Private hospitals association INNOVATIONS IN AN INDUSTRY GUIDED BY ETHICS JOSEPHINE MWAKUTUYA REGISTRAR MEDICAL AND DENTAL PRACTITIONERS OF ZIMBABWE B. Management (HR) MBA DIP Law (student UZ) 2015  MEMBER OF COMMITTEE ASSOCIATION OF MEDICAL COUNCILS OF AFRICA(AMCOA)  MEMBER OF MEMBERSHIP COMMITTEE INTERNATIONAL ASSOCIATION OF,MEDICAL REGULATORY AUTHORITIES (IAMRA)  PAST MEMBER IAMRA MANAGEMENT COMMITTEE  MEMBER IAMRA 2014 CONFERENCE ORGANIZING COMMITTEE (UK)  CHAIRPERSON OF THE NATIONAL HEALTH TASK FORCE OF MOH&CH  ( WHO TEMPORARY TECHNICAL ADVISOR, ESTABLISHING THE SOUTH SUDAN GMC) 4-8/5/2015

Outline of the paper Introduction Objectives of the paper What Does the Law Say? Unethical Innovative Initiations Surviving With Adversity Conclusion

INTRODUCTION One of the roles of the Medial & Dental Practitioners Council of Zimbabwe is to ensure ethical practice and adherence to Council regulations by authorities in the medical industry, a precept of good corporate governance. The practical importance of good corporate governance has been acknowledged for a long time (Shlifer Vishny 1997). Governance ensures that right things are done in the right way for the right people in the right manner in an inclusive, open honest and acceptable manner. Processes must not be mass of destruction (Prof Merviyn King 2010) Good corporate governance is a tool for creating and sustaining shareholder value (Dube C Corporate Governance Zimbabwe).

OBJECTIVES OF THE PRESENTATION Sensitise the members on the need to comply with regulations - good corporate governance Sensitise members on the importance to stick to their core business avoid conflict of interest. Avoid unethical illegal innovative initiations Good governance -tool for creating and sustaining shareholder value. Private institutions Private medical care compliments health service delivery in the country

WHAT DOES THE LAW SAY 1) Fundamental Constitutional Rights: Constitution of Zimbabwe 2) Amendment (N0 20) Act 2013 : Access of information – exercising the protection of a right patients records S.62 Confidentiality S.57 (e) Right to Health S.76(3) “No person may be refused emergency medical treatment in any health care institution” 3) S.I 93 0f 93: Reporting of any table or maternal death occurred in 24 within 24 hours of an operative procedure Reporting of any act of unprofessional and unethical practice to Council

What does the law say continued 4)Advertising Section 135 Health Professions Act (Chapter 21:19) includes:- Publishing of a statement, claim in a newspaper, magazine, hand bill pamphlet, card or circulars. Broadcasting statement, claims electronically or other means,that skilled, competent etc. What does the law say?

UNETHICAL INNOVATIVE INITIATIONS Advertising professional services- promoting medical tourism Medical Personnel Abuse of task shifting concept Inadequately trained Nurses in ICU – cutting costs (SCN extubating patients) Employment of doctors contrary to Statutory Instrument 41 of 2004 Employment of Senior Registrars as specialists in private institutions employment of Nurse Anaesthetists to private patients (short changing the patients on medical insurance) cutting costs of medical insurance Employment of GMOs with restricted Licence to Practice

UNETHICAL INNOVATIVE INITIATIONS continued POOR COMMUNICATION BY HOSPITALS To patients on fees in general Admitting patients until exhaustion of medical insurance then pass to public institution Poor communication in handing over patients from private institutions to public institutions ( after resources have been exhausted) Enhanced communication to patients during stabilization before referral to public institutions Enhanced communication No feedback to referring clinicians / institutions

UNETHICAL INNOVATIVE INITIATIONS continued DUPLICATION OF ROLES Conflict of interest : Medical Insurance Companies (MIC)engaged in private health service provision Managed health care – setting targets for health professionals – innovation Demanding unjustified /levies from doctors Disrupting effective practice of doctors Guarantee letters by MIC to patients for admission in private hospitals which do not guarantee service provider payment Orders given to practitioners and institutions not to see patients with valid medical insurance Directing patients to own Specialists by MIC restricting patient choice

SURVIVING WITH ADVERSITY Compliance with regulations – enhances sustainability Good governance demands accountability, honest, trust. Stick to one area of practice Avoidance of illegal innovative initiations- advertising, employment of unregistered persons to cut costs, shortages of manpower Sustainability is a function of ethical practice doing what is right at the right time to the right people openly transparently Exercising the duty of Care, Skill & Diligence and Good Faith

CONCLUSION One of the roles of the Council is to ensure ethical practice through control of the practice of medicine for the benefit of the patient. Adherence to regulations, a precept of good corporate governance leads to sustainability in a challenging business environment Are our Companies being and being seen as decent citizens by acting responsibly and responsively to all our stakeholders the public, Government, the professionals, employees etc????? Should we redefine the purposes or our companies??? Private medical care compliments delivery of health care in the country Tatenda Siyabonga Thank you!!