Medical Practice in Uganda: Professional Indemnity, Professional Councils and the State. 1Obuku EA 1-Africa Centre for Systematic Reviews and Knowledge Translation, Makerere University College of Health Sciences, Kampala, Uganda eobuku@chs.mak.ac.ug  

The problem To describe recent cases of medical-legal related cases available in the public media in Uganda Increase in allegations of medical-legal or medical malpractice events. METHODS Retrospective - 2010 – 2015 Media analysis: - newspaper articles - Google search Personal communication

RESULTS METHODS >15 instances of medical malpractice Retrospective - 2010 – 2015 Media analysis: - newspaper articles - Google search Personal communication YEAR Hospital Description 2011 December New Vision 2012 2013 November NTV 2014 January Red pepper 2015 Daily Monitor May

RESULTS >15 instances of medical doctors arrests YEAR Hospital Description 2011 December New Vision 2012 2013 November NTV 2014 January Red pepper 2015 Daily Monitor May

Summary of results: *** 83 cases; 100 arrested; 6 billion saved Between 2010 and 2015, >15 cases of medical doctors being arrested. Majority (7 cases, 10 doctors) by MHU; with drug theft being the most common reason (5 cases, 8 doctors). Only 1 case involving 1 doctor was related to professional misconduct. In this same period, >15 cases of professional malpractice of which maternal and child health predominated (13, 87%). Awards or suits ranged from Ugx 35M to 127M. *** MHU, 2010 MHU – Medicines & Health Services Monitoring Unit MHU – Medicines & Health Services Delivery Monitoring Unit *** MHU, 2010

THE MEDICAL AND DENTAL PRACTITIONERS ACT. CHAPTER 272 THE MEDICAL AND DENTAL PRACTITIONERS ACT. Commencement: 30 January, 1998. An Act to consolidate the law relating to the medical and dental practice and for other connected purposes.

Functions of the council. The functions of the council shall be — (a) to monitor and exercise general supervision and control over and maintenance of professional medical and dental educational standards, including continuing education; (b) to promote the maintenance and enforcement of professional medical and dental ethics; (c) to exercise general supervision of medical and dental practice at all levels; (d) to exercise disciplinary control over medical and dental practitioners; (e) to protect society from abuse of medical and dental care and research on human beings; (f) to advise and make recommendations to the Government on matters relating to the medical and dental professions; (g) to exercise any power and perform any duty authorised or required by this Act or any other law; (h) to disseminate to the medical and dental practitioners and the public, ethics relating to doctor-patient rights and obligations; and (i) for the purposes of discharging its functions under this Act, to perform any other function or act relating to medical or dental practice as the Minister may direct.

http://hmu.go.ug/ Vision…a healthy Ugandan population supported by an effective and responsive health care system. Mission…monitor and support an efficient, responsive and accountable national healthcare system which provides accessible, affordable and quality services to the Ugandan population. The Constitution of the Republic of Uganda (1995) provides that “the state shall take all practical measures to ensure the provision of basic medical services to the population”. The President, in pursuit of this objective, set up the Health Monitoring Unit (HMU) on 1st September 2009 as a strategic response to existing challenges in the health sector and the resulting poor service delivery. “…a department under State House whose broad remit is to improve health services for the population…” 1 Monitor healthcare service delivery in Uganda 2 Strengthen the Ugandan health system 3 Improve citizen ownership of health services

Conclusions: These preliminary data suggest an important burden of medical malpractice and doctors being arrested for drug theft related offences. There is need for dialogue between the Uganda Medical and Dental Practitioners Council, Uganda Medical Association and the Medicines and Health Services Monitoring Unit. Ugandan Doctors should be sensitized (UMA, UMDPC) to consider options for professional indemnity.