CAN'T KILL BILL Volume 4

KILLED three times in the past on the strength of the lobby of groups opposed to it--particularly the medical sector--the medical malpractice bill is staging a comeback in the halls of Congress.

By Dennis Gadil
Correspondent

IN THE SENATE, at least two bills have been filed espousing the same stiff penalties embodied in the bills filed in the old Senate. They were authored by Senators Manuel Villar and Sergio Osmeña III. In the House of Representatives, the bill has just been "adopted" and revived by Rep. Rodriguez Dadivas of Capiz with Leyte Rep. Eufrocino Codilla and Lanao del Norte Rep. Alipio Badelles as coauthors.The proposed measure is docketed as House Bill (HB) 261.
A "tamer" version
A so-called watered-down version, HB 226, was also filed by Rep. Ruffy Biazon of Muntinlupa in the 13th Congress, which provides, among others, the opportunity for doctors convicted of malpractice to be "rehabilitated" and be able to rejoin the medical mainstream.
HB 226 is entitled "An Act Establishing a Medical and Health-Care Liability Law, Providing Penalties Therefore and for Other Purposes," to obviously give it a "tamer" tone.
The bill refiled by Villar, Senate Bill (SB) 743, was more direct and gutsy: "An Act Punishing the Malpractice of Any Medical Practitioner in the Philippines and for Other Purposes."
In the 12th Congress, Biazon also filed HB 5293, which sought to "ensure the safety and well-being of patients by creating an environment wherein incompetent and negligent medical practitioners shall not go unpunished."
The bill, according to Biazon, "died a natural death," just like the other related measures.
Unknown to many, Biazon got his "inspiration" in filing the bill from his staff who fell victim to medical negligence right at the clinic of the Lower House. The story goes that a doctor or nurse at the House clinic inadvertently left a syringe needle after injecting the sick staff. The broken needle was discovered stuck beneath the forearm skin when the poor staff had a check-up afterwards in a hospital.
Doctor-friendly?
The buzz in the medical circles is that the Biazon version is more "doctor-friendly" compared with the other malpractice bills.
Biazon insists that his pet bill should not be mistaken as another "Patient Rights Bill" in disguise. "This is different. It could complement the other measures, but this is different," Biazon maintained. He added that he is not inclined to sign up as coauthor of the revived bill of Dadivas.
In Biazon's proposed measure, an erring doctor or any medical personnel suspended from practicing medicine, or those whose licenses were revoked because of malpractice conviction, could still regain their license and resume their practice.
Biazon said this is important in order to give a second chance to erring medical professionals whose livelihood was disrupted by their conviction. "This is the redeeming provision of the bill, doctors will be given a chance to redeem themselves and salvage their profession," he told MEDICAL OBSERVER.
He admitted though that it was a make-or-break provision, some sort of compromise to the medical sector, which has been very much against any legislation threatening their livelihood and profession.
Under Biazon's bill, a doctor or hospital personnel could be reinstated or have his license back or his suspension lifted after passing a validation examination administered by an authorized body like the DOH or the Board of Medicine. For a canceled license, an offender will have to wait for two years before applying for reinstatement.
Prescription period
Time is also a "unique" feature of the Biazon bill, which introduces a prescription period for filing cases. Biazon said aggrieved parties will have only two years to file their complaint or charge against an erring doctor or else they may "hold their peace forever." Biazon stressed this will protect medical professionals from becoming the object of harassment by unscrupulous groups or individuals.
The Patient Rights bills of Dadivas and the Senate versions of Villar and Osmeña (SB 1720) do not provide for a prescriptive period. Their most common features are penalties ranging from PhP500,000 to PhP1 million and imprisonment of at least five to 12 years plus the revocation of the offender's license.
While the other malpractice bills have an "insurance provision," Biazon's does not.
In the Osmena-Villar bill, doctors are mandated to secure a minimum insurance of P50,000 to answer for any claims for damages brought forth by "aggrieved" patients.
Biazon nevertheless explained that the insurance clause would just have to be incorporated in the implementing rules and regulations (IRR) once his bill is enacted into law.
No gov't meddling
Biazon also thinks that government agencies and nongovernment organizations should not take the cudgels for an aggrieved patient. He said aggrieved parties have already themselves, their families, and other institutions like orphanages, childcare centers, home for the aged, and even a mental hospital, which could do that for them.
A bill authored in the 11th and 12th Congress by former Rep. Oscar Rodriguez of Pampanga, the original proponent of the "Medical Malpractice bill" in the House, allows "concerned, responsible hospital employee" to file the suit on behalf of the victim "but with the patient's consent."
Rodriguez's version of the bill was considered harsh as it does not provide for a glimpse of redemption for those convicted. In his version, Rodriguez even belittled the effect of a pardon or a last-minute waiver from the victim, stressing that "a pardon whether expressed or implied" should not impede any criminal action against the doctor-offender.
Rodriguez came close to having his bill enacted when the 11th Congress passed it on third reading. His luck, however, was ended by a dysfunctional Senate rocked by intense leadership struggle the time.
Like its predecessor bills, the Biazon bill is also silent on passing the buck to hospitals and other medical centers by not making them automatic respondents to a malpractice suit.
"It's not automatic, unless it is proved that the hospital, for instance their equipment, was part of the reason why a patient was injured or killed," Biazon said.
Hostile environment
As recent history would show, even the power tandem of ABS-CBN talents Korina Sanchez and former Leyte Rep. Ted Failon--a coauthor of the Rodriguez measure--was no match to the resounding objection posed by the medical sector. Sanchez campaigned hard for the approval of the measure but failed.
Medical lobby groups led by the Philippine Medical Association (PMA) and even the academe condemned the measure and, by extension, its proponents.
PMA president Bu Castro, in recent media interviews, said the bill on medical malpractice creates a hostile environment for doctors.
"Do you want us to leave because you are pushing that medical malpractice bill as though a sword is hanging over our heads? Doctors are in a very difficult situation because of that bill," Castro said.
He also called the bill antipoor and antipatient.
"It will increase the health cost in the country at least four times [to cover] treatment, referral, and malpractice insurance premiums. It will cause patients all over the country to suffer," Castro said.
In a position paper submitted to the Senate, the PMA stressed that: "The Senate bills would be untimely as it would send a wrong signal to those doctors still contemplating on joining the exodus by finally deciding to take up nursing and leave the country."
The Alliance of Health Professional Organizations (AHPO), a movement composed of major health and medical specialty groups like the PMA said the proposed measures were "a direct attack against the medical community."
Dr. Darby Santiago, PGH Physicians Association vice president and AHPO member, said that some patients have become combative against doctors. He also said that some patients now resort to "doctor-hopping" to get "accurate" diagnosis.
"At this point, the effects of the bill are not yet severe but there have been several instances wherein combative na ang mga patients sa mga doktor. Ilag na sila," Santiago said.
Laudable, but...
In a position paper, the University of the Philippines Manila said that both the Senate and House versions were laudable since they "strengthen the right of a patient to quality medical care."
But it stressed the bill would erode the sanctity of the patient-doctor relationship because it would spawn doubts and mutual distrust on both sides, thereby destroying the very foundation of ideal health-care delivery and depriving patients of their right to self-determination.
"It will provide an opportunity for third parties including nonrelatives to sue medical practitioners even if the patient does not want to do so. Patients owe it to themselves to choose the medical practitioner they trust," it said.

Updated last May 15, 2005 , Developed and Maintained by JML Internet Solutions