Organisations, professionals and users of health services find themselves in a scenario in which the existence of conflicts within the health system is a reality. The World Health Organisation, with sustainable development goal 3 in mind and concerned about the existence of controversies within the health system, its observation, study and proposed solutions, makes an investment in the optimization of human capital, in the improvement of the work atmosphere and in the relations of the organisation itself with its workers, users and patients. Definitely, an intelligent conflict management will have a positive influence in any health organisation, handling appropriately the resources invested, diminishing many problems associated in this area and reducing the expenses and the costs that are inevitably related to the conflict.
I. Introduction. What's new?
There are no scientific articles regarding ODS that focus on a specific objective (in this case, ODS 3) related to the Spanish positive law or to the conflicts that can occur in the healthcare environment of our country, in the sustainable development goals (specifically number 16) and in the alternative ways of dispute resolution needed to achieve a response or remedy to the problems posed within the healthcare environment.
This initial outline presented, applicable in our country, can be used on a wider level respecting the existing regulations in any place, environment and scenario, as will be observed. This publication provides knowledge and conceptual tools in order to improve the effectiveness of legal rules and the fulfillment of their objectives, offering solutions to the real problems exposed in this article and providing the most advantageous solution for the parties in conflict from the point of view of quickness, efficiency, discretion and economy.
The problems arise from an existing dispute within the healthcare environment that will be explained further on and the solutions are supported by the strategies presented to make progress with a constructive dialogue that will help improve the relations, as well as in the catalogue of solutions proposed by our legal system to circumvent this problem, taking into account that ODS 16 proposes the promotion of “just, peaceful and inclusive societies for sustainable development, facilitating access to justice for all people and building effective and inclusive institutions" and is oriented and focused on finding solutions through mutual cooperation.
We start from the idea that in the last decades there have been important transformations in the healthcare environment: the increase of longevity, the expansion of the concept of health, the importance of physical, psychic and social well-being beyond the absence of illness and the need to guarantee the right to healthcare services for all citizens, among others. In this fast-changing environment the reality is that, with the emergence of new scenarios, frameworks and circumstances, there are more and more complaints and claims in the field of health by users. It is within this framework that complaints and claims are growing more and more and, as conflicts tend to escalate and not be resolved or not knowing how to manage disputes can lead to greater conflicts between healthcare providers among themselves, patients, management or administrative personnel, the expense will be significant. On the other hand, it is necessary to refer to the cases of health professionals who are the object of threats, insults and aggressions by users of the health system due to dissatisfaction with the management of their complaints.
The existence of many complaints has already been stressed, but perhaps the most important grounds for complaint occur, above all, in relation to the aspects of organisation and complaint procedures, both in hospital care and primary care and mental health care. In the case of social health care, the main reason for complaint is assistance. This leads us to analyse the causes for complaint. The different reasons presented by citizens before health centers usually are:
- In primary care: organisation and norms, inadequate personal treatment, disagreement with the change or assignment of the doctor, delay or dissatisfaction with assistance and waiting lists.
- In specialized care: excessive delay due to waiting list for surgical procedure, excessive delay due to waiting list for consultation/prior appointment, organisation and norms, dissatisfaction with assistance, inadequate personal treatment.
Another classification could be that which informs us that conflicts within the health field involve health workers, doctors, nurses, patients, their relatives, personnel or trade unions, sometimes between one another and other times among themselves.
-The hospital or clinic and its health staff in general, its management, workers or unions; conflicts between clinics and suppliers, product manufacturers or pharmaceutical laboratories regarding new drugs or medical devices; between clinics and insurance companies; clinics and their controversies with the public sector: patient referral
- Specific reference should also be made to labor conflicts, which are very common between a health worker or a worker in a hospital or clinic and a staff member of equal, superior or inferior category.
- Certain disputes over payment and reimbursement of money to insurance companies; private and public disputes over payments to pharmacies, doctors, patients...
This is because ADR in general and mediation in particular are important approaches in the development of a culture of peace, to find peaceful solutions and collaborate on how to promote access to justice.
Finally, in relation to women’s health specifically, it is mentioned that the health consequences of violence against women and girls extend to their children, who can witness the abuse and suffer long-term trauma affecting their physical, emotional and social development.
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