Senators have expressed disappointment over delays in implementation of the law establishing medical professional insurance, which was passed and published in the Official Gazette two years ago.

The legislation seeks to ensure that health workers, as well as patients, are insured against any health risk likely to be suffered while in hospital and that if this happened, compensation would be called for.

In a consultative meeting at the Senate yesterday, members of the Senatorial Standing Committee on Social Affairs, Human Rights and Petitions put to task heads of various medical associations to explain why the law was not being implemented.

Senator Narcisse Musabeyezu said the law was passed and gazetted, meaning that whatever clinical mistake done people must be compensated.

"We want to hear from you; why don’t you analyse the law and implement it as first beneficiaries?” Musabeyezu asked.

The law stipulates that besides patients, all health workers should be insured against health risk, and should be duly compensated in case they fall victims.

"Any health facility, whether public or private, must take out an insurance,” reads Article 15, while Article 14 indicates that every health professional must take out insurance from a state-authorised insurance company.

It was also noted that physicians have not taken time to educate the patients and other stakeholders of their rights to health, as stipulated by the law.

Looking into the legislation

Dr Emile Rwamasirabo, the president of Rwanda Medical and Dental Council, acknowledged the observations made by the legislators, and promised that together with other stakeholders, they would have a dialogue through which they would come up with mechanisms to implement the law with immediate effect.

"This law has a lot of importance to us. We have been waiting for a ministerial order to give us the guidelines of implementation including the establishment of the premiums health facilities will be paying,” Dr Rwamasirabo, who is also the acting chief executive of King Faisal Hospital, Rwanda, said.

Article 17 of the law stipulates that in case a health facility has several employers, the health professional (head of the facility) must ensure that each employer has paid their share of compulsory insurance premiums.

"An Order of the minister in charge of insurance shall determine the contribution of each party to the insurance policy,” the law reads in part.

"I know that the hospital where I work, everyone is insured, but I cannot say that this is the case at all health facilities. Very few hospitals have this in practice,” Dr Rwamasirabo added.

Agnes Uwayezu, the chairperson of National Council of Nurses and Midwives, said the public and other stakeholders are yet to be sensitised on the applicability of the law.

"When the law was published, there was no extra effort to sensitise Rwandans about its provisions. It is, therefore, hard to see it being implemented if we have not taken time to inform all stakeholders about it,” Uwayezu said.

Reports indicate that 63 cases related to health risks have been reported to Rwandan Healthcare Federation, over the last three years, of which more than 80 per cent are maternity related.

At least three physicians have since been suspended from their duties over the cases reported.Physicians believe that when the legislation is fully implemented, it will reduce cases of negligence, as well improve sense of responsibility among health workers.

However, heads of medical associations asked lawmakers to advocate for the institution of a regulatory body that would address the delays for the implementation of the law, as well as coordinate the functions of the various medical associations.

Shortage of personnel

Dr Rwamasirabo said there is still low numbers of medical specialists at the district level, which may also carry health risks.

"In health centres, we have deployed nurses to treat people, which they are not professionally trained to do. This is how our capacity stands so far. We need more medical assistants,” he said.

There are about 400 health centres countrywide, while from 1996 to date, at least 2,000 medics have graduated as medical assistants but only 800 are practicing, accoding to the medical council register.

"The remaining 1,200, we cannot tell where they are,” Dr Rwamasirabo said.