Lawyers fault demand for deposits before emergency treatment of patients

Some Lagos-based lawyers on Saturday, warned hospitals and healthcare providers against demanding upfront payments before treating patients in medical emergencies.

The lawyers told the News Agency of Nigeria (NAN) that such actions violate the National Health Act of 2014, and attract legal sanctions.

They argue that section 20(1) of the Act prohibited healthcare providers, health workers and health establishments from refusing emergency medical treatment for any reason, including a patient’s inability to pay a deposit.

The lawyers, however, called for effective healthcare financing and reimbursement mechanisms, to protect hospitals from financial losses while ensuring that patients received timely medical attention.

An Associate of the Institute of Medical and Health Law, Ms Odinichionye Egwuenu, told NAN that the law was clear that emergency treatment must not be withheld because a patient could not make upfront payment.

Egwuenu said the provision applied to both public and private hospitals, noting that internal hospital policies could not override statutory obligations.

She, however, urged stakeholders to consider the financial challenges facing healthcare institutions, including staff salaries, equipment maintenance and the procurement of medications.

According to her, the situation becomes more complicated when a hospital provides emergency treatment but the patient dies and the family subsequently abandons the deceased or refuses to settle the outstanding medical bills.

“We must also consider the practical realities of healthcare delivery; Hospitals have staff to pay, equipment to maintain and medications to purchase.

“So, while human life must take priority in an emergency, what happens when a hospital provides treatment, the patient dies despite its efforts, and the family abandons the deceased,” she said

While noting that section 11 of the National Health Act established the Basic Health Care Provision Fund, she said that the effectiveness of such funding required clos examination to determine whether hospitals received adequate support for emergency services.

Meanwhile, she also drew attention to the Compulsory Treatment and Care for Victims of Gunshot Act, 2017, which requires hospitals to treat gunshot victims without demanding deposits or insisting on police clearance.

She urged hospitals to notify the nearest police station within two hours of commencing treatment in compliance with the law,
The lawyer also called for institutional safeguards to protect medical practitioners who disregarded internal payment policies to fulfil their professional obligations to emergency patients.

She, consequently, called for the strengthening of emergency healthcare funding, establishing effective reimbursement mechanisms as well as providing lawful avenues for recovering outstanding medical expenses.

On his part, another lawyer, Mr Spurgeon Ataene, said doctors had an ethical obligation to prioritise saving lives in emergency situations before turning their attention to payment.

Ataene said demanding payment before attending to a patient in a life-threatening condition, could amount to professional misconduct and potentially expose the practitioner to disciplinary action.

He added that denying emergency care on financial grounds could also raise concerns about the patient’s fundamental right to life.
Ataene specifically stressed that gunshot victims should be treated before questions were asked about the circumstances of their injuries.

“It will therefore, be unethical for a doctor to make a demand for payment before treatment; He could be sanctioned and may lose his license,” he said

Ataene, however, acknowledged that patients should pay for medical services, particularly in non-emergency situations, noting that hospitals required funds to maintain equipment, pay staff and provide a clean and orderly environment.

He urged lawmakers to strengthen legislation requiring healthcare providers to stabilise emergency patients before making payment demands or conducting further inquiries that could delay treatment.

Similarly, another Lagos-based lawyer, Mrs Jumoke Ajayi of Olorunwapelumi Chambers, warned that healthcare providers could face criminal sanctions for refusing emergency medical treatment over unpaid bills.

Ajayi cited Section 20(2) of the National Health Act, which prescribes a fine of N100,000, imprisonment for a period not exceeding six months, or both, for contravening the provision on emergency medical treatment.

She explained that patients suffering from serious injuries sustained in road accidents, severe bleeding or other life-threatening conditions were entitled to immediate medical attention, irrespective of their financial circumstances.

“The legal position is that the hospital must attend to the patient’s emergency medical needs without refusing treatment on financial grounds,” she said.

Ajayi, however, clarified that the law did not automatically exempt patients from paying their medical bills, adding that hospitals could subsequently seek payment for services provided, subject to applicable laws and relevant payment arrangements.

According to her, determining whether a hospital or healthcare worker had committed an offence would depend on the circumstances and available evidence, including whether treatment was refused, delayed or referred to another facility.

Meanwhile, Ajayi noted that healthcare workers could not be held liable for consequences arising from their inability to provide particular emergency services where a hospital lacked the necessary equipment or capacity to handle the case.

Besides, she noted that the law protected patients’ access to emergency care but did not require every form of medical treatment to be provided free of charge.

On the whole, the lawyers maintained that protecting patients’ lives and sustaining healthcare institutions should not be competing objectives.

They consequently, urging government and relevant stakeholders to develop a system that guarantees emergency treatment while providing hospitals with adequate financial support.

NAN

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