We need serious debate on medical complaints

August 2016 ElesbanKihuba; Isn’t the untimely death of a patient under the care of a health worker the most unfortunate outcome? When I heard of the late Mr. Odhiambo case I felt empathy. His eight hours search for care ended in failure, death and controversy. Shortly after the event the family took to the social media with allegations of ‘negligence’, which was vehemently denied by the administration. The public discontent with the case was clear and questions mounted over safety of health services, complaints procedure and justice for victims.

For starters, although much of the coverage of the ‘scandal’ focused on the ‘young doctor’ from Mbagathi, the real issue is to do with quality of care and inequity in access to care.  Even for our budding county health systems, an eight hours wait for care is a new low and highlights how difficult it is to navigate the system. More importantly the health worker assertion that ‘they only handle such cases (TB patients) during weekdays’ suggests intentional rationing of (certain) health services on weekends. In fact, if I were discussing this case with a medical colleague I would ask why no one noted the patient was severely sick, but then I know that counties have largely concentrated their investment on infrastructures while neglecting ‘software’ side of things like health services safety and quality of care. These attendant problems are clearly articulated in previous task force reports yet very little action has been taken. For example, it is still unclear why junior health workers are providing outpatient and emergency services at county referral hospitals while the norms provides that these services should be provided by trained general practitioners.

With regards to the due process, the complaints handling procedure requires one to formally file a complaint. The goal of the inquiry is to determine; did the patient receive proper care as needed? Did the health worker follow medical principles and standards in the process of providing care? However, the large numbers of public complaints on social media platforms questions the way in which the due process is structured and choice on how patients communicate with the hospitals. The central point of the new trend is that it’s cheaper, more transparent and convenient to share concerns on social media platforms than through the bureaucratic structures. This poses two great questions: how can health establishments limit online complaints in the first place? And how should hospitals respond to patients’ demands for better care, without citing lack of resources?

Lastly, it is worth noting that complaints are inevitable in healthcare due to human and system limitations. In deed a recent publication by Martin M. shows that medical errors is a leading cause of death and suffering worldwide. Most of these complaints and errors are amenable to conciliation and compensation for damages; a proven strong financial disincentive. In countries that value patients and life of their citizens, there are well established legal instruments for pooling funds for compensating victims’ of botched treatments. For administrative rigor, such instruments requires that hospitals and employers- who are responsible for any errors incurred by their employees- must provide professional indemnity insurance cover to their employees. The same logic applies to government owned facilities. In our health sector, these systems are non-existent and the response of our health sector to medical complaints only consists of whitewashing and panic. Without these instruments the discussion on negligence will remain toxic.

 

 

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