Delta State Private Health Care Facilities (registration, Operations and Prohibition) Law

DELTA STATE PRIVATE HEALTH CARE FACILITIES (REGISTRATION, OPERATIONS AND PROHIBITION) LAW

1. Short Title and Commencement. This Law may be cited as the Delta State Private Health Care Facilities (Registration, Operations and Prohibition) Law and shall come into force and on the 26th day of March, 2019.

2. Interpretation. In this Law, unless the context otherwise requires: "AGPMPN" means Association of General and Private Medical Practitioners of Nigeria, Delta State chapter; AGPNP means Association of General Private Nursing Practitioners, Delta State chapter; "AMLSN" means Association of Medical Laboratory Scientists of Nigeria; Delta State chapter; "Alternative Medical Practitioners" includes Practitioners of Acupuncture, Homeopathy Naturopathy and Traditional Medicine; "Appropriate Authority" means the Commissioner or any other person authorized to be in charge of the Ministry of Health; "Committee" means the Joint Monitoring Committee; "Company" includes a company duly registered under the provision of Companies and Allied Matters Act 1990 and company established outside Nigeria and Company, or another/or Association or Partnership of any number of persons; "Federation" means the Federal Republic of Nigeria: "Governor" means the Governor of Delta State; "High Court" means the High Court of Delta State; "HCPAN" means Health Care Providers Association of Nigeria, Delta State chapter; "Health Professional in Charge" Means a licensed professional Medical Officer in charge. "Infectious disease" shall have the same meanings from time to time contained in the Public Health Law; "MDCN" means the Medical and Dental Council of Nigeria, Delta State chapter; "Ministry" means Delta State Ministry of Health; "MISN" means Medical Imaging Society of Nigeria, Delta State chapter; "MLSCN" means Medical Laboratory Science Council of Nigeria, Delta State chapter; "NANNM" means National Association of Nigeria Nurses and Midwives, Delta State chapter; "NMA" means the Nigeria Medical Association, Delta State chapter; "NSP" means Society of Physiotherapy, Delta State chapter; "NOA" means Nigeria Optometric Association, Delta State chapter; "OSN" means Ophthalmological Society of Nigeria, Delta State chapter; "Paramedical staff" means healthcare professional, predominantly in the pre-hospital and out-of-hospital environment and working mainly as part of Emergency Medical Service (EMS) as on an ambulance; "Permanent Secretary" means the Permanent Secretary of Ministry of Health, "Premises" means land, building, tent, vessel and includes any mechanically propelled vehicle intended or adopted or adapted for use on roads and every description of vehicle propelled by means of mechanism contained within itself; "PCN" means Pharmacist Council of Nigeria, Delta State chapter: "PSN" means Pharmacy Society of Nigeria, Delta State chapter; "Private Healthcare Facilities" includes any Hospital, Convalescent Home or Nursing Home, Clinic or Consulting Room, Maternity Home or Hospital, X-Ray Operation, Radiography Services, Medical Laboratory Services, Physiotherapy Services, Optical Services, Nursing or Medical, Nursing Agency, Optometry, Dentistry, Dental Technology Laboratory, Radiology Services, Pathology Services, Ophthalmological and Visual Rehabilitation Services and any premises used or intended to be used for the reception and treatment of persons from any, sickness, injury, or bodily or mental infirmity whether or not any payment or reward is made or premises by on behalf of any person so received but does not include any such Hospital, Convalescent Home, Nursing Home or premises maintained or controlled by the Government or a Local Government Council; "Private Health Professional" includes duly registered Medical Doctor, Dentist, Nurse, Radiographer, Optometrist, Physiotherapist, Laboratory Scientist and Pharmacist in the Public employment and as listed and defined by the Federal Ministry of Health; "Professional Regulatory Body" includes all relevant regulatory bodies established by relevant laws; "State" means the Delta State of Nigeria: "Traditional birth attendant" includes traditional Midwives, Community Midwives whose function is to provide pregnancy and childbirth care.

3. Establishment/Membership of the Monitoring Committee. (1) For the purpose of this Law, there is hereby established a Joint Monitoring Committee (hereinafter called the "Committee") whose membership shall consist of the following: (2) (2) (a) The Director of Medical Services/ Training in the Ministry who shall be the Chairman (b) Director, Nursing Services of the Ministry; (c) One representative from the AGPMPN; (d) Chairman, Nigeria Medical Association; (e) Director, Department of Pharmaceutical Services, Ministry of Health; (f) Director, Department of Public Health Care. Ministry of Health: (g) One representative from AMLSN; (h) One representative from the Ministry of Justice: and (I) One representative from the Ministry of Information. (3) The Chairman and members of the Joint Monitoring Committee shall be constituted by the appropriate authority.

4. Powers and Functions of the committee. (1) The Committee may at all reasonable times or prompted by petition from the public enter a private Health Care Facility for the purpose of monitoring and inspection and may demand to be produced all or any record, register and other documents required to be kept under the provisions of this Law and the health professional in charge shall take such steps as may be necessary to facilitate such supervision and inspection: Provided that nothing in this Section shall be deemed to authorize the inspection of any medical record relating to a patient in a Private Health Care Facility. (2) The Committee shall send the report of its findings in writing to the Appropriate Authority and communicate the health care facility concerned whenever they go on monitoring and inspection of Private Health Care Facility: Provided that such report shall be properly signed by all members who were physically part of the monitoring and inspection. (3) The quorum for all meetings shall be two-third of the members.

5. The Report of the Committee. (1) Where arising from the report of the committee, the Appropriate Authority is satisfied that the provisions of this Law or any part thereof have been violated by a Private Health Care facility or that activities of a private Health Care Facility are not being conducted in the best interest of the public or the health or well-being of the patients admitted thereto or that any health professional connected with a Private Health Care Facility is not or has ceased to be a fit and proper person, he may by order; (a) suspend the registration of such a Private Health Care Facility until the necessary conditions which caused the order of suspension to be issued have been met: or (b) cancel the registration of such a Private Health Care Facility. (2) Where an order of suspension or cancellation of the registration of a Private Health Care Facility has been made under the provision of subsection (1) of this Section such Private Health Care Facility shall thereupon be closed down with the aid of the police in recalcitrant cases provided that in the case of a private hospital or clinic no new patients shall be admitted and the remaining in patients shall in the discretion of the Appropriate Authority be discharged or transferred to another hospital. (3) A Health Professional in charge of a company aggrieved by an order of suspension or cancellation made under the provision of this Section may appeal to the High Court but the order of suspension or cancellation shall have immediate effect and shall not be stayed by reason of the lodging of any such appeal. (4) Any order of suspension or cancellation made under the provision of this Section shall be in addition to any proceedings which may be instituted in respect of any contravention or failure to comply with the provisions of this Law and to any penalties which may be imposed on conviction in such proceedings whether or not such conviction is made on the same facts on which the order of suspension or cancellation was made.

6. Management of Private Health-care. Subject to the provision of this Law and without prejudice to extant professional regulatory laws, every Private Health Care Facility shall be under the management, control and monitoring of duly registered and licensed health professional who shall be responsible for the carrying into effect the provisions of this Law in the Private Health Care Facility concerned.

7. Health professional in Charge. Where more than one health professional is connected with a private Health Care facility, one of such health professional shall be nominated as the appropriate health professional in charge.

8. Application for Registration. Application for the registration of a Private Health Care Facility shall be made to the Appropriate Authority in the form and manner prescribed by the extant Professional Regulatory laws.

9. Registration of Private Health-care. No person or company shall institute or operate a Private Health Care Facility unless such a facility has been duly registered by the Appropriate Authority and the relevant Professional Regulatory body under the provisions of this Law.

10. Conditions for Registration. (1) Subject to the provisions of this Law, a Private Health Care Facility shall not be registered unless the Appropriate Authority is satisfied; (a) that the health professional in charge of and any other health professional with the Private Health Care Facility or any part thereof is qualified to practice any special branch of the health professional for which the Health Care Facility is registered and is in all other respects a fit and proper person: (b) that other paramedical staff is adequate and in conformity with the provisions of any regulations made hereunder; (c) that the site, buildings and general amenities satisfies the relevant laws in the State and Nigeria: (d) that the requisite and suitable equipment is available and sufficient to meet the requirements of such Private Health Care Facility in accordance with the provisions of the relevant Professional Regulatory body; (2) All properly registered Private Health Care Facility shall display the certificate of registration to the public, indicating that the premises properly registered. (3) Where a rural community is not proximate to a Government Health Care Facility or a duly registered Private Health Care Facility, the Appropriate Authority may make modifications in the registering of a Private Health Care Facility under this Law provided that such modification is made without prejudice to the extant relevant Professional Regulatory laws. (exemptions) (4) Any such exemption, relaxation or modification shall be expressed to be for a period not exceeding one year but the appropriate authority may, in like manner, from time to time, renew any such exemption, relaxation or modification for periods not exceeding one year. (5) Any such exemption, relaxation or modification shall be in writing signed by the appropriate authority and shall be displayed with the certificate of registration in the Private Health Care Facility concerned in a prominent place accessible to all patients or intending patients.

11. Power to make Regulation. Without prejudice to extant Professional Regulations, the Appropriate Authority may, with the approval of the Governor make regulations in respect of the institution, operations, monitoring and inspection of Private Health Care Facilities excluding Pharmacies and Patent Medicine Stores under this Law and without prejudice to the generality of the power so conferred, in particular for- (a) prescribing any matter or thing required to be prescribed under the provisions of this Law; (b) prescribing the standard of sanitary arrangements in accordance with the Public Health Law of Nigeria; (c) regulating the accommodation for patient and paramedical staff; (d) regulating the accommodation and equipment for operating a Private Health Care Facility in accordance with appropriate bodies or laws of the Federation; (e) regulating the preparation and storage of food and drugs and where drugs are dispensed in a Private Health Care Facility, the number of qualified pharmacist or other essential staff to be employed; (f) prescribing the records and statistics to be kept and the mode of keeping them in accordance with the National Health Act or Bureau of Statistics; (g) prescribing the fees for registration and annual renewal of registration of a Private Health Care Facility; (h) prescribing the notification of deaths, births, still-births, miscarriages and abortions and also infectious disease; (i) regulating the arrangement for disinfection in accordance with the Public Health Law of Nigeria; and (j) prescribing the arrangements to be made for the prevention and control of fire and safety of patient and staff in the event of fire.

12. Offences And Penalty. Where an offence has been committed under this Law, in respect of the institution or operations of a facility and such Private Health Care Facility is owned or controlled by a person or company, then. in addition to the health professional in charge, such person or company knowingly being a party to such offence shall be guilty of the lick offence and liable to the same punishment.

13. Unregistered Private Healthcare Facility. (1) Where a premises which is not registered under this Law is found to be employed as a Private Health Care Facility, such premises shall be sealed off permanently. (2) Any health professional involved in the operation of such an unregistered Private Health Care Facility is guilty of an offence and shall on conviction be sentenced to a ten of imprisonment for a period not less than six (6) months but not exceeding one (1) year or to a fine of five million naira.

14. Prohibition for not having 24 hours Doctors Service. Any hospital or clinic that does not have 24 hours Doctor service is hereby prohibited from operating in- patients service and shall run only out-patients services.

15. Liability for Offences of Quackery. (1) Where a Private Hospital or Clinic is registered and designated as Specialist Hospital or Clinic; it shall essentially confine its operations to the specialty under which it is clearly registered except stabilization treatment before referral in other special cases. (2) Where a Private Hospital or Clinic fails to confine itself to the provision of subsection (1) of this Section, such a private Hospital or clinic shall be shut down permanently and the operators of such a private hospital or clinic shall be guilty of an offence of quackery and on conviction shall be liable to a term of imprisonment of not less than two (2) years or to a fine of five million naira or both.

16. Offence of lack of Medical qualification and Registration. Any person who having no medical training or qualification but purports to having medical qualification and not registered with the MDCN and purports to treat patients is guilty of an offence of quackery and shall on conviction be liable to a term of imprisonment of not less than five (5) years or to a fine of five million naira.

17. Premises Registered as pharmacy Facility. (1) Any premises which is registered as a pharmacy shall not be used for any purpose other than for the purpose for which it was registered and licensed by the professional regulatory body. (2) Any premises which is registered as a pharmacy shall not dispense ethical drugs in the absence of a properly registered and licensed pharmacist: provided that where the pharmacist in charge or the pharmacist on duty is on break or outside the premises there shall be a sign placed in a conspicuous place within the premises indicating the absence of a pharmacist and shall not dispense any ethical drugs until the pharmacist is in residence. (3) Where any of the provision of this Section has been contravened such a person on conviction shall be liable to prison term of not less than six (6) months but not exceeding twelve (12) months or to a fine of two million naira.

18. Use of Patent Medicine Shops. (1) Any premises which is registered as a Patent Medicine Shop shall not be used for any purpose other than for the purpose for which it was registered and licensed by the Professional Regulatory body. (2) Any premises which is registered as a Patent Medicine Shop shall dispense only Over the Counter (OTC) drugs that are listed in "Approved Patent Medicine List". (3) Where any of the provisions of this Section has been contravened such a person on conviction shall be liable to an imprisonment term of not less than six months but not exceeding twelve months and a fine of one million naira.

19. Private Hospital/ clinic running in House Medical Laboratory service Pharmacy. (1) Any properly registered private hospital that runs an in-House Medical Laboratory Service shall have such Laboratory manned by a qualified Medical Laboratory Scientist registered and licensed by relevant Professional Regulatory body. (2) Any properly registered Private Hospital or Clinic that runs an in-House pharmacy shall have such pharmacy manned by a pharmacist duly registered and licensed by relevant professional regulatory body or a pharmacy technician. (3) Any properly registered Private Hospital or Clinic which contravenes the provisions of this Section. shall be liable to a fine of one hundred thousand naira only in the first instance and for repeated offender shall pay a fine of five hundred thousand naira, and ten thousand naira, thereafter for everyday the offence subsists.

20. Private Medical Laboratory facility. (1) Any properly registered Private Medical Laboratory Facility which is involved in Medical Laboratory investigations shall have qualified Medical Laboratory Scientist duly registered and licensed with the relevant professional regulatory body as its health professional in charge and the premises shall not be used for anything other than that for which it is registered. (2) Any properly registered Medical Laboratory which contravenes the provision of sub- section (l) of this section shall be closed down permanently and any person operating such Medical Laboratory shall be guilty of an offence and shall on conviction be liable to a term of imprisonment for a period not less than six (6) months but not exceeding eighteen (18) months or to a fine of one million naira or both.

21. Private Physiotherapy Faculty. (1) Any properly registered Private Physiotherapy Facility shall have a qualified Physiotherapist duly registered and licensed by the relevant regulatory body as the health professional in charge. (2) Any premises properly registered as a Private Physiotherapy facility shall not be used for any other purpose than that for which it is registered. (3) Any person who contravenes the provision of sub section (l) and (2) of this Section, shall be guilty of an offence of quackery and shall have the premises permanently closed down and shall on conviction be liable to imprisonment for a period not less than six (6) months but not exceeding eighteen (18) months to a fine of one million naira and shall have the certificate of registration cancelled by the Appropriate Authority.

22. Private Radiological Facility. (1) Any Private Radiological Facility shall have a qualified Radiologist duly registered and licensed by the relevant regulatory body as the Health Professional in Charge. (2) Any premises properly registered as a Private Radiological Facility shall not engage in any other service for which it is not registered. (3) Any person who contravenes the provision of sub section (l) and (2) of this section shall on conviction be liable to a minimum term of imprisonment of six (6) months but not exceeding eighteen (18) months or to a fine of one million naira and shall have the premises permanently shut down and the certificate of registration shall be cancelled by the appropriate authority.

23. Private Radiographic/Imaging Facility. (1) Any Private Radiography Imaging Facility shall have a qualified Radiographer/imaging Technologist and licensed by the relevant regulatory body as the Health Professional in Charge. (2) Any premises properly registered as a Private Radiographic Imaging Facility shall not engage in any other services which it is not registered for. (3) Any person who contravenes the provisions of subsections (l) and (2) of this Section, shall -on conviction be liable to a minimum term of imprisonment for six months-but not exceeding eighteen months or to a fine of one million naira or both and shall have the premises permanently shut down and the certificate of registration. suspended by the Appropriate Authority.

24. Private Optometry Facility. (1) Any properly registered Private Optometry Facility shall have a qualified Optometrist duly registered and licensed by the relevant regulatory body as Health Professional in Charge. (2) Any premises properly registered as a Private Optometry Facility is hereby prohibited from engaging in any other services for which it is not registered. (3) Any person who contravenes sub-section (l) and (2) of this Section shall be guilty of an offence and shall on conviction be liable to a minimum term of imprisonment of six (6) months but not exceeding eighteen (18) months or to a fine of one million naira or both and shall have the premises closed down permanently and shall have the certificate of registration cancelled by Appropriate Authority.

25. Private Ophthalmological Facility. (1) Any properly registered Private Ophthalmological Facility shall have a qualified Ophthalmologist duly registered and licensed by the relevant regulatory body as the health professional in charge. (2) Any premises properly registered as a Private Ophthalmological Facility is hereby prohibited from engaging in other services for which it is not registered. (3) Any person who contravenes sub-section (l) and (2) of this Section shall be guilty of an offence and shall on conviction be liable to a minimum term of imprisonment of six (6) months but not exceeding eighteen (18) months or to a fine of one million naira or both and shall have the premises sealed and certificate of registration cancelled by the relevant authority.

26. Private Nursing Home. (1) Any properly registered Private Nursing Home shall have a qualified nurse duly registered and licensed by the relevant regulatory body as the health professional in charge. (2) Any premises properly registered as a private nursing home is hereby prohibited from engaging in any other service for which it is not registered or lack the requisite qualified personnel. (3) Any person who contravenes sub-section (1) and (2) of this Section shall be guilty of an offence of quackery and shall on conviction be liable to a minimum term of imprisonment of six (6) months but not exceeding eighteen (18) months or to a fine of one million naira and shall have the premises closed down permanently and shall have the certificate of registration cancelled by the Appropriate Authority.

27. Private Dental Facility. (1) Any properly registered Private Dental Facility shall have a qualified Dentist duly registered and licensed by the relevant Regulatory body as the health professional in Charge. (2) Any premises properly registered as a Private Dental Facility is hereby prohibited from engaging in other services for which it is not registered. (3) Any Person who contravenes subsections (1) and (2) of this Section shall be guilty of an offence and shall on conviction be liable to imprisonment for a term of not less than 6 Months, but not exceeding 18 months or to a fine of One Million naira or both.

28. Alternative Medical Practitioners. All Alternative Medicine Practitioners, Maternity Homes and Traditional Birth Attendants shall be registered with the Ministry in the form and manner prescribed by the Federal Ministry of Health. Practitioners are hereby prohibited from advertising in any form in the state.

29. Prohibition of Advertising Traditional Birth Attendants. (1) All Traditional Birth Attendants and Alternative Medicine Practitioners are hereby prohibited from advertising in any form whatsoever in the state. (2) Any person who contravenes the provision of sub-section (1) of this Section including the Advertiser and Advertising Agency and or Media House airing such advertisement shall be guilty of an offence. (3) Any person found guilty under sub-section (2) of this Section shall be liable to an imprisonment for a term not less than one (1) year but not exceeding eighteen (18) months or to a fine of one million naira and such a person shall have the premises on which he practices his trade closed permanently. (4) Any Advertising Agency and or Media House found guilty under subsection (1) and 2 shall be liable to a fine of five million naira.

30. Prohibition of Advertising Herbal Drugs/Products. (1) All form of advertisement of Herbal Drugs or Products is hereby prohibited except as expressly approved by the appropriate authority with a certificate of approval issued. (2) Where any person is found to have contravened the provision of subsection (1) of this Section, such a person shall be liable to a fine of five hundred thousand naira and a term of imprisonment not less than six (6) months but not exceeding two (2) years or both.

31. NGOs rendering free medical services. (1) Whenever any Non-Governmental Organization or Non-Profit Organization seeks to render Free Medical Services of any kind, such a Non-Governmental Organization or Non-Profit Organization shall apply and obtain a written approval from the appropriate authority. (2) Such an application shall be in the form and manner prescribed by the Appropriate Authority. (3) Any person or organization who contravenes the provision of subsection (1) of this section have committed an offence and liable on conviction to a term of imprisonment not less than six (6) months or to a fine of one hundred thousand naira; provided that in the case of an organization, such organization shall be banned from operating anywhere in the State for a period not less than six (6) months but not exceeding twelve (12) months.

32. Closure of Premises. Where a properly registered premises is used for any service(s) other than that for which it is registered; such premises shall be closed down and shall have the certificate of registration recommended to the Appropriate Authority for cancellation.

33. Repeal. The Delta State Private Hospitals (Registration and Prohibition) Law 2006 Cap 160 is hereby repealed.