MPs address doctors' concerns - Egypt - Al-Ahram Weekly
MPs gave the thumbs up to the controversial Medical Liability and Patient Protection law on Tuesday. The approval came only after MPs in coordination with Health Minister Khaled Abdel-Ghaffar addressed complaints received from the Doctors Syndicate over the draft bill.
Abdel-Ghaffar pointed out that though the bill had been approved by the Senate in December without changing controversial articles that stipulated detention, imprisonment, and hefty fines for doctors in cases involving negligence and malpractice, parliament intervened to amend the articles in coordination with the Health Ministry and Chairman of the Doctors Syndicate Osama Abdel-Hai.
As a result, Abdel-Ghaffar said, the law strikes a balance between protecting the rights of doctors and patients in accordance with the provisions of the constitution.
Abdel-Hai indicated that the Doctors Syndicate had rejected the law as approved by the Senate on the grounds that it imposed pretrial detention, prison sentences, and hefty fines for medical errors.
Speaker Hanafi Gebali said the parliament 'was keen to conduct a fruitful dialogue with the Doctors Syndicate and other state health authorities to respond to doctors' demands and address their concerns. My message to doctors in Egypt is that you now have a law that can achieve your ambitions, preserve your rights and ensure the safety of patients at the same time,' Gebali said. He added that 'in its current form, the law aims to create a safe environment for medical staff and provide legal protection for patients at the same time.'
Abdel-Ghaffar indicated that the collaboration between MPs, the Health Ministry and the Doctors Syndicate resulted in a version that had numerous gains, and a clear text that was drafted to define medical errors which occur only when a physician violates established professional principles. 'A physician is obligated to provide care based on the patient's health, following established scientific principles and agreed upon medical procedures,' Abdel-Ghaffar said.
Upon an amendment submitted by MP Karim Badr Helmi, parliament decided to delete words like 'negligence, recklessness, and lack of caution' from the definition of 'gross medical error'. The final definition of Article 11 now states that 'a gross medical error is a mistake of such severity that it results in certain harm. This includes, in particular, committing a medical error under the influence of alcohol, drugs, or other psychotropic substances, or refraining from assisting someone who has been the victim of a medical error or from requesting assistance for him/her, despite being able to do so at the time of the incident, or deliberately practising the profession outside the scope of the specialty and in non-emergency situations.'
MPs also amended articles to differentiate between 'normal' and 'gross medical errors'. Article 1 (Clause 10) now states that a normal medical error is one which does not align with established medical principles or violates the ethics and traditions of medical professions, as outlined in relevant laws and charters issued by the Egyptian Health Council.
Head of the House's Health Committee Ashraf Hatem indicated that the revised draft states that a Supreme Committee for Medical Liability and Patient Safety shall be established, reporting to the prime minister and shall include members from medical and health institutions.
The Supreme Committee shall meet every month upon an invitation from its chairman whenever necessary.
Article 10 states that the Supreme Committee shall be responsible for examining complaints filed against medical service providers or facilities regarding medical errors, establishing a database for medical errors in cooperation with unions and relevant authorities, and coordinating with unions and relevant authorities to issue guidelines on raising awareness of the rights of medical service recipients and following up on their implementation.
Hatem also highlighted that in response to the syndicate's demands, MPs agreed to eliminate two articles — 28 and 29 — imposing pretrial detention and prison sentences for medical errors in general which had 'sparked uproar among doctors and medical service providers'.
Article 28 stated that medical service providers who commit a medical error resulting in harm to a patient will face up to one year in prison and/or a fine of up to LE50,000. Punishment will increase to a maximum of two years in prison and/or a fine of up to LE300,000 if the medical error resulted in permanent disability, if the crime occurred as a result of a serious medical error, or if the service provider was under the influence of alcohol or drugs.
Article 29 imposed pretrial detention for crimes committed by medical service providers during the provision of medical services.
MPs decided to amend Article 27 to reduce the fine for medical errors, lowering it from a maximum of LE1 million to a maximum of LE100,000. The article, however, maintained prison sentences for gross medical errors. It now states that 'anyone who commits a medical error that causes real harm to the service recipient shall be punished with a fine of not less than LE10,000 and not more than LE100,000 (instead of not less than LE100,000 and not more than LE1 million). The penalty shall be imprisonment for a period of not less than one year and not more than five years and a fine of not less than LE500,000 and not more than LE2 million, or one of these two penalties if the crime occurred as a result of a gross medical error.
Also responding to the doctors' demands, MPs decided to amend Article 20 of the law to stipulate that a government insurance fund be established to insure against risks and damages resulting from medical errors, directly or through contracting with an insurance company. The fund may also contribute to covering other damages that hit the service recipient during or because of the provision of the medical service.
Hatem indicated that the fund will cover all doctors working in Egypt, whether Egyptian or non-Egyptian, and will be insured against risks.
Chairman of the Doctors Syndicate Abdel-Hai said the amended law largely responds to the demands of the medical community and strikes a balance between the rights and duties of doctors and health providers on the one hand and patients on the other. 'The enactment of this law was long overdue as most world countries have had such laws for 50 years, and that the Gulf states, for example, had enacted them 15 years ago,' said Abdel-Hai, noting that MPs addressed four concerns: the first includes designating the role of the Supreme Committee for Medical Liability as the technical expert for the investigating authorities and courts. The second, he added, is that the law clearly distinguishes between gross negligence and a standard medical error. 'The third is that Article 27 was amended to reduce financial penalties, while the fourth is that an insurance fund will be created to cover damages resulting from medical errors,' he said.
* A version of this article appears in print in the 27 March, 2025 edition of Al-Ahram Weekly
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