Draft bill 100.

Summary.

The draft bill establishes a national framework for cancer prevention and care, from clinical suspicion and diagnosis through treatment, rehabilitation, palliative care, and follow-up. It would apply to public health institutions and facilities, private oncology service providers, health professionals, and support organizations. Its implementation would be guided by principles of dignity, equality, continuity of care, geographic equity, confidentiality, patient safety, and financial sustainability. It defines comprehensive care, a person with cancer, the service network, the epidemiological registry, and palliative care.

It recognizes rights to dignified and continuous care; access to services according to system capacity and protocols; understandable information, informed consent, confidentiality, a second opinion, an up-to-date medical record, the submission of complaints, and support subject to institutional availability. Public institutions would be required to give administrative priority to minors, older adults, people with disabilities or living in poverty, patients with advanced cancer, and residents of hard-to-reach areas.

The Ministry of Health would lead, coordinate, and evaluate the plan. Together with the Social Security Fund (Caja de Seguro Social) and the National Oncology Institute (Instituto Oncológico Nacional), it would progressively implement the National Oncology Care Network, while respecting their respective powers, autonomy, and budgets. The text provides for a technical body to coordinate policies and protocols and assigns the national program responsibility for planning, managing the National Cancer Registry, preparing guidelines, community education, monitoring indicators, training, and research. The plan would be approved and updated every five years, with goals, responsible parties, a timetable, funding, care pathways, and evaluation. The National Oncology Institute would serve as the national specialized referral center.

The national care pathways would cover suspected cases, referral, confirmation, treatment, and follow-up. For people with a well-founded suspicion of cancer, the bill sets a target of no more than 75 days until diagnostic confirmation and the start of treatment, subject to clinical exceptions and available resources. Dedicated queues or service counters would be introduced progressively in services connected with oncology care; unjustified failures to meet the deadline would be reported to the health authority, without prejudice to administrative liability. Regulations would set out how these pathways operate and are verified.

The National Cancer Registry would collect and publish epidemiological information; facilities, laboratories, pathology services, and professionals would be required to report cases under the regulations. The data would be subject to confidentiality, security, and statistical anonymization. The Ministry of Health would provide public guidance, ongoing prevention campaigns, screening programs, and telemedicine tools. The plan would include pediatric cancer, while public services would progressively incorporate palliative care, pain management, and family support.

The bill also provides for training and research subject to applicable ethical rules, and for a network of patients, survivors, and organizations to participate and make recommendations. The Ministry of Social Development (Ministerio de Desarrollo Social) could design support measures for vulnerable people and caregivers; the Ministry of Labor and Workforce Development (Ministerio de Trabajo y Desarrollo Laboral) would promote guidance and return to work. Unjustified discrimination would be prohibited in accordance with the Constitution. Funding would come from institutional budgets and other permitted resources, in accordance with the Budget Law and the guidelines of the Ministry of Economy and Finance (Ministerio de Economía y Finanzas), without authorizing expenditure where funds are unavailable. There would be annual reports to the National Assembly (Asamblea Nacional), verifiable indicators, regulations issued by the Executive Branch within six months of promulgation, and adjustments to internal procedures. In Panama, these provisions would be relevant to health services, universities, patient organizations, employers, insurers, and social protection agencies.