency treatment”, where the section mandates any healthcare provider on duty to attend to a patient in an emergency without any hesitation or formality. Contravening the section can attract a fine of ₦100,000 or imprisonment of not more than six months, or even two, as the case may be.
“User (Patient) to have full knowledge” is what section 23 is all about. It explained the right of a patient to be well informed of his condition and the possible treatment that will be administered to him/her, unless in the case where informing the patient will cause more harm. Section 24 expatiates the “duty to disseminate information” by federal, state or local government health authorities. Facilities should make such information visible at the entrance. The information should include the services provided by the facility, operating schedule and visiting hours, processes for making complaints and the rights of the patients as well as the health care providers.
Section 25 explained the “obligation to keep records”. This record involves the demography, treatment as well as medical history of the patients. It is mandatory for any health facility to keep records of their patients for future reference. “Confidentiality” of the patients must be a priority for any health facility and its personnel, as stated in section 26 of the National Health Act 2014. Disclosure of a patient’s information without a genuine reason is an offence that can attract punishment if reported.
The health record of the patient can be disclosed in some cases where the disclosure is in the best interest of the patient or is required by the court of law for judgement. It is stated as “Assess Health Record” under section 27 of the National Health Act 2014. “Protection of health record” is stated under section 29. Negligence in handling the record of a patient or deliberately tampering with any information without legitimate authorisation is an offence that can attract conviction to imprisonment for not more than two years or a fine of ₦250,000.
The last section with respect to patient’s rights under the National Health Act 2014 is section 30, which expatiates on the “Laying of complaints”. Any patient that is maltreated by any health personnel has the right to complain. The complaint should be in accordance with procedures provided by the federal or state ministry of health.
As a citizen of Nigeria, knowledge of fundamental and specific rights is necessary regardless of one’s level of education. People are being oppressed and maltreated on a daily basis due to ignorance of their rights and how to seek justice. To have a just and egalitarian society, people need to be aware of their rights and what should be considered a violation of those rights.
Conclusively, the law is set aside for justice to prevail, and nobody has the authority to deprive you of your right to justice. To get justice, you have to find it by going through the right channel. Albert Einstein said, “In matters of truth and justice, there is no difference between large and small problems, for issues concerning the treatment of people are all the same”.
Abdullahi Yusuf is a final year student of Health Education, Department of Human Kinetics and Health Education, Bayero University Kano.
He can be contacted via [email protected].