REPUBLIC OF LITHUANIA
L A W
ON
THE HEALTH SYSTEM
recognizing, that
the health of the population is the greatest social and
economic value of
society,
health is not only the absence of diseases and physical
deficiencies, but physical, spiritual and social welfare of
people as well,
the potential of health and conditions of its maintaining
are determined by stability of the development of economic
system, guarantees for social security and education of society,
employment and sufficient income of the population, provision
with dwellings, accessible, acceptable and adequate health care,
proper nutrition, quality of work, living and natural
environment, as well as by the efforts of the population to
promote health,
person's efforts to stay healthy may only be promoted by
social and economic measures which are acceptable from the point
of view of human dignity and the current time,
the best possible public health is a necessary prerequisite
for the security and prosperity of the State of Lithuania, as
well as for creating of an open, just and harmonious civic
society;
taking into consideration the provisions of the global
strategy "Health to Everybody - 2 000", adopted at the 30th
Session of the World Health Assembly in 1977, the Ottawa Health
Promotion Charter and the National Health Concept of Lithuania;
seeking to ensure the in-born human right to enjoy the best
possible health, as well as the right to have healthy
environment, acceptable, accessible and adequate health care;
acting in compliance with the Constitution of the Republic
of Lithuania,
enacts this Law on the Health System.
Part I
The Health System
Chapter 1
General Provisions
Article 1. The Purpose of the Law of the Republic of
Lithuania on the Health System
The Law of the Republic of Lithuania on the Health System
shall regulate the national health system of Lithuania, its
structure, limits of legal regulation of health care, health
strengthening and health recovery, fundamentals of establishment
of the scope of health activities, organization and management of
individual and public health care, health promotion, conclusion
of contracts concerning health activities, fundamentals of the
liability for violations of legal norms of health activities,
rights and duties of the residents and subjects of health
activities.
Article 2. Legal Regulation of Health Relations
Health relations arising from protection, strengthening and
assistance in recovering of individual and public health, as well
as relations concerning the implementation of the individual's
rights to have the best possible health, protection of health
interests of an individual and society, shall be regulated by
this Law, other laws on health activities, as well as laws, if
they do not contradict the meaning of the above mentioned laws,
concerning the structure and institutions of state power and
government, local self-government, public organizations, human
rights and other social affairs, environmental protection,
economy, national defense and internal order, subordinate
legislation acts, contracts and agreements concerning health
activities and working conditions.
Article 3. The Scope of the Legal Regulation of Health
Relations
The following shall only be established by the laws of the
Republic of Lithuania on health activities:
2) the system of types and subjects of health activities,
the competence of the main subjects of health activities
management, rights and duties of state services and state
inspectorates of health activities coordination and health care,
institutions of individual and public health care and subjects of
pharmaceutical activities in the individual and public health
care or pharmaceutical activities, legal framework for their
establishment, activities and termination thereof;
3) the legal framework of establishment, activities,
reorganization of the state hygiene inspectorate, conditions and
procedure for the state hygiene control;
5) the basis for organizing, management of the health
activities, as well as for health support and financing;
7) the rights and duties of the population in health
activities, legal framework of participation of the population in
the management of health matters;
8) the legal framework of accrediting of the persons who
have the higher or special secondary medical or other education
for health and pharmaceutical activities, basic professional
rights and duties of medical specialists, procedure for
establishing of the qualification requirements, for the
improvement of their qualification and the restrictions of their
practice, legal framework of the restriction of health care
advertising, for establishing of civil responsibility for the
damage done to the patients' health while carrying out the health
care of individuals;
10) the legal framework of organizing and management of the
primary health care, of the control over the conditions thereof;
11) the system of public health care, legal framework of its
organizing, management, of the hygiene regulation,
epidemiological protection against contagious diseases, hygiene
and epidemiology control, and hygiene expert examination;
12) the legal framework of labour protection and labour
medicine, for organizing and management of consumers' health
protection;
13) the general requirements for food products quality;
procedure for the conditions of producing, importing, trading,
advertising of such products, control over the quality of food
products and their tare, marking thereof;
14) the general requirements for the quality of drinking
water, legal framework of water treatment, rendering harmless,
and quality improvement;
15) the procedure for controlling of production, trade,
import, export, licensing and consumption of narcotic and
psychotropic substances, alcohol products, tobacco and its
products, the system of reducing the consumption of alcoholic
beverages and tobacco products, the procedure for narcological
supervision, prohibition of advertising of alcoholic beverages
and tobacco products;
16) the conditions for production, trade, import, export,
transportation, utilization of poison, other toxic and
radioactive material, requirements for working with ionizing
radiation sources, conditions for ensuring radiation safety and
the procedure for the control thereof;
17) the system of the prophylaxis of contagious diseases,
legal framework of organizing and management of the control over
said diseases;
18) the conditions of public health monitoring, expert
examination of public health, legal framework of their organizing
and management;
19) the legal framework of organizing and management of
physical culture and sport, control over dope and sex;
20) the rights of persons in the sphere of supervision over
the psychic health; the conditions of psychic health supervision
and the legal framework of its organizing and management, as well
as of the control over the conditions thereof;
22) the conditions of stomatological and narcological
supervision and the legal framework of organizing and management
thereof;
23) the procedure for family planning and genetic
consulting, the legal framework of birth-control, artificial
insemination, foetus protection, termination of pregnancy, and
sterilization;
24) the requirements for the ethics of biomedical tests, the
procedure for the control of observing said requirements, as well
as liability for violations of the requirements for the ethics of
biomedical tests;
25) the conditions and procedure for giving human blood by
donors, production of blood products, transfusion of human blood
and its products;
26) the basic principles, conditions and procedure for
taking organs or tissues for transplantation, their use for
transplantation, medical research, diagnostics, and treatment;
27) the criterion of the establishment of terminal
conditions and the fact of death of an individual, conditions of
an individual's refusal from all or part of life prolongation
services, conditions and procedure for postmortem examination
(autopsy) of a corpse;
28) the legal framework of providing of pharmaceutical
services, organizing and management of pharmaceutical activities;
29) the conditions and procedure for granting of a permit to
dispense drugs and medicinal substances, for the control of the
quality thereof;
30) the health insurance system, the procedure for
collecting funds for compulsory health insurance, legal framework
of voluntary health insurance, rights and duties of the insured
and insurers, procedure for establishing and activities of health
insurance institutions as well as rights and duties of these
institutions; and
31) basic principles of liability for violations of the
requirements of laws concerning health activities.
The Government of the Republic of Lithuania, ministries,
state services and state inspectorates shall enjoy the right to
adopt within their competence legal acts on the issues of the
regulation of health relations, with the exception of those
issues which are regulated by the laws concerning health
activities. Provisions of legal acts of the Government of the
Republic of Lithuania, ministries, state services and state
inspectorates, which worsen the conditions of health activities
comparing to those conditions which are established by the laws
concerning health activities, shall be deemed invalid.
Within their competence, enterprises, institutions and
organizations shall have the right to adopt legal acts
establishing, in comparison to laws and other legal acts,
additional economic and social incentives for citizens to foster
their health, for economic entities - to engage in economic-
commercial activities beneficial to health, additional support to
socially vulnerable groups of the population by compensating the
expenses of their health care, additional requirements for
implementing of public health care. Provisions of legal acts of
enterprises, institutions and organizations which worsen the
level of health activities comparing to the level which is
established by laws and other legal acts concerning health
activities, shall be deemed invalid.
Article 4. Health Activities
The health activities shall comprise:
4) traditional medicine, folk medicine, and non-medical
methods of health recovery.
Article 5. The Purposes of Health Activities
The purposes of health activities shall be as follows:
1) to reduce the falling behind of certain social and
professional groups of society from other groups of society as
shown by the health condition indicators, without worsening the
general level of the population's health;
4) to increase economic and social efficiency of life.
Article 6. Principles of Regulating of the Health
Activities
The following principles shall be applied to the regulation
of the relations specified in Article 1 of this Law:
3) the equality of individual's rights to have the best
possible health regardless of his or her sex, race, nationality,
citizenship, social status and profession;
6) the persons' freedom to unite into public organizations,
defending the interests of public and individual health, and the
State support of the programmes of activities of these
organizations;
7) the all-round, rightful and timely informing of the
population about the conditions of promoting the best possible
health and advertising of these conditions;
8) the participation of public organizations in the health
activities management directly as well as through the
democratically elected representatives;
10) the partial or full compensation, which is guaranteed by
the State, of health care costs which might worsen the quality of
life;
11) the all-round prevention of threat and damage to
individual and public health exercised by all subjects of the
health activities; and
12) the promotion by the State of economic efforts and
initiatives beneficial to health.
If the relations specified in Article 1 of this Law are not
regulated by laws and provisions of legal norms, which regulate
similar relations, cannot be applied thereto, the principles set
forth in Par. 1 of this Article shall be applied in the
settlement of any disputes that may arise.
Chapter 2
The Lithuanian National Health System
Article 7. The Foundations of Forming of the Lithuanian
National Health System
The foundations of forming of the Lithuanian National Health
System shall be as follows:
2) integration of all resources of health activities into a
unified system, their planning and use according to the national
priorities of health activities;
4) introducing of the elements of the social market economy
into health activities without violating the national priorities
of health activities;
5) ensuring of the implementation of the Lithuanian health
programme, and the programmes of the health system reform;
7) ensuring of participation of the public in the health
activities management.
Article 8. The Structure of the Lithuanian National
Health System
The Lithuanian National Health System (hereinafter referred
to as the LNHS) shall consist of:
4) the activities and a range of services rendered by the
LNHS.
Article 9. The Executive Bodies of the LNHS
The executive bodies of the LNHS shall be:
2) enterprises, accredited for certain types of health
activities and having concluded health activities contracts with
the customers of activities and a range of services by the LNHS
in accordance with the procedure established by this Law.
Article 10. The Managing Bodies of the LNHS
The managing bodies of the LNHS shall be:
5) institutions exercising control over the conditions of
the LNHS activities.
The managing bodies of the LNHS shall within their
competence supervise and coordinate the health activities of
other health activities bodies which do not belong to the LNHS
system, according to the procedure established by this and other
laws and legal acts.
Article 11. The Resources of the LNHS
The LNHS resources shall comprise:
1) the land, which belongs to the State or municipalities by
the public ownership right and it intended for recreational
purposes and organizing of health resorts;
2) natural resources (mineral water, curative mud, etc.)
intended for medical rehabilitation activities carried out by the
LNHS;
5) financial resources from the State and municipal budgets
intended for ensuring of the LNHS activities;
8) specialists and other employees of state and municipal
institutions of individual and public health care, state
enterprises which are accredited for individual or public health
care and pharmaceutical activities; and
9) databases of information concerning individual and public
health.
The LNHS resources shall be regulated by this and other laws
and legal acts.
A claim to property cannot be made to state or municipal
institutions of individual or public health care.
Article 12. The LNHS Activities and Services
The activities and a range of services rendered by the LNHS
shall comprise:
4) paid services specified in Chapter 4 of Part 1 of this
Law.
Article 13. Levels of Organizing of the LNHS Activities
The levels of organizing of the LNHS activities shall be as
follows:
3) tertiary (hereinafter referred to as "tertiary health
activities").
The primary health activities shall comprise administrative
units of municipal territories. It shall be carried out by the
LNHS bodies subordinate to municipalities. Other LNHS executive
bodies belonging to the levels of organizing of the LNHS
activities may within their competence perform this work on a
contractual basis.
The secondary health activities shall comprise higher-level
administrative units. It shall be carried out by the LNHS bodies
of higher-level administrative units. The LNHS executive bodies
belonging to the tertiary level of organizing of the LNHS
activities may within their competence perform this work on a
contractual basis.
The tertiary health activities shall be carried out within
their competence by university and academic clinics and other
medical treatment centers, which provide specialized and very
specialized medical treatment to persons without taking into
consideration their places of residence. These LNHS executive
bodies may within their competence carry out the primary and
secondary health activities on a contractual basis.
The procedure and conditions of implementation of the
primary health activities shall be established by laws and other
legal acts.
The list of types of the primary, secondary and tertiary
health activities and the LNHS executive bodies of health
activities which implement them, their competence, procedure and
conditions of the secondary and tertiary health activities shall
be established by laws and other legal acts.
Article 14. The Exclusive Rights of Health
Activities of the LNHS Executive Bodies
The LNHS executive bodies shall have the right to provide
and carry out:
2) medical and social examination, forensic medical
examination, forensic psychiatric and narcological examination,
and pathologoanatomical examination;
3) public health care measures entered in the list
established by the Government of the Republic of Lithuania; and
4) state monitoring of public health and state expert
examination of public health.
Article 15. Customers of the LNHS Activities and
Rendered Services
The main customers of the LNHS activities and rendered
services shall be the Government of the Republic of Lithuania,
its institutions, local authorities, state and territorial
patients' funds, other legal and natural persons.
The limits of the orders for the LNHS activities and
rendered services which can be established by the relevant
customers of the LNHS activities, shall be regulated by the laws
and other legal acts.
Chapter 3
Levels of Health Activities
Section 1
The Required Level of Health Activities
Article 16. The Indicators of the Required Level of
Health Activities
The required level of health activities shall establish the
scope of health activities which are supported by the State or
local authorities, necessary conditions for health activities,
the list of measures and institutions which are necessary for
retaining or maintaining of the already achieved level of public
health.
The required level of health activities shall be defined by:
2) the necessary assortment of medicines and other medical
articles approved by the Ministry of Health;
3) the list of individual health care measures supported by
the State and local authorities free of charge;
4) the list of state institutions and services of individual
and public health care, and pharmacies according to the type
thereof;
8) the basic volume, established by this Law, of financing
of health activities which are carried out by the Lithuanian
National Health System, from the State, municipal budgets and
compulsory health insurance funds.
The required level of health activities shall be established
taking into consideration the demographic, health and
environmental quality indicators and tendencies of changes
thereof.
The required level of health activities, with the exception
of the indicators of acceptability and adequacy of individual and
public health care established in items 1 and 2 of Par.2 of this
Article, shall be established by the Government of the Republic
of Lithuania on the joint recommendation of the Ministry of
Health and the National Health Council.
Article 17.The Structure of Individual Health Care
Supported (Free of Charge) by the State and
Local Authorities
The individual health care supported (free of charge) by the
State and local authorities shall comprise:
6) services which are attributed to medical treatment in
accordance with the manner prescribed by this Law.
Article 18. Individual Health Care Supported (Free of
Charge) by the State
The following shall be attributed to the individual health
care supported (free of charge) by the State:
2) individual health care provided to servicemen, cadets and
law and order and law-enforcement officers and volunteers;
3) individual health care provided to persons detained by
the police, put into places of detention, prisoners (with the
exception of medical rehabilitation in sanatorium and resort
institutions);
4) individual health care provided to persons who have
suffered from violations of law, provided that they are witnesses
in criminal cases according to the procedure established by legal
acts;
5) individual health care in accordance with the list of
categories of civil servants established by the law;
6) individual health care provided to persons who are ill
for an uninterrupted period of more than four months;
7) provision of persons ill with diseases, the list thereof
is approved by the Government of the Republic of Lithuania, with
prostheses of teeth, limbs, joints and other organs;
8) individual health care provided to persons who are ill
with tuberculosis, sexually transmitted diseases, AIDS,
infectious and endocrinal diseases entered in the list
established by the Government of the Republic of Lithuania, as
well as mental diseases, oncogenic diseases, alcoholism, drug
dependence, and toxic substance addiction; and
9) blood donorship, haemodialysis, organ and tissue
transplantation.
The scope of individual health care (types of individual
health care and the list of measures thereof) which is supported
by the State, with the exception of the case specified in item 5
of Par.1 of this Article, shall be established by the Government
of the Republic of Lithuania on the joint recommendation of the
Ministry of Health and the National Health Council.
Article 19. Individual Health Care Supported (Free of
Charge) by Local Authorities
The following shall be attributed to the individual health
care supported (free of charge) by local authorities:
6) individual health care provided to persons whose income
is less than the level of income supported by the State, as well
as orphans under 18 years of age;
8) provision of persons of established categories with
prostheses of teeth.
The scope of individual health care (types of individual
health care and the list of measures thereof) which is supported
by local authorities shall be established by the Government of
the Republic of Lithuania on the joint recommendation of the
Ministry of Health and the National Health Council.
Local authorities shall have the right, when possible, to
establish an additional scope, comparing to the scope established
by the Government of the Republic of Lithuania, of individual and
public health care supported by local authorities, on the joint
recommendation of a physician of the town or district
municipality and the community health council.
Article 20. Necessary Conditions of Health Activities
The necessary conditions of health activities in the
Republic of Lithuania shall be as follows:
2) accessibility, acceptability and adequacy of individual
and public health care.
Health activities shall comprise only the territory of the
State of Lithuania, unless otherwise provided for in
international treaties of the Republic of Lithuania.
The procedure and conditions of accrediting for individual,
public health care or pharmaceutical activities shall be
established by this Law and other legal acts.
The indicators of accessibility of individual health care
shall be established by the Government of the Republic of
Lithuania on the joint recommendation of the Ministry of Health
and the National Health Council. The requirements for the
acceptability of individual health care shall be established by
laws and other legal acts.
The requirements and norms of adequacy of individual health
care shall be regulated by normative documents of
standardization, which are prepared by university, academic
clinics and centres. Normative documents of standardization which
regulate the requirements for adequacy of public health care
shall be within their competence prepared by the State Public
Health Care Service in the Ministry of Health of the Republic of
Lithuania, institutions of control over the health activities
conditions in other governmental institutions. These normative
documents shall within their competence be approved by the
Ministry of Health or the Lithuanian Standardization Agency in
the Ministry of Economics.
The necessary conditions of health activities must be
ensured by all subjects of health activities. Health activities
subjects which do not ensure the established necessary conditions
of health activities, shall be liable under laws.
Section II
Contractual Level of Health Activities
Article 21. Conditions of Establishing of the
Contractual Level of Health Activities
The health activities which do not belong to the required
level of health activities shall be attributed to the contractual
level of health activities.
The scope and conditions of the contractual level of health
activities shall be established by the contract of health
activities provided by this Law. The scope and conditions of the
contractual level of health activities, determined by the parties
to those contracts, must not worsen the required level of health
activities.
Article 22. A Health Activities Contract and the
Procedure for Concluding It
A health activities contract shall be an agreement between a
subject or subjects of health activities (contractor or
contractors) who have the right to engage into health activities
or carry out them and a customer of customers of health
activities, by which the subject (subjects) of health activities
shall undertake an obligation to carry out health activities of
certain scope and types, render a range of services of this
field, and the customer (customers) of health activities shall
undertake an obligation to pay for the performed work and
rendered services.
Article 23. The Parties to Health Activities Contracts
Governmental institutions, bodies of administration of local
authorities, health insurance institutions, enterprises,
institutions, organizations, legal and natural persons may be the
parties to the health activities contracts on the one part and
legal persons, enterprises without a status of a legal person,
accredited for health activities - on the other part.
Article 24. Conclusion of a Health Activities Contract
The health activities contract must normally be concluded in
writing. It shall be considered concluded, if the parties to the
contract agree upon the basic terms and conditions of the health
activities contract.
Article 25. The Structure, Text and Validity of the
Health Activities Contract
The parties to health activities contracts shall establish
the structure, chapters and appendices of the contracts.
The text of the health activities contract shall be the
terms and conditions of the contract specified by the parties to
it, defining the rights and duties of the parties, the procedure
for carrying out thereof and the responsibility of the parties,
as well as basic terms and conditions of health activities
contracts established by this Law.
The parties to the contract cannot establish in the contract
such conditions of health activities which would worsen
conditions of health activities comparing them with those which
are established in this Law, other laws and legal acts. In the
case of a dispute concerning application of the terms and
conditions of the health activities contract, it shall be settled
in the court.
The health activities contract shall become effective on the
moment of its signing. Terms of the duration of a contract shall
be established upon mutual agreement of the parties.
Article 26. Basic Terms and Conditions of the Health
Activities Contract
In each contract of health activities, its parties must
agree on the following basic terms and conditions:
2) prices of health activities and the procedure for
financing of the scope of health activities agreed upon by the
parties, as well as compensation for general, particular,
additional expenses;
3) the procedure for compensation of expenses of
transportation of patients, medicines and medicinal substances;
6) an additional, comparing to this Law, material liability,
which is established by the parties to the contract, for an
improper fulfillment of the contract obligations and the
unilateral termination thereof; and
7) the procedure and terms of fulfillment of the contract
obligations and the control over them.
Item 4 of Par.1 of this Article shall be applied only to
private health activities subjects, who have concluded a contract
with the LNHS customers concerning performance of work on the
required level of health activities.
Article 27. Control over the Execution of the Health
Care Contract
Control over the fulfilment of obligations of health
activities contract shall be carried out by the parties which
have entered into such contract. The procedure and time limits
for reporting on the fulfilment of obligations under health
activities contract, by representative of the parties to the
contract shall be set forth in the contract.
Article 28. Liability for Failure to Perform the Health
Activities Contract
Both parties to the contract shall be liable for performing
of health activities contracts.
The grounds for the unilateral termination of health
activities contract shall be established by the Civil Code of the
Republic of Lithuania.
If the obligations of the health activities contract are not
fulfilled or the contract is terminated unilaterally through the
fault of the subject of health activities (contractor), losses
incurred by health activities customer shall be compensated with
the funds of the health activities subject (contractor). If the
obligations of the health activities contract are failed to be
fulfilled or the contract is unilaterally terminated through the
fault of the health activities customer, the losses incurred by
the health activities subject (contractor) shall be compensated
with the funds of the health activities customer.
Chapter 4
Paid Services in Health Activities Rendered by State
and Municipal Institutions of Individual and Public
Health Care and Subjects of Pharmaceutical Activities
Article 29. Paid Individual Health Care Services
Paid individual health care services shall comprise the
following:
1) individual health care measures entered in the list drawn
up by the Ministry of Health and the National Health Council and
approved by the Government of the Republic of Lithuania;
2) services (bed linen, hospital clothing, telephone, TV
set, etc.), entered in the list established by the Ministry of
Health, which are rendered in in-patient individual health care
institutions;
4) provision with medicines which are more expensive, but
possessing analogous effect in in-patient medical treatment
institutions; and
5) services entered in the list established by the Ministry
of Health, which are rendered in individual health care
institutions upon the death of a patient.
The procedure for rendering of paid individual health care
services, rates, procedure for paying and reduced charges shall
be established by the Government of the Republic of Lithuania on
the basis of this Law, Law on State Social Insurance and other
laws.
Article 30. Paid Pharmaceutical Services
Paid pharmaceutical services shall comprise:
3) sale without a prescription of medicines (except for
medicines possessing narcotic and psychotropic effects, which are
entered in the established list) to the population in pharmacies;
4) accepting of orders by telephone from medical treatment
institutions and legal persons accredited for individual health
care for compounding of extempore medicines (except for medicines
possessing narcotic and psychotropic effects which are entered in
the established list);
6) other services.
The procedure for rendering of paid pharmaceutical services,
rates, procedure for paying and reduced charges shall be
established by the Government of the Republic of Lithuania on the
basis of this Law and other legal acts.
Article 31. Paid Public Health Care Services
Paid public health care services shall comprise:
1) health training of workers of professions, jobs, branches
of production established by the Ministry of Health of the
Republic of Lithuania;
2) public health monitoring, public health expert
examination conducted on the order of interested legal and
natural persons;
3) preventive vaccination of adults, with the exception of
the vaccination carried out in the centers of dangerous
infections and for the purpose of treatment;
4) disinfection, disinsection, deratization of premises and
territories, except for works, carried out in the centers of
dangerous and extremely dangerous infections;
5) issue and distribution of normative documents of
standardization and other publications concerning the matters of
public health care;
7) other public health care services.
The procedure for rendering of paid public health care
services, rates, procedure for paying shall be established by the
Government of the Republic of Lithuania on basis of this Law and
other legal acts.
Part II
Health Activities
Chapter 1
Engaging in Health Activities
Article 32. The Right to Engage in Health Activities in
the Republic of Lithuania
The right to engage in individual or public health care or
to apply its measures shall be enjoyed by persons who have
received education and special training in institutions preparing
these specialists and authorized by the Government of the
Republic of Lithuania to issue documents certifying an adequate
qualification of an individual or public health care specialist,
as well as who are accredited in the manner prescribed by this
Law and other legal acts for individual or public health care and
who possess the license to engage in these types of activities in
the Republic of Lithuania.
The conditions and procedure for accrediting of persons for
other types of health activities shall be established by this Law
and other laws.
In the procedure established by the Ministry of Health,
individual or public health care services may be rendered by
foreign individual or public health care specialists only for
charity purposes or for the purposes of specialist training,
unless otherwise provided for in international treaties of the
Republic of Lithuania.
Upon obtaining in the established procedure a license to
engage in private practice, specialists of state or municipal
institutions of individual or public health care shall have the
right to engage in private practice only outside these
institutions.
The Ministry of Health shall determine the qualification and
the procedure for recognizing of the qualification of persons who
have received individual or public health care education, but do
not have a special training.
The right to engage in health activities may be taken away
only on the basis and in the procedure established by laws.
Article 33. Professional Duties, Rights, Professional
Training and Responsibility of Individual and
Public Health Care Specialists
Laws and other legal acts shall establish main professional
duties, rights of individual and public health care specialists,
text of the Hippocratic oath and the conditions and manner in
which it is taken, procedure for restriction of their practice,
as well as the responsibility for the health damage done in the
process of health care.
Article 34. The Duty of Health Care Specialists to Keep
the Secret of Individual's Health (Medical
Secret)
Individual or public health care specialists shall be
restricted from violating of confidentiality of the information
about individual's health, which they have acquired while
performing professional duties. The medical ethics requirements
for keeping the information about individual's health
confidential shall be established by the Ministry of Health.
Chapter 2
Individual Health Care
Section 1
Preventive Medical Aid
Article 36. Information Services Regarding Prophylaxis
Questions
All those involved in individual health care shall provide
information services on issues of disease prophylaxis. The
Ministry of Health shall determine the conditions and order of
provision of such services.
Article 37. Selective Individual Health Examinations
Selective individual health examinations are conducted in
accordance with the decision of and the order established by the
Ministry of Health.
The Health Information Services shall determine the number
of respondents, who shall be subject to selective health
examinations, and the methods of collection, accumulation and
processing of the statistical information.
Article 38. Immuno-prophylaxis and Chemical Prophylaxis
of Communicable Diseases
The Ministry of Health shall establish the list of those who
must carry out the immuno-prophylaxis and chemical prophylaxis of
communicable diseases, as well as the contents, conditions and
order of the immuno-prophylaxis and chemical prophylaxis of these
diseases.
Compulsory measures of immuno-prophylaxis and chemical
prophylaxis may only be applied on the grounds and according to
the procedure provided by laws, in the event of an actual threat
that they may succumb to particularly dangerous or dangerous
communicable diseases.
Medical specialists who are in violation of the requirements
of this Article, are held responsible under the laws.
Article 39. Prophylactic Examinations
Workers of certain professions and individuals, working in
certain fields and lines of production, must submit to a health
examination prior to engaging in professional activity and during
the course of such activity. The Government of the Republic of
Lithuania compiles the list of workers in these professions, jobs
and production branches and sectors, as well as the procedure for
individuals' prophylactic examinations.
The health of workers of the professions, jobs and
production branches and sectors, listed by the Ministry of
Health, as well as of those individuals who had associated with
those who had contracted the diseases specified on the list of
communicable diseases, established by the Ministry of Health,
shall be subject to required health examinations.
Medical aid institutions shall within the prescribed time
limit, examine the health of:
3) individuals who had associated with patients, who had
contracted communicable diseases, included on the list
established by the Ministry of Health.
Workers of the professions, jobs, production branches and
sectors, listed and other individuals, who had associated with
patients, who had contracted communicable diseases, included on
the list of communicable diseases, provided by the Ministry of
Health, shall be quarantined and held under observation, for the
purpose of having their health monitored, over the period of
time, specified by this Law or other laws. In the event these
individuals, the persons close to them, or their representatives,
do not agree with the doctor's decision regarding isolation and
health status observation, these individuals must, in accordance
with the established order, be placed under compulsory quarantine
and compulsory health observation. The police must, at the
request of the institutions of health protection, assist in
placing such persons under quarantine.
Individuals working in the professions, branches and sectors
of production established by the Government, as well as
individuals who have associated with those who had contracted the
communicable diseases included on the list provided by the
Ministry of Health, who refuse to have their health examined in
the prescribed time period, shall be held responsible under the
laws.
Section 2
Medical Recovery Aid
Article 40. Vital Medical Aid
The following shall be attributed to vital medical aid:
2) institutional (in-patient or out-patient) urgent medical
aid.
For those individuals, who must be rendered medical aid, in
order to save their lives, because of accidents, accidental
emergencies, ecological or natural disasters, or due to sudden
onset of illness, medical and pharmaceutical specialists, who
were present together with the victims or patients at the site of
an accident or sudden acute and life-threatening illness, must
render first medical aid.
Out-patient medical aid must be provided by:
2) the nearest individual health-care institutions.
Urgent in-patient medical aid must be rendered in
specialised in-patient medical care institutions or specialised
sections of medical aid institutions, for rendering this type of
aid.
In the event the life of this individual is seriously
endangered, urgent in-patient medical aid may be rendered without
the consent of the individual, following a decision by at least
two consultant physicians, and having informed the patient, his
family members or his representative, and in instances where the
victim or suddenly taken ill individual, happens to be a minor,
his parents or guardians must be notified of the medical aid
rendered to him.
The Ministry of Health shall determine the content of urgent
medical care, the basis, conditions, and order of rendering it
and the competence of institutions of personal health care, and
medical/pharmaceutical specialists on questions of rendering
urgent medical aid, in keeping within the allotted fund limits.
The Ministry of Health shall determine the structure,
establishment and order of financing, and competence of mobile
urgent medical aid services.
Individuals, who are bound by this Law and other legal acts,
to furnish vital medical aid, who have by their inaction or
actions, contributed to the health damage of victims or
individuals experiencing sudden illness, shall be applied
disciplinary, administrative, material, and criminal
responsibility, as prescribed by laws.
Article 41. Application of Diagnostic and Treatment
Measures
The scope of diagnostic measures, applied at the medical aid
institutions of the Republic of Lithuania, must not be smaller
than those prescribed by the lists of obligatory measures in
disease diagnostics.
Medical aid specialists shall have the right to choose
treatment technologies, in the order prescribed by this Law and
other legal acts. The order of application of the treatment
technologies shall be established by the normative documents of
health care standardisation.
Medication shall be apportioned to diagnostic and treatment
measures, provided that it is:
2) they are registered in the Republic of Lithuania, in the
prescribed order;
A medical specialist may employ all scientifically
substantiated, but not yet registered, in the prescribed order
medicines, prophylactics, diagnostic and treatment methods,
medical equipment and instruments only in trying to cure the
patient and, to save or prolong his life. In this instance, he
must obtain permission of the patient, and if the patient is
unconscious, or is a minor, of his/her parents, relatives,
guardians, or his representative's permission and also, the
consent of the ethics commission, of the health aid institution,
regarding the use of such individual health care technologies
use. This consent must be executed in writing. When the patient
is in an unconscious state and there is no information available
regarding his relatives, parents, guardians or his/her
representatives, these technologies shall only be applied by
written consent and with the approval, by at least, two
physicians in consultation, as well as that of the ethics
commission of the medical aid institution.
The application of compulsory hospitalisation, compulsory
diagnostic, and compulsory treatment measures to individuals,
shall only be allowed in accordance with the order prescribed by
law, in the presence of a genuine threat, that these individuals
by actions, or because of the state of their health may cause
substantial harm to their own health or life or to that of other
persons. Medical experts, who violate these requirements, shall
be held responsible in accordance with the order prescribed by
law.
Article 42. Transfusions of Human Blood and its Products
Human blood for transfusion purposes or blood products'
production, may be taken from a donor solely, of the free will
and by the consent of the donor. Human blood and its products may
only be imported in and transported out of the Republic of
Lithuania, for donor purposes, on the basis of agreements
concluded with legal persons of foreign countries, by individual
health care facilities accredited for this purpose.
The conditions and order of importing into the Republic of
Lithuania and exporting from it of human blood and its products,
the quantity of donor's blood and its products, intended for
individual treatment use, to be imported into the Republic by
Lithuanians and foreign nationals, and the conditions and order
of conducting tests of human blood and its products in order to
ascertain their harmlessness to human health, to be used for
transfusion, shall be established by the Ministry of Health.
The conditions and order of taking of human blood for
donorship, production of blood products and use of human organs
and tissue for transplants, medical research, diagnostics and
treatment, order and conditions shall be established by laws.
Individuals in violation of this Article shall be held
responsible in accordance with laws.
Article 43. Transplantation of Human Tissue and Organs
Human tissues and/or organs may not be objects of commercial
transactions and must be used only for transplants or for
biomedical research purposes. The purchase or sale of human
tissue and/or organs of the human body and the advertisement of
such activities, shall be punishable in accordance with the laws.
Conditions and order of the use of human tissues and organs
taken from a body, for use in transplantation, medical research,
diagnostics and treatment and tissue and/or organ donor rights,
are established by laws.
Section 3
Medical Rehabilitation, Nursing , Social Services, Care and
Assistance Attributed to Individual Health Care
Article 44. Medical Rehabilitation
The conditions and order of Medical rehabilitation of
patients, in medical assistance and nursing facilities, patient
selection and their dispatching to rehabilitation hospitals and
sanatoriums shall be established by the Ministry of Health.
The fundamentals of the invalids' medical rehabilitation
organising system shall be established by the Law on Social
Integration of Invalids. The conditions and order of medical
rehabilitation of invalids is established by the Government of
the Republic of Lithuania.
The order of identification of localities suitable for
medical (and social) rehabilitation, as resorts, as well as the
conditions of resort organisation, shall be established by the
Government of the Republic of Lithuania.
Article 45. Nursing
Individuals shall be nursed at home, as well as, in medical
aid, nursing and social care institutions.
The content, conditions and order of nursing of disabled and
senior individuals shall be established by the Government of the
Republic of Lithuania.
Article 46. Social Services and Social Care Provided
under Individual Medical Care
Provision of social services and social care shall be
organised within the auspices of individual health care for the
purpose of reducing the psycho-emotional stress level and to
assist them in fighting stress and ensure their social security.
The social services and social care are managed by the social
workers of medical aid institutions.
The order and conditions of the social services kinds and
the scope of supplying them, the content of social care of an
individuals in health care, as well as the regulations guiding
health care social workers, are established by the Government of
the Republic of Lithuania.
The order of social workers preparation and the raising of
their qualifications is established by Ministries of Social
Protection and Labour.
Article 47. Services and Other Assistance, Attributed
to Medical Aid
The following services and other types of assistance are
attributed to medical aid:
1) pharmaceutical aid (prescription acceptance and checking,
selection of medicine of equivalent effect, oral or written
information of the individual regarding administering of the
medicine, informing about the safe use of the medicine, issuing
of non-prescription medicine, issuing for self-administering of
medicines, or other means of medicinal purpose, in accordance
with the health condition problems, indicated by the individual
and in the order established for issuance of the medicine,
provision of information regarding its availability);
2) patient transportation, prosthesis, orthopaedic
appliances, provision with compensational equipment, articles and
products (including food products), used in medical aid, and
services.
The services, as well as other assistance, specified in the
first part of this article, shall be attributed to medical aid,
provided they:
2) they are included in the list of prescribed services,
compiled by the medical aid subject and the customer of his
activities, the Ministry of Health, or municipal governments,
when these services belong to an individual's health care,
supported by state or municipalities.
The medical aid shall not comprise services and products
intended for cosmetic or hygienic use, even if they are also
beneficial for individual health purposes.
Section 4
Expert Examination of Individual's Health
Article 48. Expert Examination of the Health Potential
of an Individual
Individual health potential expert examinations shall be
performed by health centres. The Ministry of Health shall
establish the order of the performance and organisation of this
expert examination.
Article 49. Medical Expert Examination of Ability To
Work
Temporary individual expert examination of work ability
shall be performed by medical aid institution doctor or doctors'
commission. The order of organisation and performance of this
expert examination shall be established by the Ministry of
Health.
Article 50. Medical and Social Expert Examination
In instances of long-term or permanent disability, a medical
and social expert examination shall be performed by a state
medical aid institution social and medical commissions and State
medical-social expert commissions. The order of approval of
regulations and competence of these commissions and their
competence is regulated by the Law on Social Integration of
Invalids. The medical and social criteria, regarding long-term or
permanent work disability, shall be established by the Ministry
of Health along with the Ministry of Social Protection and the
Ministry of Labour.
Article 51. Forensic Expert Medical Examination
The forensic medical expert examination shall be performed
based upon the decision of the interrogation bodies,
investigation bodies, or per decision by the prosecutor, or court
decision, as well. Expert examinations shall be performed by the
State Forensic Medicine Service. The order of the expert
examination and performance is established by the Government of
the Republic of Lithuania.
Article 52. Forensic Psychiatric and Forensic
Narcological Expert Examination
Forensic psychiatric and forensic narcologic expert
examinations shall be conducted based on the decisions by
interrogation bodies, investigation bodies, or the prosecutor, as
well as court decision. Expert examinations shall be performed by
the State Forensic Psychiatric and Forensic Narcological Service.
The order of organisation and performance of the expert
examination shall be established by the Government of the
Republic of Lithuania.
Article 53. Pathoanatomical Expert Examination
Pathoanatomical expert examination shall be performed,
following the death of an individual. The conditions and order of
the pathoanatomical examination (autopsy) shall be regulated by
laws and other legal acts.
Chapter 3
Public Health Care
Article 54. Universal Character of Public Health Care
The duty of all natural and legal persons shall be to take
care of public health, the aim of which consists in promoting of
health, preventing of the deterioration of the quality of
consumer goods, food products, drinking water and residential,
work, and natural environment, preventing of diseases and
traumas, and decreasing the morbidity rate. Legal and natural
persons who are in violation of this requirement, shall be held
responsible, in accordance with the order established by this and
other laws.
Article 55. Promotion of Public Health
The promotion of public health shall consist of:
4) family planning consultation.
Health propaganda, supporting initiatives of health policy
shall be organised through the mass media by the Government of
the Republic of Lithuania or municipalities, from the Government
or municipality funds. The Government of the Republic of
Lithuania shall determine the order and conditions with reference
to the health propaganda disseminated through mass information
media.
Health knowledge promoting a healthy lifestyle among the
population, shall be popularised, consultations on family
planning shall be organised in accordance with state and
municipality health programs.
Health instruction shall be comprised of the totality of
voluntary and compulsory health education measures, as well as
physical training and physical culture measures.
The conditions and order of health promotion shall be
regulated by this and other laws and legal acts.
Article 56. Protection of Public Health
The basis of public health protection shall be comprised of
a system of measures limiting harm and danger in living, working
and natural environment.
Prevention and limitation of danger and harm to health shall
be implemented:
by applying:
1) hygienic regulation of indicators and requirements of
non-dangerousness and harmlessness of economic or another type of
activity, to health of the working, living and natural
environment, foodstuffs and drinking water and raw materials,
machinery and equipment, as well as other goods;
3) accrediting of legal and natural persons for individuals
and public health care activities;
by establishing:
5) quotas for production of goods detrimental to health;
by suspending economic-commercial and other activities
detrimental or dangerous to health;
by applying individual excise duties to the goods
detrimental to health, included in the Law on Excise Duties and
other methods of economic regulation;
by applying responsibility, established by law for
violations of legal acts on health activities.
Raw materials, equipment, machinery, building materials,
elements of residential dwelling interiors, food and its
packaging, tare, other goods, and drinking water should not incur
any risk to health, or else this risk may only be minimal.
Standardisation normative documents of the Republic of Lithuania,
which are being prepared by the Ministry of Health, determine
requirements for and indices of non-dangerousness and
harmlessness to health, working, residential and natural
environment.
The types of economic-commercial activities that are
detrimental to human health, and their work and living
environment, for which a permit must be obtained from the
Government of the Republic of Lithuania, or from the State Public
Health Care Service, authorised by it, shall be limited through
refusals to issue licenses for such activities, in accordance
with decisions by the Law on Enterprises.
Economic-commercial activities by enterprises, that have an
adverse effect upon people's health, and their working and health
environment, must be limited in accordance with the order
established by the Law on Enterprises, shall be limited by
refusing of revoking the permit (license) for this activity.
The criteria for such revocation and suspension or banning
of the above-mentioned activities and the order of granting
authorisation to legal persons, shall be established by this Law,
the Law on Enterprises and other laws and legal acts.
State agencies and state inspectorates, which are exercising
control over public health, shall decide on the harmfulness of
the economic-commercial and other activities.
The conditions and order of expert examinations regarding
the harmfulness or dangerousness to health of services of
economic and commercial and other activities, living, working, or
studying conditions, various structures, their designs,
technological processes, drinking water, raw materials, machinery
and equipment and other goods and services laws and other state
acts shall be established by the laws and other legal acts. The
lists of goods detrimental or dangerous to health the production
and sale of which and supplying of services detrimental and
dangerous to health, must be prohibited and limited in accordance
with the order established by this Law, and the lists shall be
confirmed by the Government of the Republic of Lithuania.
Production quotas of harmful or dangerous goods, whose
manufacture must be limited, shall be established by Government
agencies, which issue permits (licenses), for the manufacture of
such goods.
The order of accreditation in health supervision or
pharmaceutical activity and taxation of harmful goods by
individual excise amounts, shall be determined by the Government
of the Republic of Lithuania.
Article 57. Prophylaxis and Control of Contagious
Diseases
Those individuals engaged in health activities shall carry
out the first, second and tertiary prophylaxis of and exercise
control over infectious diseases, within their competence.
The Government of the Republic of Lithuania, ministries and
other Government agencies shall guarantee the protection of the
territory of the Republic of Lithuania and its population members
from the importation and spread of particularly dangerous and
dangerous contagious diseases. The Ministry of Health shall
approve and update lists of such diseases. The order of
application of a system of sanitary-antiepidemic and quarantine
measures intended to protect the population from particularly
dangerous and dangerous diseases shall be established by the
Government of the Republic of Lithuania. Veterinary-sanitary
requirements for the prophylaxis of the previously-mentioned
diseases shall be established by the Veterinary Law.
In the event of the existence of a threat of appearance or
spread of infectious diseases and after the appearance and spread
of such, the Government of the Republic of Lithuania, or
municipal governments may, in the order prescribed by laws,
introduce within appropriate territories, state of emergency
measures and regimes regarding work, study, travel and
transportation, in order to provide protection from such
diseases.
Legal and natural persons, who have violated the established
requirements regarding the prophylaxis and control of
communicable diseases, shall be held responsible in accordance
with the laws.
Article 58. Extraordinary Situations Affecting Public
Health
Situations that are extraordinary with respect to public
health, shall be the circumstances which arise in development of
public health, under which the effect of environmental factors
cause a sudden:
2) occurrence of group or mass damage to the health of the
population.
The territory where the danger of group or mass health
damage suddenly arises, is declared a region dangerous to the
health of the population, shall be declared by the Government of
the Republic of Lithuania a region dangerous to public health.
The territory on which damage is caused to the health of
groups of the population, or the health of a large population
mass is harmed, is declared by the Government of the Republic of
Lithuania an area harmful to public health.
The criterion for determining extraordinary to public health
situations, the administration, control, and removal of effects
negative to public health and economy, and also the order of
their financing, shall be approved by the Government of the
Republic of Lithuania.
Article 59. Prophylaxis and Control of Non-Infectious
Diseases and Traumas
Enterprises, establishments, organisations, medical aid and
social rehabilitation and nursing institutions shall control
within their competence cases of non-infectious illness, as well
as prophylaxis of traumas, morbidity and traumatization.
The conditions and order of prophylaxis and control of
occupational diseases and poisoning shall be established by the
Law on Safety at Work, other laws and legal acts.
Prophylactic measures and content of traumatization
resulting from transport-connected circumstances are established
by the Government of the Republic of Lithuania.
The application of measures of secondary and tertiary
prophylaxis of non-infectious diseases shall be established by
this Law and other legal acts.
Article 60. Public Health Control
Public health control shall be exercised by the State and
municipalities.
9) state medical audit.
Municipalities shall maintain sanitary control of healthy
living environment within their respective territories.
The content of public health control, order of its
implementation and the competence of control institutions shall
be regulated by this Law, the Law on Veterinary Medicine, Law on
Environmental Protection, Law on Labour Protection, other laws
and legal acts.
The content and order of sanitary control, which must be
conducted by municipalities within their territorial
administrative units shall be established by the Government of
the Republic of Lithuania on the proposal of the Ministry of
Health.
Article 61. Suspension of Economic and Commercial
Activities Detrimental to Health
State inspections and municipal sanitary inspections,
exercising public health control shall have the right to demand
that the employer (individual authorised by him) would suspend
the work if:
2) it becomes evident that raw materials, manufactured and
sold production, sold goods and means of work are harmful to
health;
3) due to violation of normative documents of health care
standardisation, the health environment becomes dangerous to
health or damage to health is done;
4) other grounds established by the laws.
The order of suspension of work due to danger and harm to
health causes, is established by this law, Labour Protection Law
and other laws.
State inspectorates, controlling public health care, and the
municipality sanitary inspectorates, who determine legal act
violations of public health care, may apply penalties and
economic sanctions, whose order of application and exaction is
established by the Code of Violations of Administrative Law, and
other laws and legal acts.
Article 62. The Functions of Health Activity
Management, Attributed to Public Health Care
The functions of health activity, described in Part IV,
Chapter 2, Articles 86,87,88,89,90, and 94 are attributed to
public health care.
Chapter 4
Pharmaceutical Activities, Traditional Medicine,
Folk Medicine and Non-Medical Measures
of Health Recovery
Article 63. Pharmaceutical Activities
Only legal individuals, enterprises, not holding the status
of legal person, natural individuals, who are accredited for this
activity, shall have the right to engage in pharmaceutical
activities.
The structure of pharmaceutical activity, the legal bases of
its organisation and the order and the conditions of
accreditation of this activity shall be established by this Law,
the Law on Pharmaceutical Activity and other laws and legal acts.
Article 64. Traditional medicine, Folk Medicine, Non
-Medical Health Recovery Measures
Traditional medicine, folk medicine, non-medical health
recovery measures shall be supplied solely by juridical and
natural individuals, accredited in the order prescribed by legal
acts, for this activity. The order and conditions of traditional
medicine, folk medicine services and non-medical measures of
health recovery application are established by this Law and other
legal acts.
Part III
Executive Bodies of Health Activities,
the Content of their Rights and Duties
Chapter 1
Executive Bodies of Health Activities,
Public Health Care Pharmaceutical Activity Subjects
and their Founding
Article 65. Individual Health Care, Public Health Care
and Pharmaceutical Activity Entity Founding
Founding of individual health care, public health care and
pharmaceutical activity shall be regulated by laws and other
legal acts.
The public individual health care, public health care
institutions, and public pharmacies shall be founded by a
decision of the Government of the Republic of Lithuania or upon
its order, by the Ministry of Health.
Municipality individual health care and public health care
institutions, or pharmacies shall be founded per decision of a
municipal council.
Subjects of individual health care, public health care, or
pharmaceutical activity, functioning in accordance with the right
of private ownership, shall be founded by the decision of the
founders themselves, upon obtaining a permit (license) from the
Ministry of Health.
Article 66. Founding Documents of Individual Health
Care, Public Health Care and Pharmaceutical
Activity Subjects
Individual health care, public health care, as well as
pharmaceutical activity founding documents shall be:
1) documents issued by State accrediting service or State
pharmaceutical control service in accordance with its area of
competence, attesting to the projected possibilities of the
subject to ensure the required conditions of health activity;
2) individual health care, public health care, as well as
pharmaceutical activity subjects' regulations (bylaws);
3) documents established by the Law on Enterprises or by
other laws.
The regulations (bylaws) of individual health care, public
health care and pharmaceutical activity subjects are established
in accordance with model regulations (bylaws) approved by the
Government of the Republic of Lithuania.
Article 67. Forms of Ownership and Subjects of Property
Right within Individual Health Care, Public
Health Care and Pharmaceutical Activity
Forms of ownership, as well as property right subjects
within individual health care and pharmaceutical activity, are
regulated by the Civil Code.
The property right objects, which are necessary to implement
primary health activity, within a municipal territory, shall be
assigned in accordance with municipal property laws.
Article 68. Types and Range of Economic Activity of
Subjects of Individual Health Care, Public
Health Care and Pharmaceutical Activity and
Their Nomenclature
The type of economic activity conducted by subjects of
individual and public health care and pharmaceutical activity, as
well as their competence, shall be established by their founders
and the laws.
Subjects of individual health care, public health care, as
well as pharmaceutical activity, which are being set up and
function as State or municipal institutions, and also the types
of health activity, that can be carried on solely by them, shall
be established by this and other laws.
The range of subjects of individual health care, public
health care, as well as pharmaceutical activity, shall be
regulated by this Law and other legal acts, in accordance with
the health activity carried out by them.
Article 69. Registration and Reregistration of State
and Municipal Individual and Public Health
Institutions
Every state or municipal individual or public health care
institution, prior to beginning of its health activity, must be
registered in the register whose founder and senior registrar
shall be the Ministry of Health. This register shall also be
administered by the managerial bodies of municipalities.
The Ministry of Health shall register only individual health
care and public health care institutions, founded from state
funds, and shall collect and process all data on all individual
health care and public health care institutions registered with
the municipalities of the Republic of Lithuania.
Municipal administrative bodies shall register, accumulate
and process data of individual and public health care
institutions, founded on the basis of municipal funds.
In the event, state or municipal individual or public health
care institution founding document shall be changed or amended,
they must be reregistered in accordance with the established
order.
The order of the registration and reregistration of the
above, as well as the grounds for refusal to register State and
municipal individual or public health care registration and
reregistration shall be established by the Government of the
Republic of Lithuania.
Article 70. Liquidation of State and Municipal
Individual or Public Health Care Institutions
and Enterprises Engaged in Health Activities
The grounds for liquidation of State or municipal individual
or public health care institutions may be:
2) the decision of the Ministry of Health or the municipal
council to revoke the registration of the institution founded by
the Ministry of Health or the municipal board, when they fail to
obtain accreditation for individual or public health care.
Grounds for liquidation of enterprises, engaging in health
activity, shall be established by the Law on Enterprises.
Chapter 2
Individual Health Care, Public Health Care
and Pharmaceutical Activity Entity Rights
and Obligations
Article 71. The Rights of the Entities of Individual
Health Care, Public Health Care and
Pharmaceutical Activities
Individual health care, public health care and
pharmaceutical activity entities shall have the right to:
1) conclude agreements on health activities in accordance
with this Law and other laws, as well as agreements provided for
in the Civil Code;
2) hold accounts in one of the Republic of Lithuania, as
well as one foreign-registry banks, and use the funds contained
therein;
3) to establish ways and means of utilising of all the
capital on hand, to the extent this does not contradict this Law,
other laws and individual health care, public health care, or the
pharmaceutical activity entity's regulations (bylaws);
4) conclude agreements on short-term interest free loans
from non budgetary income to state (municipal) health care
institutions, or on obtaining such loans;
5) establish, to the extent it does not contradict this Law,
individual or public health care subject's regulations (bylaws),
internal organisational structure, as well as its branches, for
the purpose of servicing the primary activities of the subject of
the individual health care, public health care or pharmaceutical
activity and to receive additional income for its development and
to define the legal status of divisions;
7) establish personal health care activities and services,
medicines and other medicinal article prices, tariffs, work
compensation systems, excepting those instances when, according
to this, or other laws, the prices of individual or public health
care and service, medicine, and other medicinal designation
article prices and other normatives, shall be regulated by the
Government of the Republic of Lithuania and municipalities;
8) submit legal claims for damages inflicted upon them
through illegal acts of state authority bodies, municipal boards,
health insurance institutions, and also by officials, in the
performance of their job-related duties and administrative
management actions.
Individual or public health care subjects may also have
other rights, provided they do not contradict this or other laws,
as well as individual health care, public health care of
pharmaceutical activity founding documents of the subjects.
Article 72. The Duties of Individual Health Care,
Public Health Care and Pharmaceutical
Activity Entities
The duties of individual health care, public health care and
pharmaceutical activity entities shall be as follows:
1) to observe the requirements of this Law and other health
activity laws, as well as those of legal acts;
3) to attempt to prevent danger and damage to health or
environment in health activity, and to also, limit the possible
health danger and damage effects of this activity;
4) to ensure the compliance of their health activity with
the provisions set forth in accreditation documents;
6) to supply the population with information concerning
individual health care, public health care institutions and
services, pharmacies, their activities and the services rendered
by them;
7) to ensure individuals right to obtain information
regarding one's own health, as well as the confidentiality of
such information;
8) to organise public health monitoring and provide
statistical health information, in the established order;
9) to provide timely information to State public health care
service concerning identified contagious disease cases;
10) to organise in the order, prescribed by this Law, other
laws and legal acts, the individual health care of medical
personnel;
11) to organise, on the basis and order established by laws
and other legal acts, liability insurance for subjects of
individual health care, public health care and pharmaceutical
activity, for health damage caused while performing health-
related activities.
Individual or public health care subjects may also have
other duties, provided they do not contradict this and other
laws, as well as their founding documents.
Part IV
Fundamentals of Health Activity Management
Chapter 1
Ways and Means of Health Support
Article 73. The Use of State Regulatory Subsidies for
Health Activity Regulation
Health relations shall be regulated through application of
economic means regulated by laws and other legal acts:
11) other economic measures.
Article 74. The use of Special-Purpose Budgetary
Subsidies for the Support of Health
Activities
The priorities of distribution of special-purpose budgetary
subsidies for support of health activities shall be as follows:
2) acquisition of expensive medical technologies and
equipment, and its introduction into state individual and public
health care institutions and state pharmacies;
3) elimination of negative consequences for public health,
resulting from extraordinary situations (epidemics, natural
disasters, ecological catastrophes);
4) other individual and public health needs established by
the Government of the Republic of Lithuania.
The Government of the Republic of Lithuania shall set the
specific objects of subsidies.
Article 75. Application of Soft Loans
Interest on obtained loans shall be paid out of state or
municipal budgets, in accordance with the order established by
the Government, to legal and natural persons who are clients of
required state or municipal health programs and have approved
them in accordance with the established order and to state
medicine supply enterprises that have received bank loans for the
implementation of such programs or the supply of medicines of the
indispensable assortment and other articles of medicinal purpose
to Lithuania.
Article 76. Order of Fixing the Prices and Tariffs on
the Measures and Services of Required Level
of Health Activities
The basic prices and tariffs on measures and services of
required level of health activities shall be approved by the
Government of the Republic of Lithuania or, upon its
authorisation, the Ministry of Health. It shall fix them to be
uniform throughout the country, upon co-ordinating them with the
State Price and Competition Service, the State Patients Fund,
State Public Health Care Services, as well as other interested
subjects of health activities. In case the Ministry of Health
does not agree with the established prices, in the month prior to
the end of the current budgetary year, they shall be indexed by
the Government of the Republic of Lithuania, at least once a
quarter, should the quarterly inflation rate exceed 10 per cent.
Article 77. Compensation of Costs of Measures and
Services of Required Level of Health
Activities to the Population
Individual health care and services shall be provided free
of charge to the citizens of Lithuania and persons without
citizenship permanently residing in Lithuania, according to basic
prices fixed for the indispensable diagnostic measures and
medicines and other articles of medicinal purpose of
indispensable assortment.
The differences between the basic costs of individual health
care, supported by the state or municipalities, shall be covered
in accordance with the order established by Law, from the
required health insurance funds.
Article 78. Compensation of Costs of Other Means and
Services of Health Activities Required from
Required Health Insurance Funds
The order of compensation of costs from the required health
insurance funds, to persons to whom the health care and services
supported by the state, are not applied, in accordance with
Articles 18 and 19 of the present law, shall be established by
the laws and other legal acts.
Article 79. Encouragement of Professional Improvement
of Health Care Specialists
The costs of raising qualifications or requalification of
medical specialists in individual and public health care
institution and services of State or municipality shall be
compensated from the state and municipal budgets, in accordance
with the order and conditions established by the Government of
the Republic of Lithuania, provided other laws do not establish
compensation for these costs from other sources.
The costs of qualification improvement and requalification
of pharmaceutical enterprise specialists shall be covered from
the funds of these enterprises.
Article 80. Liability Insurance of Enterprises and
Institutions Accredited for Individual Health
Care for the Damage Caused to Individuals'
Health in the Course of Individual Health
Care
Enterprises and institutions accredited to provide
individual health care must obtain liability insurance for
damages caused to individuals', health in the course of
individual health care treatment.
The provisions and order of concluding the required
insurance agreements, the sources of required insurance and the
order of utilisation of these funds by enterprises and
institutions accredited to provide individual health care,
liability for damages caused, shall be established by the Law on
Insurance, other laws and legal acts.
Article 81. Support to Health Care Establishments, for
Health Care Program Implementation and Public
Health Care
The order of support to individual and public health care
institutions shall be established by the Law on Charity and
Sponsorship.
The costs of individual and public health care with respect
to groups of the population whose health is strongly influenced
by the health risk factors, except in cases where the risk
factors arise from the individual's harmful habits may be covered
from state or municipal health program funds. Such population
groups shall be identified by the Ministry of Health.
Article 82. Support of Programs of Public Organisations
Protecting Public Health Interests
The resources of the State Health Fund and the health funds
of municipal state funds, enterprises, establishments,
organisations, religious establishments and other legal or
natural persons may be utilised for the support of action
programs of public organisations, who protect public health
interests, in the established order. The conditions and order of
the support of these funds shall be established by the Government
of the Republic of Lithuania.
Article 83. Restrictions on Advertising of Goods and
Services Harmful to Health
The advertising of alcohol and tobacco products and of other
goods and services having a negative effect on health shall be
prohibited in the Republic of Lithuania. The procedure for the
prohibition or restriction of the advertising of such goods and
services shall be prescribed by the laws and other legal acts.
Article 84. Application of Economic Sanctions
Economic sanctions may be applied to enterprises upon
disclosing violations of legal acts regulating health activities
or when legitimate instructions of state inspectorates, state
agencies controlling public health care, pharmaceutical
activities, quality control of medicines and medicinal substances
are not complied with. economic sanctions may also be applied to
enterprises when there are cases of concealment of accidents at
work, occupational diseases, occupational poisonings, hospital
infections or contagious diseases.
The procedure for the application of sanctions in cases
referred to in this Article, their collection and appealing
against as well as the rate of sanctions shall be set by laws.
Chapter 2
Management Functions of Individual Health Care,
Public Health Care, Pharmaceutical Activities
and other Health Activities
Article 85. Restrictions on Making Available to the
Public of Information Concerning the Health
of an Individual
The availability of information on the health of an
individual may be restricted only in cases provided by laws when
such information represents a secret of individual's health (
medical secret). The criteria of a secret of individual's health
(medical secret) shall be established by laws.
It shall be prohibited to announce information concerning
individual's health through the mass media without his/ her
written consent. Protection of information on the health of an
individual stored in computers must ensure its confidentiality.
The requirements for the protection of confidentiality of
information concerning individuals' health, which is stored in
computers belonging to subjects of health activities shall be set
by the Ministry of Health.
Persons who violate confidentiality of such information
shall be liable under the laws.
Article 86. Public Health Information and its
Monitoring
Information concerning public health must be available to
the public without restrictions and it may not be considered the
State secret.
The system of public health monitoring shall be established
in the Republic of Lithuania for the observation of public
health, physical, chemical and biological factors of health,
health care requirements and resources, accessibility and
adequacy of health care , and registering of information on these
issues.
The monitoring of public health shall be conducted by the
ministries, other state-run institutions, municipalities,
enterprises and health care facilities within the scope of their
competence.
The public monitoring of public health shall be conducted by
the State Public Health Care Service.
The content, structure, charges for public health
monitoring, the procedure for its conducting and the procedure
for making the monitoring data available to the public , as well
as the scope of competence of the subjects of public health
monitoring shall be established by the laws and regulations.
Article 87. Expert Examination of Public Health
Public health expert examination shall be carried out for
the purpose of assessment of the data of the public health
monitoring.
Such expert examination shall be carried out by the
ministries , other governmental institutions,municipalities,
enterprises and health care institutions within the scope of
their competence.
The state public health expert examination shall be carried
out and the conclusions shall be presented by the Ministry of
Health and the State Public Health Care Service as well as other
legal persons authorised by the Government.
The fundamentals and content of public health expert
examination, the procedure for its financing, conduct and making
available to the public of its findings, charges, and competence
of the subjects of public health expert examination shall be
established by the laws and other legal acts.
Article 88. Planning of Health Activities
Programme planning shall form the basis for the planning of
health activities in the Republic of Lithuania.
The Seimas of the Republic of Lithuania shall approve, on
the proposal of the Government, the objectives of health
activities, the indices of health level to be achieved on the
national scale and the Health Programme of Lithuania for the
period of at least 10 years. The structure of the Lithuanian
Health Programme as well as the procedure for its preparation,
financing, implementation, and control shall be governed by the
regulations approved by the Government of the Republic of
Lithuania.
For the fulfilment of the tasks defined in the Health
Programme, the Government, ministries, other government
institutions, and municipalities shall prepare relevant
government, sector or municipal comprehensive or special-purpose
programmes, or shall provide for the measures for the
implementation of these tasks in other social and economic
development programmes.
The procedure for the preparation, approval, financing,
implementation and supervision of the health programmes shall be
governed by the regulations approved by the Government of the
Republic of Lithuania.
Article 89. Standardisation of Health Care and
Pharmaceutical Activities
Conditions for the implementation of individual and public
health care and the quality of medicines must be in conformity
with the requirements set by the standardisation normative
documents of the Republic of Lithuania.
Such documents shall be prepared by the institutions of the
health care system and shall be approved by the Ministry of
Health or the Lithuanian standardisation service under the
Ministry of Economics.
In such cases where the quality of health care is not
regulated by standardisation documents, the requirements set for
the health care conditions may be legalised by the acts issued by
the Ministry of Health.
Legal and natural persons who do not meet the requirements
set by the standardisation normative documents shall be liable
under the laws.
Article 90. Accrediting of Legal and Natural Persons
for Health Activities
The right to engage in health activities shall be granted to
persons who have received special training and licences in
accordance with the procedure prescribed by this Law, other laws
and legal acts. The right to provide specific health care
services shall be granted to persons who have been issued
certificate ( a document confirming the right to render specific
services) in the manner prescribed by the laws of the Republic of
Lithuania.
The right to engage in health activities shall be granted to
legal persons and enterprises without the right of a legal person
that have received permit to engage in such activities in the
manner prescribed by this Law, other laws and legal acts.
Individual or public health care licences, certificates and
permits shall be issued or revoked by the State Service of
Accrediting for Health Care under the Ministry of Health.
The procedure for the issue, registration and revocation of
licences, certificates and permits shall be regulated by this
Law, other laws and legal cats. A licence to engage in health
activities shall state the type of an institution, financing
sources, profit distribution, and the procedure for furnishing
information about its activities to the public. Permits
(licences) and certificates shall be issued on the basis of the
structure of the types of health activities established by this
Law.
The disputes concerning the issuing, registration and
revocation of licences, certificates and permits shall be settled
in court.
Health activities carried out by unaccredited natural
persons and enterprises without the rights of a legal person
shall be illegal. Natural and legal persons who engage in illegal
health activities shall be liable under the laws.
Professional organisations of medical and pharmaceutical
employees may participate in the accrediting activities of health
care facilities and pharmaceutical enterprises, and their
employees according to the procedure established by this Law and
other legal acts.
Article 91. Control over the Implementation of
Necessary Conditions of Individual Health
Care
Administration of every facility of individual health care
must conduct a local medical audit of the adequacy and
accessibility of individual health care. The procedure for the
local medical audit shall be established by the Ministry of
Health.
A patient willing to be sure in the adequacy of medical
service rendered to him, with the exception of cases of first
aid, shall have the right to apply to a physician selected by
him, who, at the written request of the patient, may agree to
carry out individual medical audit. The conditions, content and
procedure of the individual medical audit, as well as other
conditions shall be established by laws and other legal acts.
State medical audit shall be conducted by the State Medical
Audit Inspectorate under the Ministry of Health and the State
Patients' Fund. The content of the state medical audit and the
procedure thereof shall be established by the Government of the
Republic of Lithuania.
Article 92. Organising of Scientific Research into
Health Activities
The criteria for the applied and fundamental bio-medical
research shall be determined by the Ministry of Health in
conjunction with the Lithuanian Scientific Board.
The priorities of the applied bio-medical and public health
research shall be identified, ordered, financed and controlled by
the Ministry of Health.
The priorities of the fundamental bio-medical and public
health research shall be identified, ordered, financed and
controlled by the Lithuanian Scientific Board.
It shall be prohibited to conduct bio-medical research
without the approval of the Lithuanian Committee for Medical
Ethics. The requirements set for the ethics of biomedical
research and the procedure for their control shall be established
by the Law on Ethics of Bio-medical Research.
Research into health activities shall be conducted pursuant
to the agreements concluded in the manner prescribed by the Civil
Code.
Article 93. Organising of Training and Qualifications
Improvement of Health Care and Pharmaceutical
Specialists
The Ministry of Health and professional organisations of
health care specialists shall be concerned within the scope of
their competence with the training and qualifications improvement
of health care and pharmaceutical specialists.
A register of health care and pharmaceutical specialists
shall be established for the registration of health care and
pharmaceutical specialists, the manager of which shall be the
Ministry of Health.
The procedure for the qualifications improvement of
individual and public health care specialists and of
pharmaceutical specialists shall be established by the Ministry
of Health upon co-ordination with the professional organisations
of health care and pharmaceutical specialists.
Article 94. Evaluation of Health Care Technologies
The subjects of individual and public health care shall be
prohibited from applying the unevaluated technologies of
individual and public health care, with the exception of cases
provided by this Law.
The procedure for such evaluation shall be established by
the Government of the Republic of Lithuania.
So that the acquisition of expensive individual or public
health care technologies out of the state budget or municipal
budgets would be justified, the state-run or municipal health
care institutions must provide economic and social grounds for
the acquisition of such technologies to the State Medical Audit
Inspectorate under the Ministry of Health. The cost limits of
such technologies shall be set by the Ministry of Health.
Article 95. Procedure for the Application of Individual
and Public Health Care Technologies
Only the medicines, prophylactic, diagnostic and treatment
methods, medical equipment and instruments that are duly
registered in the Republic of Lithuania may be applied for
individual or public health care. Medicines that are not
registered in the Republic of Lithuania may be used only if there
are documents evidencing their registration in foreign countries,
as well as on other grounds provided by this and other laws. Such
medicines shall be used as prescribed by the Ministry of Health.
The procedure for the evaluation and registration of
individual and public health care technologies shall be
established by this and other laws and legal acts.
Chapter 3
Financing of Health Activities
Article 96. The Base Amount of Financing of the LNHS
Activities
The base amount of the financing of the LNHS activities
including the funds of state budget and municipal budgets and the
funds of the compulsory health insurance funds must, according to
the calculation methods prescribed by the Government, account for
5 % of the value of the GDP each year.
Article 97. The Grounds for the Financing of Executive
Bodies of the LNHS Activities
The executive bodies of the LNHS activities shall be
financed on the following bases:
1) documents certifying the accrediting of legal persons or
enterprises without the rights of legal persons, for individual
or public health care activities;
3) compulsory liability insurance contract for damage caused
to individual's health while providing individual health care,
entered into between the enterprises and institutions accredited
for individual health care.
The basis for the financing of works performed on the
compulsory public health care level shall be the conditions
referred to in items 1 and 2 of part 1 of this Article.
Article 98. Sources of Financing of the Facilities
Engaged in Health Activities
The state-run or municipal facilities of individual and
public health care accredited for certain types of health
activities shall be financed from the following sources:
6) interest on the non-budgetary funds of individual and
public health care facilities, kept in banks.
The procedure for the financing of state-run and municipal
facilities of individual and public health care , state-owned
enterprises accredited for certain types of health activities
from the funds of state budget and municipal budgets shall be
established by the Government of the Republic of Lithuania.
The private subjects accredited for health activities shall
be financed from the following sources:
5) resources of health funds of enterprises, institutions,
organisations, confessions, and of other legal and natural
persons.
Subsidies from the state budget and municipal budgets may be
allocated to private persons and facilities accredited for the
individual and public health care, for the purpose of ensuring
required level of works and services, accordance with the
procedure established by the Government or a local authority.
Resources of the State Health Fund and Municipal Health Funds may
be allocated for the implementation of health programmes.
Article 99. Financial Activities of State-run and
Municipal Health Care Facilities
State-run and municipal health care facilities shall
independently determine their cost structure other than labour
costs. The rates of labour costs shall be approved by the
Government of the Republic of Lithuania.
The terms of the payment of salaries for state-run and
municipal individual and public health care facilities without
exceeding the established norms shall be set forth in the Law on
Collective Disputes and Collective Agreements.
Article 100. Procedure for Financing of Public Health
Monitoring and Public Health Expert
Examination
The enterprises whose business or other activities make a
harmful effect on health and have an adverse effect on living and
working environment must incur the costs of monitoring of such
impact (health care monitoring) and public health expert
examination, which are carried out by the State Health Care
Service under the Ministry of Health and its subdivisions.
The enterprises the business activities of which or any
other activities cause harm to human health and the quality of
living and working environment shall be determined by the State
Hygiene Inspectorate at the State Public Health Care Service.
Article 101. Financing of Scientific Research into
Health Activities
The funds of the state budget allocated for health care may
also be applied for the financing of applied research into health
activities. Budgetary funds allocated for science and technical
progress shall be applied for the financing of scientific
fundamental research into health activities.
Article 102. The State Health Fund
The State Health Fund shall be established for the
accumulation of resources for the financing of government health
programmes and for the support of the programmes of activities of
non-government organisations that protect public health
interests. The State Health Fund shall be established by the
Government of the Republic of Lithuania.
The sources of the funds of the State Health Fund shall
consist of:
1) the share of state budget subsidies, set by the Seimas of
the Republic of Lithuania, allocated for the government
programmes of social and economic development;
2) the share of allocations of insurance agencies to the
preventive fund, established by the Council of Insurance Affairs;
3) share of excise duties on alcoholic beverages and tobacco
products as well as on ethyl petrol transferred to the Fund from
the cumulative account of the State Tax Inspectorate, prescribed
by the laws;
4) set portion of the return on utilisation of temporarily
idle funds of the insurers who pay state social insurance
contributions;
7) 50 % of funds received from the fines and economic
sanctions imposed for the violation of laws and other legal acts
regulating health activities; and
8) miscellaneous funds received by lawful means.
Article 103. Municipal Health Funds
Municipal Health Funds shall be established for the purpose
of accumulation of resources for the financing of public health
care programmes and for the support of the programmes of
activities of non-government organisations protecting the public
health interests. Municipal Health Funds shall be established and
their budget of expenditures shall be approved by Municipality
Council.
Model statutes of the Municipal Health Funds shall be
approved by the Seimas of the Republic of Lithuania.
The sources of the funds of the Municipal Health Funds shall
include:
5) part of allocations from compulsory health insurance
contributions into Municipal Health Funds, prescribed by the Law
on Health Insurance; and
6) other funds received by lawful means.
Article 104. Health Funds of Enterprises,
Institutions, Organisations, Confessions, and
other Legal and Natural Persons
Enterprises, institutions, organisations, confessions, other
legal and natural persons shall have the right to establish
Health Funds for the financing of health programmes and support
of health institutions. The procedure for the formation and
liquidation of these Health Funds as well as the application of
their resources shall be set forth in their statutes that shall
be approved by the Government of the Republic of Lithuania. The
budget of expenditures of this Fund shall be approved by its
founder (founders).
The resources of the Health Funds of enterprises,
institutions, organisations, confessions and other legal and
natural persons shall consist of:
3) other funds received by lawful means;
Article 105. Financing of Pharmaceutical Activities
The sources of financing of pharmaceutical activities shall
include:
1) proceeds from medicines and other goods meant for medical
purposes sold in the Republic of Lithuania;
2) proceeds from the medicines and other goods meant for
medical purposes produced in the Republic of Lithuania and sold
abroad;
4) other funds established by laws.
Part V
Competence of the Managing Bodies of the LNHS
Chapter 1
Competence of the State Managing Bodies of the LNHS
Article 106. Basic Powers of the Government of the
Republic of Lithuania in Managing Health
Activities
The Government of the Republic of Lithuania shall manage and
regulate health activities by:
3) determining the competence of ministries and government
institutions in matters of health activities;
5) preparing and submitting draft legislation and other
regulations to the Seimas of the Republic of Lithuania;
6) preparing and adopting legal acts concerning other issues
of regulation of health activities that are within the scope of
their competence;
7) establishing government agencies and state inspectorates
carrying out health activities and discharging the functions of
their founder;
8) taking care that the Lithuanian state borders and its
territory be protected from the bringing in and spreading of
contagious diseases; and
9) discharging other functions of the management of health
activities assigned to the Government by the Constitution, this
Law and other laws of the Republic of Lithuania.
Article 107. Basic Powers of the Ministry of Health in
Managing Health Activities
The Ministry of Health shall:
- determine the scope of required level of health activities
and submit it to the Government of the Republic of Lithuania for
approval;
-study the state of health of the population and its future
perspectives, contribute to the identification of objectives of
health activities and the indicators of health level aimed at by
the government and the Lithuanian health programme for their
achievement;
- contribute to the preparation of government health
programmes;
- on the instructions of the Government of the Republic of
Lithuania and in conjunction with the municipalities, identify
the basic trends of development of primary health care;
- take part in the activities of accrediting for health care
and supervise the activities of private and public facilities of
individual and public health care and the establishments of
pharmaceutical activities;
- administer other matters pertaining to individual and
public health care and pharmaceutical activities;
- prepare and adopt, within their scope of competence, legal
acts concerning the issues of the implementation of all types of
health activities specified in this Article.
The Ministry of Health shall manage other matters pertaining
to health activities in conjunction with other ministries in
compliance with to Articles 108 and 109, and shall perform other
regulatory functions provided for in this Law, other laws and the
regulations of the Ministry.
Article 108. General Competence of the Ministries and
Government Institutions in Health Matters
The ministries and government institutions shall:
1) suspend and restrict the activities of economic entities
that cause harm to health and environment if the requirements
prescribed by legal acts regulating health care and environmental
protection are being violated;
2) make available to the public projects, plans and
programmes of business and other activities which may cause harm
to health;
3) inform in reasonable time the population on health risk
level in the living and working environment;
5) support the improvement of educational and cultural level
of the population and its supply with information with the aim to
promote healthy way of life;
8) prohibit or restrict production of goods and rendering of
services that are detrimental to health, as well as import, sale,
and consumption of such goods;
10) organise the implementation of measures meant for the
restoration and maintenance of the set established quality of
food products and drinking water;
11) organise activities for the elimination of consequences
of emergency situations that pose a threat to human health and
life;
12) develop and optimise the network of state-run public
health care facilities, services and state-owned pharmaceutical
enterprises;
13) control how legal and natural persons observe laws on
health care and comply with the health care standardisation
documents;
14) submit proposals to the Government of the Republic of
Lithuania on how to establish liability of legal and natural
persons for the violations of health care regulations and for
damage caused to human health and environment by means of
legislation;
16) develop international co-operation in the sphere of
health activities.
Article 109. Special Competence of other Ministries
when Dealing with Issues of Health Activities
The matters pertaining to the policy of the protection of
patients' rights, liability for hazard and harm to health shall
be administered by the Ministry of Health and the Ministry of
Justice within the scope of their competence.
The matters pertaining to foreign humanitarian relief and
technical assistance to health system shall be managed by the
Ministry of Foreign Affairs and the Ministry of Health.
The matters pertaining to the prevention of traffic
accidents and harm done to health by reason of criminal
activities shall be managed by the Ministry of Transport and the
Ministry of Internal Affairs.
The matters pertaining to individual health care in the
penitentiary sphere shall be managed by the Ministry of Internal
Affairs and the Ministry of Health within the scope of their
competence.
The matters pertaining to individual health care of the
officers of internal affairs and police, as well as other persons
equated with them shall be managed by the Ministry of National
Defence, the Ministry of Internal Affairs and the Ministry of
Health within the scope of their competence.
The matters concerning health insurance policy, assessment
of harm to health, medical and social examination, integration of
social services and social care into the health care system and
safety at work shall be managed by the Ministry of Social
Security and Labour and the Ministry of Health within the scope
of their competence.
The matters concerning the liability insurance of
institutions and enterprises accredited for the individual health
care, for harm done to health when providing health care, shall
be managed by the Ministry of Finances and the Ministry of
Health.
The matters concerning the maintenance of the environment
suitable for human health shall be managed by the Ministry of
Environmental Protection and the Ministry of Health.
The matters concerning the supply of the population with
food products of good nutritional and biological value,
veterinary control and supply of consumers with veterinary
medicines shall be managed by the Ministry of Agriculture and the
Ministry of Industry and Trade.
The matters concerning transport and road ecology shall be
managed by the Ministry of Transport.
The matters concerning the improvement of the quality of
goods shall be managed by the Ministry of Industry and Trade.
The matters concerning the supply of the population with
good quality drinking water and the matters concerning the policy
of healthy dwelling space shall be managed by the Ministry of
Construction and Urban Planning.
The matters concerning the promotion of health at
educational establishments and improvement of teachers'
qualifications in health promotion shall be managed by the
Ministry of Education and Science in conjunction with the
Ministry of Health, within the scope of their competence.
The matters of state registers of health activities,
preparation of classifiers, the policy of computerisation of
health system shall be managed by the Ministry of Communications
and Informatics and the Ministry of Health within the scope of
their competence.
State statistics about health activities shall be managed by
the Department of Statistics under the Government of the Republic
of Lithuania and the Ministry of Health.
Chapter 2
Competence of Municipalities and their Institutions
in Matters of Health Activities
Article 110. Competence of the Municipal Council in
Matters of Health Activities
The Municipal Council shall:
1) approve the primary health care development programme,
other comprehensive and purpose -oriented programmes of a local
authority and control their implementation;
5) form the Municipal Health Fund, approve the accounts of
the funds utilised and control their application;
7) establish, reorganise or liquidate local primary health
care institutions, pharmaceutical enterprises and perform the
functions of their founders;
8) establish the powers of enterprises, institutions and
organisations that are under their jurisdiction, in the sphere of
individual and public health care;
9) revoke the decisions and directives of the municipal
board, the mayor, and the elders, as well as the decisions of
committees, commissions, health board of a local community and of
other institutions formed by the Council that are not in
compliance with the laws on health activities or the decisions of
municipal Council concerning the issues of health activities; and
10) exercise other powers in the sphere of health activaties
established by the laws and other legal acts.
Article 111. Competence of the Mayor of a Municipality
or the Municipal Board in Matters of Health
Activities
The Mayor of the municipality or the Municipal Board shall:
1) organise the implementation of the Lithuanian Health
Programme, state health programmes and other health programmes,
the programme of the primary health care development, the
preparation of municipal comprehensive and purpose- oriented
draft programmes, as well as the implementation of the programmes
approved by the Municipal Council, the laws on health activities
and other legal acts in the territory of a municipality;
2) ensure, within the scope of its competence , the required
level of health activities in the territory of the municipality
and organise the supervision of the maintenance of such level;
5) conclude contracts concerning health care pursuant to
this Law and other legal acts, submit them to the Municipal
Council for approval, and control how they are being complied
with;
6) perform the functions of a customer of designing,
construction, and major repairs of primary health care facilities
belonging to the municipality by the right of ownership;
7) organise the medical audit of primary health care
establishments belonging to the municipality by the right of
ownership;
8) organise supervision of the implementation of patients'
rights at the individual health care establishments of primary
level;
9) on basis provided by laws, prohibit enterprises from
engaging in business activities, revoke licences issued in the
prescribed manner to legal and natural persons to engage in such
activities; and
10) exercise other powers in the sphere of health activities
established by laws and other legal acts.
Article 112. Competence of a City/ District Physician
in the Matters of Health Activities
The city/district physician shall be appointed and dismissed
from office by the Municipal Council.
Medical specialists who have passed examinations in health
economy, health law, management and organising of health
activities may be appointed to the post of a city or district
municipality physician. The board of examiners shall be formed
and the programme shall be drawn by the Minister of Health.
The city/ district municipality physician shall run the
subdivision of health activities of the municipality the number
of the employees of which shall be determined by the local
authority.
The city /district municipality physician shall:
1) perform the functions of the mayor of the municipality or
the Municipal Board, referred to in items 1, 2, 3, 5,7 and 8 of
Article 111 of this Law; and
2) exercise other powers in the sphere of health activities
provided for in the regulations of the subdivision of health
activities of the municipality, approved by the mayor of the
municipality or Municipal Board.
Article 113. Competence of the Physician of the Higher
Level Administrative Unit of the Territory
when Dealing with Health Matters
The physician of the higher level administrative unit of the
territory shall be appointed and dismissed by the Government of
the Republic of Lithuania on the recommendation of the Minister
of Health. The physician of the higher level administrative unit
of the territory shall be concurrently the director of the
Regional Public Health Centre of the State Public Health Care
Service.
The physician of the higher level administrative unit of the
territory shall:
1) supervise the implementation of health activity laws,
other legal acts, Lithuanian Health Programme and government
health programmes, and facilitate the implementation of municipal
health programmes in the higher level administrative unit of the
territory;
2) generalise the application practice of government
regulatory measures of health relations in a higher level
administrative unit of the territory and prepare proposals to the
State Committee on Health Affairs with regard to their
preparation and improvement;
3) co-ordinate the issues concerning the establishment,
reorganisation, or liquidation of the secondary health care
establishments with the Administration of the higher level
administrative unit of the territory and the Ministry of Health;
4) supervise how the Administration of the county discharge
the functions of the customer of construction and major repairs
of secondary health care facilities;
5) supervise the activities of the individual health care
establishments of the secondary level and arrange their audit;
6) organise the supervision of the implementation of
patients' rights at an individual's health care institutions of
the secondary level; and
7) exercise other powers of health activities established by
laws and other legal acts.
For the discharge of his functions, the physician of the
higher level administrative unit of the territory shall have at
his disposal specialists and auxiliary personnel the structure
and number of which shall be determined by the Government of the
Republic of Lithuania.
Chapter 3
Institutions Co-ordinating the LNHS Activities
Article 114. The National Health Board
The National Health Board shall be self-regulating
institution co-ordinating health policy. The National Health
Board shall be formed and shall operate in compliance with the
regulations approved by the Seimas of the Republic of Lithuania.
The National Health Board shall consist of: 1/3 representatives
of the community health boards, 1/3 representatives of non-
government organisations that defend the interests of public
health, 1/3 specialists of public health care. The activities of
the National Health Board shall be financed out of the state
budget.
The National Health Board shall:
co-ordinate on the state level:
6) disease prophylaxis and control policy;
approve draft government health programmes within the scope
of their competence;
approve the scope of health activities of required level,
draft indicators of the health level targeted by the government,
the drafts of the Lithuanian Health Programme;
prepare and each year submit to the Seimas of the Republic
of Lithuania the report on the state of public health and health
policy implementation;
discharge other functions assigned to it under this and
other laws and regulations of the Board.
The National Health Board shall have the right:
1) to obtain from the Government of the Republic of
Lithuania, ministries, other governmental institutions, managing
bodies of municipalities, enterprises, institutions, and
organisations draft legal acts, draft programmes, and other
information necessary for the discharge of functions established
by this Law and the Statute of the Board;
2) to conduct, within its competence, expert examination of
laws, other legal acts, draft programmes of social and economic
development and submit its findings to those who prepared the
programme;
3) to provide, within its competence, consultations to the
Seimas of the Republic of Lithuania, the Government, ministries,
other governmental institutions;
4) to form expert commissions for the discharge of the
functions of the Board.
Article 115. The State Health Commission
The State Health Commission under the Government of the
Republic of Lithuania is an institution co-ordinating the
planning of health support and implementation at the ministries
and other governmental institutions as well as enforcement of the
laws on health activities and other legal acts.
The State Health Commission shall be formed and its
regulations shall be approved by the Government of the Republic
of Lithuania. The activities of the State Health Commission shall
be financed out of the state budget.
The State Health Commission shall co-ordinate the planning
and implementation of the following spheres of health support:
2) environmental protection, environmental hygiene, safety
at work, labour hygiene, and labour medicine;
6) control and prophylaxis of infectious diseases;
co-ordinate the enforcement of laws on health activities and
other legal acts, generalise their application practice, co-
ordinate their preparation at the ministries and other government
institutions, submit proposals to the Government of the Republic
of Lithuania concerning their preparation and improvement, as
well as submit draft regulations to the Government of the
Republic of Lithuania;
conduct expert examination of government programmes for
social and economic development, of government investment
programmes, conceptions, laws, and other legal acts and submit
proposals to the authors of these projects on issues that are
within their competence;
on the instructions of the Government, conclude health
support contracts between the Government of the Republic of
Lithuania and local authorities.
The State Health Commission shall have the right:
1) to obtain draft laws and other legal acts, draft
programmes, and other information from the Government of the
Republic of Lithuania, ministries, other government institutions,
managing bodies of municipalities, enterprises, institutions, and
organisations ,necessary for the discharge of functions
established by this Law and the regulations of the Commission;
2) to conduct, within its competence, expert examination of
laws, other legal acts, draft programmes of social and economic
development and submit their findings to those who prepared the
programme ;
3) to provide, within its competence, consultations to the
Government of the Republic of Lithuania, ministries, government
institutions, managing bodies of municipalities;
4) to take part in the considerations of health support
issues when they are discussed at managing bodies of
municipalities, interested ministries, and other government
institutions and to submit proposals concerning the resolution of
these issues;
5) to form temporary or permanent expert or other specialist
groups for the resolution of issues assigned to the competence of
the commission.
Article 116. Community Health Board
Community Health Board is an independent institution co-
ordinating health activities under the Municipal Council. This
Board shall be formed and its regulations shall be approved by
the Municipal Council. Community Health Board shall consist of:
1/3 of health care specialists, 1/3 of the representatives of
enterprises, institutions, organisations of a municipality, 1/3
of the representatives of the NGO that defend public health
interests. The activities of the Community Health Board shall be
financed out of the municipal budget.
Community Health Board shall :
coordinate in the territory of municipality:
6) infectious diseases prophylaxis and control policy;
approve municipal primary health care development and other
municipal programmes;
examine, submit, in accordance with its competence, issues
to the municipal council, municipal board, and the chief
executive (the mayor);
perform other functions assigned to it in accordance with
this Law, other laws and the regulations of the Council.
The municipal community health council shall have the right
to:
1) receive from the managing institutions, and enterprises,
institutions and organisations within the territory of the
municipality information necessary for the performance of the
functions provided for by this Law and the regulations of the
Council;
2) carry out, in accordance with its competence, expert
examinations of managerial decisions adopted by the municipal
council and municipal managerial bodies as well as to draft
municipal socio-economic development programmes and to present
its conclusions to the bodies preparing such programmes;
3) provide consulting, in accordance with its competence, to
the municipal council, municipal managerial bodies, and economic
entities;
5) delegate its representatives to the National Health
Board.
Chapter 4
Special Managing Bodies of the LNHS
Article 117. State Tobacco and Alcohol Control Agency
under the Government
The State Tobacco and Alcohol Control Agency under the
Government shall be established and its regulations shall be
approved by the Government of the Republic of Lithuania. The
Agency shall be a legal person. Its activities shall be financed
from the State Budget.
The State Tobacco and Alcohol Control Agency shall:
3) perform other functions prescribed by other laws and the
regulations of the Agency.
Article 118. State Public Health Care Service under the
Ministry of Health
The State Public Health Care Service under the Ministry of
Health shall be established and its regulations shall be approved
by the Ministry of Health.
The State Public Health Care Service under the Ministry of
Health shall:
1) perform the functions of regional divisions of the
Ministry of Health for the management of public health care in
the higher-level administrative units of the territory;
2) on the instruction of the Ministry of Health, establish,
in conjunction with municipalities, priority development trends
of primary health care;
4) on the instruction of the Ministry of Health prepare
standardisation normative documents for the regulation of public
health care;
5) in accordance with the procedure and on the grounds
established by laws and other legal acts, issue permits to engage
in economic-commercial activities; and
6) perform other functions prescribed by other laws and the
regulations of the Service.
Article 119. State Medicines Control Agency under the
Ministry of Health
The State Medicines Control Agency under the Ministry of
Health shall be established and its regulations shall be approved
by the Ministry of Health. The Agency shall be a legal person.
The Agency activities shall be financed from the State Budget.
The State Medicines Control Agency under the Ministry of
Health shall:
6) carry out monitoring of pharmaceutical activities
(collecting, accumulating, processing and disseminating
information concerning medicines and their production, import,
sale and export); and
7) perform other functions established by other laws and the
regulations of the Service.
Article 120. State Legal Medicine Service under the
Ministry of Health
The State Legal Medicine Service under the Ministry of
Health shall be established and its regulations shall be approved
by the Ministry of Health. The Service shall be a legal person.
The activities of the Service shall be financed from the State
Budget.
The State Legal Medicine Service under the Ministry of
Health shall:
1) on the instruction of bodies of inquiry or interrogation
and court, carry out expert examinations and investigation in the
area of legal and forensic medicine;
2) perform other functions provided for by laws and
regulations of the Service.
Article 121. State Legal Psychiatry and Narcological
Service under the Ministry of Health
The State Legal Psychiatry and Narcological Service under
the Ministry of Health shall be established and its regulations
shall be approved by the Ministry of Health. The Service shall be
a legal person. The activities of the Service shall be financed
from the State Budget.
The State Legal Psychiatry and Narcological Service under
the Ministry of Health shall:
1) on the instruction of bodies of inquiry or interrogation
and court, carry out expert examinations in the area of forensic
medicine, legal psychiatry and narcology;
2) perform other functions provided for by laws and
regulations of the Service.
Article 122. State Service of Accrediting for Health
Care Activities under the Ministry of Health
The State Service of Accrediting for Health Care Activities
under the Ministry of Health shall be established and the
regulations of the Service shall be approved by the Ministry of
Health. The Service shall be a legal person. The activities of
the Service shall be financed from the State Budget.
The State Service of Accrediting for Health Care Activities
under the Ministry of Health shall:
1) control whether health care institutions, the areas and
equipment of enterprises comply with the requirements of
standardisation normative acts;
2) carry out monitoring of medical audit data and data
concerning the control of health care acceptability;
3) issue legal and natural persons with licences,
certificates or permits to engage in health care activities or
revoke said documents in accordance with the established
procedure; and
4) perform other functions established by the regulations of
the Service.
The State Service of Accrediting for Health Care Activities
under the Ministry of Health shall have the right to demand:
1) that natural and legal persons should present information
and documents necessary for the performance of its functions;
2) that the unaccredited health care institutions, services,
agencies, enterprises, their structural subdivisions should be
reorganised in compliance with the requirements prescribed by
standardisation normative documents of health care activities
into health care institutions, pharmaceutical enterprises of
another type in accordance with the nomenclature as approved by
the Ministry of Health; and
3) that legal persons who issued permits (licences) to
enterprises to conduct economic-commercial activities should
revoke said permits in accordance with the established procedure
if the enterprises are not accredited for public health care
activities.
Article 123. State and Territorial Patients Funds
State and territorial patients funds shall accumulate, in
accordance with the established procedure, health insurance
contributions and other legally acquired funds, ensure payment
for (purchase of) individual health care services, control the
costs and quality thereof, provide means for the implementation
of municipal health programmes, perform other functions provided
by law and regulations of the funds.
Article 124. Professional Organisations of Individual
and Public Health Care and Pharmaceutical
Workers
Professional organisations of individual and public health
care and pharmaceutical workers shall participate, in accordance
with the procedure established by this Law, other laws and other
legal acts, in the activities of the National Health Board and
municipal community health councils, in the accrediting of
natural and legal persons for health activities, in the
management of enterprises and institutions accredited for health
activities, shall take care of the improvement of their members'
qualifications and conclude collective agreements concerning work
and terms and conditions of payment for it.
Chapter 5
Institutions Exercising Control over the Conditions
of the LNHS Activities
Article 125. State Hygiene Inspectorate at the State
Public Health Care Service
The State Hygiene Inspectorate at the State Public Health
Care Service shall be established and its regulations shall be
approved by the Ministry of Health. The Inspectorate shall be a
legal person. Its activities shall be financed from the State
Budget.
The State Hygiene Inspectorate at the State Public Health
Care Service shall:
2) control compliance with the laws on health care and with
the standardisation normative documents;
3) grant permits for the carrying out of work related to
land lot utilisation, construction and reconstruction, for
introducing new raw materials, technologies, means of production,
recipes, for selling products and consumer goods;
4) impose sanctions on natural and legal persons who do not
comply with the requirements of legal acts on health activities;
and
5) perform other functions prescribed by laws, other legal
acts and regulations of the Inspectorate.
Article 126. State Medical Audit Inspectorate at the
Ministry of Health
The State Medical Audit Inspectorate at the Ministry of
Health shall be established and the regulations of its activities
shall be approved by the Ministry of Health. The Inspectorate
shall be a legal person. Its activities shall be financed from
the State Budget.
The State Medical Audit Inspectorate at the Ministry of
Health shall:
2) control the compliance by natural and legal persons with
the health care quality requirements prescribed by
standardisation normative documents;
3) control the compliance by state-run and municipal health
care institutions with the health care accessibility
requirements; and
4) perform other functions prescribed by the regulations of
the Inspectorate.
Article 127. Lithuanian Committee on Medical Ethics
The Lithuanian Committee on Medical Ethics shall be
established and the regulations of its activities shall be
approved by the Ministry of Health. The Lithuanian Committee on
Medical Ethics shall be a legal person. Its activities shall be
financed from the State Budget.
The Lithuanian Committee on Medical Ethics shall:
1) control whether natural and legal persons who either
carry out or are engaged in individual health care comply with
the medical ethics requirements set by laws and standardisation
normative documents;
3) perform other functions established by the Committee
regulations.
The Lithuanian Committee on Medical Ethics shall have its
regional divisions in higher-level administrative units of the
territory.
Article 128. Medical Ethics Commissions of Health Care
Institutions
Medical ethics commissions of health care institutions shall
supervise the compliance with the requirements of medical ethics
by specialists of individual health care.
Medical ethics commissions of health care institutions shall
be formed and shall function in accordance with the regulations
approved by the Ministry of Health.
Article 129. Municipal Sanitary Inspectorate
Municipal sanitary inspectorate is a specialised division of
municipal administration which controls sanitary conditions
within the territory of the municipality.
The tasks, competence and structure of the inspectorate, the
rights and duties of its officials, the contents and procedure of
sanitary control shall be regulated by regulations approved by
the Government of the Republic of Lithuania on the recommendation
of the Ministry of Health
The sanitary requirements shall be regulated by
standardisation normative documents prepared and approved by the
State Hygiene Isnpectorate.
Article 130. Patients' Rights Supervision Officials
Municipal boards, chief executives (mayors) must appoint
patients' rights supervision officials (controllers). The staff
norms with respect to such officials shall be approved by the
municipal Council, however, their number must be not less than 2
per municipal territorial administrative subdivision. The
patients' rights supervision controllers must explain to patients
their rights regulated by this Law and other laws, help patients
when they apply with complaints concerning violations of
necessary health care conditions or infringement of their rights
in health activities, and must examine the patients' complaints.
The State Service of Accrediting for Health Care Activities
shall appoint controllers for supervising the patients' rights
who shall supervise the manner in which health care institutions
of secondary and tertiary health care levels guarantee the
patients' rights.
The procedure for protecting the patients' rights and for
the supervision thereof shall be regulated by this Law, other
laws and legal acts.
The competence of patients' rights supervision controllers
shall be regulated by the regulations approved by the Government
of the Republic of Lithuania.
Article 131. Competence of other Health Activities
Control Institutions in the Issues Pertaining
to Health Activities
Competence of other health activities control institutions
(State Veterinary Service, State Labour Inspectorate, etc.) in
the issues pertaining to health activities shall be established
by laws, other legal acts and the respective regulations of the
above institutions.
Part VI
The Contents of Rights and Duties of Individuals
and Economic Entities in Health Care Activities
Chapter 1
Rights and Duties of Individuals in Health Care Activities
Article 132. The Rights of the Population in Health
Activities
The residents of the Republic of Lithuania shall have the
right to:
1) have a healthy and safe physical and social environment
as well as information about any danger existing in the
environment;
3) have information about health care institutions and
services, and health care services provided by them;
4) receive information concerning their health and
guarantees concerning the confidentiality of said information;
6) choose, in accordance with the established procedure, a
health care specialist, health care institution, type of health
care, or refuse any of the above, unless the law provides
otherwise;
9) take part, in accordance with the procedure established
by this Law, in determining the priority trends of health care
development, in controlling the accessibility and adequacy of
health care.
Parents, adoptive parents, guardians or tutors of minors or
legally incapable persons shall have the right to choose for
their children, adopted children, or wards health care
specialists, health care institutions, types of health care or
refuse any of the above, unless the law provides otherwise.
Only citizens of the Republic of Lithuania and stateless
persons who are permanently residing in the Republic of Lithuania
shall have the right to free medical care (state-supported
individual and public health care and services) state-established
assistance in protecting, recevering and strengthening their
health.
The procedure and conditions of health protection for
foreigners shall be specified by international agreements to
which the Republic of Lithuania is a party.
Article 133. Rights of the Population in the Health
Activities
The residents of the Republic of Lithuania must:
1) take care of the health of their children (adopted
children, wards) who are under age, and their elderly parents;
3) protect the environment from harmful effects.
Persons who violate the requirements of this Law shall be
liable under law.
Article 134. The Duty of Individuals to Provide First
Aid in Case of Accidents and Acute Dangerous
Diseases
Workers of professions, places of employment or spheres of
activities that are on the list determined by the Government of
the Republic of Lithuania as well as amateur drivers of motor
vehicles who happen to be present at the sites of accidents or
acute dangerous diseases together with the victims or sick
persons must without delay provide first aid to persons in need
of such aid because of an accident or acute dangerous disease.
The qualification requirements of training the above persons to
provide first aid and the procedure and conditions of testing
first aid skills shall be established by the Government of the
Republic of Lithuania.
Persons who are obligated under this Law and other legal
acts to provide first aid and who by their failure to act or by
their actions increase the damage to the health of the victims or
persons who have fallen acutely ill shall be held liable under
law.
Chapter 2
The Rights and Duties of Enterprises, Institutions
and Organisations in the Sphere of Health Activities
Article 135. The Rights of Enterprises, Institutions
and Organisations in Health Activities
Enterprises, institutions and organisations shall have the
right to:
1) conclude agreements on health activities in accordance
with the procedure established by this Law and other legal acts;
2) set up, in accordance with the procedure established by
this Law and other legal acts, funds for health activities
3) establish, in accordance with the procedure established
by law, subjects of individual or public health care, or
pharmaceutical activities and perform the functions of their
founder, establish their own structural subdivisions which carry
out personal or public health care; and
4) organise the preparation of health programmes and finance
their implementation with resources from the health funds
established by them or with other legally acquired resources.
Enterprises, institutions and organisations may also have
other rights provided that they are in compliance with this Law
and other laws and founding documents.
Article 136. The Duties of Enterprises, Institutions
and Organisations in the Sphere of Health
Activities
In their economic-commercial or other activities
enterprises, institutions and organisations must :
3) timely notify health care institutions, services and the
population of the danger to their health which arises as a result
of the activities pursued, products manufactured or goods sold by
them;
5) prevent the imminent danger to the environment, limit the
scope of danger and harm to the environment;
6) protect people against contagious diseases spread by food
or drinking water, or invasions of such diseases, as well as
against food poisoning, and implement measures to restrict the
spreading of contagious diseases;
7) organise and pay, in accordance with the established
procedure, public health monitoring and expert examination;
9) compensate for the damage to health and environment
caused by their actions.
Enterprises, institutions and organisations may also have
other duties, provided that they are in compliance with this Law
and other laws as well as their founding documents.
The implementation of rights and performance of duties in
the sphere of health activities by enterprises, institutions and
organisations must not violate the rights of other natural and
legal persons.
Enterprises, institutions and organisations which violate
the requirements of this Article shall be liable under law.
Part VII
Liability for the Violations of Legal Norms
Regulating Health Activities
Article 137. Liability for the Violation of Legal Norms
Regulating Health Activities
Natural and legal persons who do not comply with the
requirements of legal norms regulating health activities shall be
liable under law.
Article 138. Compensation for the Damage Caused to
Health
Legal and natural persons who by their actions or failure to
act cause damage to human health must compensate for the losses
sustained by reason of the damage caused to health, and in the
event of the person's death - must compensate for the losses to
his family and other persons. Unless the law provides otherwise,
losses resulting from health damage shall be assessed in
accordance with the amounts and methods applied with respect
thereto and approved by the Government of the Republic of
Lithuania; the assessed sums shall be collected by bringing a
suit. The procedure for compensating for damage shall be
determined by the Civil Code, other legal acts.
The procedure of compensating for the losses incurred due to
health damage to persons insured against accidents at work (and
in the event of death of the victim - to his family and other
persons) and the amount of such compensation shall be established
by the Law on Accident Insurance.
The terms and procedure for compensating patients for the
losses sustained while having their health cared for (and in the
event of their death - for making said compensation to their
dependants) shall be regulated by laws and other legal acts.
Article 139. Liability to Compensate Health Care State
Services, State Inspectorates, Health Care
Institutions and Legal Persons for the
Expenses Incurred due to Damage Caused to
Health Caused by Unlawful Actions
Legal and natural persons who by their unlawful actions
cause damage to human health must compensate state services and
state inspectorates of health care, health care institutions,
other legal persons for the expenses incurred by them by reason
of unlawful actions of said legal and natural persons and
expenses which are connected with establishing and diagnosing
individual and group cases of contagious diseases included in the
list compiled by the Government of the Republic of Lithuania,
food poisoning, occupational diseases and poisoning as well as
with the treatment, nursing and feeding of persons ill with the
above diseases at health care institutions, their medical and
social rehabilitation, provision of prosthetic appliances and
social assistance, implementation of measures to restrict the
spreading of the above diseases and liquidation of their
consequences for human health and economy, unless they prove that
the damage to human health was due to vis majeur or deliberate
malice of the victims.
In the cases specified in part one hereof compensation for
the expenses incurred by state services and state inspectorates
of health care, health care institutions and other legal persons
shall be collected either by mutual agreement between the parties
or by filing a suit, upon prior assessment of the amount of
claims in accordance with the actual expenses of the claimant or
the party which submits material claims.
Article 140. Compensation of Moral Damage
Persons who violate the requirements of acceptability of
health care, confidentiality of information concerning individual
health (a person's medical secret) must compensate for the damage
caused to the person.
While determining the amount of moral (non-property) damage
in terms of money, the court shall take into account the property
status of the person guilty of the damage, the degree of
seriousness of the offence and other circumstances, however, in
any case the amount may never exceed 500 minimum monthly wages.
Article 141. Liability for Illegal Engagement in or
Carrying out of Health Care and
Pharmaceutical Activities
Illegal engagement in health care and pharmaceutical
activities or unlawful performance thereof shall incur economic
sanctions on legal persons and administrative responsibility on
officials or citizens, or responsibility provided for in the
Civil Code.
Part VIII
Final Provisions
Article 142. Basic Principles of International
Cooperation of the Republic of Lithuania
in the Sphere of Health Activities
While cooperating with other states and international
organisations in the sphere of health activities, the Republic of
Lithuania must guide itself by the following principles:
1) ensuring that by their economic-commercial activities the
enterprises of the Republic of Lithuania do not inflict harm on
the persons residing in the territories of other states;
3) endeavouring to implement the global strategy of the
World Health Organisation "Health to Everybody"; and
4) cooperating in the liquidation of the negative
consequences of ecological catastrophes, accidents and natural
disasters on the health of the society.
Article 143. The Law on the Health System of the
Republic of Lithuania and International
Agreements
In the event that an international agreement to which the
Republic of Lithuania is a party prescribes requirements other
than those established by this Law, the provisions of the
international agreement shall prevail.
Article 144. As Used in the Law on the Health System of
the Republic of Lithuania:
Health means physical, mental and social welfare of society.
Health protection means observation of factors which are
hazardous to health, timely establishment of any danger to
health, prevention or restriction of the harmful effects of the
physical and social environment.
Health recovery means restoration of health potential by
applying medical aid, nursing, medical and social rehabilitation.
Health strengthening means the sum total of obligations,
measures and actions undertaken by state power and government
bodies, local authorities and the public which helps to increase
and use more rationally health care resources and to control the
people's health.
State targeted health level means indicators of public
health level determined by the state for a definite period, the
achievement of which level is guaranteed by the state.
Health system means the system of management of matters
related to health comprising health activities, executive and
managing entities of health activities.
Required level of health activities means basic scope of
health protection of the population, and the recovery and
strengthening thereof, which provide the initial position for the
planning of health activities development.
Individual health care means the activities of natural and
legal persons accredited by the state the aim whereof is to
timely diagnose and prevent health disorders of individuals and
help them recover and strengthen health.
Public health care means protection and stregthening of
health of the society or its individual groups.
Pharmaceutical activities means the activities of natural
and legal persons regulated by the Law on Pharmacy.
Health support means the system of legal, social and
economic measures established by the state and programmes of
activities of non-government organisations which support health
protection and health recovery, and promote the strengthening of
individual and public health.
Primary health care means non-specialised qualified
individual health care, mental health care, and non-specialised
public health care provided at the place of residence.
Secondary health care means specialised individual health
care provided by the health care institutions of the higher-level
administrative units of the territory, specialised public health
care provided in the higher-level administrative units by the
subdivisions of the state services and state inspectorates
assigned by the state.
Tertiary health care means very specialised individual
health care, very specialised public health care provided by
central individual and public health care institutions.
Acceptability of health care means health care conditions
which ensure the conformity of health care services to the
principles of medical science and requirements of medical ethics
and which have been recognised in accordance with the procedure
established by the state.
Accessibility of health care means health care conditions
which ensure economic, communications and organisational
accessibility of individual health care services to an individual
or the public and which have been recognised in accordance with
the procedure established by the state.
Adequacy of health care means health care conditions which
ensure the quality and effectiveness of health care services and
which have been recognised in accordance with the procedure
established by the state.
Health care and services supported by the state and local
authorities means individual and public health care of the types
and in the scope established by the state the conditions and full
coverage of costs whereof is guaranteed by the state or local
authorities.
Standardisation of health care means regulation of health
care quality requirements and indicators in normative documents.
Standardisation normative documents of health care means
legal acts which establish the requirements, norms and standards
for health factors, health care and its quality.
Medical audit means expert examination and control of
accessibility and adequacy of health care services.
Accrediting of natural and legal persons and enterprises
without the status of a legal person for health care or
pharmaceutical activities means activities established by the
state whereby the right to engage in or carry out health care or
pharmaceutical activities is either granted or cancelled.
Health programme means a plan for the development of
priority health relations the purpose whereof is to approve
comparative effectiveness of alternative measures of health
activities, and applied and fundamental research, and to optimise
the use thereof.
Health promotion means the aggregate of state regulation and
civic initiative, social marketing, social advertising, health
education and propaganda, which develops a healthy life style,
informs the public about the conditions of health and health care
problems.
Health education means the activities carried out by health
care institutions the purpose whereof is to educate individual
groups of the population to protect and strengthen health.
Public health control means a form of public health
management, either established by the state or developed
independently, directed at identifying, on the basis of
indicators of public health monitoring, negative shifts in the
health and health care levels which are regulated by standard
acts as well as in the health care quality indicators, and to
shape appropriate management decisions.
Control of health care resources means state-regulated
activities of natural and legal persons directed at ensuring
optimum use of material and economic health care resources.
Public health monitoring means a state-established or
independent system of observation and analysing of public health
requirements, health care resources, health development, health
care level, and the etsablished indicators of health care quality
and environmental conditions.
Public health expert examination means making an analysis of
public health monitoring data and forecasts of public health
development trends, interpreting the received data in the manner
established by standard acts and determining the damage done to
public health and public health care.
Individual health care technologies means medicines, methods
of prophylaxis, diagnostics and treatment, medical equipment and
instruments.
Article 145. Coming into Force of this Law
Article 3, part 2 of Article 10, Article 11, parts 5 and 6
of Article 13, part 3 of Article 15, part 4 of Article 16, part 2
of Article 18, part 2 of Article 19, parts 4, 5, 6 and 7 of
Article 20, item 1 of part 1 of Article 29, part 2 of Article 30,
part 2 of Article 31, Articles 32, 33 and 34, part 2 of Article
35, Article 36, part 2 of Article 37, Article 38, parts 1, 2, 4,
and 5 of Article 39, parts 2, 6, and 7 of Article 40, parts 2, 3,
4, and 6 of Article 41, parts 3, 4 and 5 of Article 42, Article
43, Article 44, part 2 of Article 45, parts 2 and 3 of Article
46, Article 48, Article 49, Article 50, Article 51, Article 52,
Article 53, parts 2, 3, and 5 of Article 55, Article 56, parts 2,
3, and 4 of Article 57, part 2 of Article 58, parts 3 and 4 of
Article 59, parts 3 and 4 of Article 60, Article 61, part 2 of
Article 63, Article 64, part 1 of Article 65, Article 66, parts 2
and 3 of Article 68, Article 69, Article 70, Article 73, Article
74, Chapter 1 of Part 4, part 3 of Article 85, part 5 of Article
86, part 4 of Article 87, parts 2, 3, and 4 of Article 88, parts
2, 3, and 4 of Article 89, Article 90, Article 91, parts 1, 2, 3,
and 4 of Article 92, parts 2 and 3 of Article 93, Article 94,
Article 95, Article 96, parts 2 and 4 of Article 98, part 1 of
Article 99, part 1 of Article 102, part 2 of Article 103, part 1
of Article 104, Article 105, Article 108, Article 109, Article
112, Article 113, part 1 of Article 114, part 2 of Article 115,
part 1 of Article 116, part 1 of Article 117, part 1 of Article
118, part 1 of Article 119, part 1 of Article 120, part 1 of
Article 121, part 1 of Article 122, Article 123, part 1 of
Article 125, part 1 of Article 126, part 1 of Article 127, part 2
of Article 128, parts 2 and 3 of Article 129, parts 3 and 4 of
Article 130, part 2 of Article 133, Article 134, parts 1, 2, and
3 of Article 138, Article 139, and Article 141 of the Law on
Health System of the Republic of Lithuania shall come into force
in accordance with the procedure established by the Resolution of
the Seimas of the Republic of Lithuania "Regarding the
Implementation of Articles Specified in Article 145 of the Law on
Health System of the Republic of Lithuania", and prior to the
approval of the legal acts set forth in the above Articles, the
effective legal acts shall apply.
I promulgate this Law passed by the Seimas of the Republic