LAW
of the Republic of Lithuania
AMENDING THE
LAW ON THE HEALTH SYSTEM
1 December 1998 No.VIII-946
Vilnius
Article 1. Revised Version of the Law on the Health System of the Republic
of Lithuania
“REPUBLIC OF LITHUANIA
LAW ON THE HEALTH SYSTEM
recognising, that
the health of the population is the greatest social and economic asset of the society,
health means not only the absence of diseases and physical defects, but also people’s physical, mental and social welfare,
health potential and its maintenance conditions are dependent on the stability of the economic system development, the society’s social security and education guarantees, employment and adequate income of the population, provision with housing, accessible, acceptable and adequate health care, proper nutrition, adequate quality of work, living and natural environment, as well as on the efforts of the population to promote health,
a person’s efforts to stay healthy may only be spurred by social and economic measures which are acceptable from the point of view of the present time and human dignity,
the best possible state of health of the population is a necessary prerequisite of security and prosperity of the State of Lithuania as well as a sine qua non for the creation of an open, just and harmonious civic society;
taking into consideration the provisions of the strategy “Health for All”, adopted by the World Health Organisation, the Ottawa Health Promotion Charter and the National Health Concept of Lithuania;
seeking to safeguard the in-born human right to enjoy the best possible state of health as well as the right to a healthy environment and acceptable, accessible and adequate health care;
guided by the Constitution of the Republic of Lithuania,
enacts this Law on the Health System.
Article 1. The Purpose of the Law on the Health System
The Law on the Health System shall regulate the national health system of Lithuania, its structure, the scope of legal regulation of health protection, health strengthening and health recovery, the basic principles of individual and public health care organisation, of ensuring, management of the health care guaranteed by the state or local authorities (free health care), of health support, conclusion of contracts concerning health activities, also the liability for infringement of health activities regulations and the rights and duties of the population and the health activities bodies.
Article 2. Definitions
As used in this Law:
2. Public health protection means the totality of organisational, technical, social, economic and legal measures intended to protect the health of the society or its individual groups from harmful effect of the environmental factors or to reduce the risks thereof to the minimum.
3. Strengthening of public health means organisational, legal, social and economic measures implemented by state institutions, executive institutions of municipalities, other legal and natural persons, contributing to the augmentation and rational use of health care resources, formation of the social control system of public health problems settlement, encouraging the public to take part in the formation of state and municipal health policy, helping to create a healthy environment, promoting a healthy life style and increasing the effectiveness of motivation in espousing it, spurring health insurance organisations and individual health care institutions to opt for health measures with greater economic efficiency, based on disease prevention.
4. National Health System of Lithuania means the system of management of state health affairs, health institutions, health activities and relating resources.
5. Health activities means individual health care, public health care, pharmaceutical and other health activities, the types and requirements whereof to the bodies performing the activities shall be established by the Ministry of Health Care.
6. Individual health care means the activities of natural and legal persons licensed by the state, the purpose whereof is to timely diagnose and prevent the individual’s health disorders, also to help recover and strengthen health.
7. Public health care means the aggregate of organisational, legal, economic, technical, social and medical measures which help implement disease and trauma prevention, preserve public health and strengthen it.
8. Pharmaceutical activities means the activities of natural and legal persons, regulated under the Law on Pharmaceutical Activities.
9. Acceptability of health care means the conditions of health care recognised according to the procedure established by the state, which ensure the conformity of health care services with the principles of medical science and medical ethics.
10. Accessibility of health care means the conditions of health care recognised according to the procedure established by the state, which ensure economic, communicative and organisational acceptability of health care services to the individual and society.
11. Adequacy of health care means the conditions of health care recognised according to the procedure established by the state, which guarantee the quality and effectiveness of health care services.
12. Individual health care guaranteed by the state (free individual health care) means individual health care services financed from the compulsory health insurance fund, state or municipal budgets, state or municipal health funds.
13. Medical audit means expert examination and control of accessibility, economic efficiency and adequacy of health care services.
15. State control of public health means official actions performed by state inspectorates, state offices and services, other institutions authorised by the state, their officers for the purpose of:
1) supervising compliance with legal acts regulating public health protection by enterprises and institutions, other legal and natural persons and applying sanctions prescribed by law for their violations (direct state control of public health);
2) achieving, by means of negotiations or contracts, that enterprises and institutions, other legal persons commit themselves to improving the state of public health care (support of public health care);
3) collecting, storing, processing and analysing, within the limits of competence, information relating to the violations of legal acts regulating public health protection, the social, economic and other causes of the violations as well as all other factors affecting the state of public health protection (indirect public health control).
16. Public health monitoring means the system of monitoring of public health factors, developments, effects of the factors upon public health, also of public health resources and public health care processes and results (recording, storing and processing of data).
Article 3. The Scope of Legal Regulation of Health Relations
The following shall only be established by laws:
2) the system of types and bodies of health activities, the competence of the main bodies of health activities management, rights and duties in the sphere of pharmaceutical activities of state services and state inspectorates of health activities co-ordination and health care, also of institutions of individual and public health care and bodies of pharmaceutical activities, the legal framework for their establishment, activities and termination thereof;
3) the legal framework of establishment, activities, reorganisation of the state inspectorates of public health control subordinate to the Ministry of Health Care, the conditions and procedure of state control of public health;
4) the structure of resources of the national health system and basic principles of their management;
5) the basic principles of health activities organisation and management and of health support and financing;
7) the rights and duties of the population in health activities, the basic legal principles of participation of the population in the management of health matters;
8) the basic legal principles of licensing for health activities the persons who have higher or special secondary medical or other education, basic professional rights and duties of medical specialists, the procedure for establishing the qualifications requirements, for their in-service training and the restriction of their practice, the legal framework of the restriction of health care advertising, of the establishment of third party liability for the damage done to the patients’ health in the course of implementing individual health care;
9) the procedure for entering into health activities contracts and basic terms and conditions thereof;
10) the system of public health care, the procedure of its organisation, management and financing as well as for implementing public health care;
11) the legal framework of the organisation and management of safety at work and occupational medicine, also of consumer health protection;
12) the general requirements for the quality of food products. The procedure of control over the conditions of manufacture, importation, trading in, advertising of such products, control over the quality of food products and their containers, also of marking said containers;
13) the general requirements for the quality of drinking water, basic legal principles of water treatment, decontamination, and quality improvement;
14) the procedure for controlling the production, trade, import, export, licensing and consumption of narcotic and psychotropic substances and their precursors, alcohol products, tobacco and its products, the system of reducing the consumption of alcoholic beverages and tobacco products, the procedure for restricting or prohibiting the advertising of alcoholic beverages and tobacco products;
15) the conditions of production, trade in, import, export, transportation, use of poisons, other toxic and radioactive substances, requirements for working with ionising radiation sources, conditions for ensuring radiation safety and the procedure of their control;
16) the system of prevention of communicable diseases, legal framework of organisation and management of the prevention and control of said diseases;
17) the conditions of public health monitoring, expert examination of public health, legal framework of organisation and management thereof;
18) the basic legal principles of the organisation and management of physical education and sport, of dope and gender control;
19) the conditions of mental health care, the basic legal principles of the organisation and management thereof as well as the legal framework of control over the conditions of care;
20) the basic legal principles of the organisation of medical and social rehabilitation of the disabled;
21) the conditions of dental care and substance dependence supervision and the legal framework of organisation and management thereof;
22) the requirements of biomedical tests ethics, the procedure of control over compliance with said requirements as well as liability for violations of requirements of biomedical tests ethics;
23) the conditions and procedure for taking blood from donors, production of blood products, transfusion of human blood and its products;
24) the basic principles, conditions and procedure for taking organs or tissues for transplants, their use for transplants, medical research, diagnostics, and treatment;
25) the criteria 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 post-mortem examination (autopsy) of the cadaver;
28) the health insurance system, the procedure for collecting compulsory health funds, legal framework of voluntary health insurance, rights and duties of the covered persons, the policy holders and the insurers, the procedure for establishing health insurance institutions and their activities as well as rights and duties of these institutions; and
Article 4. 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 population’s general level of health;
Article 5. Principles of Health Activities Regulation
The following principles shall be applied to the regulation of the relations specified in Articles 1 and 3 of this Law:
3) equality of the individual’s rights to have the best possible health regardless of his or her sex, race, nationality, citizenship, social status and profession;
6) the freedom of individuals to unite into public organisations defending the interests of the individual and public health, as well as state support for the programmes of activities of these organisations;
7) comprehensive, accurate and timely notification of the public of the best possible conditions of health development and the advertising of said conditions;
8) participation of public organisations in the health activities management both directly and through their elected representatives;
11) full prevention against threat and damage to individual and public health carried out by all bodies of health activities; and
Article 6. Basic Principles of Formation of the National Health System
of Lithuania
The basic principles of formation of the National Health System of Lithuania shall be as follows:
3) integration of all health activities resources into the unified system, their planning and use according to the national priorities of health activities;
5) ensuring the implementation of the Health Programme of Lithuania as well as of the state and municipal health programmes;
Article 7. The Structure of the National Health System of Lithuania
The National Health System of Lithuania (hereinafter referred to as the NHSL) shall consist of:
Article 8. The Executive Bodies of the NHSL
The executive bodies of the NHSL shall be the following institutions possessing licences for health care or pharmaceutical activities:
Article 9. The Administrative Bodies of Health Activities
1. The administrative bodies of health activities shall be:
1) bodies of state administration of health activities (the Government, ministries, other Government institutions, county governors);
Article 10. The Resources of the NHSL
The NHSL resources shall comprise:
6) specialists and other employees of state and municipal institutions, enterprises, possessing licences for individual and public health care, pharmaceutical activities;
Article 11. Activities and Services of the Executive Bodies of the NHSL
1. The activities of and services supplied by the NHSL shall comprise:
4) other (paid) services supplied by the executive bodies of the NHSL, which are not attributed to health care and pharmaceutical services but are necessary in order to ensure the provision thereof. Charges for the services shall be fixed by the administration of the institutions providing the services.
2. The executive bodies of the NHSL shall provide, according to their respective competence, health care services of the following types:
1) individual and public health care services not paid for directly to the health care institutions by their recipients but financed from the compulsory health insurance fund, state or municipal budgets or health funds;
Article 12. Health Care and NHSL Activities Organisation Levels
1. The levels of the NHSL activities organisation shall be:
2. The health care levels shall be:
3. Local authority executive institutions shall organise primary individual and public health care. The procedure for organising primary health care shall be laid down by the Government or the institution authorised by it.
4. Local authority executive institutions shall also fulfil the function of the state delegated by law - shall organise secondary health care the scope and profiles whereof shall be determined by the Ministry of Health Care.
5. County governors shall organise secondary individual and public health care the scope and profiles whereof shall be determined by the Ministry of Health Care.
6. The Ministry of Health Care and state institutions subordinate to it shall organise, according to their respective competence, individual and public health care of the prescribed scope within the NHSL institutions subordinate to it. In the health care institutions whose founders are the Ministry of National Defence or the Ministry of the Interior, the individual health care of the prescribed scope shall be organised accordingly by the Ministry of National Defence, the Ministry of the Interior or state institutions subordinate to them.
7. The institutions of the tertiary level of the NHSL health care organisation may practise primary and secondary health care only for scientific and educational purposes.
Article 13. Contractors of the NHSL Activities and of the Services Provided
by the Executive Bodies of the NHSL
1. The contractors of the NHSL activities and provided services shall be the Government, the Ministry of Health Care, other state institutions, county governors, municipal councils, State and Territorial Patients’ Funds and other institutions disposing of the NHSL resources.
Article 14. The Contents of Health Activities
Health activities shall comprise:
Article 15. Mandatory Conditions of Health Activities
1. The mandatory conditions of health activities in the Republic of Lithuania shall be:
2. Health activities shall cover only the territory of the Republic of Lithuania, unless otherwise provided for by international agreements to which the Republic of Lithuania is a party.
Article 16. The Right to Engage in Health Activities
1. The right to engage in a certain type of health care practice shall be recognised to natural persons who have been issued, in the manner prescribed by law, a licence and a certificate. The right to engage in a certain type of pharmaceutical practice shall be recognised with respect to natural persons who have received a permit in the manner prescribed by law.
2. Enterprises and institutions shall acquire the right to engage in health care activities only upon receiving the licences according to the procedure prescribed by the Government or the institution authorised by it.
3. Enterprises, institutions and organisations shall acquire the right to engage in pharmaceutical activities only upon receiving licenses in the manner prescribed by the Government or the institution authorised by it. The pharmaceutical activities shall be carried out in compliance with the Law on Pharmaceutical Activities, other laws and legal acts.
5. Health care or pharmaceutical activities carried out by natural persons, enterprises or institutions who are not in the possession of a licence or permit shall be illegal.
6. The right to engage in other health activities the types and requirements whereof for the entities engaged in the activities shall be established by the Ministry of Health Care shall be recognised only for the enterprises and institutions which have on their staff physicians or other health care specialists who have acquired the right to the activities according to the procedure prescribed by this Law and other laws. Natural persons who are not health care specialists or do not meet the requirements laid down by the Ministry of Health Care shall have no right to engage in health activities.
Article 17. The Contents of Preventive Medical Aid
Preventive medical aid shall comprise:
1) information services on issues of disease prevention, which must be provided by all individual health care specialists;
Article 18. Prophylactic Examinations
1. Workers of certain professions and individuals working in certain jobs, production branches and sectors must undergo a health examination before taking up professional activity and in the course of such activity. The list of the above professions, jobs, production branches and sectors and the procedure of examination of individuals’ health shall be established by the Government or the institution authorised by it.
2. Health care institutions must within the established time period examine the health of pregnant women and children under 16 years of age, also the health of mothers until the infant reaches the age of one and of other persons whose list shall be compiled by the Ministry of Health Care.
Article 19. Basic Medical Aid
The following shall be attributed to basic medical aid:
2. The scope of basic medical aid and the procedure of provision thereof shall be established by the Ministry of Health Care.
3. When rescuing the lives of individuals who must be rendered medical aid following an accident, mishaps, ecological or natural disasters, or a sudden onset of illness, first medical aid must be promptly rendered by the health care, pharmaceutical specialists and other persons, who are with the victims or patients at the site of an accident or during the onset of an acute and life-threatening illness. The list and sphere of competence of health care, pharmaceutical specialists and other persons who must render first medical aid shall be established by the Ministry of Health Care.
Article 20. Peculiarities of Application of Diagnostic and Treatment Measures
1. Health care specialists shall have the right to choose methods and technologies of diagnostics and treatment approved in the manner established by the Ministry of Health Care.
2. Health care specialists may use all scientifically substantiated, but not yet registered in the prescribed manner medicines, preventive, diagnostic and treatment methods, medical equipment and instruments only when trying to cure the patient and to save or prolong his life. In this instance, they must obtain the patient’s permission, and if the patient is unconscious or is a minor - the permission of his parents, relatives, guardians, or his representative and also the consent of the ethics commission of the health care institution. This consent must be confirmed in writing. When the patient is in an unconscious state and there is no information available regarding his relatives, parents, guardians or representatives, these technologies shall only be applied upon written consent of at least two physicians of the appropriate medical speciality in consultation as well as that of the ethics commission of the health care institution.
3. The application of compulsory hospitalisation, compulsory diagnostic, and compulsory treatment measures to individuals shall only be allowed on the grounds and in the manner provided for by law in the presence of a genuine threat that these individuals by their actions or because of the state of their health may cause substantial damage to their own health or life or to that of other persons.
Article 21. Transfusions of Human Blood and its Products
Human blood may be taken from a donor for transfusion purposes or for the purpose of production of blood products only of the donor’s free will and with the latter’s consent. The relations connected with the taking of human blood and production, export, import and transfusion of blood products shall be regulated by the Law on Blood Donorship.
Article 22. Restrictions on the Use of Human Tissues and Organs
Article 23. Medical Rehabilitation and Treatment in Sanatoria
The conditions and procedure for selecting and sending patients to health care institutions of medical rehabilitation and sanatoria-type health care institutions shall be established by the Ministry of Health Care.
Article 24. Nursing of Patients
1. Nursing services shall be provided to the patients at home, in health care institutions and in social care institutions.
Article 25. Social Services Provided while Carrying out Individual Health Care
1. Provision of social services when carrying out individual health care shall be organised in order to guarantee social security of the patients, children and elderly people, disabled individuals, other individuals belonging to risk groups, to ensure their mental health care and psychosocial rehabilitation. Social services shall be provided by social workers of individual health care institutions.
2. The procedure for providing social services at health care institutions shall be regulated by laws and other legal acts.
3. The regulations of work at health care institutions of social workers employed at health care institutions shall be approved, the procedure of their training and in-service training shall be established by the Ministry of Social Security and Labour in conjunction with the Ministry of Health Care.
Article 26. Expert Examination of Temporary Disability
1. The expert examination of temporary disability shall be performed by the health care institution physicians or a consultative commission of physicians. The procedure for organising and performing the expert examination shall be established by the Ministry of Health Care and the Ministry of Social Security and Labour.
Article 27. Medical Social and Specialised Medical Expert Examination
1. In cases of long-term or permanent loss of ability to work medical social expert examination shall be performed in the manner prescribed by the Ministry of Health Care and Ministry of Social Security and Labour.
2. The procedure for organising and performing the specialised medical expert examination within the scope of their respective competence shall be established by the Ministry of Health Care or Ministry of the Interior or Ministry of National Defence on co-ordination with the Ministry of Health Care.
Article 28. Forensic Medical Expert Examination
Forensic medical expert examination shall be performed on the decision of inquiry or investigation bodies, also following the court ruling. The executive bodies of the expert examination, its organisation and performance procedure shall be established by the Government or the institution authorised by it.
Article 29. Forensic Psychiatric Expert Examination, Forensic Expert
Examination of Substance Dependence and Forensic Psychological
Expert Examination
Forensic psychiatric expert examination, forensic expert examination of substance dependence and forensic psychological expert examination shall be performed on the decision of the bodies of inquiry or investigation or the prosecutor, also following the court ruling. The expert examinations shall be performed by the State Forensic Psychiatric and Substance Dependence Service under the Ministry of Health Care and health care institutions subordinate to it. The procedure for organising and performing the expert examinations shall be established by the Government or the institution authorised by it.
Article 30. Pathoanatomical Expert Examination
Pathoanatomical expert examination shall be performed in the event of a person’s death. The conditions and procedure of pathoanatomical examination (autopsy) shall be regulated by the Law on Health Care Institutions and other legal acts.
Article 31. Universal Character of Public Health Care
Implementation of public health care the purpose whereof is health promotion, prevention of the deterioration of the quality of consumer goods, food products, drinking water, also of living, working and natural environment as well as prevention of diseases and traumas and decrease of morbidity shall be the duty of all natural and legal persons.
Article 32. Promotion and Strengthening of Public Health
1. The conditions and procedure of public health promotion shall be established by this Law and other laws. The promotion of public health shall consist of:
2. The Ministry of Health Care, other governmental institutions, county governors, executive bodies of local authority shall organise with state and local budget funds, according to their respective competence, health propaganda in support of health policy initiatives over the radio and television as well as other media.
3. Health education shall be the aggregate of voluntary and compulsory health and physical education measures.
Article 33. Protection of Public Health
1. Public health protection shall be based on a system of measures limiting harm and danger in living, working and natural environment.
2. Prevention and limitation of danger and harm to health shall be implemented in the manner prescribed by laws and other legal acts:
1) the indicators of safety and harmlessness to health as well as the hygiene requirements of the working, living and natural environment, food products and drinking water, raw materials, machinery and equipment, other goods, economic or other activity shall be regulated;.
3) individual and public health care activities of legal and natural persons, enterprises without the rights of the legal person shall be subject to licensing;
8) goods harmful to health, which have been listed in the Law on Excise Duties shall be subjected to individual excise duties and other economic regulation measures prescribed by law;
3. Raw materials, machinery, equipment, building materials, elements of the interiors of housing, food and its packaging, containers, other goods, drinking water must not carry a risk to health, or else this risk may only be minimal. The Ministry of Health Care shall lay down the requirements of safety and harmlessness to health of working, living and natural environment, economic or other activities, consumer goods.
4. Enterprises and persons who are engaged in the economic-commercial activities put on the list drawn up by the Ministry of Health Care must be in possession of a permit - hygiene certificate.
5. The procedure for issuing permits - hygiene certificates and grounds for refusing the issuance thereof shall be laid down by the Ministry of Health Care. Permits - hygiene certificates shall be issued by the state public health care institutions authorised by the Ministry of Health Care, also by the enterprises entitled under law to perform expert examination of public health protection.
Article 34. Disease Prevention and Control
1. The basic principles and procedure of communicable disease prevention and control shall be established by the Law on Human Communicable Disease Prevention and Control.
2. Health care institutions, other enterprises and institutions must organise, according to their respective competence, prevention of non-infectious diseases and traumas.
3. The procedure of non-infectious disease prevention and control shall be established by the Ministry of Health Care.
4. The measures preventing traumatism conditioned by transport and their contents shall be specified, according to their respective competence, by the Ministries of Health Care, Transport, the Interior and other.
Article 35. Public Health Emergencies
1. Public health emergency shall be a situation where the environmental factors condition a sudden:
2. The territory where the danger of damage to public health on the group or mass scale suddenly arises shall be declared on the Government’s resolution an area dangerous to public health.
3. The territory where damage is caused to population groups or a large section of the population shall be declared on the Government’s resolution an area detrimental to public health.
4. The criteria for determining public health emergencies, the measures of public health emergency situations management, control, measures for the elimination of adverse negative effects to public health and economy and their financings shall be approved by the Government or the institution authorised by it.
Article 36. Public Health Monitoring and Expert Examination
1. Access to the information on public health may not be restricted and the information may not be considered as state or commercial secret.
2. Public health monitoring shall be carried out in the Republic of Lithuania for the purpose of observation of public health and factors affecting it, also for the purpose of registration of the effects and collection of information thereon.
3. State public health monitoring shall be organised or carried out in the manner prescribed by law by the institutions of state administration or executive institutions of local authorities, also by individual institutions and enterprises.
4. Public health expert examination shall be carried out in the Republic of Lithuania in order to evaluate and substantiate public health monitoring data and the management decisions.
5. Enterprises and institutions which engage in economic-commercial activities posing a threat or detrimental to public health must organise, at their own expense, in the manner prescribed by legal acts the monitoring and expert examination of public health. The lists of such enterprises and institutions shall be approved by the Ministry of Health Care.
Article 37. Control of Public Health
1. The procedure of public health control shall be laid down by laws and other legal acts. The implementation of public health control shall be co-ordinated by the Ministry of Health Care.
2. Public health control shall be:
3. There shall be the following types of state public health control:
4) state control of safety at work (to the extent it is connected with the control of compliance with the labour hygiene regulations);
5) state veterinary control (to the extent it is connected with epidemiological control of communicable diseases common to humans and animals):
6) state environmental control (to the extent it is connected with the prevention and limitation of environmental pollution detrimental to health);
Article 38. Sources of Financing of Health Care Delivered by the NHSL
Executive Bodies
1. The sources of financing of health care delivered and services provided by the NHSL executive bodies shall be:
Article 39. Base Amount of Financing of the Activities of the National Health
System of Lithuania
Each year the base amount of financing of the activities of the National Health System of Lithuania, including the resources of state and municipal budgets and the compulsory health insurance fund budget resource, must account for at least 5% of the GDP value.
Article 40. State Health Fund
1. The State Health Fund shall be formed for the purpose of accumulating resources for the financing of compulsory state health programmes and for the support of programmes of public organisations aimed at health strengthening. The Ministry of Health Care shall form the State Health Fund, approve its estimate, dispose of the Fund and use its resources in the established manner. The regulations of the Fund shall be approved by the Government.
2. The sources of the State Health Fund finances shall be:
1) allocations from the State budget prescribed by the Seimas (including a part of the excise duty on alcohol and tobacco products and a part of economic sanctions for violations of legal acts regulating health activities) intended for state health programmes;
Article 41. Municipal Health Funds
1. Model regulations of the municipal health fund shall be approved by the Seimas. Municipal health funds shall be formed for the purpose accumulation of resources for the support of municipal public health programmes. The municipal health fund shall be formed by the municipal council which shall also approve its regulations in accordance with the Model Municipal Health Funds Regulations.
2. The sources of municipal health fund resources shall be:
2) at least 0.3% of the compulsory health insurance fund budget, taking into account the number of residents;
Article 42. Health Funds of Enterprises, Institutions, Organisations, Religious
Communities and Societies, other Legal and Natural Persons
1. Enterprises, institutions, except for the institutions maintained from the State budget, organisations, religious communities and societies, other legal and natural persons shall have the right to form health funds (hereinafter - health funds of enterprises) the resources whereof shall be used for supporting municipal health programmes, financing health protection or health strengthening programme of the enterprise, institution, or organisation, insuring the enterprise’s employees by voluntary health insurance, performing the enterprise, institution or organisation employees’ labour hygiene assessment and morbidity investigation works. The formation of the health fund and the procedure of use of the fund resources shall be established in model regulations, which shall be approved by the institution approved by the state. The fund’s estimate of expenditure shall be approved by its founder (founders).
2. The resources of health funds of enterprises shall consist of:
1) the part of the enterprise’s, institution’s profit (income) transferred to the health fund of the enterprise or institution;
Article 43. Economic Measures of State Regulation of Health Relations
Health relations shall be regulated by applying economic measures regulated by laws and other legal acts, i.e.:
Article 44. Priorities of Issuing State Budget Targeted Grants for the Support
of Health Activities
1. The priorities for issuing State budget targeted grants for the support of health activities shall be:
2) elimination of consequences detrimental to the health of the population, brought about by public health emergencies (epidemics, natural disasters, ecological disasters);
Article 45. Investments into Health Activities and the Promotion thereof
1. Allocation and use of funds for expanding the range of health care services, acquiring and introducing new health care technologies, implementing state and municipal health programmes, improving the accessibility and adequacy of health care, developing health information systems shall be considered as investment into health activities.
Article 46. Planning of Health Activities
1. By the advice of the Government, the Seimas shall approve the Health Programme of Lithuania, which shall specify the objectives of health activities, health level indicators sought by the state as well as health activities strategies for the achievement thereof.
2. In order to perform the tasks established in the Health Programme of Lithuania, the Government, ministries, other Government institutions, county governors, municipalities shall organise the drawing up and implementation of state, county (regional) and municipal health programmes and planning documents prescribed by law or shall provide for measures for the performance of said tasks in other economic and social development programmes.
HEALTH CARE GUARANTEED BY THE STATE (FREE HEALTH CARE),
HEALTH CARE SUPPORTED BY MUNICIPALITIES AND THE PROCEDURE
OF HEALTH CARE PROVISION
Article 47. Health Care Guaranteed by the State (Free Health Care)
1. Services of health care guaranteed by the state (free health care) shall be financed from the compulsory health insurance fund, state or municipal budgets, state or municipal health funds.
2. Attributed to health care guaranteed by the state (free health care) shall be:
3) individual health care of police and other internal affairs officers, additionally supported through the programmes;
4) individual health care of persons arrested by the police, persons kept in places of pre-trial detention, convicted persons and refugees and illegal migrants;
5) individual health care of persons specified in the Law on Health Insurance, who have been insured by compulsory health insurance;
6) provision of persons ill with diseases the list whereof is approved by the Ministry of Health Care with prostheses of limbs, joints and other organs;
7) individual health care provided to persons who are ill with tuberculosis, sexually transmitted diseases, AIDS, communicable, endocrinous, mental, oncologic diseases, alcohol dependence syndrome, drug addiction, toxic substance addiction and other diseases entered on the list compiled by the Ministry of Health Care as well as to pregnant women;
8) compensation to the persons covered by health insurance of the cost of medicines entered on the list compiled by the Ministry of Health Care and of medical aid appliances charges for which are subject to compensation from the compulsory health insurance budget;
9) public health care according to the nomenclature of the required public health care measures and services;
Article 48. Health Care Supported by Municipalities
Municipalities shall support health care of the population of their respective territories by providing additional financing from the municipal budgets. Attributed to the health care supported by municipalities shall be:
Article 49. Procedure for Providing Individual Health Care Services
Guaranteed by the State (Free) in the NHSL Institutions
1. Citizens of the Republic of Lithuania, foreign nationals and stateless persons, permanently residing in the Republic of Lithuania (hereinafter - permanent residents) shall have the right to individual health care guaranteed by the state (free). Basic medical aid shall be provided to permanent residents in the NHSL institutions free of charge irrespective of whether or not they are insured by compulsory health insurance, also regardless of the number of the patient’s visits to the institution within the calendar year and his place of residence. Foreign nationals, stateless persons not attributed to permanent residents shall be provided basic medical aid by the NHSL institutions in accordance with the procedure established by the Ministry of Health Care of the Republic of Lithuania, unless international agreements of the Republic of Lithuania provide otherwise.
2. Main conditions of provision of state-guaranteed (free) individual health care services in the NHSL institutions shall be as follows:
1) the patient’s application for the provision of free services to the physicians of primary health care, the list of whose specialities shall be drawn up by the Ministry of Health Care;
3. The patient shall have the right to choose the NHSL primary health care institution and the physician according to the procedure prescribed by the Ministry of Health Care and Compulsory Health Insurance Council, also the secondary and tertiary health care institution and the physician in accordance with the conditions prescribed by this Article in order to be provided free individual health care services.
4. Conditions set forth in paragraph 2 hereof shall not be applicable to patients who apply to the NHSL institutions for the provision of basic medical aid.
5. In NHSL institutions state-guaranteed (free) individual health care shall be provided free of charge and the patient may not be charged additionally for free health care services. If patients entitled to free individual health care services choose more expensive services, materials, or forms of treatment on their own initiative, they shall have to pay, in the manner prescribed by the Ministry of Health Care, the difference between the actual prices of said services, materials and forms of treatment and the basic prices of free services, materials and forms of treatment. If patients entitled to free individual health care services choose additional services or forms of treatment on their own initiative, they shall pay the price of said services or forms of treatment.
Article 50. Professional Duties, Rights and Responsibility of Health Care and
Pharmaceutical Specialists
1. The main professional duties of health care and pharmaceutical specialists, their rights, restrictions of their practice shall be established by the laws on the Medical Practice of Physicians, on the Pharmaceutical Activities, on the Prevention and Control of Human Communicable Diseases, on the Compensation of the Rights and Damages to the Health of Patients, other laws and legal acts.
2. Health care and pharmaceutics specialists may practice, only upon being issued a license, exclusively in the speciality they have been trained in and in the cases specified by law. The Register of Health Care and Pharmaceutics Specialities shall be set up for the registration of specialities, the keeper whereof shall be the Ministry of Health Care.
Article 51. Professional Advancement of Health Care and Pharmaceutical
Specialists and its Funding
1. Professional advancement of health care and pharmaceutical specialists shall be the concern of health care and pharmaceutical activities institutions, enterprises, their founders as well as professional organisations of health care and pharmaceutical activities specialists. The contractors of the training and professional advancement of specialists shall be the Ministry of Health Care and the Ministry of Education and Science.
2. Health care and pharmaceutical specialists’ qualifications improvement procedure shall be established by the Ministry of Health Care upon co-ordination with professional health care and pharmaceutical activities specialists.
3. The costs of qualifications improvement and requalification of state and municipal health care institution specialists shall be covered with the state or municipal budget funds according to the procedure and conditions laid down by the Ministry of Health Care, unless other laws prescribe other sources for defraying the costs.
Article 52. Restrictions on the Accessibility of Information Related to Individual
Health
1. Accessibility of information related to individual health shall be restricted with a view to ensuring the inviolability of privacy and the person’s health secret.
2. It shall be prohibited to announce in the media information concerning the individual’s health without the person’s written consent. The protection of computerised information concerning individual’s health must guarantee its confidentiality.
3. Individual or public health care specialists shall be prohibited, except in cases provided by law, from violating the confidentiality of the person’s private life or information concerning individual health which constitutes the person’s health secret and which has come to their knowledge in the performance of their professional duties.
Article 53. Medical and Public Health Care Audit
1. The management of every individual or public health care institution, facility having the right to perform individual or public health care must organise the local audit of medical or public health care according to the procedure laid down by the Ministry of Health Care.
Article 54. Assessment of Individual and Public Health Care Technologies
1. The use of individual and public health care technologies that have not been assessed or approved shall be prohibited, except in cases provided by law.
Article 55. Peculiarities of Health Activities Research Organisation and
Financing
1. The Ministry of Health Care shall establish the priorities of applied biomedical and public health research and shall order, finance and control the research.
2. It shall be prohibited to conduct biomedical research without the permission of Lithuania’s Committee for Medical Ethics. The requirements of biomedical research ethics and the procedure of control of said research shall be established by laws and other legal acts.
Article 56. The Procedure of Health Care Support with the Funds Allocated
for Health Programmes
The costs of individual and public health care with respect to groups of the population whose health is strongly influenced by health risk factors, except in cases where the risk factors arise from the individual’s harmful habits, may be covered, according to the procedure prescribed by the Ministry of Health Care, from the funds allocated for state, municipal health programmes.
Article 57. Restriction or Prohibition of Advertising of Goods and Services
which may Affect Health
1.In the Republic of Lithuania the advertising of goods, products and services which may have a detrimental effect on health shall be prohibited. The procedure for restricting or prohibiting the advertising of the above goods, products and services shall be established by laws and other legal acts.
2. The advertising of tobacco and tobacco products shall be prohibited in the Republic of Lithuania. Advertising of alcohol products and alcoholic beverages shall be restricted or prohibited according to the procedure established by the Law on Alcohol Control.
Article 58. Health Activities Contracts and their Terms and Conditions
1. Contracts of health activities shall be concluded for the implementation of health programmes of the state or municipalities or other entities and for the provision of health services. Health activities contracts shall be concluded in writing. In each contract of health activities its parties must agree on the following terms and conditions:
1) the types of provided health care services, their nomenclature, the scope and time period of provision;
4) the requirements of adequacy of services as well as their organisational and territorial accessibility, if the requirements are not specified in legal acts;
5) penalties for improper fulfilment of the contract or failure to fulfil the contract or its unilateral termination, including penalty for non-compliance with the requirements of the prescribed essential terms and conditions of health care;
Article 59. Binding Character of Regulatory Provisions
1. The conditions of economic-commercial activities, the living and working environment, raw materials, products, imported and sold goods and services must conform to the requirements of public health protection, communicable disease prevention and control, and pharmaceutical activities regulatory provisions.
2. Regulatory provisions regulating the requirements of public health protection, communicable disease prevention and control as well as pharmaceutical activities shall become binding on enterprises, institutions and natural persons upon their endorsement by legal acts of the Ministry of Health Care and shall become effective on the next day after their publication in the “Valstybës þinios” (Official Gazette), unless the acts establish a later data of their coming into force.
Article 60. Main Powers of the Government in the Management of Health
Activities
The Government shall manage health affairs and regulate health activities shall:
2) determine the competence of ministries, Government institutions or other state institutions in the matters of health activities;
4) prepare and submit to the Seimas for consideration draft laws on health activities and drafts of other legal acts;
5) draft and adopt, according to its competence, legal acts on other issues of health activities regulation;
6) establish state services and inspectorates or other state institutions and perform the functions of their founder;
7) make arrangements to ensure the protection of Lithuania’s state borders against the importation and spread of communicable diseases;
Article 61. The Scope of Authority of the Ministry of Health Care in the
Management of Health Activities Matters
1. The Ministry of Health Care shall:
1) establish, reorganise, liquidate institutions subordinate to it as well as management institutions;
2) analyse the state of health of the population and its development forecast, contribute to identifying the goals of health activities, the health level indicators sought by the state and to implementing Health Programme of Lithuania and other state health programmes;
4) charged by the Government, establish, in conjunction with municipalities, main trends of primary health care;
5) organise accreditation for health care and the licensing thereof and supervise the activities of all individual and public health care entities of all types of ownership;
6) carry out the licensing of pharmaceutical activities, except for the licensing of pharmaceutical activities in veterinary science;
Article 62. General Competence of Ministries, Government Institutions in
Health Care Matters
1. Ministries, other Government institutions shall, according to their competence:
1) suspend, restrict the activities of economic entities, detrimental to health and the environment, should the requirements of legal acts on health care or environmental protection be violated;
2) announce to the public the projects, plans and programmes of economic and other activities which might have a detrimental effect on health;
5) support the improvement of educational and cultural level of the population and its supply with information with the aim of influencing human behaviour in order to promote the adoption of a healthy way of life;
8) prohibit or restrict the production of goods and the supply of services that are detrimental to health, as well as the import, sale and consumption of such goods;
10) organise the implementation of measures meant for the restoration and maintenance of the 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 institutions, services and state-owned pharmaceutical enterprises;
13) supervise the compliance by legal and natural persons with laws on health care and requirements of health care standardisation regulations;
14) submit proposals to the Government of the Republic of Lithuania on the procedure of establishing, by means of legislation, liability of legal and natural persons for the violations of health care regulations and for damage caused to human health and the environment;
Article 63. The Competence of the Municipal Council in the Matters of Health
Activities Management
The municipal council shall:
1) approve the primary health care development programme, other comprehensive and municipal target programmes and control their implementation;
4) approve, according to its competence, sanitary and hygiene regulations the violation whereof shall result in administrative liability;
5) form the municipal health fund, approve the report on the use of the fund resources and control the use of thereof;
7) establish, reorganise or liquidate local primary health care institutions, pharmaceutical enterprises and perform the functions of their founders;
9) establish the powers in individual and public health care of institutions assigned to the sphere of municipal regulation;
10) revoke the decisions and directives of the municipal board, the mayor as well as the decisions on health activity matters adopted by committees, commissions, also subdivisions formed by community health council, if said decisions and directives are not in compliance with laws or municipal council decisions;
Article 64. The Competence of the Municipality Mayor 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 Health Programme of Lithuania, state health programmes, the drafting of the municipal primary health care development programme, other municipal comprehensive and target programmes, as well as the implementation in the municipality’s territory of the programmes approved by the municipal council, the laws on health activities and other legal acts;
2) in the territory of the municipality ensure, within the scope of their competence, health care guaranteed by the state and supported by the municipality;
3) organise primary health care and perform the function delegated by the state, i.e. organisation of the secondary health care;
4) organise control over the compliance with the sanitation and hygiene regulations in the territory of the municipality;
5) conclude health activities contracts according to the procedure prescribed by this and other laws, submit them to the municipal council for approval and control their execution;
6) perform the functions of the customer of design, construction, and major repairs works of primary health care institutions owned by the municipality;
7) organise medical and public health care audit of primary health care institutions subordinate to the municipality;
8) organise supervision of the implementation of patients’ rights at the individual health care institutions of primary level;
9) on the basis provided by laws, prohibit enterprises from engaging in business-commercial activities, revoke, in the prescribed manner, licences to engage in such activities issued to legal and natural persons;
10) organise the control of compliance with restriction and prohibition of alcohol and tobacco advertising in outdoor advertising signs and displays;
Article 65. The Municipality Physician and Establishment of his Competence
in the Matters of Health Activities
1. Health care specialists meeting the qualifications requirements laid down by the Ministry of Health Care shall be appointed municipality physicians on the competitive basis.
2. The municipality physician shall head the municipality’s health activities unit the number of staff whereof shall be specified by the municipal council.
Article 66. The County Physician and his Competence in the Matters of Health
Activities
1. The county physician shall be appointed and dismissed by the county governor after consultation with the health care minister.
2. The county physician shall:
1) supervise the implementation of laws on health activities, other legal acts, the health programme of Lithuania and state health programmes and support the implementation of municipal health programmes in the county;
2) generalise the practice of state regulatory measures application in respect of health relations of in the county and draft proposals for the State Health Commission on the preparation and improvement of said measures;
3) co-ordinate with the county administration and the Ministry of Health Care the issues of setting up, reorganisation or liquidation of secondary individual health care institutions;
4) supervise the fulfilment by the county administration of the secondary health care institution construction, capital repair works and customer’s functions;
6) organise the supervision of the execution of the patients’ rights at secondary health care institutions;
3. For the fulfilment of his functions the county physician shall have at his disposal specialists and ancillary staff, whose structure and number of employees shall be prescribed by the county governor keeping within the limits of the established pay-roll fund. Public consultative council shall be set up under the county physician for the rationalisation of provision of health care services in the county.
Article 67. National Health Council
1. The National Health Council is an institution co-ordinating health policy, which is accountable to the Seimas. The National Health Council shall be formed and function in accordance with the regulations approved by the Seimas. The composition of the National Health Council shall be as follows: 1/3 of its members shall be representatives of municipal community health councils delegated by Lithuania’s association of municipalities, 1/3 - representatives of public organisations protecting public health interests, 1/3 - public health care specialists. The activities of the National Health Council shall be financed from the State budget.
2. The National Health Council shall co-ordinate:
3. The National Health Council shall submit findings concerning the health level indicators sought by the state, the targets of health activities, Health Programme of Lithuania and other state health programmes, shall co-ordinate, within the limits of its competence, the implementation of the Health Programme of Lithuania, prepare and annually present to the Seimas a report on the state of the population health and the shaping and implementation of health policy, shall perform other functions assigned to it by this and other laws as well as the Council regulations.
4. The National Health Council shall have the right to:
1) receive from the Government, ministries, other Government institutions, administrative bodies of municipalities, enterprises, institutions, organisations drafts of legal acts and programmes, other information necessary for the performance of the functions provided for in this Law and the Council regulations;
2) carry out within the limits of its competence expert examination of laws, other legal acts, drafts of social and economic development programmes and submit its findings to the persons who drafted the programmes;
3) within the limits of its competence offer consultations to the Seimas, the Government, ministries, other Government institutions;
Article 68. The State Health Commission under the Government of the Republic
of Lithuania
1. The State Health Commission under the Government of the Republic of Lithuania is an institution co-ordinating the planning of health policy measures and the implementation thereof at the ministries, other Government institutions as well as implementation of the laws and other legal acts on health activities.
2. The State Health Commission under the Government of the Republic of Lithuania shall be formed and its regulations shall be approved by the Government. The activities of the State Health Commission under the Government of the Republic of Lithuania shall be financed out of the State budget.
3. The State Health Commission under the Government of the Republic of Lithuania shall:
3) submit proposals to the Government concerning the establishment of special competence of ministries and other Government institutions;
4. The State Health Commission under the Government of the Republic of Lithuania shall have the right to:
1) receive from the Government, ministries, other Government institutions, administrative bodies of municipalities, enterprises, institutions, organisations drafts of laws, other legal acts and programmes as well as other information required for the performance of the functions provided for in this Law and the Commission regulations;
2) carry out within the limits of its competence expert examination of laws, other legal acts, drafts of social and economic development programmes and submit the findings of the expert examination to the persons who drafted the programmes;
3) within the limits of its competence submit proposals to the ministries, other Government institutions, county governors, local authority executive bodies;
4) take part in the consideration of health policy issues in the Government, local authority executive bodies, county administrations, ministries, other Government institutions;
Article 69. Community Health Board of the Municipality
1. Community Health Board of the municipality is an independent institution under the Municipal Council, set up for the co-ordination of health activities. The municipality’s Community Health Board shall be formed and its regulations shall be approved by the Municipal Council. The composition of municipality’s Community Health Board shall be as follows: 1/3 of the Board members shall be persons appointed by the municipality; 1/3 - representatives of municipal enterprises, institutions and organisations, 1/3 - representatives of public organisations protecting public health interests. The programme of activities of the municipality’s Community Health Board shall be financed from the municipal budget.
2. Community Health Board of the municipality shall co-ordinate the preparation and implementation in the municipality’s territory of measures of health promotion, alcohol, tobacco and drugs control, public health protection and health strengthening and disease prevention, shall lay down the priorities for the use of municipality’s health fund resources, submit to the Municipal Council for approval the draft budget of the fund and perform other functions assigned to it pursuant to this Law and other laws as well as its regulations.
3. Community Health Board of the municipality shall have the right to:
1) receive from municipal executive institutions, enterprises, institutions, organisations located in the municipality’s territory information necessary for the fulfilment of the functions provided for in this Law and its regulations;
Article 70. State Tobacco and Alcohol Control Agency under the Government
of the Republic of Lithuania
1. The State Tobacco and Alcohol Control Agency under the Government of the Republic of Lithuania shall be established and its regulations shall be approved by the Government of the Republic of Lithuania. The State Tobacco and Alcohol Control Agency shall be a legal person. Its activities shall be financed from the State budget.
2. The State Tobacco and Alcohol Control Agency under the Government of the Republic of Lithuania shall:
3) control compliance by the media with restrictions and prohibitions imposed on tobacco and alcohol advertising;
Article 71. State Public Health Care Office under the Ministry of Health Care
1. The State Public Health Care Office under the Ministry of Health Care shall be established and its regulations shall be approved by the Ministry of Health Care. The State Public Health Care Office shall be a legal person.
2. The State Public Health Care Office under the Ministry of Health Care shall co-ordinate state public health monitoring, state public health expert examination, examination of public health safety carried out by institutions subordinate to it, shall control the accessibility, quality (adequacy) and effectiveness of health care services as well as fulfilling other functions provided for in its regulations.
Article 72. State Medicines Control Agency under the Ministry of Health Care
1. The State Medicines Control Agency under the Ministry of Health Care shall be set up and its regulations shall be approved by the Ministry of Health Care. The Agency shall be a legal person. Its activities shall be financed from the State budget.
2. The State Medicines Control Agency under the Ministry of Health Care shall:
4) carry out the monitoring of pharmaceutical activities (collection, storage, processing and dissemination of information on medicines, their production, import, sale and export);
Article 73. State Forensic Medicine Office
1. The State Forensic Medicine Office shall be a legal person. The activities of the Office shall be financed from the State budget.
Article 74. State Forensic Psychiatry and Substance Dependence Service under
the Ministry of Health Care
1. The State Forensic Psychiatry and Substance Dependence Service under the Ministry of Health Care shall be established and its regulations shall be approved by the Ministry of Health Care. The Service shall be a legal person. The activities of the Service shall be financed from the State budget.
2. The State Forensic Psychiatry and Substance Dependence Service under the Ministry of Health Care shall:
1) carry out forensic medicine, forensic psychiatry, forensic substance dependence and forensic psychology examinations on the instruction of the bodies of inquiry, investigation or the court;
Article 75. State Office for Accrediting for Health Care Activities under
the Ministry of Health Care
1. The State Office for Accrediting for Health Care Activities under the Ministry of Health Care shall be established and its regulations shall be approved by the Ministry of Health Care. The Office shall be a legal person. The activities of the Office shall be financed from the State budget.
2. The State Office for Accrediting for Health Care Activities under the Ministry of Health Care shall:
1) issue licenses and give accreditation to engage in health care activities to enterprises and establishments;
3) in conjunction with other institutions draft statutory documents for the regulation of health care institutions;
Article 76. State and Territorial Patients’ Funds
State and territorial patients’ funds shall ensure, within the limits of their competence, payment for the prescribed types of individual health care services, shall control the number and quality of said services, perform the financial and economic analysis of the use of compulsory health insurance fund resources, provide state and municipal funds with resources, fulfil the functions prescribed by laws and regulations of the patients’ funds.
Article 77. State Health Care Service under the Ministry of the Interior and
Military Medicine Service Board under the Ministry of National
Defence
1. The State Health Care Service under the Ministry of the Interior shall be established and its regulations shall be approved by the Ministry of the Interior. The Service shall be a legal person. The activities of the Service shall be financed from the State budget.
2. The Military Medicine Service Board under the Ministry of National Defence shall be established and its regulations shall be approved by the Ministry of National Defence. The Service shall be a legal person. The activities of the Service shall be financed from the State budget.
3. The State Health Care Service under the Ministry of the Interior and the Military Medicine Service Board under the Ministry of National Defence shall:
1) implement the health care activities assigned by this Law and other laws to the special competence of the Ministry of the Interior and Ministry of National Defence;
Article 78. State Hygiene Inspectorate
1. The State Hygiene Inspectorate shall be established and its regulation shall be approved by the Ministry of Health Care.
2. The State Hygiene Inspectorate shall exercise state hygiene control, supervise compliance with the requirements of laws and other legal acts on public health care, impose sanctions on legal and natural persons for the violation of said legal acts and perform other functions prescribed by laws and the regulations of the Inspectorate.
Article 79. State Medical Audit Inspectorate under the Ministry of Health Care
1. The State Medical Audit Inspectorate under the Ministry of Health Care shall be established and the regulations of its activities shall be approved by the Ministry of Health Care. The Inspectorate shall be a legal person.. Its activities shall be financed from the State budget.
2. The State Medical Audit Inspectorate under the Ministry of Health Care shall:
1) control the accessibility, quality (adequacy) and economic efficiency of individual health care services;
2) control the compliance by natural and legal persons with the health care quality requirements prescribed by standardisation regulations;
Article 80. Medical Ethics Committee of Lithuania
1.The Medical Ethics Committee of Lithuania shall be established and its regulations shall be approved by the Ministry of Health Care. The Medical Ethics Committee of Lithuania shall be a legal person. Its activities shall be financed from the State budget.
2. The Medical Ethics Committee of Lithuania shall:
Article 81. Medical Ethics Commissions of Individual Health Care Institutions
1. Medical Ethics Commissions of individual health care institutions shall supervise compliance with the requirements of medical ethics by individual health care specialists.
Article 82. Municipal Sanitary Inspectorate
1. Municipal Sanitary Inspectorate is a specialised unit of the municipality administration, which controls compliance with sanitary requirements in the territory of the municipality.
Article 83. The Competence of other Health Activities Management and Control
Institutions in the Matters Pertaining to Health Activities
The competence of other health activities management and control institutions (State Veterinary Service, State Labour Inspectorate, etc.) in the matters pertaining to health activities shall be defined by laws, other legal acts the regulations of the institutions.
Article 84. The Rights of the Residents of the Republic of Lithuania in Health
Activities
1. 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 to health existing in the environment;
4) obtain information concerning their health and be guaranteed the right to the confidentiality of said information;
6) choose, in the established manner, a health care specialist, health care institution, type of health care, or refuse the services of any of the above, unless the law provides otherwise;
Article 85. The Duties of the Residents of the Republic of Lithuania
in the Sphere of Health Activities
The residents of the Republic of Lithuania must:
Article 86. The Rights of Enterprises and Institutions Operating in the Republic
of Lithuania Pertaining to Health Activities
1. Enterprises and institutions operating in the Republic of Lithuania shall have the right to:
1) conclude contracts pertaining to health activities according to the procedure laid down by this Law and other laws;
3) establish, in the manner prescribed by laws, individual or public health care institutions, set up their own facilities for carrying out health care;
Article 87. The Duties of Enterprises and Institutions Operating in the Republic
of Lithuania Pertaining to Health Activities
1. The enterprises and institutions operating in the Republic of Lithuania must:
2) timely inform health care institutions, services, the population of the danger to health which arises as a result of the activities pursued, products manufactured or goods sold by them;
4) prevent the imminent danger to the environment, limit the scope of danger and harm to the environment;
5) protect people against communicable diseases spread by food or drinking water, or invasions of such diseases, as well as against food poisoning, and implement measures to restrict the spread of communicable diseases;
6) organise, in accordance with the established procedure and in the prescribed cases, public health monitoring and expert examination and defray related costs;
2. The enterprises and institutions may also have other duties provided that these do not contradict this Law and other laws.
Article 88. Compensation for the Damage Caused to Health
Legal and natural persons who by act or omission cause damage to human health must indemnify for the losses sustained by reason thereof, whereas in the event of death of the injured party damages must be paid by the guilty persons to the family of the dead person and other persons. Unless otherwise provided by law, damages for harm caused to health or for deprivation of life shall be assessed based on the amounts and according to the methods of assessing harm to health approved by the Government; in the event of a dispute damages shall be sued out. The indemnification procedure shall be established by the Civil Code, other legal acts.
Article 89. Third Party Liability Insurance of Individual Health Care
Institutions and Facilities
1. Individual health care institutions and facilities must insure themselves against liability for damage caused to the patients’ health while providing individual medical care.
2. The procedure for effecting third party liability insurance against damage caused by individual health care facilities and institutions to the patients’ health while providing individual health care shall be regulated by the Law on the Compensation of the Rights and Damage to the Health of Patients, the Law on Insurance, other laws and legal acts.
Article 90. Obligation to Indemnify State Offices and Services, State
Inspectorates, Health Care Institutions and other Legal Persons
for the Losses Incurred by Reason of Damage to Health Caused
by Unlawful Acts
Legal and natural persons who by their unlawful acts cause damage to human health must indemnify , in the manner prescribed by laws, health care institutions, state services or offices or state inspectorates, other legal persons for the losses incurred by reason thereof.
Article 91. Indemnification for Moral Damage
1. Persons who fail to comply with the requirements of acceptability of health care or violate confidentiality of information on personal health (the individual’s medical secret) must compensate the persons for the inflicted moral damage.
2. When assessing the extent of moral (non-property) damage in monetary terms, the court shall take into account the property status of the person who inflicted the damage, the gravity of the offence, its consequences and other circumstances, in each case, however, the amount may not be in excess of 500 minimum monthly wages.
Article 92. Liability for Unlawful Health Care Practice
Legal and natural persons illegally practising health care activities shall be held liable under law.
Article 93. Imposition of Economic Sanctions
Pursuant to the Law on Economic Sanctions for Breaches of Legal Acts on Public Health Care, economic sanctions shall be imposed on enterprises for breach of legal acts on public health care.
Article 94. Basic Principles of International Co-operation of the Republic
of Lithuania in the Sphere of Health Activities
Co-operating with other states and international organisations in the sphere of health activities, the Republic of Lithuania must adhere to the following principles:
1) ensure 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;
Article 95. The Law on the Health System of the Republic of Lithuania and the
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.”