Rights and obligations

When you visit OLVG you will have to deal with several employees. You can expect expert treatment and proper care. That is our obligation and your right. What other rights do you have as a patient? What rights and obligations does OLVG have? And what can we expect from you? 

The rights and obligations of the patient are laid down in law. In addition to rights and obligations, trust between the patient and the care provider is also, of course, important. Good cooperation between you and an employee is necessary so that we can treat you as well as possible.

Rights

Your rights

As a patient you have a right to:

• expert treatment
• information
• privacy
• professional secrecy and duty of confidentiality
• that we request your permission for your treatment
• giving permission for your treatment
• different rights with regard to your medical records
• a second opinion

Expert treatment
OLVG will make every effort to ensure that you receive expert treatment and proper care.

Information
You must have received all relevant information before your examination or treatment. You will receive oral, and possibly written, information about the nature, purpose and risks of an examination or treatment and also about any alternative options. It is important for you and your healthcare provider to exchange complete and correct information. If you need more information because, for example, you have not understood something, tell your care provider. Alternatively, if you do not want information, you can also indicate this. The care provider will accept this request if this does not have any adverse consequences for you or others.

Privacy
Everyone at OLVG has a right to privacy. This applies to patients, their loved ones, healthcare providers and other employees. As a patient, you have the right to the protection of your privacy, and your private life. At OLVG, all data necessary for your treatment is recorded and is stored in accordance with the legal time frame. Your privacy is protected in accordance with applicable laws and regulations.

Professional secrecy/duty of confidentiality 
The doctors, nurses and other employees at OLVG are bound by professional secrecy and must comply with their duty of confidentiality. The hospital may not provide any information about you to people or agencies that are not involved in your treatment without your permission. Your permission is also required to provide information about you to, for example, close relatives such as your partner, children, parents*, carers and/or legal representatives.

*parent(s) = the person/people who has/have legal authority

There are a few exceptions - established by law - whereby information is provided to third parties without your permission. For example, OLVG is required to report some infectious diseases to the Municipal Health Service (gemeentelijke gezondheidsdienst, GGD) so that measures can be taken quickly to prevent the spread of these diseases. OLVG may also provide certain information without your permission if the health insurer requests it. For example, information that is needed to authorise treatment or to check the treatment bill. The determination of this information is bound by laws and regulations.

Sometimes your examination and/or treatment at the hospital forms part of a broader treatment or process, which also involves other doctors, such as your GP. If this is the case for you, the doctor treating you at OLVG will keep the other healthcare providers informed. Your GP will receive a medical letter, unless you object to this. Other specialists who are treating you, within and/or outside OLVG, will then receive a copy.

Permission for treatment
Your permission is required for examination and treatment. In an emergency, if consultation is not possible and immediate medical action is necessary, the care provider may act without your permission. For example instances in which someone is unconscious as a result of a car accident and immediate medical intervention is necessary. If possible, the practitioner will consult with your representative if you are not able to communicate.

Refusal or withdrawal of permission
You can refuse examination or treatment. The doctor will respect your decision and, in general, cannot force you to receive specific treatment. He/she will, however, discuss the possible consequences of your decision with you.
If you want to withdraw permission that you have previously given, let your doctor know as soon as possible. You can then discuss the best course of action in your situation together.

As far as healthcare is concerned, people from the age of 16 can decide on their treatment themselves. This is laid down in the Medical Treatment Agreement Act (Wet op de Geneeskundige Behandelovereenkomst, WGBO). The rights of parents and children depend on the age of the child.

Medical records
For proper (medical) treatment, all kinds of personal information about you must be collected: address details, the state of your health, results of examinations, diagnosis and treatment plans. These are recorded in your medical records. You have various rights with regard to your medical records. 

Second opinion
A second opinion means the opinion or advice of a medical specialist other than the doctor treating you. This expert will give his/her opinion at your request, but he/she will not take over the treatment.

You can, for example, request a second opinion if you are faced with an important decision regarding treatment or if you have doubts about a diagnosis or treatment. It is wise to discuss the doubt with the GP or doctor treating you. They can, if you wish, help refer you to another expert.

Ask your health insurer about the conditions of a reimbursement before you request a second opinion. If the health insurer does not accept the costs of a second opinion, you will need to pay these costs yourself.

Your obligations

Obligations

• Identification
• Cooperation
• Complete information
• Photos, film images and sound recordings
• House rules
• Payment

Identification

In the Netherlands, it is a legal requirement for hospital patients to identify themselves. During your visit to OLVG, we may ask you for a legally recognised, valid proof of identity on which your Dutch Social Security Number (BSN) is indicated, such as passport, driver's licence or identity card (for Dutch citizens). Registering a child in the parents' passport is no longer possible. Children therefore also need valid proof of identity. The identification obligation applies to every visit to the hospital.

Cooperation
As a patient, you have an obligation to cooperate in the treatment that you have agreed to. This means, for example, your cooperation in following the healthcare provider's advice as closely as possible.

Complete information
The care provider may expect you to clearly and fully inform him/her during examination(s) and during your treatment about important matters related to your illness or treatment. The better informed the care provider is, the better he/she will be able to treat you.

Photos, film images or sound recordings
Due to privacy rules, taking photos, film images or making sound recordings is not permitted at OLVG without permission. This applies to public spaces, as well as to the treatment rooms and the nursing ward. Would you like to take photos or record a conversation with a practitioner to be able to listen to this later? Then discuss this in advance and request permission.

House rules
We think it is important that everyone feels comfortable at OLVG. It is therefore necessary to agree clear ground rules with each other. When you enter our hospital, we ask that you follow our house rules. Decency and mutual respect form the basis of the contact between hospital staff, patients, their loved ones and visitors. At OLVG, there is no place for derogatory or discriminatory comments, aggressive behaviour or other forms of threat. If a patient violates the house rules, this may be a reason for the healthcare provider to cancel the treatment agreement.

Payment
OLVG is entitled to payment for the treatment and care provided. If you use the hospital's medical services, you are liable for the payment of the costs incurred.
We try to arrange this in such a way that minimises the amount to which you need to worry about it. However, it is important that you ask your own health insurer about possible reimbursement. We need your health insurance details for this. You must therefore take these with you when you visit the hospital.

Privacy

You have the right to be examined and treated outside other people's field of vision. You can also ask to have a conversation with the doctor treating you in a separate room. In the interest of your treatment, the hospital records all kinds of medical and administrative information about you. Only the doctor(s) treating you and OLVG employees who are involved in your treatment will have access to this data. They are required to keep this information confidential. Internal measures will be taken if these rules are broken. The privacy statement for OLVG patients indicates how OLVG will handle your personal data.

Everyone at OLVG has the right to privacy, both patients and employees. This is why taking photos, film images or sound recordings without permission is prohibited. This applies to public spaces, as well as to the treatment rooms and the nursing ward. If you would like to take photos or record a conversation with a practitioner to be able to listen to this later, discuss this in advance and request permission.

Medical records

At OLVG, we register all the information that is required for your treatment in your medical records. The file contains: your personal data, notes about the state of your health, data relating to examinations and treatments performed, the findings of the doctor treating you, other doctors involved, nurses and other care providers involved in your examinations and treatments.

Your medical records are not your property, they must remain at OLVG. Your file will be saved for the period stipulated by law. Your file will be treated confidentially according to the legal regulations. Only employees at the hospital who are authorised to do so may request certain information.

All doctors, nurses and other support staff, such as assistants and secretaries, must comply with professional secrecy obligations. The right to view your own data, or to receive a copy of it, is laid down in the law.

View or copy of medical records
You have the right to inspect and obtain a copy of your medical records. People other than you, for example your family, are only entitled to view or obtain copies of your medical records if you have authorised them to do/have this. For patients younger than 12 years of age, the parents have the right to inspect and be provided with copies of medical records. Children from 12 to 16 years of age require permission from both the parent and the child. Parents need the child's permission if they want to view the file or receive copies if their children are aged between 16 and 18.

Because a patient's privacy must also be protected after his/her death, family members or third parties may not necessarily be automatically granted access to a deceased individual's records. There are some exceptions, such as cases in which the deceased's consent can be assumed, or if certain data is of great importance to third parties (for example, data about a hereditary disease).

Correcting the medical records
You have the right to supplement, correct or delete personal data. If you believe that your medical records are incorrect or incomplete on certain points, you can ask the doctor treating you to add a statement with your views to your medical record. You can also submit a request to have (parts of) the medical record
deleted. If there are no legal and/or medical objections, your request will be granted.

Electronic Patient File
We record your medical and nursing data in an electronic patient file (elektronisch patiëntendossier, EPD). OLVG works continuously to provide safe and optimal patient care. All medical, nursing and other data about care is therefore in one file. The practitioner(s) concerned can view your data on the computer.
OLVG is constantly working on providing safe, optimum patient care. All medical, nursing and other care-related data has therefore been brought together in one file. This might include, for example, your specialist's diagnosis, nursing data regarding an admission to hospital, laboratory results, medical data or your physiotherapist's report. The data can be viewed by everyone involved in the provision of care so that they can see a complete picture of you. This reduces the chance of mistakes being made.

The Electronic Patient File is well protected against unauthorised access and is therefore in compliance with the applicable laws and regulations. At OLVG, access is only possible using login codes. The hospital has drawn up rules establishing which healthcare providers are allowed to view what parts of your data. The guiding principle here is that access is only permitted to the extent that this is necessary for the provision of care. Internal measures will be taken if these rules are broken.

Medical scientific research

Scientific research improves the care, knowledge and skills of doctors and nurses. You, generally speaking, will derive no immediate personal benefit from this research. The benefit is, primarily, to improve care for future patients. Medical scientific research takes place at OLVG. The goal is:

• to find better treatments for diseases
• to find out more about a disease
• to detect diseases more effectively.

Both the doctors and OLVG's board of directors closely monitor that medical scientific research takes place in a responsible manner. There are different types of research:

• research involving human participants (test subjects)
• research with medical data and/or with bodily material.

Medical scientific research involving human participants (test subjects)
Any department may ask you to participate. Data that the researcher collects about you during the investigation will remain confidential. You can, of course, always say no. This will have no impact on your treatment. If you do want to participate, you will receive detailed information about the investigation and you will sign a consent form. Your signature indicates that you voluntarily agree to cooperate in the research. You can always say no during the research. This will have no impact on your treatment.
The Medical Research Involving Human Subjects Act (Wet medisch-wetenschappelijk onderzoek met mensen) stipulates the conditions under which medical research can take place when human participants are involved. Before a study can be initiated, it is tested by a recognised medical ethics review committee. The board of directors ultimately decides whether the investigation can be conducted at OLVG.

Medical scientific research using medical data and/or bodily material
In addition to medical scientific research, status or records research is also done. These are examinations based on different patient records. It is common for the medical data and/or bodily material collected to be analysed in this context. Your personal information cannot be traced. This research must also meet strict conditions. Your permission does not always have to be separately requested for this type of research because, as your personal data cannot be traced, it is assumed that you would have no objection to this.
If you do object to the use of the medical data collected about you and/or your bodily material for scientific research, you can indicate this to the doctor treating you or the department where you are being treated. Your data will then not be used.

General

Terms and Conditions
The General Treatment Conditions apply to all treatment contracts and other legal relationships between OLVG and the patient.

Rights of parents and children
In healthcare, people 16 years old or older can make their own decisions about their treatment. This is established in the Medical Treatment Contracts Act (Wet op de Geneeskundige Behandelovereenkomst). The rights parents have vis-à-vis their children depends on the child's age. A treatment contract can be entered into independently from the age of 16. If the patient is younger than 16, the following rules apply:

• Patients younger than 12 years old are represented by their parents. The doctor shall inform the parents about the treatment or examination that their child will undergo. The parents must give their permission. The doctor shall inform the child at the child's level of understanding.
• Patients who are between the ages of 12 and 16 enter into the treatment contract together with their parents. The doctor must inform both the patient and the parent and ask for permission.

Parents have the right to inspect the medical records and to have a copy of them if their children are under 12 years old. Both the permission of the child and the parents is required to view and provide copies of data on children aged between 12 and 16 years old. People from the ages of 16 to 18 must give their permission to allow their family members (including their parents) and others to view and/or receive a copy of their file. Depending on the parent's insurance policy under which the child is co-insured until the age of 18, a personal contribution may be due or it's possible that not all treatments will be insured.

Representation
If you are unable to represent your own interests due to your physical or mental condition, someone else can represent you - if you are unconscious, for example. These cases are generally referred to as cases of (temporary) incapacity.

Who decides? Incapacity
Someone is capable until the contrary is true. You can't just decide that someone is incapacitated. The doctor is the first individual to determine whether or not a patient is capable of making a specific decision regarding their care or treatment. He/she does this together with other practitioners. Family members or other people involved in the patient's life can also give their opinion. In general, a person is incapacitated if he/she cannot understand the information about his/her illness at that time. If this is the case, he/she cannot make a proper decision about the treatment and cannot assess the possible consequences.

If you are deemed to be incapacitated, the doctor must inform your representative about the condition of your health and ask for permission for the treatment or examination to be conducted. If a trustee or mentor has been appointed, they will be the first in line to be considered as your representative. If you have authorised someone in writing to act on your behalf with regard to decisions concerning your treatment (if you are no longer able to do so) this individual will be the one that will be designated if no trustee or mentor has been appointed. If no written authorisation exists, your partner will be your representative. If you do not have a partner, your parents, children, brother or sister will act as the representative. In the latter case, your family will decide who is appointed as the representative.

A Living Will
You can record how you want to be treated if you become incapacitated in a written statement. This statement must have been prepared by you, voluntarily, at a time when you were of sound mind. The statement concerns specific, clearly defined disease(s) and/or a specific treatment request. In general, a doctor must act according to this statement. However, the doctor may derogate from what is stated in the statement if there are reasonable grounds for this. For example, the doctor may not be convinced of the validity and/or applicability of the statement. The doctor will act to the best of his knowledge when urgent action is required and there is no time to check whether such a declaration exists, or to analyse its contents properly. Do you have a living will? Then report this to the doctor treating you.

It is important that you discuss the contents of your living will with him/her when you are still of sound mind, so that he/she is aware of your wishes. It is also important that you inform your loved ones (partner and family) about the living will. An example of a declaration that might appear in a living will is statement indicating that you do not want to be resuscitated.

Research by a 'co-assistent' or a doctor in training to become a specialist
At OLVG, people are training in various departments and in various specialties to become a nurse, specialised nurse, doctor or specialist. It is possible that, during your treatment or examination, you will have to deal with apprentices, students, assistants or doctors in training to become specialists. This individual will always discuss the results with the medical specialist responsible.
If you have objections to examination by a 'co-assistent' or a doctor in training to be a specialist, please make this known.

Complaint, compliment or comment?
Have you experienced something that made you (un)satisfied with your treatment at OLVG? Or do you have a comment that you think would help us to improve healthcare? We would love to hear it! 

OLVG Patient Council
The Patient Council advises OLVG's board about matters of interest to patients such as care provision, accessibility and treatment, but also on organisational and financial matters. The aim is to improve the quality and safety of care and services. The Patient Council does not deal with individual complaints - that's what the complaints officer is for - but it does advise on the handling of complaints in general.