Opinions of Tuesday, 3 October 2023

Columnist: Evans Mawunyo Tsikata

Protecting patients' rights: Assessing the legal effects of dialysis fee increases beyond parliamentary approval

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Aside from parliamentary approval, the increase in dialysis fees raises ethical considerations about patient protection and access to healthcare.

Dialysis is a life-sustaining treatment for persons with end-stage renal disease (ESRD), and any increase in charges must be justified by a reasonable balance of patient, healthcare provider, and insurer interests. Unexpected cost increases may harm vulnerable patients who may struggle to absorb the additional economic strain, resulting in treatment discontinuation and severe negative health consequences.

Furthermore, the decision to raise charges lacks transparency and accountability, as patients have the right to be informed and advised about any changes affecting their access to healthcare.

This raises worries about the democratic process and large industrial groups' interests taking precedence over patients' rights. Ethical principles of justice and beneficence require that healthcare decisions be made in the best interests of the patients and that they not be subjected to financial exploitation or neglect. Policymakers and healthcare practitioners must evaluate the moral implications of any changes that influence patients' access to life-sustaining treatments to protect their interests.

Concerns have been raised concerning the legal ramifications of Korlebu Teaching Hospital raising dialysis fees without parliamentary authorisation. Many countries have different laws and legislation that govern the delivery of healthcare services. Before implementing fee hikes, public hospitals must normally acquire clearance from relevant authorities, such as the Ministry of Health and parliamentary agencies. Failure to follow these requirements may result in legal consequences for the facility.

Among the consequences are potential violations of healthcare regulations, breaches of existing patient contracts, violations of consumer protection laws, legal challenges and lawsuits from patients or advocacy groups, administrative penalties imposed by regulatory bodies, and public backlash and reputational damage. Understanding these legal consequences is critical for healthcare practitioners to ensure legal compliance while providing patients with competent medical treatment.

There are several laws and regulations in Ghana that require public institutions to seek parliamentary approval before adjusting fees. Some of these laws include:

Fees (Miscellaneous Provisions) Act, 2016 (Act 935) - This Act provides detailed procedures for public institutions to adjust fees. Section 7 of the Act requires institutions to obtain parliamentary approval before adjusting fees:

Financial Administration Act, 2003 (Act 654) - Section 23 of this Act requires that all proposals for new fees or fee adjustments are submitted to Parliament for approval before implementation:

National Health Insurance Act, 2012 (Act 852) - Section 75 of this Act requires that any proposed increase in the national health insurance premium must be submitted to Parliament for approval:

Internal Revenue Act, 2018 (Act 1065) - This Act requires parliamentary approval for any proposals to impose or increase taxes, levies, or charges:

Public Financial Management Act, 2016 (Act 921) - Section 34 of this Act requires that all public institutions seeking to adjust fees or charges must obtain parliamentary approval:

These laws and regulations are designed to ensure transparency and accountability in the fee-setting process. Public institutions are required to provide detailed justifications for any proposed fee adjustments and to obtain the necessary approval before implementing them. Failure to comply with these provisions can result in legal and reputational consequences for the institution.

If Korle Bu Teaching Hospital, as a public institution, may raise dialysis prices without parliamentary consent, there could be legal ramifications. Ghana's healthcare facilities and services are governed by strict regulations and laws.

Before implementing fee increases, hospitals may be required by these regulations to seek clearance from competent authorities, such as the Ministry of Health or parliamentary organizations. If the hospital fails to comply with these standards, it may be in breach of the law.

If the hospital already has contracts or agreements in place with patients for the provision of dialysis treatments, raising rates without parliamentary approval may be considered a breach of contract. Patients who are unable to pay the additional costs may sue the hospital for breach of contract. Customers are protected from unscrupulous pricing practices by specific regulations.

These constraints may push enterprises, particularly healthcare providers, to seek or justify hefty price hikes. If the hospital increases dialysis prices without first obtaining approval, it may be breaking consumer protection rules.
Patients or patient advocacy groups may sue to stop the fee increase. They may argue that the hospital's acts are discriminatory or that they disproportionately affect vulnerable communities, such as the poor.

These legal challenges could lead to court orders that reverse the fee hike or compensate aggrieved patients. For failing to seek parliamentary clearance, regulatory entities in charge of regulating public healthcare services have the authority to levy administrative penalties against the institution. Fines, suspension of services, or other disciplinary processes may be imposed to ensure legal compliance.

If the hospital does not obtain parliamentary authorisation to raise dialysis fees, it may face negative headlines. This might result in public outcry, with patients and the general public doubting the hospital's ethics and dedication to low-cost healthcare. As a result, the hospital's reputation may suffer, making it more difficult to recruit patients, retain employees, and gain future funding or partnerships.

Finally, the legal consequences of failing to get parliamentary approval to increase dialysis pricing would be determined by the respective jurisdiction's individual laws, conventions, and contractual agreements. Healthcare personnel must strictly adhere to regulatory standards to prevent any legal and reputational repercussions while also ensuring that patients receive proper medical care.

In conclusion, Korle Bu Teaching Hospital may face major legal consequences if it hikes dialysis fees without first obtaining parliamentary approval. Healthcare regulations violations, breaches of patient contracts, violations of consumer protection laws, legal challenges and litigation, administrative penalties imposed by regulatory agencies, public reaction, and reputational loss are all possible repercussions.

To avoid these consequences, healthcare practitioners must strictly adhere to legal processes while still prioritizing patients' access to vital medical treatment. Healthcare facilities can fulfill their ethical commitments while also boosting the health of their patients and communities.