Article 9 Federal Law No. 323-FZ dated November 21, 2011"On the Fundamentals of Protecting the Health of Citizens in the Russian Federation" (hereinafter referred to as the "Basics"), state authorities and local self-government bodies, officials of organizations, within their powers, are responsible for ensuring guarantees in the field of health protection established by the legislation of the Russian Federation. One of the measures designed to provide guarantees in the field of health protection, is state control.
can be, For example:
- Control over the conduct of preclinical trials of medicines and clinical trials of medicines;
- Monitoring compliance with licensing requirements in the implementation of pharmaceutical activities;
- Federal state supervision in the field;
- Control for ; quality control of medicines in civil circulation;
- Monitoring compliance by medical organizations and individual entrepreneurs engaged in medical activities; control over compliance by medical organizations and individual entrepreneurs engaged in medical activities, health care standards;
- Monitoring compliance with the procedure for conducting an examination for the presence of medical contraindications to driving a vehicle;
- Monitoring compliance with the procedure for conducting a military medical examination, incl. independent military medical expertise;
- Monitoring compliance with the order of conduct;
- Monitoring compliance with the procedure for conducting an examination of temporary disability;
- Monitoring compliance with the procedure for conducting a forensic psychiatric examination;
- Monitoring compliance with licensing requirements in the implementation of activities for the production and maintenance of medical equipment (except for the case when maintenance is carried out to meet the own needs of a legal entity or individual entrepreneur).
- Monitoring compliance by the subjects of circulation of medical devices with the rules in the field of circulation of medical devices; implementation in accordance with the established procedure of inspections of the activities of organizations engaged in the production, circulation and use of medical devices;
- State control over the application of prices for medicines included in the list of vital and essential medicines.
- Compliance control;
- Control over the implementation of activities of the programs for the modernization of healthcare in the constituent entities of the Russian Federation and programs for the modernization of federal state institutions that provide;
- Others.
Checks must be carried out strictly in, established by law, and at the end of the audit, an audit report is drawn up.
When conducting an inspection, employees of the state control body upon presentation of their service certificates and the decision of the head of the state control body, his deputy on conducting an inspection of compliance with the legislation of the Russian Federation in the field of health protection, the legislation of the Russian Federation on the circulation of medicines they have a right(Article 86 of the Fundamentals):
- Organize the conduct of the necessary studies, tests, examinations, analyzes and evaluations, including scientific research on the implementation of control in the established field of activity;
- Request and receive information necessary for making decisions on issues within the competence of the state control body;
- Provide legal entities and individuals with clarifications on issues within the competence of the state control body;
- Involve, in accordance with the established procedure, scientific and other organizations, scientists and specialists to study issues in the field of health protection;
- To freely gain access to the territory of the audited bodies or organizations or to the buildings, structures, structures, premises used by these bodies or organizations in the course of their activities, to the equipment used by them, similar objects, vehicles and transported goods;
- Seize samples of manufactured goods in accordance with the procedure established by the legislation of the Russian Federation;
- Make copies of the documents required for state control in the field of health protection, in accordance with the procedure established by the legislation of the Russian Federation;
- Apply restrictive, preventive and preventive measures provided for by the legislation of the Russian Federation, aimed at preventing and (or) eliminating the consequences of violating the legislation of the Russian Federation in the field of health protection, the legislation of the Russian Federation on the circulation of medicines.
However, the legislation and certain restrictions when conducting inspections. For example, officials of the control (supervision) body are not entitled to inspect activities if this is beyond their powers (for more details, see the Law on Protection). An order to eliminate violations, and not an administrative measure. But in the course of the inspection, officials, within the framework of their powers and in accordance with the provisions of the Code on the Russian Federation (hereinafter referred to as the Code of Administrative Offenses of the Russian Federation), can, under the relevant article of the Code of Administrative Offenses of the Russian Federation.
The rules of administrative proceedings are already regulated by other legislation, namely: the Code of Administrative Offenses of the Russian Federation. But for failure to comply with the instructions given by the supervisory authority during the audit, a medical or pharmaceutical organization may be (Article 19.5 of the Code of Administrative Offenses of the Russian Federation) or, for example, for obstructing the legal activities of an official of the state control (supervision) body to conduct audits or evading such audits (Article 19.4.1 of the Code of Administrative Offenses of the Russian Federation).
Also, in accordance with Article 17 of the Law on Protection, supervisory authorities have the right to impose organizations in the manner prescribed by the Code of Administrative Offenses of the Russian Federation when establishing during the verification of facts indicating that the activities of a medical or pharmaceutical organization pose a direct threat of harm to the life and health of citizens, harm to animals , plants, the environment, state security, natural and man-made emergencies, or such harm has been caused.
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Illegal actions of employees of state medical institutions can be stopped by citizens of the Russian Federation. Any mistake by a doctor in a polyclinic or hospital, or simply a rude attitude towards patients, is punishable by law.
We will tell you to whom and where to complain about such negligent specialists, and we will answer all the important questions.
The rights of the patient of Russian hospitals and polyclinics, which may be violated by unscrupulous doctors and health workers
Citizens of Russia should know their rights when they come to a hospital or clinic.
Everyone can count on:
- Respectful and humane attitude towards yourself.
- Appropriate conditions of stay in the institution.
- Opportunity to consult.
- First aid.
- Keeping a secret about your personal life.
- The choice of the doctor with whom you wish to be treated.
- Informing and obtaining any medical information.
- Obtaining VHI services.
- The possibility of refusing medical intervention.
- Acquaintance with the medical documentation that concerns the patient.
- Compensation for damage that could be caused to health, property of a citizen.
- Admission of a legal representative together with a sick patient.
- Reimbursement of expenses that were spent unreasonably while receiving medical care under the CHI policy.
- Support not only medical, but also emotional, spiritual.
- Appeal against illegal actions of doctors and employees of medical organizations.
In case of violation of the above rights, the patient can report the actions of an unscrupulous employee to government agencies and other organizations designed to control the work of medical institutions.
This says federal law number 59 and the title “On the Procedure for Considering Appeals from Citizens of the Russian Federation”, adopted on May 2, 2006, as amended this year.
Where to complain about a doctor in a hospital or clinic - all options
There are several options for complaining about a hospital or clinic doctor.
We list the instances that can help solve the problem and understand the situation.
1. To the head of the medical organization - the head physician or head
Of course, it is better to try to achieve justice on the spot. By determining what the level of severity of the problem is, you can decide on your own - who should be contacted and whether it is necessary to file a complaint.
For example, for rudeness or lack of service, the patient can come to the manager and complain about the employees.
The manager, in turn, must resolve the situation, accept the complaint and find out who was right and wrong.
If you are filing a complaint in writing, then ask for a written explanation from the head of the organization.
In the event that the head of the medical institution sided with the culprit and did not solve the problem, you can move on to other, more serious measures.
2. To the reception of the Ministry of Health of your district or region
1) You can always contact the reception of the ministry personally.
Prepare your complaint in advance in order not to explain in words the problems that have arisen and their desires, requirements.
2) You can also apply online by writing to the address of the ministry, or by using the online form on the website.
3) Another way to complain - write a letter to the postal address of the organization.
You must respond to your complaint in writing within 1 month., and when applying in person, they must issue a notification confirming the acceptance of the document.
3. To law enforcement agencies
If the violations are very serious and violate the rights and interests of citizens, then you can apply to the prosecutor's office.
This body can not only deal with the problem, but also identify the perpetrator in order to bring to justice.
A prosecutor's check can be provided to a medical institution if the citizen's appeal indicates violations of the current legislation.
Within 30 days you must be told whether or not a criminal case will be filed.
4. To court
A written application to the prosecutor's office can also be sent to the court.
If you want to receive monetary compensation for the harm caused, or for unreasonably spent funds on the purchase of medicines, although they should have been allocated by a hospital or clinic, then the court will just help you with this.
Also, through the courts, it is possible to punish the perpetrators of illegal actions that were committed against patients of medical institutions.
When writing a claim It should be noted that everything written must be supported by documents.For example - certificates, extracts, contracts or video-photo materials.
You can even find witnesses to the crime.
5. To the local police station
If a crime was committed against a citizen that caused harm to health or life, then you should contact the police.
Employees have a responsibility to look into the situation, review the complaint, and stand up for you by taking action against the healthcare worker.
But there are times when it makes no sense to go to the police. For example, when the crime was committed through no fault of the doctor and not intentionally.
Its useful to note that a hospital and a polyclinic are almost one medical institution, so there should not be a division on where to complain about one of the organizations - of course, to the same authorities.
The most common situations in which it is necessary to complain about doctors - lawyers comment
We will answer the most common questions asked by patients who are faced with lawlessness in Russian hospitals and clinics.
- I'm pregnant and the doctor yelled at me. Where to complain about the rudeness and rudeness of the doctor?
The first person to help you is - head or head physician of a hospital to which you applied. Talk to him, explain which doctor was rude or yelled at you, and then ask to deal with him and transfer you to another specialist.
If the head physician did not take your side, then file a complaint to the Ministry of Health in your area . Your message will definitely not be ignored.
- The doctor refused to accept the patient or come to the call - where to complain about the refusal of medical care?
Medical care, which should be provided to citizens of the Russian Federation, is strictly controlled.
If you received assistance in going to a hospital or clinic, you can complain to the following authorities: The administration of the medical institution, the Ministry of Health, the Social Insurance Fund.
If the refusal to help turned into serious consequences, for example, the patient died, then you can contact prosecutors, police, courts.
- The doctor asks for a bribe, gives hints or takes time to help the patient.
In the event that a health worker requires or hints at a bribe from you, you should prepare evidence of this.
You can record the conversation on a dictaphone, agree on the amount, and then contact the authorities so that you no longer understand the problems yourself.
Worth contacting law enforcement agencies, police, federal security hotel, public chamber of the Russian Federation, tax service.
- The doctor refused to issue a sick leave.
If there are no good reasons for this, then solve the problem first with the head of the medical institution - chief physician or manager . Ask to understand why the doctor does not want to issue a sick leave, although he should.
If the medical organization failed to solve the problem, then contact to the Ministry of Health. They must consider your complaint within 1 month.
The doctor misdiagnosed and prescribed the wrong treatment.
To get started, file a complaint with chief physician of a medical facility .
If the administration of the clinic does not resolve the issue, then contact the following authorities: Ministry of Health, Prosecutor's Office, Court, Police .
Often, incorrect treatment and an incorrect diagnosis lead to serious health problems, so you should not ignore irresponsible, inattentive health workers.
- Doctors refused to issue documents for disability. Where to complain?
Applying for a disability is a long process. However, if you were immediately denied a disability application, you should contact to the administration of a hospital or clinic, and try to resolve the issue with the head physician. Usually you have to write a statement, after which a commission is convened, which decides whether or not to issue documents for disability.
You can also contact with a complaint that you are denied paperwork.
- The doctor does not help the patient. Where and how to complain about the inaction of a doctor?
Ignoring requests for help or inaction on the part of employees of medical institutions, unfortunately, can be found in medical institutions in Russia.
- You can complain about an irresponsible doctor, firstly, to the hospital administration .
- Secondly, you can apply to the Ministry of Health .
- If inaction goes beyond all boundaries, and this poses a direct danger to the life and health of a citizen who has applied to the hospital, then you can attract law enforcement and police .
- The doctor treats his duties dishonestly. How to complain about doctor's negligence?
In the event that the patient was harmed intentionally, on purpose, then you should contact to the prosecutor's office or the police .
According to the current legislation, there is an article for the negligence or dishonesty of a doctor - 293 of the Criminal Code of the Russian Federation.
After considering your application, law enforcement officers must conduct a check and either initiate a criminal case or refuse to initiate one.
In other cases, you can complain about negligence to the administration of the medical institution, and then to the Ministry of Health .
- The doctor does not write the right prescription.
Doctors are not always to blame for this problem.
However, if you are sure that the pharmacy has the necessary medicine, but the doctor simply refuses to issue a prescription at his own request, then you should write a complaint and send to the administration of the medical institution, the Ministry of Health .
If after that the problem was not solved, write a complaint to the prosecutor's office .
- Nasty in the registry of the clinic.
Ordinary rudeness can be stopped by a complaint written to chief physician, head of a hospital or clinic.
If you understand that this will not solve anything, and the doctor will be on the side of the nurses working in the registry, then write a complaint to the Ministry of Health .
- Inadequate behavior of doctors and medical staff in a hospital or clinic - where to complain?
There can be many examples of inadequate behavior of medical personnel.
for example, doctors "celebrate" a holiday at the workplace (such cases are especially frequent on New Year's or May long weekends) and drink, or simply do not pay attention to patients who need first aid. For such inappropriate behavior, the doctor can be held accountable.
The topic of line control audits always causes awe in the hearts of managers and employees of medical organizations, because line control is an indicator of the shortcomings that exist in our work.
What legal acts govern line control inspections of medical institutions?
1.Order of the Committee of Health of Moscow dated 22.07.1997. No. 416“On the control and administrative service of the Moscow Health Committee” (together with the provisions on the operational and administrative group of the control and distribution service of the Moscow Health Committee”, “On the linear control group ...”)
2.Order of the Department of Health of Moscow dated 15.05.1996. №292"On the introduction of categories of deficiencies identified in medical institutions by the linear control group of the Department"
3. Letter from the Department of Health of the Government of Moscow dated August 10, 1995. №25/09-95"Methodology for checking the linear control of outpatient clinics"
History of creation from line control services of the Department of Health of the city of Moscow (the former Committee of Health of the city of Moscow).
The linear control group of the control and administrative service of the Moscow Health Committee was created for the purpose of operational management and rational use of the forces and means of urban healthcare, improving the quality of medical care for citizens, exercising daily operational control over the activities of medical institutions subordinate to the Committee, and taking urgent measures to correct shortcomings in their work.
The linear-control group includes a doctor (or 2 doctors) and a driver on duty.
The positions of doctors of the linear control group are appointed by experienced doctors from among the employees of the Moscow City Health Department and its subordinate institutions, who are in the reserve for promotion to managerial positions, who have experience in medical and organizational work in healthcare, who are able to make independent decisions aimed at organizing the actions of the medical service cities in different situations.
The tasks of the doctor of the line control service:
1. Operational control of the work of medical and preventive institutions subordinate to the Department of Health of the City of Moscow (except for substations of the SS&NMP, emergency and resuscitation departments of hospitals that are part of the emergency medical service);
2. fulfillment of any operational tasks of the head of the Department of Health (deputy heads) and directly the management of the organization of emergency or planned medical care in the field;
3.information to the head of the Department (at operational meetings) about the identified shortcomings in the work of the inspected medical organizations.
Rights and obligations of the doctor of the linear control group:
1. upon presentation of an official ID - unhindered entry to the medical and preventive institutions subordinate to the Department of Health to check the work of any structural units in connection with an emergency or in a planned manner.
2. in case of emergency or non-compliance of the medical personnel on duty with the legal requirements of the doctors of the control and administrative service of the DZM - a call to the workplace (including from home) of the heads of institutions.
3. upon completion of the check - registration of documentation.
3.1. in a verified institution - a journal of the control and administrative service of the DZ of Moscow (together with the doctor on duty - the head of the medical institution).
3.2. in the DZM - an act of checking a doctor of the control and administrative service of the DZ in Moscow.
How is line control performed?
Representatives of the line control come to the medical institution at various times:
1) before the start of the work of the institution,
2) at the end of the working day, sometimes just before the end,
3) late at night (more often in the interval from 23.00 to 4.00),
4) weekends and holidays.
Recently, repeatedline control cases on two consecutive days. Be carefull!
The Line Control Service of the Moscow City Health Department checks not only medical institutions located in Moscow, but also remote objects of the DZM, located on the territory of the Moscow region(any time of the day!).
Objects of verification can be all offices and structural divisions of the institution, information stands of the institution, the territory adjacent to the medical institution.
Checked availability of work schedules for structural divisions and duty schedules on weekends and holidays of the month, the work schedule of the duty administrator.
In hospitals, very often the line control doctor asks for information on the number of patients in the department, then reconciles this data against the presence of individuals at the moment and recalculates the case history. Moreover, recently, the control of the number of patients in the department is carried out even at night, including in medical institutions of a specialized type - narcological and psychiatric hospitals. An employee of the line control service quietly enters the ward, turns on the light and counts all the patients “head by head”.
January 2017 in medical institutions of stationary type began with monitoring the compliance of the number of beds according to the staffing table with the actual number of beds. During the check, the doctor of the line control service of the DZM counts all the beds currently deployed in the medical institution, taking into account the “reserve” beds of the isolation ward.
Strictly scheduled check presence of medical staff in the workplace medical institution. It is necessary to provide an identity document - this can be a passport or a pass to a medical organization, which every employee must have.
Are checked aseptic rooms(procedure rooms, operating rooms, vaccination rooms, endoscopy rooms, dental rooms, sanitary rooms).
Physician-methodologist of the line control service of the Department of Health of the city of Moscow has the right to access in any premises of a medical organization any time of the day!
Are checked storage rooms for narcotic drugs and their residues.
The test results are entered into control and administrative service log in a health care facility and checking act according to Appendix 5 to Order of the Moscow Health Committee dated July 22, 1997 No. No. 416 "On the control and administrative service of the Health Committee of Moscow"
, with the obligatory indication of the assessment of identified shortcomings on a four-point system. As a rule, in a medical organization this journal is called Line Control Log and is always kept in the reception area. The Line Control Log should always keep copies of reports of all inspections carried out. The methodologist of the line control service of the DZM necessarily checks the identified shortcomings of the previous check for elimination and fixes this fact in the act.
What practical experience do you have with line inspections?
Let's take a look at one of the tests. compliance with the rules for handling narcotic drugs on weekends and holidays in a polyclinic (in a medical institution, a line control doctor is accompanied by an administrator on duty during the check).
Representatives of the line control checked the room where there is a safe for storing the remains of narcotic medicines handed over over the weekend.
We checked the availability and correct storage of the keys to this room and the safe.
We checked the correctness of keeping a log of the transfer of keys from the safe of the doctor on duty.
We checked the presence in the safe of a copy of the license for the right to work with narcotic drugs, a list of patients receiving narcotic drugs in the current month, a certificate for the safe, a table of the highest single and daily doses of narcotic drugs, a table of antidotes to narcotic drugs.
Another situation, this time the line control holds due diligence.
Line control doctor checks:
sanitary condition of the adjacent territory(illumination, including in front of the entrance to the admission department; the line control doctor, passing through the checkpoint of the medical institution, assesses the availability of a pass regime; the presence of all vehicles, while parking on the territory of the pass in a conspicuous place under the windshield)
availability of a copy of the license in the registry
the presence of a log of linear control
availability of a log book for the operation of vehicles and the procedure for maintaining it
Keys to all rooms
the presence of security and the order of its work
clinic work schedule
schedule of doctors and ancillary services
availability of information about the work of specialists in other medical institutions, including auxiliary services, if they are not available in this medical organization
availability of information on the provision of traumatological, dental, ophthalmological, psychiatric, narcological anti-tuberculosis, skin and venereal and other care during the day and at night
working hours of a medical and physical education dispensary, a polyclinic for rehabilitation treatment
addresses and phone numbers of nearby pharmacies
addresses and telephone numbers of medical and social expert commissions
addresses and phone numbers of higher-level organizations (health departments, health departments, prefectures)
information about the administrator on duty (name, location, telephone number, availability of an order or approved schedule of administrators on duty)
time of reception of the chief physician and his deputies by day of the week
on the procedure for organizing an extraordinary reception of preferential contingent
list of population groups entitled to free and preferential dispensing of medicines
availability of information about insurance companies (time of issuance of compulsory health insurance policies, address and telephone number of the insurance company)
the presence or absence of paid services (in the presence of paid services - the procedure and organization of payment)
organization of appointments with doctors (preliminary and during the day), especially with specialists
organization of the work of the registry and map storage: the state of outpatient cards
the presence of a book of records of proposals, the work of the administration with critical remarks and thanks
organization of receiving house calls on weekdays from 14:00 until the end of the polyclinic
call execution time from the moment of arrival
organization of emergency care: the presence of a laying at the doctor making house calls, in the treatment room, or at the intensive care unit
availability of instructions and a set of medicines for emergency care in case of cardiogenic shock, anaphylactic reaction and other urgent conditions
expiration date and storage conditions of medicines
sanitary condition of offices and implementation of anti-epidemic measures by medical personnel, knowledge of the rules of the anti-epidemic regime by the personnel
availability and accessibility of instructional material, protective suit, actions of personnel in case of detection of a patient with a particularly dangerous infection
Availability of emergency stowage in the cabinets and the ability to use it
Availability and use of disposable syringes
quality and sufficiency of dental, otorhinolaryngological, ophthalmic, surgical instruments
fire-prevention condition of the premises of the polyclinic
How oce
niyatsya, revealed during the check line controlm, lackki?
The deficiencies identified during the line control check are evaluated according to the table "Categories of deficiencies detected in health care facilities by doctors of the line control service of the Moscow Health Department." These categories are reflected in
In my opinion, it is possible to talk about something only after professional control will work. And only then, as an auxiliary function, this can be done by society, certain public institutions.
The problem is that independent expert control institutes have not yet been created in our country. We do not have such a tool as compulsory liability insurance of a medical institution and a doctor. The basis for the existence of this institution is precisely the presence in the country of independent expert organizations. We do not have such organizations.
What is our main concern? This is the quality of the work of a medical institution, a particular doctor and possible medical errors. It is possible to reveal this only by creating a professional institute. No student or grandmother will appreciate either the quality of the work of a medical institution, or the presence or absence of a medical error. If we are talking about public control, then they can evaluate such factors as the cleanliness of the premises and the rudeness of the staff, but again, subjectively. Everything else is the care and responsibility of a professional. In my opinion, it is necessary to work on the introduction of the institution of professional responsibility of medical institutions and doctors, for which it is necessary to create appropriate expert institutions, they must be separated from the healthcare system.
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