FILING A COMPLAINT
If the insured person believes that he/she does not receive adequate healthcare, he/she may:
a) file a motion for review to the manager of the healthcare facility or its founder
Any complaint should first be addressed to the manager of the healthcare facility who will investigate the matter. The settling of a complaint is governed by the Act No. 500/2004 Coll., the Code of Administrative Procedure, and the complaint should therefore be settled within 60 days. If the insured person is not satisfied with how his/her complaint addressed to the manager of the healthcare facility has been settled, he/she may subsequently contact the founder of the specific healthcare facility (usually the Region or the Ministry of Health) to complain about how his/her previous complaint has been settled. Such complaint should also be settled within 60 days.
b) contact the competent public authority who performed the registration of the healthcare facility in accordance with a special act (Section 8 of the Act No. 160/1992 Coll., on Healthcare in Non-Governmental Healthcare Facilities).
If the insured person is not satisfied with how his/her complaint addressed to the manager of the healthcare facility which is a non-governmental healthcare facility has been settled, he/she may subsequently contact the competent public authority who performed the registration of the healthcare facility in question to complain about how his/her previous complaint has been settled. In this case, the complaint should again be settled within 60 days.
c) contact the Czech Medical Chamber, the Czech Dental Chamber or the Czech Pharmacists’ Chamber if the deficiencies concern the professional or ethical procedure applied by a physician or a pharmacist, or any other professional, if established, if the mentioned deficiencies concern other healthcare personnel.
The Act No. 220/1991 Coll., of the Czech National Council, on the Czech Medical Chamber, the Czech Dental Chamber and the Czech Pharmacists’ Chamber stipulates the terms and conditions of membership in individual Chambers and the activities of the Chambers including the procedure for filing complaints and the settlement thereof. Pursuant to this Act, every physician practising the medical profession in medical treatment and preventive care (i.e. treats and works with patients) in the territory of the Czech Republic must be a member of the Czech Medical Chamber. Similarly, every dentist practising the profession of a dentist in the territory of the Czech Republic must be a member of the Czech Dental Chamber. And last but not least, a graduate of higher education in the field of pharmacy practicing his/her profession in a pharmacy facility in the territory of the Czech Republic must also be a member of the Czech Pharmacists’ Chamber.
The Act confers to the Chambers an authority to settle complaints concerning the professional practice of their members and at the same time to apply disciplinary authority in the extent set out in this Act if any member of the Chamber fails to practice their profession in an expert manner, in line with the profession’s ethics and in a manner set out by law and in the Chambers’ regulations. If, therefore, the patient believes that this is the case, he/she has a right to contact the respective Chamber with his/her complaint. The procedure for the settlement of such complaints is set out in the disciplinary regulations of each of the Chambers which may be downloaded from the websites of the individual Chambers:
Czech Medical Chamber: http://www.lkcr.cz/
Czech Dental Chamber: http://www.dent.cz/
Czech Pharmacists’ Chamber: http://www.lekarnici.cz/
d) contact the health insurer with whom he/she is insured, namely if the healthcare personnel refuse to perform a medical act included in healthcare cover.
In such a case, the health insurer may only deal with the issue provided that it concluded an agreement with the respective healthcare provider (i.e. the hospital, clinic or physician). The insurer will examine the justification of the complaint via its medical inspector. The settlement of a complaint is governed by the Code of Administrative Procedure and the complaint should therefore be settled within 60 days.
If the insured person believes that public authorities and other institutions act in conflict with the law, not in line with the principles of democratic rule of law and good governance or that public authorities are idle, he/she may contact the Public Defender of Rights – the Ombudsman of the Czech Republic.
In the area of health insurance and the provision of healthcare, the Ombudsman can review for instance the procedure applied by the Regional Authority, the Ministry of Health of the Czech Republic or the health insurer to the settlement of the insured person’s complaint, but he is not authorised to examine the professional medical aspect of the complaint.
Contact and further details are available at the Public Defender of Rights’ website here.
The insured person may also contact the so called hospital ombudsman if he/she is not satisfied with the acts or services of any specific hospital.
The hospital ombudsman is a defender of patients’ rights and interests in the hospital in which this position is established. He/she accepts proposals for improvement of the services provided and assists in the solution of any dissatisfaction of the patients or their family members with the services provided, immediately and directly in the hospital. The activities of the hospital ombudsman include arranging for communication between the respective hospital ward concerned in the complaint and the patient or his/her family, establishing the actual state of affairs and assisting in securing a remedy. The ombudsman may be contacted in person, by telephone or in writing to the e-mail or postal address of the hospital. Further contact details are available directly in the respective hospital or on its website.
If the insured person believes that the European legal regulations have been applied incorrectly by the public authorities, he/she may contact SOLVIT – the system of solving problems in the EU internal market which principally handles any problem between a citizen on one side and an EU Member State on the other side. SOLVIT consist of a network of centres cooperating with each other to solve problems caused by misapplication of European law by public authorities. There are SOLVIT centres in every EU Member State as well as in Norway, Lichtenstein and Iceland.
Contact details and further information on how SOLVIT centres work are available here.
OUT-OF-COURT DISPUTE SETTLEMENT / MEDIATION
Mediation as such is regulated in the Czech legal system only in criminal law for the purposes of resolving disputed between the aggrieved party and the offender in criminal proceedings. Mediation as an alternative to civil legal proceedings (e.g. concerning compensation for damages) is nor expressly regulated by law, which however does not mean that it is forbidden by law or that the results of mediation are not considered legally valid.
As a part of an out-of-court resolution of disputes which occurred, the parties may conclude a so called settlement agreement in accordance with Section 585 of the Act No. 40/1964 Coll., the Code of Civil Procedure, and thereby resolve the situation in dispute in a way that is binding on both parties without the need for legal proceedings which is often disadvantageous due to great time and financial demands. It must be emphasised that any settlement agreement concluded has effects similar to a judgement of a court even though no legal proceedings occurred. In other words, the resolution on the parties’ respective rights and obligations contained in the agreement is binding and it is not possible to validly re-claim performance on the same grounds in court.
The basic principles of mediation are as follows:
Mediation is a voluntary procedure and, of course, the other party may not be forced to take part in it (as opposed to legal proceedings). Any resolution of a dispute through mediation is therefore a matter of agreement between both parties.
Mediation is not open to the public; it does not take place in court. Mediation is a confidential procedure taking place in the presence of a mediator selected by both parties. An agreed remuneration is then paid to the mediator, either by one of the parties only or by both of them.
The mediator is actively involved in the resolution of the matter in dispute, he does not assume a superior position to the parties, he does not take the decision (unlike a judge). His task is to help the parties find such a solution to their problem which will satisfy both parties.
Mediation usually tends to resolve the matter in dispute much faster than in case of legal proceedings. The matter in dispute is usually being solved during several mediation meetings (generally 1-5 meetings). If the parties do not come to an agreement during these meetings, the mediation is usually terminated and the parties may attempt to resolve their dispute in court or by other means.
The publication “How to reach an out-of-court settlement – Mediation as a means of settling disputes in healthcare” is available for download at the League of Human Rights’ website here.
DISPUTE SETTLEMENT BY MEANS OF LEGAL PROCEEDINGS
Generally, the patient chooses to resolve a dispute by means of legal proceedings if an agreement has not been reached by means of an out-of-court settlement, for instance because the patient and the healthcare provider failed to agree on the amount of compensation for damages the patient asks for.
In case the patient decides to contact a court with a civil lawsuit (Act No. 99/1963 Coll., the Code of Civil Procedure), he/she may do so in two ways, either by filing an action for damages (Section 415 et seq. of the Act No. 40/1964 Coll., the Civil Code), or an action for the protection of personality (Section 11 et seq. of the Civil Code). The two types of action mentioned above may also be filed simultaneously. Each of them not only has a different purpose, however, but there are also differences in the competence of courts, the deadline for filing an action, the costs of proceedings, possibilities of satisfaction etc. An action for damages may only be filed in case that a physician’s fault caused damage to the patient’s health; an action for the protection of personality, on the other hand, is filed in case of an encroachment on the right to the protection of personality (i.e. violation of the patient’s civil honour and human dignity, privacy, family life etc.). When filing a lawsuit, a court fee must also be taken into consideration (Act No. 549/1991 Coll., on Court Fees) and possible further expenses (remuneration to a legal representative, preparation of an expert opinion) as well as rather long timeframe of the whole proceedings and the necessity to carry the burden of proof to prove one’s allegations.
Quite certainly, the more frequently filed type of lawsuit is an action for damages caused by a specific physician’s fault. That must be filed within two years of the date on which the aggravated person found out about the damage and who is responsible for it, otherwise the right to a compensation for damages will be forfeited (and the right can not then be successfully claimed in court if the defendant raises the objection of forfeiture). It is true, however, that even following the expiry of this term, the healthcare provider may voluntarily compensate the aggravated person.
In court, the compensation for damages is determined in accordance with the provisions of the Civil Code and the Decree of the Ministry of Health No. 440/2001 Coll., on Compensation for Pain and Aggravation of Social Position. The actual damages will be paid, i.e. the costs related to medical treatment, along with lost profit (loss of income) and compensation for pain and aggravation of social position (as a lump sum the amount of which is determined in accordance with the Decree. In justified cases, the amount of such compensation may be increased to correspond to the actual damage).
The Civil Code also stipulates that for any death loss the survivors will be paid a lump sum compensation in a certain amount, being CZK 240,000 to the spouse, each child, each parent and every other closely related person living in the common household with the deceased person at the time of the occurrence of the event which was the cause of the damage to health resulting in death, and further CZK 85,000 to each parent in case of a loss of an unborn conceived child, and CZK 175,000 to each sibling of the deceased person. Further, in case of death, the cost of alimony is paid to the survivors as well as reasonable costs related to the burial unless these were covered by burial allowance provided in accordance with the Act on State Social Support. The extent of this lump sum compensation is thus set out by law as specific financial sums, which may be considered as a somewhat unusual solution within private law.
In addition to the above right to lump sum financial compensation, the survivor may also apply in court the right following from the protection of personality (Section 11 et seq. of the Civil Code) where the amount of compensation for this non-proprietary damage is not limited in any way.
A situation may also occur where the fault of specific healthcare personnel may be considered so serious that it could represent a criminal offence (this could involve mainly crimes against life and health set out in Chapter I. of the Special Section of the Act No. 40/2009 Coll., the Criminal Code, namely negligent bodily injury pursuant to Section 148, serious negligent bodily injury pursuant to Section 147, negligent killing pursuant to Section 143, etc.). A criminal charge may then be filed to the respective office of the Police of the Czech Republic or the Office of the Public Prosecutor. A criminal charge may be filed orally or in writing (by means of a letter, facsimile or e-mail) by any person, not only the aggravated person. No administrative or other fees are charged for filing a criminal charge. The utilization of this means should, however, be considered carefully since it represents an ultimate remedy which should only be used in cases of very serious faults.