The proposal was prepared in cooperation with the Ministry of Health and Population in 2014 and stresses the basic conditions for ensuring the formation of a council that will achieve a radical and sustainable reform of the governance of the health care system.

The Egyptian Initiative for Personal Rights re-publishes the proposal submitted to the Cabinet, which was prepared in cooperation with the Ministry of Health and Population in 2014 and affirms the basic conditions for ensuring the formation of a council that achieves radical and sustainable reform of the governance of the health care system. In response to the Prime Minister’s directives for the establishment of a higher health council, and the comments submitted by the Doctors ’Syndicate. EIPR re-publishes the proposal submitted to the cabinet, which was prepared in cooperation with the Ministry of Health and Population in 2014.

A Collaborative Proposal Presented to the Cabinet in 2014

In 2014, the Egyptian Initiative for Personal Rights presented a proposal to the government to reconstitute the High Council for Health, developing and activating the High Council for Health Services established by Presidential Decree No. 61 of 1966 and its amendments No. 81 of 1978 and 1993. This proposal came on the basis of the urgent need to reform the health care system by establishing an effective and sustainable entity to govern the health care sector in the country, and  actualize strategic policies aimed at achieving justice and efficiency in health care for all Egyptians without discrimination, and to achieve citizen participation in setting health policies and to monitor their implementation with transparency and integrity.

This proposal is the culmination of work that began several years ago by a variety of experts, specialists and representatives of civil society and executives from the health sector leaders, and based on their agreement on the importance and centrality of this new formation of a higher health council that defines the approach to reform and sets priorities, draws plans, evaluates and follows up with their implementation through real community participation mechanisms and appropriate powers that ensure that the goals of equity and health efficiency are achieved in a concrete and transparent manner.

This proposal was presented in its latest version and explanatory note after 22 reviews by the Ministry of Health and Population under the leadership of Prof. Dr. Maha al-Rabatt, civil society organizations, syndicates, experts in health care governance, and others, and was presented to the cabinet at that time without a decision being taken.

Participatory Council to Set Strategies

This proposal comes as an update of the current council, which has become a marginal entity with no function or influential powers, as practical experience has shown that the current council, whose membership was restricted to representatives of the executive bodies of the government and its function was limited to coordination between them. It did not play its expected role and did not achieve any goals, and that its dependence on the Ministry of Health has limited its role to providing some non-binding recommendations to the Ministry, in addition to being subject to its directions.

In its proposal, EIPR envisions the Council to become an independent legal entity whose president is elected from members who are not working with the state executive, and to turn it into a space of expertise and representation of all those involved in health policies, and that its main role be setting policies for the health sector as a whole, and strategies for every five or ten years. EIPR proposes that the council includes a diverse group of individuals based on their professional competencies, representing the various active and concerned sectors, and beneficiaries of health services in Egypt.

And based on the powers granted to it, this council should have the authority and responsibility to follow-up and assess the extent to which the executive agencies have achieved, foremost among them  the Ministry of Health, according to agreed timetables. Thus, the state's health policies and strategies are far from cabinet changes and political fluctuations. The proposal calls for the council to hold its general meetings periodically no less than four times annually and it may convene more than that at the invitation of the president of the republic, or at the request of the majority of members, and that the council works through an internal charter which it prepares by itself and the formation of sub-committees concerned with specific files provided that the council is fully constituted by approving what the committees do.

To read more about the role and goals of this council, you can read an article by Dr. Alaa Ghannam, Director of the Right to Health Program, on this issue, published in 2014

It is wrong to confuse the High Council of Health with the General Medical Council

The Egyptian Doctors’ Syndicate submitted earlier this week a response to the proposal submitted to it on the Egyptian Health Council, with some comments and proposals, mainly focusing on the goals, powers and composition of the council.

It seems that this proposal was marred by the ambiguity between the High Council for Health (or the Egyptian Health Council), another entity that has a completely different role under the name “General Medical Council”, which has long been demanded by specialists, headed by Professor Dr. Sameh Morcos, who presented a detailed proposal for it and called it “The Guardian of Medical Services. " This board has a complementary and different role to the High Council for Health, as it is similar to the General Medical Council in the United Kingdom. This medical board aims to protect patients, improve medical education and medical services, and provide clear guidelines and standards for their provision. It sets standards for the medical profession and appropriate professional behavior for physicians, sets standards for medical education and specialized training, issues licenses to practice the medical profession (instead of the union) and holds accountable doctors who violate medical ethics and values (instead of the union as well).

This council has an important and effective role in setting systematic standards for the provision of medical services and eliminates the conflict of roles and interests, for the Doctors’ Syndicate on the one hand representing physicians and their interests and on the other hand being the entity that performs registration and accounting procedures. You can read more about the proposal submitted by Prof. Dr. Sameh Morcos here. The comments made by the Doctors’ Syndicate took the High Council for Health in a direction that confuses it with the proposed General Medical Council, which is not commensurate with the role desired by the two entities and must be separated.

Prerequisite conditions to ensure establishing an effective High Council for Health, representing its beneficiaries and able to achieve its goals

The desired High Council for Health would be a place of expertise and representation for stakeholders, aiming at setting policies for the health sector as a whole and the five-year strategic plan for it and adopting it societally and then monitoring the executive branch in achieving it. This council consists of a diverse group of individuals according to their professional competencies, representing the various stakeholders, and those who influence health policies and beneficiaries of health services in Egypt, with the intention of providing the highest levels of health services to citizens.

In view of the composition of the council, which includes the various stakeholders and key players in this sector, and based on the powers granted to it, the plans prepared and approved by the council become binding to the various sectors in their implementation, primary among them is the Ministry of Health. This council is an independent legal entity whose president is elected from members who do not work with the state executive. The council would have the authority and responsibility to follow up and assess the extent to which the executive agencies, primary among them the Ministry of Health, have met the agreed timetables. Thus, the state's health policies and strategies are far from the impact of cabinet changes and political fluctuations that have long distracted visions and wasted efforts, resources and expertise that have caused the inefficiency of the health care system.

For the proposed council to achieve these goals, its founding charter must observe the following basic conditions:

1. Be independent in its operation, not affiliated with the Ministry of Health.

2. To work with an internal charter written by members and not have its work interfered with by any executive body.

3. That its president be elected by the members of the Council who are not members in the executive branch of state.

4. Its composition should include all sectors and health care stakeholders with wide and predominant participation from civil society and representatives of the beneficiaries (not only doctors, but also nursing, patient support groups, academics, medical service rooms, equipment manufacturers, medical products, the private sector, human rights organizations, etc.).

5. Its outputs should be binding strategies and directions for the various executive bodies.

6. Its membership is not a source of profit, and the budgetary aspects of its work are limited and regulated.

EIPR stresses the importance of respecting these conditions while working on the law proposal. Through this paper, EIPR presents again the proposed law submitted in 2014, an explanation of it and a proposal for its formation and mechanisms of action.

Finally, the Egyptian Initiative for Personal Rights extends its thanks and gratitude to a large group of experts, colleagues, and colleagues who contributed directly and indirectly to the formulation of this proposal through their participation, comments and hard work in order to reach a vision agreed upon by all and achieve the desired results. Among them we include but are not limited to: members of the Health Sector Governance Committee in the Ministry of Health, members of the Health Sector Governance Forum, Cairo Medical Colleges and Ain Shams working groups, members of the Doctors’ Syndicate Board, members of the Health Sector Reform Group, members of the Reflections on Egypt's Health group, and the Egyptian Ministry of Health, various international and local civil society organizations.