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Many patients are told that there are no beds in hospitals: even if you come to the hospital, we cannot accept it. The patient does not have to search for beds. When the patient is in an emergency, they can be transferred from their relatives to an emergency department. And if you are in an emergency, the lack of free hospital beds is no reason to refuse emergency medical care. This is what Maria Sharkova, a medical law specialist from Plovdiv, told Mediapool about the situation late last week when ambulances scrambled through hospitals unsuccessfully in an attempt to accommodate patients in poor health.
Sharkova explained that even if there are no suitable conditions to hospitalize the patient and continue treating him, the medical institution is obliged to organize his transport and provide the necessary emergency medical care until the implementation of this transport. “Under no circumstances can you refuse emergency medical care,” he said. According to her, with the organization thus created, patients with Covid-19 do not have access to adequate outpatient care and therefore there is an overload of hospitals and emergency care.
“I am very concerned that Covid-19 patients are virtually deprived of full access to outpatient care. Once a person tests positive, they are quarantined and there is no outpatient organization, they must be screened. and properly diagnosed. You have access only to your family doctor by phone. If it is necessary to perform any test – paraclinical, imaging, etc., the patient cannot be referred to the DCC, medical center, and the only thing that is advised is to seek emergency medical attention, so that they come and assess whether he must be transported to a medical center to perform these activities, which is highly irrational and generates a lot of chaos in the system, because Emergency is for emergencies, and in the practice some of these people are not emergencies, they just need additional specialized care agnostics that can be performed in outpatient care if the organization is adequate uada. And continue to receive treatment at home, “Sharkova explained.
According to her, it would be more appropriate if outpatient care is open to Covid patients and there are DCCs and medical centers in large cities that only serve Covid patients with exams and tests. Instead of being part of the Emergency Service to perform the fee function for coronavirus patients. “Rules can be easily created and the quarantined patient can inform the police that on the recommendation of the personal doctor they go to a polyclinic with a certain transport. And to organize specialized transport for people without their own car,” said Sharkova. According to her, the current organization not only affects the rights of the patient, but also creates chaos in the system and is extremely unsuccessful. This applies not only to people diagnosed with coronavirus, but also to people with flu-like symptoms and a diagnosis not yet specified. “The massive signals that come to me are for people who feel unwell, but their personal doctor does not pick up the phone or has exhausted his capabilities, a photo and additional tests are needed and people are advised to call 112. Then come in. in the spiral of ringing 112, waiting hours or days, “he said.
“In this organization, in practice, the patient can only receive help in the hospital and therefore the hospitals fill up. Some patients may not have indications for hospitalization, but due to the impossibility of receiving other medical care, this is their only option, “he said.
Sharkova noted that with the order of the Minister of Health that all hospitals are obliged to open a certain number of beds for the treatment of the coronavirus, there is a risk that medical institutions and doctors will take legal responsibility. This can happen if a patient is treated in a hospital not suitable for coronavirus treatment – for example, specialized ophthalmologist, orthopedic and others that do not comply in any way with medical standards and requirements. “When damage occurs as the result of an unlawful act or omission, a person is entitled to compensation. In certain cases, criminal liability may be incurred. There is no doubt that these hospitals that open beds for Covid-19 patients do not comply with requirements and standards Physicians and medical facilities are not presumed to be exempt from legal liability during the period in which an emergency or epidemic emergency occurs.
Some of the hospitals have the necessary wards, specialists and equipment and some do not. Those patients who fall into the latter, among other things, are discriminated against. One will end up in an infectious disease or pulmonology ward and the other in an inappropriate medical facility. “Some treatment is better than none, but on the other hand, no one currently guarantees doctors and medical institutions that over time they will not be legally responsible for the fact that the treatment has caused adverse events,” Sharkova explained. This is not the case in specialized hospitals that treat patients who treat their main pathology in them, for example, pregnant women, cancer patients.
“It is one thing to determine where and which cases will be accommodated, and another is to force the hospital to have an isolator for its patients with Covid-19. It makes sense for a woman in labor to be monitored or, after giving birth, stay in the OB / GYN hospital. she is looking for a place in an infectious disease clinic with the use of consultants, “Sharkova explained. She also noted that the state has a positive obligation, including under the European Convention on Human Rights, to protect everyone’s right to life. citizens. This includes taking measures that save the lives of citizens. “When the State has not taken such measures or with its measures creates chaos and endangers the lives of citizens, a lawsuit against the State is admissible. This is not exotic, “he said.
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