Sovereign Trust Insurance Plc (SOVREN.ng) listed on the Nigerian Stock Exchange under the Insurance sector has released it’s 2018 abridged results.For more information about Sovereign Trust Insurance Plc (SOVREN.ng) reports, abridged reports, interim earnings results and earnings presentations, visit the Sovereign Trust Insurance Plc (SOVREN.ng) company page on AfricanFinancials.Document: Sovereign Trust Insurance Plc (SOVREN.ng) 2018 abridged results.Company ProfileSovereign Trust Insurance Plc is an insurance and risk management services company in Nigeria licensed to cover all cases of life and non-life insurance. Products cover the spectrum of travel, quote and buy, family wellbeing, vehicle, 3 rd party motor and marine insurance. Sovereign Trust Insurance Plc was established following the restructuring and recapitalisation of the then Grand Union Assurances Limited. Its head office is in Lagos, Nigeria. Sovereign Trust Insurance Plc is listed on the Nigerian Stock Exchange
Solicitors Bates, Wells and Braithwaite share their advice on a possible change in the law that would affect charities that sell second-hand goods.Bates, Wells and Braithwaite write in their Spring 2001 Charity Update: “Any charities involved in the sale of secondhand goods should be aware of a potential change in the law due to come into effect on 1st January 2002. This arises from the UK Government’s plans to implement an EU Directive on the sale of consumer goods and associated guarantees.“The DTI have issued a Consultation Document with responses requested by Monday 2nd April 2001 following which they will draft UK legislation. Anyone interested should access the DTI Consultation Document which is available from the “What’s New” section of www.dti.gov.uk. This contains a comparison of the new rights under the Directive with current consumer rights. Secondhand goods will be covered but the period of liability for any defects can be reduced to not less than one year. The Government does propose to allow an exclusion for secondhand goods sold at public auction. The Consultation Document indicates that as the current position is that guarantees will be the same for secondhand goods as for consumer goods in terms of determining whether goods are satisfactory, the Government is not proposing to take advantage of the exception to reduce liability to one year for secondhand goods.” Advertisement AddThis Sharing ButtonsShare to TwitterTwitterShare to FacebookFacebookShare to LinkedInLinkedInShare to EmailEmailShare to WhatsAppWhatsAppShare to MessengerMessengerShare to MoreAddThis 14 total views, 1 views today AddThis Sharing ButtonsShare to TwitterTwitterShare to FacebookFacebookShare to LinkedInLinkedInShare to EmailEmailShare to WhatsAppWhatsAppShare to MessengerMessengerShare to MoreAddThis Howard Lake | 28 June 2001 | News Sale of second-hand goods – possible change in the law About Howard Lake Howard Lake is a digital fundraising entrepreneur. Publisher of UK Fundraising, the world’s first web resource for professional fundraisers, since 1994. Trainer and consultant in digital fundraising. Founder of Fundraising Camp and co-founder of GoodJobs.org.uk. Researching massive growth in giving.
Boletín: La Corte de Apelaciones del Noveno Circuito de los Estados Unidos dio su fallo el 14 de septiembre en contra de los beneficiarios de TPS, sosteniendo que el presidente Trump puede rescindir el estatus legal de las personas de todos los países que ahora viven en los EE.UU. Bajo la protección del programa. El fallo deja a cientos de miles vulnerables a la deportación.Para obtener un mapa de la caravana e información sobre Journey for Justice, visite www.nationaltpsalliance.org/journey-for-justice/.El 21 de septiembre, los activistas migrantes partirán de Los Ángeles hacia San Francisco, la primera de 54 paradas en 32 estados en el recorrido en autobús # TPSJourney4JusticeII, que finalmente llegará a Washington, D.C., a mediados de noviembre.En 2018, la primera Jornada por la Justicia que pidió la protección de los beneficiarios del Estatus de Protección Temporal (TPS) atravesó el país después de que Trump terminó el programa. El TPS ahora finalizará después del 4 de enero de 2021 para 411.000 beneficiarios que luego perderán la autorización legal de trabajo, las licencias de conducir (en la mayoría de los estados) y la protección contra la deportación. (nationaltpsalliance.org)En junio, la intensificación de la lucha #ResidencyNow atrajo una caravana de más de 200 automóviles a D.C. En medio de la rebelión Black Lives Matter y la pandemia de COVID-19, la movilización de verano centró la unidad multinacional de la comunidad Black and Brown TPS y sus contribuciones como trabajadores esenciales.“Queremos ser legalizados”, dijo el activista de Massachusetts Julio Pérez a Workers World. “Hemos estado viviendo legalmente en los EE.UU. durante 20 años o más y no obtuvimos nada, por lo que también simpatizamos con los 12 millones de indocumentados en este país”.Pérez conducirá la ruta de 13.000 millas Journey for Justice II, diseñada por National TPS Alliance, National Day Laborers Organizing Network (NDLON) y Centro American Resource Center (CRECEN). Las 300 horas de conducción le costarán todo su tiempo de vacaciones, más ocho semanas de licencia sin goce de sueldo, incluidas dos en cuarentena, antes de volver a trabajar como conserje en la Universidad de Harvard. Reconociendo la urgencia de proteger a un gran número de miembros, el sindicato de Pérez SEIU 32BJ negoció el tiempo libre.Los trabajadores de TPS ya han pagado sus cuotas a los EE.UU. Elmer Romero, Director de Asociación Estratégica de CRECEN, que se organiza en la comunidad salvadoreña de Houston con más de 36.000 titulares de TPS, explicó a Workers World: “La pandemia de COVID-19 ha demostrado que la comunidad de TPS está compuesto por trabajadores esenciales y necesarios para sostener y servir a la economía de nuestra nación. Es un acto inmoral e inhumano negar un estatus migratorio legal a las personas que nos cuidan y alimentan.”Historias de violenciaLos residentes de EE. UU. son elegibles para TPS, si su país de origen se vuelve inseguro debido a un desastre o violencia. Al igual que la Acción Diferida para los Llegados en la Infancia (DACA), protege temporalmente a los destinatarios de la expulsión. El TPS no es un camino hacia la ciudadanía, aunque muchos beneficiarios tienen más de 20 años de extensiones de 18 meses. Los beneficiarios de TPS tienen 300.000 niños nacidos en EE. UU.La cancelación de TPS por parte de Trump para los diez países actualmente designados: El Salvador, Haití, Honduras, Nepal, Nicaragua, Somalia, Sudán del Sur, Sudán, Siria y Yemen, es racista. Es notorio que etiquetó a estas naciones como “países mierda”, culpando a las víctimas de las condiciones que creó el imperialismo estadounidense.TPS fue una concesión a los activistas salvadoreños de la década de 1980 que huyeron de la dictadura de derecha, que el presidente Reagan estaba financiando con más de $3 millones por día en dólares de hoy. La mayoría de “Tepesiana /os” [TPS] – la palabra que los receptores de habla hispana dan a su estatus – son salvadoreños que llegaron allí después del terremoto de 2001.Las intervenciones de Estados Unidos en Honduras y Nicaragua también intensificaron la devastación del huracán Mitch antes de que esos países fueran designados. Estados Unidos ha impuesto una deuda debilitante a Haití durante siglos. Los detenidos de ICE también son desproporcionadamente haitianos.Ningún desastre es completamente “natural” en países desestabilizados por la intervención de Estados Unidos. El imperialismo estadounidense y británico redujo a Nepal a “uno de los países más pobres del planeta” antes del terremoto de 2015. (Workers World, el 28 de abril 2015) Varios “pretextos. . . encubrir los intereses geoestratégicos y económicos del imperialismo estadounidense” en el Cuerno de África y el Medio Oriente también. (Workers World, el 4 de febrero 2019)Décadas de cambios en las políticas de inmigración reflejan la inestabilidad del capitalismo. Los migrantes mantienen la economía estadounidense en pleno auge cuando los negocios están en auge.Se fomenta la inmigración para escapar de las secuelas de las políticas estadounidenses; el éxodo neutraliza la amenaza que representa la revolución que se desarrolla después de un desastre. En tiempos de inactividad, la clase dominante se desvía en sentido contrario: recortando trabajadores.Muchos líderes sindicales negros y latinos, que están revitalizando el movimiento laboral estadounidense y beneficiando a todos, tienen TPS. Cancelar el TPS destruye a los sindicatos, purga a los líderes para socavar la resistencia al próximo ataque, ya sea el desempleo, el derecho al trabajo o la reapertura insegura. Wall Street es el beneficiario.Viajes transformadoresLa Alianza Nacional TPS se formó inmediatamente después de que la secretaria del Territorio Nacional, Kristjen Nielsen, anunciara la terminación en enero de 2018. En marzo, los activistas presentaron el caso Ramos v. Nielsen en el Tribunal del Noveno Circuito, argumentando que el racismo llevó a un corte de esquina procesal inconstitucional por parte de la administración Trump. Los jueces de la Corte Suprema, a la defensiva durante la rebelión de BLM en junio, admitieron el mismo argumento de los litigantes de DACA, aunque siguen sin camino hacia la residencia permanente. Y Trump atacó de inmediato a DACA nuevamente. Los beneficiarios de TPS aún esperan la decisión del tribunal inferior sobre Ramos.A medida que los ataques inspiran activismo militante, #SaveTPS ha dado paso al llamado global para #ResidencyNow. Doris Reina-Landaverde, una líder nacional de TPS y SEIU como Pérez, un conserje de Harvard en Massachusetts, dijo a Workers World: “No queremos salvar a TPS. Queremos la residencia permanente. Cuando luchamos, es para todos ahora y para todas las personas que vendrán en el futuro. Es lo que necesitamos para nuestras familias. No se trata de salvar, [a la TPS] se trata de luchar.”G. Lechat, Boston, activista de FIRE (Lucha por inmigrantes y refugiados en todas partes), es cofundadora de Harvard TPS Coalition, un esfuerzo conjunto entre los trabajadores de la Universidad de SEIU 32BJ, UNITE HERE Local 26 y AFSCME Local 3650.Gloria Rubac, Houston, activista de FIRE, es una de las fundadoras del Centro de Derechos Humanos del Sur de Texas en Falfurrias, Texas, que trabaja para salvar vidas de migrantes en la frontera entre Estados Unidos y México.FacebookTwitterWhatsAppEmailPrintMoreShare thisFacebookTwitterWhatsAppEmailPrintMoreShare this
Limerick Artist ‘Willzee’ releases new Music Video – “A Dream of Peace” Limerick Ladies National Football League opener to be streamed live Previous articleWoman dies after being hit by train in LimerickNext articleBig drop in some Limerick city bus fares Alan Jacqueshttp://www.limerickpost.ie A TOTAL of 1,478 children and young adults are waiting longer than 12 months for necessary orthodontic treatment in the Mid-West.That’s according to Fianna Fáil TD Willie O’Dea, who claims that hundreds of children in the Mid-West area of the HSE risk a future of dental problems as a result of severe delays in them accessing treatment.Deputy O’Dea was commenting this week after receiving an update from the Oireachtas Health Committee on the number of children and teenagers awaiting treatment following their assessment.Sign up for the weekly Limerick Post newsletter Sign Up “At the end of June 2017, there were 1,478 awaiting treatment over 12 months in the Mid-West, including 36 who have been waiting longer that four years to start treatment,” he told the Limerick Post.“The fact that three out of every four are waiting over a year should act as a serious wake up call for the Minister for Health. We need to bear in mind that the figures released are for children and young adults at Grade IV and V according to the HSE’s own Index of Treatment Need.“They don’t include the many tens of thousands of children and young people who are at Grades I-III who the HSE have made the determination that treatment wasn’t necessary at this time.”O’Dea finds it “inconceivable” that there are over thirty young people waiting longer than four years in the Mid-West for treatment, including 27 at Grade V, the most serious level according to the HSE.“The HSE Service Plan for 2018, based on Budget 2018, needs to reflect the need to ensure that these people get treatment in a far timelier manner. The Government is jeopardising their future dental health and wellbeing by not ensuring they receive treatment far quicker,” he concluded.In a statement to the Limerick Post, the HSE confirmed that from the end of September 2017 there are currently 1,508 patients in active treatment within the orthodontic service in Mid West Community Healthcare (CHO3).“There are currently 187 patients awaiting orthodontic assessment. As per our assessment protocol, 100 per cent of patients are assessed within six months of referral with the majority being assessed within three months of referral,” a spokesman explained.THE HSE maintain that the timely assessment of patients following referral has a number of benefits. These include parents being informed in a timely manner regarding a child’s eligibility for treatment. Pathology, they say, can be detected sooner and more timely intervention is possible. While children who may benefit from growth modification therapy can be identified at the appropriate age for such therapy.“There are currently 1,735 (Grade 4 & Grade 5) patients waiting for treatment, 930 Grade 5 patients and 805 Grade 4 patients. 455 patients are waiting less than 12 months and 1,280 patients are waiting greater than 12 months and of this group 35 patients are waiting greater than four years.“The National Orthodontic Waiting List Initiative in 2017 where Grade 4 patients who had been on a waiting list more than three years were given the opportunity to avail of treatment with a private service provider has been beneficial in reducing the numbers of Grade 4 patients on our waiting list. 181 Grade 4 patients are benefiting from this initiative. This initiative has permitted us to offer greater priority to the more complex Grade 5 patients. Going forward, continued funding for this initiative would be very welcome in addressing our waiting lists.”by Alan [email protected] TAGSFianna FáilHealth Service Executive (HSE)limerickMinister for HealthOireachtas Health Committeeorthodontic treatmentorthodonticsWillie O’Dea TD Predictions on the future of learning discussed at Limerick Lifelong Learning Festival Advertisement Twitter Email WhatsApp Linkedin RELATED ARTICLESMORE FROM AUTHOR Print NewsLocal News1,478 waiting for orthodontic treatment in Mid-WestBy Alan Jacques – October 28, 2017 3196 WATCH: “Everyone is fighting so hard to get on” – Pat Ryan on competitive camogie squads Facebook Limerick’s National Camogie League double header to be streamed live Billy Lee names strong Limerick side to take on Wicklow in crucial Division 3 clash
70% of Cllrs nationwide threatened, harassed and intimidated over past 3 years – Report Hero garda rescues woman from Donegal Town house fire Google+ Facebook WhatsApp Google+ Facebook RELATED ARTICLESMORE FROM AUTHOR Minister McConalogue says he is working to improve fishing quota WhatsApp News Pinterest A Donegal Garda is being hailed a hero after entering a blazing house in Donegal Town and rescuing an unconscious woman.Gardai were alerted to the fire at the house in The Mullins area yesterday afternoon at 4.35pm.They arrived on scene five minuted later to find the house engulfed in flames.A Garda entered the building and removed a woman in her 30’s who had been overcome by smoke.Ambulance crews and the Fire Service arrived at the scene a short time later.The woman was taken to Letterkenny General Hospital for treatment.No one else was in the house at the time of the fire – the scene has been preserved pending an investigation but it is believed the fire started accidentally. By News Highland – October 24, 2012 Pinterest Twitter Man arrested in Derry on suspicion of drugs and criminal property offences released Twitter Dail hears questions over design, funding and operation of Mica redress scheme Previous articleFunding granted to select site for Tory Island helipadNext articleNew Omagh claims reinforce case for public enquiry – Gallagher News Highland Dail to vote later on extending emergency Covid powers HSE warns of ‘widespread cancellations’ of appointments next week
ColumnsDoctors On The Phone – Navigating The Regulatory Waters Of Teleconsultation Pooja Mahajan, Sujoy Bhatia, Deeksha Manchanda & Avni Sriva1 May 2020 5:12 AMShare This – xConsultation with a doctor over the phone is not novel for most of us. Many of us have, at some time or the other, interacted with doctors over phone, WhatsApp and through other such means of communication. The importance of using information and communication technology to provide healthcare services in a country with a population of over 1.3 billion is not lost on policy makers, who…Your free access to Live Law has expiredTo read the article, get a premium account.Your Subscription Supports Independent JournalismSubscription starts from ₹ 599+GST (For 6 Months)View PlansPremium account gives you:Unlimited access to Live Law Archives, Weekly/Monthly Digest, Exclusive Notifications, Comments.Reading experience of Ad Free Version, Petition Copies, Judgement/Order Copies.Subscribe NowAlready a subscriber?LoginConsultation with a doctor over the phone is not novel for most of us. Many of us have, at some time or the other, interacted with doctors over phone, WhatsApp and through other such means of communication. The importance of using information and communication technology to provide healthcare services in a country with a population of over 1.3 billion is not lost on policy makers, who have, now and again, highlighted India’s commitment to adopt digital technology to fulfil its healthcare needs. Now, with challenges posed by COVID-19, the need for greater utilisation and faster adoption of digital communication technology for delivery of healthcare services is felt more than ever. Responding to this need, on 25 March 2020, the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 (“2002 Regulations”) were amended by the Board of Governors (acting in supersession of the Medical Council of India) to explicitly permit teleconsultation by doctors registered under the Indian Medical Council Act, 1956 (“Amendment”). Teleconsultation is a component of telemedicine and as the name suggests, it refers to consultations being provided by doctors through use of information and communication technology (like audio and video devices, chat platforms like WhatsApp and Facebook Messenger or other applications and websites). To give clarity regarding the protocol for such consultations, ‘Telemedicine Practice Guidelines’ (“Guidelines”), prepared in partnership with the NITI Aayog, were also released and included in the 2002 Regulations. In April 2020, the Board of Governors also released certain indicative FAQs based on the Guidelines (“FAQs”). While even prior to COVID-19, the need for greater adoption and use of teleconsultation was undisputed, its legal permissibility was less clear. To make matters worse, a Bombay High Court decision in 2018 casted doubts over the permissibility of prescribing treatment without an in-person consultation. In the absence of any clear guidelines, doctors did not adopt teleconsultation enthusiastically and in most instances, teleconsultations were limited to a rather rudimentary form of family doctors providing consultations to known patients. However, COVID-19 has precipitated action and, policy makers and regulators have now provided much-needed clarity in the form of the Amendment and Guidelines. Taking a cue from this enactment, the regulatory bodies for Homeopathy and Ayurveda, Siddha and Unani practices have also announced their respective Telemedicine Practice Guidelines for Homeopathy, Ayurveda, Siddha and Unani practitioners. Though differing in terminology, the ethos and terms of the Guidelines for all medical practices remains the same. The Dental Council of India, however, is yet to adopt any guidelines, implying that dentists are not explicitly permitted to offer teleconsultations. The nomenclature of the Guidelines (Telemedicine Practice Guidelines), however, is a little misleading. While Telemedicine includes within its ambit delivery of health and health-related services including medical care, provider and patient education, health information services, and self-care via telecommunications and digital communication technologies, the Guidelines are limited to teleconsultations (which is a component of Telemedicine). The Guidelines provide “practical advice to doctors” in “pursuing a sound course of action to provide effective and safe medical care founded on current information, available resources, and patient needs to ensure patient and provider safety.” In addition, the Guidelines also provide limited “practical advice” for technology platforms enabling teleconsultation, i.e., the intermediaries. We briefly explore the 2002 Regulations and the Guidelines and their impact on three key players viz. the doctor, the intermediary and the patient. Doctors – additional protocols to be followed The Guidelines contain, as promised, some helpful practical advice, laying out some procedural protocols for the doctors to fulfil. Some of these have been discussed here. Eliminate anonymity: As the patient-doctor interaction transcends through new modes of interaction, it also gives rise to differing levels of accountability for doctors. The first step towards ensuring such accountability is to eliminate anonymity and to this end, the Guidelines require that the doctors and the patients verify, albeit electronically, each other’s identity and credentials, including the registration details of a doctor. Initiation of teleconsultation and its impact on the restriction on solicitation: As per the Guidelines, a teleconsultation can be “initiated” by a patient, a doctor, a caregiver of a patient, or a health worker. The Guidelines also cover any consultation between two or more doctors. Consent of a patient has been given paramount importance and the doctor is required to ensure that the patient has consented to teleconsultation. The doctor is, in fact, not permitted to continue teleconsultation if the patient insists on an in-person consult. The Guidelines also recognise differentiated consent requirements. For situations where a patient initiates the consultation, the consent is implied, while for situations where a doctor, a caregiver of the patient (for instance, a family member), or a health worker (for instance, a nurse), initiates teleconsultation, explicit consent of the patient is required. The Guidelines also prescribe the procedure for follow-up consultations, which are defined to include consultation for the same condition. While the Guidelines provide very detailed guidance on some issues, they fail to clarify the contours of teleconsultation being initiated by the doctor. Existing regulations and the Guidelines prohibit solicitation and advertisements by doctors. Initiation of teleconsultation by a doctor is likely to be at odds with this prohibition and it may be seen as solicitation in certain circumstances. It is likely that initiation of a follow-on consultation with an existing patient would be permissible. It is also equally obvious that doctors should not be able to call up patients at random, to check if they are in need of a teleconsultation. However, in certain other situations, initiation of teleconsultation by a doctor without an explicit request from a patient may create confusion and uncertainty. For instance, can a doctor, without a request from an existing patient, initiate teleconsultation, if such patient usually comes every month for a walk-in consultation? More clarity on what initiation by a doctor implies, and circumstances in which it would be seen as solicitation would reduce apprehensions for doctors in initiating a teleconsultation. Protocol for prescriptions and the enigma of e-Prescription: The Guidelines provide three distinct lists of medicines that can be prescribed through teleconsultation. The first list or List O, includes Over-the-Counter drugs such as paracetamol, lozenges, common-cold medicines etc., which can be prescribed through any teleconsultation. The second list or List A is restricted to medicines which can be prescribed only where the teleconsultation is provided through video mode. This includes ointments for skin ailments, ear drops, and follow-up medication for re-fill in case of chronic illness such as, hypertension or diabetes. Such re-fill is permitted for a maximum period of 6 months after which an in-person visit is mandatory. The third list or List B is applicable for follow-up add-on medications, i.e., additional medications to optimize management for chronic illness such as, hypertension or diabetes. The Guidelines specifically prohibit prescription of any drugs included in Schedule X of the Drugs and Cosmetics Act, 1940 and narcotic and psychotropic substances listed in the Narcotic Drugs and Psychotropic Substances Act, 1985. For AYUSH practitioners, the only restriction applicable is a prohibition on prescribing narcotic and psychotropic substances. With consultation moving to an online platform, the Guidelines also lay down the procedure for issuing and transmitting such prescription (including directly to a pharmacy or a laboratory), with patient’s consent). The doctor can provide a photo, scan, a digital copy of a signed prescription or an ‘e-Prescription’ to the patient via email or any messaging platform. Currently, the legal framework, including the Pharmacy Practice Regulations require that a prescription should be signed. This creates some ambiguity on the meaning of an e-Prescription. For instance, would an image of a handwritten signature or signature with an electronic pen on an electronically generated prescription suffice? Currently, the only form of digital and electronic signatures legally acceptable in India are those which are in conformity with the requirements under the Information Technology Act, 2000 (“IT Act”). The FAQs also indicate that a digital signature would be necessary and as such, a scan of a handwritten signature or a signature made with an electronic pen may not suffice as e-Prescription. Since, the requirements under the IT Act are fairly cumbersome, and are typically used for making certain filings with government authorities, all doctors may not have or end up using digital and electronic signatures. The uncertainties may effectively eliminate the e-Prescription option, requiring doctors to share either scans or photos of hand-signed prescriptions. Clarity on what can be considered as a valid e-Prescription would be very helpful to make the process of teleconsultation more seamless. Doctor’s standard of care: The doctor’s standard of care towards the patient does not change while advising through teleconsultation, hence, the doctor is also required to uphold the “same professional and ethical norms and standards as applicable to traditional in-person care.” This also implies that the doctor has the responsibility to determine whether effective consultation can be rendered through teleconsultation. Where in the professional judgment of the doctor, teleconsultation is not appropriate, the Guidelines require them to refuse and terminate teleconsultations. However, it is unclear how such professional judgment would be assessed in claims of malpractice or negligence initiated under the Consumer Protection Act, 1986 and other applicable statutes against the doctor providing teleconsultation. In such cases, Courts and regulatory bodies may use well established principles and place reliance on independent expert testimony, where required. Online training for doctors: In a welcome initiative, to acquaint the doctors with the standard operating procedures of teleconsultation along with its limitations, the regulatory bodies for different branches of medicines are in process of developing an online course. Once developed, completion of this program within three years from the date of its introduction will be mandatory for a doctor to continue providing teleconsultation. Impact on cross-border healthcare: The Guidelines have bridged the geographical distance between a patient and a doctor. However, the geographical limit of the applicability of the Guidelines itself is restricted to India. This has an impact on cross-border healthcare which is left in a regulatory black hole. This not only covers a simple everyday situation where an Indian resident patient happens to be outside the country, and wants a consultation with a trusted, known Indian doctor through teleconsultation but also, on medical opinions obtained by Indian doctors from foreign doctors. Intermediaries – Navigating the troubled waters Guidelines for the intermediaries: Unlike the traditional practice of medicine, teleconsultation also involves the intermediary i.e., a technology platform which facilitates the communication between the patient and the doctor(s). Such a platform would facilitate the transmission of messages and communication, exchange of data and patient information and may also provide for the transfer and disbursement of money for such consultation. The Guidelines provide that they specifically cover those technology platforms which work across a network of doctors and enable patients to consult with them through the platform. The Guidelines state that the intermediaries are “obligated” to ensure that patients interact only with doctors who are registered with the applicable regulatory bodies viz., the Indian Medical Council for doctors practicing western medicine, the Central Council of Homeopathy Medicine for doctors practicing homeopathy and the Central Council of Indian Medicine in case of doctors practicing Ayurveda, Siddha and Unani. In addition to this, intermediaries are also required to conduct their “due diligence” before listing a doctor on their platform. The intermediaries are also obligated to inform the relevant regulatory bodies if any non-compliance by the doctors is “noted”. The Guidelines require the intermediaries to ensure that patients have a mechanism for grievance redressal. The Guidelines also prohibit use of artificial technology for providing teleconsultations as only doctors can provide teleconsultations. Need for clarity on scope of intermediaries covered by the Guidelines: The requirements laid down for an intermediary make absolute sense when one thinks from the perspective of an intermediary providing specific teleconsultation services for a doctor and a patient such as, Practo. However, the regulatory landscape and obligations on the intermediaries get murkier if one starts thinking of teleconsultation provided through platforms such as WhatsApp, Google Hangouts or Zoom. These platforms are generic in nature and cater to various kinds of communication. The Guidelines may lead to an absurd scenario where Google, WhatsApp or Zoom would need to start complying with obligations such as, ensuring that only registered doctors are using the platforms, verifying their registration details and conducting due diligence on them. While the Guidelines do state that they “specifically covers (sic) those technology platforms which work across a network” of doctors and enable patients to consult with them through the platform, the implication of “work across a network” is not clear. The FAQs also provide no guidance in this regard. Greater clarity in the Guidelines, limiting their applicability to specialised intermediaries would have avoided such stringent requirements which are near impossible for generic intermediaries to comply with. Non-compliance by doctors, uncertainty for intermediaries: The intermediary is required to inform the concerned regulatory body if any non-compliance by doctors is “noted” by the intermediary. Interestingly under the IT Act and the Information Technology (Intermediaries Guidelines) Rules, 2011 (“Intermediary Guidelines”), the obligation to take action against illegal conduct is placed on the intermediary only when it receives “actual knowledge” of such conduct. Judicial decisions have provided some meaning to the trigger of “actual knowledge” for different intermediaries, however the word “noted” is bereft of any guidance. It is hence, not clear if this requires constant active monitoring by the intermediary (which may impinge a doctor-patient confidentiality) or, whether it implies non-compliance being brought to the specific notice of the intermediary by the users of their platform. A clarification in this regard would be very helpful for the intermediaries. The obligation on the intermediary to inform the regulatory bodies of any non-compliance coupled with the obligation to ensure that patients have mechanism for grievance redressal on the platform, may also lead to a situation where the intermediary receives complaints of various nature – ranging from misconduct to medical negligence. There is no guidance in the Guidelines or the FAQs on the nature of non-compliance that the intermediary is required to report. It is also unclear if this would include complaints of medical negligence, which may require an understanding of the field of medicine which most intermediaries may not have. Absent the same, regulatory bodies may find themselves flooded with various frivolous complaints that the intermediaries will, to comply with their obligations, forward to them. Elaborating on the scope of the non-compliance that would require action by the intermediary would greatly assist in ensuring compliance. Since for cases of medical negligence in teleconsultation the patient will continue to have recourse to legal actions before courts, it may be worthwhile to exclude, complaints regarding the adequacy, appropriateness or sufficiency of the teleconsultation, from the scope of non-compliances that requires action by the intermediary. Patients – convenience v. caution For patients, the permissibility of teleconsultation would provide increased and more convenient access to healthcare. It will also be highly useful in cases of emergencies where a doctor may guide a caregiver or a patient to take some immediate first aid-steps till such time in-person care can be provided. A patient’s rights in teleconsultation: While opting for a teleconsultation, a patient needs to be mindful of her rights. Teleconsultation may lead to increased incidents of fraud. The Guidelines require adequate identification of the doctor along with the registration number. Where patients opt for teleconsultation with an unknown doctor, they should take care to verify details. Since patient’s consent is necessary for any teleconsultation as such, success of teleconsultation depends on how successfully patients can overcome the barrier of trusting a doctor over a phone or a video call. One factor that may help build a patient’s trust is that, they will have recourse to the same legal mechanism that is available in cases of medical negligence on account of an-in person consult. The Guidelines also give doctors the prerogative to terminate the teleconsultation if in their professional judgement it would not be sufficient and appropriate. Patients would be well-advised to heed to the doctor and not insist on teleconsultation if it’s not considered appropriate by the doctor. Usage of prescriptions: The Guidelines and the FAQs also provide some very helpful clarifications for patients regarding prescriptions. While there are potentially some limitations on the use of e-Prescriptions, as discussed earlier, it is clear that patients would be able to use scanned copies or photos of prescriptions and these would have to be honoured by the pharmacies and laboratories. They can also ask their doctor to directly send the prescription to the pharmacies and laboratories. This is a significant step in encouraging use of technology in healthcare. Implications for data protection: Another issue that arises for patients, is the protection of their personal data, that will inevitably be shared through the intermediaries. Currently, a bare structure of protection is provided through the Information Technology (Reasonable security practices and procedures and sensitive personal data or information) Rules, 2011. A more wholistic data protection regime is likely to inspire more confidence in patients about adequate safeguards for their personal data. This may lead to greater adoption of telecommunication, especially among those patients who are protective about their personal data. The draft Personal Data Protection Bill, 2019 is currently being considered by the Joint Parliament Committee. Given the pendency of the Bill, the proposed Digital Information Security in Healthcare Act (DISHA), by the Ministry of Health and Family Welfare has been put on hold. Adequate protection for health data in the draft Personal Data Protection Bill, 2019 and eventual passage of DISHA may provide a more wholistic regime for protection and governance of health data. Regulators – Welcome step with a need for dynamic action With the exigencies created due to COVID-19 and the practical advice provided by the Guidelines one can hope for faster adoption of teleconsultation by doctors and patients. Regulatory authorities can assist this by addressing some of the lacunae in the Guidelines identified in the article. Once a concrete patient-doctor relationship gets established based on the path set out by the Guidelines and the prevalence of the same increases, more legal and procedural lacunae are likely to surface. It is imperative for the authorities to continue addressing such voids through additional guidance or clarifications to create a robust telemedicine framework.Views Are Personal Only (Pooja and Sujoy are partners at Chandhiok & Mahajan, Deeksha is a counsel and Avni is an associate) Next Story
Pinterest Previous articleIncrease in Donegal residents choosing to work within the countyNext articleCalls for harmonisation of postal charges across Ireland News Highland Strabane based firm reveals plans to double workforce Facebook Twitter WhatsApp Important message for people attending LUH’s INR clinic Arranmore progress and potential flagged as population grows Strabane-based Fabplus is planning to more than double its workforce and turnover with support from Invest Northern Ireland, as part of a £7 million investment.The investment is part of a three year expansion plan to increase the firms market share in the Republic of Ireland and Great Britain, and gain a foothold in mainland Europe and Scandinavia.Recruitment is currently underway to employ 83 additional staff at the business, including management roles and 70 new production staff and will included expanding factory space.West Tyrone MLA Michaela Boyle has welcomed today’s announcement and is hopeful employment developments in Strabane can continue:Audio Playerhttp://www.highlandradio.com/wp-content/uploads/2017/12/boyle5pm.mp300:0000:0000:00Use Up/Down Arrow keys to increase or decrease volume. Homepage BannerNews Twitter Facebook Pinterest By News Highland – December 12, 2017 Google+ Google+ Loganair’s new Derry – Liverpool air service takes off from CODA RELATED ARTICLESMORE FROM AUTHOR News, Sport and Obituaries on Monday May 24th WhatsApp DL Debate – 24/05/21 Nine til Noon Show – Listen back to Monday’s Programme
Google+ Previous articleToday marks one year since Covid-19 restrictions were imposed in IrelandNext articleEuropeans could be key for Sam and Chloe Magee News Highland Loganair’s new Derry – Liverpool air service takes off from CODA Facebook Important message for people attending LUH’s INR clinic By News Highland – March 12, 2021 Pinterest Twitter FT Report: Derry City 2 St Pats 2 DL Debate – 24/05/21 Facebook Google+ Pinterest Government under fire again for slow rollout of NBP in Donegal Twitter RELATED ARTICLESMORE FROM AUTHOR WhatsApp News, Sport and Obituaries on Monday May 24th AudioHomepage BannerNews The Government has been criticised once again for the slow rollout of the National Broadband Plan in Donegal.Donegal Deputy Thomas Pringle told Minister Eamon Ryan this week that the county cannot remain ‘the forgotten county’ in broadband rollout.Latest figures reveal that just 4,042 of 178,000 premises in Donegal have been surveyed as part of the initiative.Speaking in the Dail, Deputy Pringle accused Minister Ryan and his Department of not doing their job:Audio Playerhttps://www.highlandradio.com/wp-content/uploads/2021/03/pringlebroadbandlong.mp300:0000:0000:00Use Up/Down Arrow keys to increase or decrease volume. Arranmore progress and potential flagged as population grows WhatsApp
ABC News(NEW YORK) — Over half a million people are in the dark across New England Thursday morning after a powerful Nor’easter struck overnight, bringing heavy rain, flooding and violent winds. In the coastal Massachusetts town of Duxbury, Fire Capt. Rob Reardon told ABC News, “This whole town got hit pretty hard. You can tell by just the amount of trees, the wires, the damage to houses.”“Roads are blocked, schools are shut down because school buses can’t access these streets at all,” Reardon said. “We’re having a difficult time trying to get to calls from one side of town to the other.” “Luckily no injuries,” he added.Over 500,000 customers were without power early Thursday across five states: Massachusetts, Maine, Connecticut, New Hampshire and Rhode Island.As the Nor’easter hammered the New England coast Wednesday night, the pounding wind gusts reached 90 mph on Cape Cod in Provincetown, and 70 mph in Boston.On Long Island, winds gusted up to 54 mph and in Greenwich, Connecticut, winds reached 52 mph.The most rainfall struck upstate New York, where some areas north of Albany saw up to 5 inches. New London, Connecticut, saw 3 to 4 inches of rain, stranding people in cars. One person had to be rescued from a basement apartment, firefighters said.The heaviest rain has left Washington, D.C., New York City and Boston, and is now hitting northern New York state and northern New England. But strong wind gusts will be a major threat to D.C., New York City and Boston Thursday with winds forecast to reach more than 50 mph. Northern New York and into Maine could see up to 3 more inches of rain Thursday. Flooding is possible in northern New England Thursday morning and early afternoon.Copyright © 2019, ABC Audio. All rights reserved.
KGO-TV(SAN FRANCISCO) — The man who allegedly stabbed two elderly Asian women in San Francisco earlier this week is now facing multiple charges, including premeditated attempted murder, prosecutors announced Thursday.Patrick Thompson, 54, was charged with two counts of premeditated attempted murder and two counts of elder abuse, with enhancements for great bodily injury, great bodily injury on elders and personal use of a deadly weapon, in the “brutal” knife attack, San Francisco District Attorney Chesa Boudin said.The district attorney’s office said it is still working with police to determine if any additional charges should be brought forth, including any evidence to support hate crime allegations.The women, ages 84 and 63, were stabbed shortly before 5 p.m. Tuesday, San Francisco police said.Both victims were hospitalized. The 84-year-old’s injuries were at first considered life-threatening; she’s since been upgraded to non-life-threatening condition, police said. The 63-year-old’s injuries are non-life-threatening, police said. One victim was stabbed in the lungs, and a knife had to be removed from the second at the hospital, according to the district attorney’s office.The district attorney is not releasing the victims’ names.Thompson was taken into custody about two hours after the incident and booked on two charges of attempted murder and elder abuse, police said. It is unclear if he has an attorney.In 2017, a judge found Thompson incompetent to stand trial during court proceedings for several cases, according to the district attorney’s office. He was transferred to Napa State Hospital and then, after returning to custody, started participating in a state mental health diversion program in October 2018, the office said. A judge granted a motion for him to leave the program after nearly two years, during which time he was not charged with any new offenses, though he was arrested for missing court and for possessing a drug pipe, the office said.“What happened is a devastating tragedy, and we will use the full force of our office’s resources to prosecute this case. We also need to work hard to stop the next crime from happening, and that involves prevention and treatment,” Boudin’s office said in a statement. “We need far more intensive tools that keep people who are mentally ill treated and supported so that they do not reoffend even when there is no pending criminal case.”The stabbing was the latest in a spate of violence against Asian Americans across the nation. The coronavirus pandemic and its suspected origins in the Chinese city of Wuhan are cited as leading to the tide of anti-Asian discrimination.There were more than 6,600 hate incidents against Asians and Pacific Islanders reported to Stop AAPI Hate, a nonprofit organization that tracks such incidents, between mid-March 2020 when the pandemic began and March 31, 2021. About 40% of the incidents were reported in California.Copyright © 2021, ABC Audio. All rights reserved.