1. National Research and Development Centre for Welfare and Health Knowledge for welfare and health Maarit Outinen 2004 1 Maarit Outinen, M.Sc., Senior Planning Officer STAKES, Quality of Services Group ENQual workshop 2.-3.4.2004 PATIENTS’ RIGHTS IN FINLAND

2. National Research and Development Centre for Welfare and Health Knowledge for welfare and health Maarit Outinen 2004 2 ENQual workshop 2.-3.4.2004 Maarit Outinen THE ACT ON THE STATUS AND RIGHTS OF THE PATIENTS ( 1993) - consent of the patient, agreement to the forms of treatment - information (if they request) on their state, treatment, risks - right to see and correct information entered in their histories - those on a waiting list: reason and estimated duration - opinion of young patients taken into account - a child’s parent/guardian not entitled to refuse treatment that would risk or save the life of an underage patient (continued)

3. National Research and Development Centre for Welfare and Health Knowledge for welfare and health Maarit Outinen 2004 3 ENQual workshop 2.-3.4.2004 Maarit Outinen DISSATISFIED PATIENTS ENTITLED TO LODGE A COMPLAINT ESTABLISMENTS MUST HAVE A PATIENT OMBUDSMAN Duties of the patient ombudsman - to inform the patients of their rights - to assist patients, if necessary, to complaint, appeal or claime for indemnity Patients can submit a complaint to 1. the director responsible for the unit of care 2. the State Provincial Offices 3. the National Authority for Medicolegal Affairs

4. National Research and Development Centre for Welfare and Health Knowledge for welfare and health Maarit Outinen 2004 4 ENQual workshop 2.-3.4.2004 Maarit Outinen THE ACT ON PATIENT INJURY (585/1986) - providers of health care services must have a patient insurance - safeguards the patient’s interests in the event of malpractice - idemnity can be claimed by the patient based on: - personal damage to the patient because of an error in medical treatment, care or neglicence - failure in the function of a medical device - infection after treatment or care - accident in treatment - fire in the location/devices - delivery of medicines against the legislation - sickness/disability/death following treatment or care

5. National Research and Development Centre for Welfare and Health Knowledge for welfare and health Maarit Outinen 2004 5 ENQual workshop 2.-3.4.2004 Maarit Outinen AMOUNT OF CLAIMSCOMPENSATED 199972151946 200070232161 200171922128 200271252189 200375652356 - feedback to the institutions for qualit/risk management

6. National Research and Development Centre for Welfare and Health Knowledge for welfare and health Maarit Outinen 2004 6 ENQual workshop 2.-3.4.2004 Maarit Outinen ACT ON COMPENSATION OF DAMAGES ACT ON PRODUCT LIABLITY - devices permanently attached to the patients CONSUMER PROTECTION - concerns only private health care services - municipal consumer advisors

7. National Research and Development Centre for Welfare and Health Knowledge for welfare and health Maarit Outinen 2004 7 ENQual workshop 2.-3.4.2004 Maarit Outinen MEASURES ENSURING ACCESS TO TREATMENT - in the Decision in Principle by the Council of State on securing the future of health care 2002 - will be embodied in legislation by the year 2005 1. Access to an initial assesment by a primary health care professional, normally a physician, within three days of contacting the service 2. Access to an assessment by an outpatient department of a specialised health care unit within three weeks of the issue of a referral(continues)

8. National Research and Development Centre for Welfare and Health Knowledge for welfare and health Maarit Outinen 2004 8 ENQual workshop 2.-3.4.2004 Maarit Outinen ACCESS TO TREATMENT (continued) 3. Access to medically justified treatment within a reasonable period, wich should normally be within 3 and no later than 6 months 4. if cannot be provided by at a facility maintained by the local health centre (= hospital disrict hospitals), must be procured from another service provider at no extra charge to the patient

9. National Research and Development Centre for Welfare and Health Knowledge for welfare and health Maarit Outinen 2004 9 THE NATIONAL ADVISORY BOARD ON HEALTH CARE ETHICS (ETENE) - deals with ethical issues related to health care and the status and rights of patients from the point of view of principle - can take initiatives and issue opinions and recommendations on ethical health care issues

10. National Research and Development Centre for Welfare and Health Knowledge for welfare and health Maarit Outinen 2004 10 PATIENT PARTICIPATION IN FINLAND ENQual workshop 2.-3.4.2004 Maarit Outinen Stakes, Finland

11. National Research and Development Centre for Welfare and Health Knowledge for welfare and health Maarit Outinen 2004 11 SITUATION AS BASED ON THE QUALITY MANAGEMENT SURVEY IN 1999 - opinions of the managers of the organisation! Participation of patients or patient organisations in - evaluation of achievement of quality targets21 % - development of criteria10 % - quality committees 8 % - quality improvement projects10 % - development of protocols or quidelines14 %