Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

FIFTEENTH CONGRESS
First Regular Session

HOUSE BILLNO.__ 3078

Introduced by Rep. KARLO A. B. NOGRALES.

EXPLANATORY NOTE

This bill seeks to establish a patient grievance mechanism in all public and
private health care institutions in the Philippines. This mechanism aims to protect the
interest and welfare of patients and to uphold their right to health and to safe, humane,
decent and quality professional health care.

Article Il, Section 15 of our Constitution provides that the State shall protect and
promote the right of health of the people and instill consciousness among them.

Reported complaints of patients with regard to their treatments, has increased
due to the advances in the practice of medicine and the increasing consciousness of
people on the importance of timely, efficient and appropriate health care. Medical
professionals are often licensed by the State to perform their jobs, and the educational
systems for these professionals are highly regulated. These professionals should
perform and live up to the expectations of the general public. However, it cannot be
denied that just as in any other profession, errors due to negligence and incompetence
still occur in the treatment of patients, sometimes resulting in an injury to or even death
of a patient. Increasing complaints regarding violations of trust in patient-doctor
relationships are also considered because one of the most critical components of the
health care delivery process should be the interaction between the care provider and
the patient and family.

In our present system, patients are provided with three options for complaints
against erring medical professionals. A patient may opt to file a civil action, a criminal
action or an administrative complaint against a physician.

Under Article 2176 of the Civil Code, when the act or omission causes damage to
another, there being fault or negligence, obliges the wrongdoer to pay for the damage
done. These damages that may be recovered are actual compensatory, moral, nominal,
temperate or moderate, liquidated, or exemplary or corrective damages. The Revised
Penal Code provides that physical injuries and other crimes against a person are


punishable with imprisonment and/or a fine. Administrative measures are provided for
by the Medical Act of 1959, which reprimands erring physicians by the suspension or
revocation of license registration of physicians who are found guilty of gross negligence,

ignorance and incompetence in the practice of his/her profession that results in an injury
to or death of the patient.

In the proposed grievance mechanism, a patient or persons on their behalf, can
express complaints, resolve disputes concerning staff actions or hospital procedures, or
bring institutions that may violate patient rights. Patients should be encouraged to use
the grievance procedure as a formal and appropriate way to express their concerns or
complaints to staff and resolve disputes, instead of relying on inappropriate, acting out
behaviors. These complaints will be filed to the grievance committee created for this
purpose, which includes hospital officials, doctors, a member of the Philippine Medical
Association, representatives from local health units, and the consumer arbitration office
in the place where the hospital is located. The use of the Patient Grievance Procedure
does not limit the right of a patient to seek remedy for a complaint in the legal system.
The grievance mechanism hopes to establish a settlement that will be mutually
acceptable to the parties.

In view thereof, the early passage of this bill is earnestly sought

whit B. NOGRALES


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

FIFTEENTH CONGRESS
First Regular Session

807.
HOUSE BILL NO. 3078

Introduced by Rep. KARLO A. B. NOGRALES

AN ACT

ESTABLISHING A PATIENT GRIEVANCE MECHANISM FOR TREATMENT-
RELATED GRIEVANCES IN ALL PUBLIC AND PRIVATE HEALTH
INSTITUTIONS WITH THE SUPERVISION OF THE DEPARTMENT OF HEALTH,
AND FOR OTHER PURPOSES

Be it enacted by the Senate and House of Representatives of the Philippines in
Congress assembled:

SECTION 1. Short Title. - This Act shall be known as “Patient Grievance
Mechanism Act of 2010."

SEC. 2. Declaration of Policy. ~ The State values the dignity of every person and
upholds full respect for human rights. It shall then maintain the policy of protecting and
Promoting the citizen's right to health and instilling health awareness among them.
Thus, it is imperative for the State to establish an effective, efficient and just grievance
mechanism that will ensure the protection of a person's right to a decent, humane and
adequate health care. This Act intends to create a functional mechanism that will
address the problems and complaints of medical patients in relation to their treatment.

SEC 3. Definition of Terms. — For purposes of this Act, the following terms shall

mean:

1. Patients — persons requiring medical attention from any medical practitioner;


2. Medical Grievance — a grievance or complaint specific to the provision or
nonprovision of medical care or services. It can be any complaint arising from injury or
death of a patient in relation to his or her diagnosis, prognosis, or treatment by a
Physician or any medical practitioner and/or his or her assistant due, but not limited to
the following:

a) Gross incompetence or negligence in the practice of his or her profession;

b) Aiding or acting as a dummy of a person unqualified or unregistered to practice
medicine;

c) Violation of the doctor-patient privilege

3) Grievance Board — the grievance mechanism instituted by the hospital which
will receive, investigate, examine and resolve all medical grievances that may fall under
its jurisdiction;

4) Gross negligence — pursuit of a course or conduct, which would naturally and
reasonably result in injury and/or death. It is characterized by a lack of care and an
intentional neglect to act in the call of duty while maintaining a conscious indifference to
consequences it will have on other people. The existence of negligence in a given case
is not determined by reference to the specific judgment of a person involved in a
complaint, but by what would be reckless, blameworthy and negligent in a person of
average intelligence and prudence;

5) Health Care Provider — all medical and health personnel involved in the
diagnosis, prognosis and treatment of a patient;

6) Hospital — health institution defined as such under Republic Act No. 4226 or the

Hospital Licensure Act of 1965;


7) Consumer Arbitration Officer — person appointed for the effective and efficient

protection of consumer rights under Republic Act No. 7394 or the Consumer Act of the

Philippines;

SEC. 4. Formation of a Grievance Board in all Public and Private Hospitals. ~ All

hospitals must create a grievance board that will receive, investigate, adjudicate, and

recommend actions to arrive at a resolution of complaints related to the diagnosis,

prognosis and treatment of patients who sought the services of such health institution.

The Hospital Grievance Board shall have at least five (5) members:

1.

One (1) grievance officer appointed and permanently designated by the
hospital who shall act as the Chairperson. He or she must hold a

‘supervisory or managerial position and must not be a medical doctor;

. Three (3) doctors from the hospital's pool of physicians, provided that

none of them were involved in the treatment of the patient-complainant
and, provided finally, that they have the necessary expertise in the

branch of medicine that is the subject matter of a given grievance case;

. The local health officer or his/her duly authorized representative,

provided that the representative is a full-time staff of the local health unit
and must be a college graduate;

One (1) representative from the Philippine Medical Association (PMA);
One (1) consumer arbitration officer who has jurisdiction over the area

where the hospital is located.


Each hospital shall draft a list of experts for each field who are authorized to
sit in the Board. Its rules and regulations must clearly state the procedures and methods
of filing and addressing grievances. The Department of Health shall have the duty of
ensuring the establishment and acting as overseer of the grievance committees.

SEC. 5. Patient Grievance Procedure. — A patient desiring to file a grievance under
this Act may submit a complaint in writing to the hospital's grievance board. The
document must be signed and sworm to by the patient himself or herself or his or her
legal representative and must be filed within 30 days from the occurrence of the event
on which the complaint is based. It must state the act or failure complained of, the
parties whom the complaint is directed against, the conduct or duty violated, and other
allegations the complainant deems necessary to include.

SEC. 6. Action on the Grievance. — It is the duty of the grievance officer to
examine the stated allegations and determine what falls within the jurisdiction of the
Grievance Board. He or she may require or allow the parties to submit affidavits, briefs
or other pertinent documents within reasonable periods and under appropriate
conditions so as to help determine the validity of the complaint.

The grievance officer shall act on the complaint within fifteen (15) days upon
receipt. If the complaint is deemed not actionable based on a valid cause, the officer
shall inform the patient, or his or her legal representative, in writing, of the basis of the
said dismissal. Should the officer find that the complaint is actionable, he or she shall
submit a report to the Board and recommend the case for mediation.

The Board shall have thirty (30) days from the receipt of the grievance officer's

report to resolve the complaint.


This Act shall not deprive the patient the right to seek other remedies allowed
under the laws, provided that he or she shall not be allowed under the laws, provided
that he or she shall not be allowed to recover twice for the same remedy.

SEC. 7. Remedies to be Awarded. — If the physician and/or his or her assistants
are found guilty of any of the acts listed on the complaint; the Board, through majority
vote of all members except the Grievance Officer who endorsed the case, may grant
relief prayed for by the complainant. Remedies shall limited to compensation for actual
monetary loss and will not cover psychological damages or other explicitly non-
monetary losses. Likewise, the Committee may recommend the respondent for
disciplinary action under the civil service rules and regulations in case of public
hospitals, and the physician's medical association.

SEC. 8. Rules of Procedure. — The hospital shall promulgate rules of procedures
governing the resolution of grievances. The rules must be consistent with the provisions
of this Act, and shall require the approval of the Department of Health before being
implemented. The procedure must be broad enough to apply to the handling of various
types of complaints and must be effectively facilitate the settlement of grievances at the
so9onest possible time. It shall include the rules on taking appeal.

All records received from the parties and the proceedings of the Board shall be
Strictly confidential and cannot be disclosed, except upon lawful order of a competent
court.

SEC. 9. Appeal. — Any party adversely affected by a decision, ruling or inaction by

the grievance board on a patient's complaint may file an appeal before the Secretary of


the Department of Health, who shall act on it within thirty (30) days from receipt of the
appeal.

SEC. 10. Rules and Regulations. — The Secretary of Health, in consultation with
the Philippine Medical Association, the Philippine Hospital Association, the Philippine
Health Insurance Corporation and concerned private agencies, non-governmental
organizations and people's organizations shall promulgate such rules and regulations
as may be necessary for its implementation within One Hundred Eighty (180) days from
the affectivity of this Act.

SEC. 11. Prescriptive Period. - The time during which the case is submitted for
mediation shall toll the running of the prescriptive period for the filing of a civil or criminal
case under the Revised Penal Coder or any administrative case under existing laws.

SEC. 12. Separability Clause. — If any of the sections or provisions of this Act is
held invalid, all the other provisions not affected thereby shall remain valid.

SEC. 13. Repealing Clause. — All Acts, Executive Orders, Rules and Regulations,
or parts thereof that are inconsistent with the provisions of this Act are hereby repealed
or modified accordingly.

SEC. 14. Effectivity. — This Act shall take effect fifteen (15) days from the date of
its publication in at least two (2) newspapers of general circulation in the Philippines.

Approved,