Draft bill 380.

Summary.

The draft bill would establish the National System for the Evaluation and Improvement of Service Quality for Citizens in Public Health Facilities (SNECA) to measure, monitor, and improve care for users of hospitals, polyclinics, and health centers run by the Ministry of Health (Ministerio de Salud, MINSA) and the Social Security Fund (Caja de Seguro Social, CSS). It would cover every facility administered by those institutions that provides direct service to the public. Its principles include respect for patients’ dignity and rights, public participation, transparency, accountability, continuous improvement, equitable access and treatment, and professional and administrative responsibility. It defines service quality through the professional and humane conduct of physicians, nurses, technicians, and support staff, including respect, clear communication, waiting time, problem resolution, and follow-up.

At the end of each visit involving patient care, the facility would have to offer a short, standardized survey. Questions would address humane treatment, clarity of information, waiting time, overall perception of care, and the performance of the professionals involved. Users could respond electronically or on paper, depending on the facility’s technological capacity. All surveys would be anonymous, and their results would enter SNECA. The system would use indicators of satisfaction by facility and staff category, average waiting times, and resolution of problems on the first visit. The Ministry of Health and CSS would jointly publish the indicators each year, broken down by facility.

The bill would create the National Commission on Quality of Care (Comisión Nacional de Calidad de Atención), comprising representatives of the Ministry of Health, CSS, patients, and hospital management experts. It would oversee SNECA and prepare an annual quality of care report. The bill also provides for public recognition and financial bonuses, as set out in implementing regulations, for staff members and teams with the highest scores. Awards would take sustained improvement over the previous year into account. Where results fall significantly below minimum standards and there is evidence of a failure to perform duties, the bill contemplates mandatory training, enhanced direct supervision, or temporary suspension from duties. Other disciplinary proceedings and administrative penalties under applicable laws or institutional regulations could also proceed.

Aggregate SNECA results would be public on an official website, with support from the National Authority for Government Innovation (Autoridad Nacional para la Innovación Gubernamental, AIG), showing information by facility and category of care. Each facility would form a Local Quality Committee of staff and user representatives to review satisfaction results and propose operational improvements. The draft bill relies on Article 3, item 9, and Article 47 of Law 462 of 2025. It directs the Executive Branch to issue implementing regulations within no more than 120 days of promulgation and provides for commencement 90 days after publication in the Official Gazette. Its provisions concern the Ministry of Health, the Social Security Fund, and the National Authority for Government Innovation, as well as patients, healthcare workers, and managers of public health facilities.