Bill 648.

Summary.

The bill would govern the appointment of regional, institutional and medical directors in public hospitals under the Ministry of Health (Ministerio de Salud), health centers and related facilities of the Social Security Fund (Caja de Seguro Social) through public merit and credential competitions. It requires equal opportunity and bars discrimination in selection. Eligibility requirements include Panamanian nationality, full civil and political rights, a health sciences degree recognized by the University of Panama (Universidad de Panamá), management training or experience, professional certification, favorable performance assessments, health certificates and employment records. Medical professionals would need a license issued by the Health Technical Council (Consejo Técnico de Salud). The bill also refers to Law 43 of July 21, 2004 and Law 462 of March 18, 2025. Identity would be documented with a card issued by the Electoral Tribunal (Tribunal Electoral).

Vacancies would be announced in the Official Gazette, at institutional premises, in the press and through institutional digital channels, followed by ten (10) working days for registration and document submission. The bill creates the Regional Selection and Evaluation Commission (Comisión Regional de Selección y Evaluación), comprising six (6) representatives of health institutions, health professions, institutional departments and an accredited university. It provides for alternates, disqualification where a member is an applicant or a relative of one, meeting rules and public records of decisions. The commission would check eligibility, reject incomplete or late applications, assess candidates and forward a preliminary list to the Hospital Board of Directors (Consejo Directivo del Hospital) through the relevant institution.

Assessment would cover academic qualifications, professional achievements, work experience, an interview and other skills. The score allocates performance assessment (5%), interview (30%) and documented achievements (65%); the annexes set out scales for medicine, administration and medical teaching or research. Each candidate would receive written notice of the score and could seek reconsideration before the Evaluation Commission (Comisión Evaluadora), followed by an appeal to the Ministry of Health or the Social Security Fund. Once the competition is complete, results would be published using identity card numbers and the appointment of the highest scoring candidate would be processed. Access to candidates’ professional, social and employment records would be restricted.

A competition could be declared unsuccessful if nobody applies, no applicant qualifies or all withdraw; an acting director would then be appointed and a new call issued. A person who declines the awarded post could not enter another competition at that institution for five (5) years, and the next highest scoring candidate would receive the award. Serving medical directors or deputy directors who apply would have to step aside from their administrative duties during the competition. Appointments would last five (5) years and could be extended once, subject to a public annual management assessment. Appointees would undertake continuing education, receive technical support during their first year, participate in budget planning and oversight, and submit annual public management reports and a public Health Plan. The Executive Branch (Órgano Ejecutivo) would regulate the reports and the Code of Ethics; directors would also file a public, updated conflict of interest declaration.

The bill provides for early removal through an administrative procedure with a right of defense on grounds including serious failures, disciplinary offenses, criminal convictions, consecutive unsatisfactory assessments, loss of professional authorization, disqualification from public office, unjustified absences, conflicts of interest or proven corruption. The Executive Branch would establish hospital management indicators through the health institutions. The bill repeals provisions of Law 34 of April 5, 2011, Law 33 of April 5, 2011 and Law 8 of March 15, 2012. Previously appointed directors would finish their terms, and governing boards would adapt their rules. Its provisions concern the Ministry of Health, the Social Security Fund and the Executive Branch, as well as health professionals, hospitals, health centers, universities and users of public health services in the Republic of Panama (República de Panamá).