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Act No. 372/2011 Coll., on health services and conditions of their provision

§ 93

(1) A complaint may be lodged against a provider's practice in providing health services or against activities related to health services

(a) a patient,

(b) the patient's legal representative or guardian,

(c) a person close to the patient if the patient is unable to do so because of his or her state of health or if the patient has died; or

(d) a person authorised by the patient.

The complaint shall be lodged with the provider against whom it is directed, without prejudice to the possibility of lodging a complaint under other legislation. The lodging of a complaint shall not be to the detriment of the person who lodged it or the patient concerned.

(2) If the person who has lodged a complaint with the provider (hereinafter referred to as "the complainant") does not agree with the handling of the complaint, he or she may lodge a complaint with the competent administrative authority which has granted the provider the authorisation to provide health services. It shall also state the reasons for its disagreement with the handling of the complaint by the provider.

(3) The provider shall be obliged to

(a) propose to the complainant that the complaint be heard orally, if appropriate in view of the nature of the complaint,

(b) deal with the complaint within 30 days of its receipt; he may extend this period by a further 30 days on reasonable grounds; if the complaint is one which he is not competent to deal with, he shall, within 5 days of its receipt, forward it to the body responsible for the subject matter; he shall inform the complainant of the extension of the time limit and of the forwarding of the complaint,

(c) keep a record of the complaints lodged and the manner in which they are dealt with,

(d) allow the complainant to inspect and take copies of the specific complaint file,

(e) in the case of an investigation of a complaint by the competent administrative authority, to provide it with timely and necessary assistance at its request; this shall also apply to the provider who has provided the related health services.

(4) The provider of inpatient or day care shall also be obliged to

(a) establish a complaints procedure,

(b) publish the procedure referred to in point (a) and information on the possibility of submitting a complaint to the bodies referred to in paragraph 2 in a publicly accessible place in the health care facility and on its website.

(5) The director of an organizational unit of the Prison Service is competent to investigate complaints of persons against the procedure in the provision of health services provided by the Prison Service, unless the Director General of the Prison Service authorizes another person to investigate the complaint.

§ 94

(1) The competent administrative authority shall

(a) deal with the complaint

1/ within 30 days from the date of its receipt,

2/ within 90 days from the date of its receipt if the complaint is a complaint that requires the appointment of an independent expert,

3/ within 120 days from the date of receipt if the complaint is a complaint requiring the establishment of an independent expert committee;

the time limit for dealing with a complaint under point 2 or 3 shall begin to run from the date on which the competent administrative authority has appointed an independent expert or an independent expert committee; the time limit under point 1 may be extended by the competent administrative authority for a further 30 days and the time limit under point 2 or 3 for a further 60 days on reasonable grounds; the competent administrative authority shall appoint the independent expert or the independent expert committee without undue delay; where the complaint is a matter for which it has no jurisdiction, it shall, within 5 working days of receipt, forward it to the body responsible for the subject matter; it shall inform the complainant of the extension of the time limit and of the forwarding of the complaint,

(b) develop a procedure for handling complaints and designate a regional office to receive complaints,

(c) publish the procedure referred to in point (b) and the address, office hours and contact details of the designated office on the official notice board,

(d) keep a record of complaints lodged and the manner in which they are dealt with,

(e) allow the complainant to consult and take copies of the specific complaint file.

(2) The competent administrative authority may terminate the investigation of a complaint if it is a complaint for the settlement of which it is necessary to inspect the medical records kept on the patient to whom the complaint relates, or to make a copy or extract from those records, if the patient, the patient's legal representative or the patient's guardian has not consented to the inspection and, where appropriate, to the making of a copy or extract. If the patient is unable to express his or her will in view of his or her state of health, the complainant referred to in Article 93(1)(c) or (d) may give such consent within the scope of his or her authorisation. The competent administrative authority shall inform the patient concerned, the complainant, if different from the patient, and the provider to whom the complaint relates of the conclusion of the investigation of the complaint under the first sentence and the reason for it.

(3) A complaint lodged by a person who is not referred to in section 93(1) shall be considered by the competent administrative authority as a complaint for inspection. Within 30 days from the date of receipt, it shall inform the person referred to in the first sentence in writing of how the complaint has been dealt with.

(4) The competent administrative authority may, on the basis of a complaint or ex officio or other initiative, in particular to assess cases in which doubts have arisen as to whether the correct procedure was followed in the provision of health services, or to rule out a causal link between the incorrect procedure and harm to the patient's health in the provision of health services, establish

(a) an independent expert; the expert shall be appointed whenever the complaint or complaint is directed against the correct procedure in the provision of health services or alleges harm to the patient in the provision of health services and the complaint or complaint is not manifestly unfounded,

(b) an independent expert committee; the committee shall be established whenever

1. an independent expert proposes its establishment on the basis of an assessment of the medical records; or

2. in his or her discretion, the case is one where the independent expert's assessment is professionally inadequate or where there is a need to assess possible harm in the provision of health services resulting in the death of the patient and the complaint or other complaint is not manifestly unfounded.

§ 95

(1) The members of the independent expert committee, appointed and removed by the competent administrative authority, shall always be

(a) a representative of the competent administrative authority; the representative of the competent administrative authority, who shall always be a health professional, shall also be the chairman of the panel and shall direct its activities,

(b) at least two health professionals qualified to practise independently as health professionals in the relevant health care field,

(c) a physician with specialised competence in pathological anatomy or forensic medicine in the case of the death of a patient,

(d) a representative of the relevant chamber or professional organisation.

(2) The Commission's deliberations

(a) a person who has completed a master's degree programme in law shall always be invited,

(b) the provider against whom the complaint is directed and the complainant may be invited to explain the facts stated in the complaint for such time as may be necessary; the complainant shall always be invited to the hearing at his or her request.

(3) The members of the independent expert committee may not be persons who, in view of their relationship to the provider, to the complainant or to the patient to whom the complaint relates or to the subject matter of the complaint under consideration, are in reasonable doubt as to their impartiality.

(4) The independent expert committee shall hear the case in the presence of at least a majority of all its members, one of whom shall always be a health professional as referred to in paragraph (1)(b).

(5) The independent expert committee shall examine the case on the basis of the medical records kept on the patient and other facts established for the purpose of the examination of the case and shall draw up a record which shall be forwarded without delay to the competent administrative authority through the chairman of the committee. The record shall include

(a) a summary of the essential data from the medical record,

(b) the conclusion of the case review

1/ with a clear statement as to whether or not due professional care was followed in the provision of the health service; in the case of non-compliance with due professional care, a description shall be given,

2/ in the case where due professional care was not followed, a statement as to whether or not there is a causal link between that care and the injury to health or damage to health resulting in death; this shall not apply where such a statement cannot be made on the basis of the facts established,

(c) a proposal for remedial action.

§ 96

(1) If the competent administrative authority, when investigating a complaint, finds a violation of rights or obligations in the provision of health services or related activities provided for by this Act or other legal regulations or other misconduct affecting the rights and interests of patients,

(a) impose corrective measures on the provider, specifying a time limit for their fulfilment, where appropriate

(b) lodge a complaint

1/ to the competent authority under other legislation.

2/ to the competent chamber, if it finds such misconduct by a health professional who is a member of the chamber, which the chamber is entitled to investigate under the law regulating the activities of chambers;

the provider shall follow a similar procedure.

(2) The competent administrative authority shall send information about the corrective measures imposed or the filing of a complaint to the health insurance company with which the patient was insured at the time of the violation of rights or obligations in the provision of health services.

§ 97

The meeting of the Independent Expert Panel shall be closed to the public. The competent administrative authority, where it has set up an independent expert or an independent expert committee, shall communicate to the patient concerned by the complaint and to the complainant, if other than the patient, the name or names of the independent expert or members of the independent expert committee and of the persons invited pursuant to Article § 95 odst. 2.