Draft bill 397.

Summary.

The draft bill governs appointments of regional, institutional and medical directors in public hospitals, health centers and related facilities under the Ministry of Health (Ministerio de Salud) and the Social Security Fund (Caja de Seguro Social) through public competitive examinations based on merit and credentials. It requires equal opportunity, gender equity, inclusion and freedom from discrimination. Applicants would need Panamanian nationality, proven by an identity card issued by the Electoral Tribunal (Tribunal Electoral); full civil and political rights; a health sciences degree recognized by the University of Panama (Universidad de Panamá); and, for medical professionals, authorization from the Technical Health Council (Consejo Técnico de Salud) of the Ministry of Health of the Republic of Panama (Ministerio de Salud de la República de Panamá). Further requirements cover management qualifications or experience, professional certification and periodic recertification under Law 43 of July 21, 2004 and Law 462 of March 18, 2025, a specialty for specialized hospitals, favorable performance assessments, health certificates, a drug test, disciplinary records and a documented résumé. Applicants who fail the requirements or submit documents late would be excluded.

The responsible institution would publish the call in the Official Gazette, at the specified premises, in a newspaper and through institutional digital channels; registration would then open. The bill establishes the Regional Selection and Evaluation Commission (Comisión Regional de Selección y Evaluación), comprising representatives of the Ministry of Health, the Social Security Fund, professional associations, medical and nonmedical department heads, and an accredited university. Applicants and specified relatives of contestants could not serve on the Evaluation Commission (Comisión Evaluadora). The commission would set its procedures, decide by absolute majority, record decisions in public minutes, verify eligibility and draw up a preliminary selection. It would assess qualifications, experience and management skills, publish results and conduct annual evaluations. Its preliminary report would be sent to the Hospital Board of Directors (Consejo Directivo del Hospital) through the relevant institution.

Assessment criteria include academic qualifications, professional work and publications, employment experience, an interview, and other knowledge or activities. Scoring assigns 5% to performance assessment, 30% to the interview and 65% to documented accomplishments; results would be kept in sealed envelopes. Each contestant would receive written notice of their score and could seek reconsideration from the commission and appeal to the Ministry of Health or the Social Security Fund. Once the competition ends, the commission would publish results using identity card numbers and forward its report so the highest scoring candidate could be appointed. Applicants’ professional, social and employment records would remain confidential. A competition could be declared vacant if nobody applies, nobody qualifies or all participants withdraw; an acting director would then be designated and another call issued. If the selected candidate declines, the position would go to the second highest scorer, while the candidate who declined could not enter another competition at that institution for five (5) years. Serving medical directors or deputy directors who apply would temporarily leave their administrative posts.

An appointment would last five (5) years and could be extended once, subject to annual assessment. Directors would undertake continuing education, receive technical support during their first year and participate in budget work. They would submit annual reports and a public Health Plan, sign a Code of Ethics and maintain a public conflict of interest declaration. The Executive Branch (Órgano Ejecutivo) would regulate report requirements, the code and management indicators. Early removal would require an administrative process with a right of defense and one of the stated grounds, including serious failure to meet targets, serious misconduct, conviction, consecutive unsatisfactory evaluations, loss of professional authorization or serious conflicts of interest.

The bill proposes repealing provisions of Law 34 of April 5, 2011, Law 33 of April 5, 2011 and Law 8 of March 15, 2012. Directors appointed earlier would finish their terms under the rules applicable when appointed, and hospital boards of trustees would adapt their regulations. The provisions concern the Ministry of Health, the Social Security Fund, the Regional Selection and Evaluation Commission, the Executive Branch, hospital boards of trustees, health professionals and users of hospitals and health centers.