Enforcement of medical liability insurance law hits snag

Health minister Diane Gashumba speaks during a past event. Sam Ngendahimana.

A law which aims at establishing medical professional liability insurance and committees for conciliation and compensation for health risks has not been implemented five years since its enactment, a situation which has irked legislators and health professionals.

The Law establishing medical professional liability insurance was published in official gazette of January 22, 2013 and has different provisions including the insurance by a health professional and a health facility, as well as the right of a victim of health risks to sue for compensation.

The concern was exposed last week during sessions between the Senatorial Committee on Social Affairs and Human Rights and councils of healthcare professionals, and officials from the Ministry of Health.

The sessions were meant to assess the activities and performance of Government in terms of offering quality healthcare to citizens.

In November 2017, Dr. Diane Gashumba, the Minister of Health, was quoted as saying that the ministerial orders on medical liability insurance would be issued by January 2018, but, that has not been done until now, hence causing delay in the implementing the law.

The application of the law required determination of fees that should be covered by a health institution, how much the health professionals will contribute, and the risks involved in the medical profession.

The ministerial orders would set up a platform to determine the magnitude of the problem, and the due compensation for damages inflicted to the victim.

Commenting on the delay to implement the law, Jean Damascène Gasherebuka, the chairperson of the Rwanda Allied Health Professions Council (RAHPC) told Sunday Times that there has been lack of efforts to put it into practice.

“If efforts were put in this activity, it should not have taken long. The same insurance exists in other parts of the world, why don’t they refer to where that is already done so as to understand how it is done?

Gasherebuka said that a professional involved in a medical harm risks having their property auctioned if they fail to pay for the damages incurred by a patient or any other victim.

“If a car knocks down a passenger, the owner’s insurance covers the damages, Such a thing can also happen at a hospital which can be unintentional, or a system in which the health professional is operating, such as that of medical equipment failure,” he said.

He added that when there is a guarantee that insurance will pay for the damages caused, it eases the work of the medical professional.

Senator Jean Damascène Ntawukuriryayo wondered whether the law should not be repealed after taking a very long time without being implemented.

“In the assessment we carried out, we were promised that the Ministerial Order by the Ministry of Finance and Economic Planning would be issued in January 2018. Now, we are in February 2019. So, how should we deal with this situation?” he asked.

“If such insurance is not implemented, all the strategies being developed to provide quality services to the citizens will be derailed because a doctor might look at a patient but will not touch them [perform surgery on them because they have no legal protection].

Gashumba admitted that the ministerial orders from the ministrie of Health and Finance had delayed, but pointed out if it is established that a citizen has fallen victim of a malpractice, they get compensation from the government.

“It is not carelessness or not attaching importance to that or forgetting it, rather, we made evaluation and had many consultations and we found that the execution of this law is complicated. Although it was passed and we know its importance, it needs more consultations.

“There are many issues including committees that need to have skills to analyse the citizen’s complaint, without speculation, and current low salaries of medics who have to make monthly contributions to the insurance scheme,” the minister said.