Major health care reforms take effect
Major changes to the health care system in the Czech Republic came about this week when the government’s reform package took effect. Called the biggest reform in the last 45 years, the aim is a redefinition of how health care services are provided, and the role of the state, the facility and the patient therein.
Patients under this system can also decree what they do not want from their doctor, be it information or a type of treatment. It is now possible to have a notary certify what you do not want a doctor to do if you are incapacitated, on life support or otherwise incapable of making a decision independently. Even in such cases however, death is not one of the patient’s options: such wishes will not be respected, the Health Ministry noted, if they were to lead to actively ending the patient’s life, for example by removing them from life support.
Children too are empowered by the new legislation, to a certain extent. Whenever appropriate, doctors must now ask children what they think about a prescribed treatment and record their opinion in their medical file. Serious procedures on children now require the consent of both parents. If that is not possible, or if the child has disagrees with the treatment approved by the parents, the court is informed and a caretaker is appointed. Children can be accompanied by their parents at all times when being treated or during a stay in hospital, and adults too can be accompanied by their friends or family.
Another driving principle of the reforms is to streamline services in the age of austerity. The reforms stipulate, for example, the minimum numbers of doctors to be on hand at hospitals, in an effort to decrease overtime and expenditures. This could mean that where night shifts are concerned, patients may be seen by doctors who are not specialists in their particular problem.
Also, in an effort to decrease mistakes, it is now for the first time possible to seek a second opinion on serious diagnoses and such consultations must be covered by health insurance.
The controversy that has accompanied the debate and passage of this legislation does not end with its taking effect. Some health care lawyers see the laws as in fact damaging, rather than strengthening the rights of patients, citing for example the fact that it will be more difficult for patients to bring their complaints to court.