THE LAW

ON HEALTH CARE

I.PRINCIPAL PROVISIONS
Art. 1

Health care represents a set of measures and activities for preservation, protection, and promotion of health, prevention and fighting illnesses and injuries, early detection of illnesses, and timely medical treatment and rehabilitation.

Art. 2

The aim of this Law is to create conditions for:

1)preservation and improvement of health of citizens of the Republic of Montenegro (hereinafter: the Republic) and improvement of health condition of the population;

2)the improvement of the quality of life in relation to health;

3)accessibility, under equal conditions, to health care for all citizens of the Republic, with particular care of health and socially vulnerable population categories;

4)sustainability of the health system;

5)improvement of the functioning, efficiency and quality of health services, along with the defining of special programs in the area of human resources, facility network, technology, and medical supplies;

6)better functional linking and harmonization among health system institutions of the Republic, as well as the harmonization of private and public interest in this area;

7)incentives for performing health activities in accordance with national and international standards.

Art. 3

The citizen shall be entitled to health care in line with the law.

The citizen shall be obliged to take care of his/her own health.

No one may put in danger health of other people.

Everyone shall be obliged, within his/her best knowledge and possibilities, to administer first aid to an injured or ill person and to facilitate his/her access to urgent medical assistance.

Art. 4

In implementation of entitlements to health care, all citizens shall be equal regardless to nationality, race, gender, age, language, religion, education, social background, income status, and any other personal characteristic.

Art. 5

Health activity is the activity of public interest.

Art. 6

Health care shall be implemented on principles of comprehensiveness, continuity, accessibility and integral approach in the primary health care, and specialized approach in the specialist-consulting and hospital health care.

Art. 7

Health care service shall be liable to the quality control of its expert functioning and to the administrative supervision, in line with this Law.

Art. 8

Means for the implementation of health care and for the functioning and development of health services shall be provided in accordance with this Law.

Art. 9

In terms of this Law, specific terms and expressions have the following meanings:

  1. Priority health care measures - health care measures that are accessible to all citizens in the Republic;
  2. The health system – comprehensive activity and participation of all entities in the Republic (including health sector and all sectors related to health, educational and other institutions, economic entities and citizens) in providing health care for the population;
  3. Health service – health institutions, including health workers and associates, employed by them;
  4. Public health – the scientific-research approach to the development of health system and health policy, as well as the organized activity for health promotion, illness prevention, and creation of conditions for equal accessibility to health care among different social categories, as well as for alignment of the population health condition within sustainable development on the Republic level;
  5. Health activity – health institutions’ activities and other forms of health services in providing health services aimed at health protection of citizens;
  6. Pharmaceutical health activity – provision of medicinal products and medical devices for citizens, in line with the law;
  7. The health institution – the legal entity registered for performing health activities, which has a relevant approval in accordance with this Law;
  8. The health institutions network – the legal act on establishing and planning the type, the number, and distribution of public and private health institutions on the territory of the Republic;
  9. Health – apart from absence of illnesses and disability, it means the state of complete physical, mental, and social welfare;
  10. Promotion of health – incentives for certain way of life and identification of social, economic, mental, personal, and other factors that contribute to health, including factors of environment as well;
  11. Health worker – a person with medical education who meets other conditions for performing health activities, in line with this Law;
  12. Health associate - a person without medical education who can perform certain duties within health activities, in line with this Law;
  13. The college specialized in health – the medical college, the dentistry college, and the pharmaceutical college;
  14. Quality of health care – the level of fulfillment of needs of citizens in terms of the condition of means and equipment and conditions for health care, staff capacity, expertise and skills and their application, improvement of health status, removal of causes and diminishing harmful influence of certain behavior and of the environmental factor, and quality of life;
  15. Accreditation – evaluation of a health institution in terms of fulfillment of established standards within certain health care area or branch of medicine;
  16. Health technology – interventions and applied expertise used in health care, including medicinal products, equipment, medical and surgical procedures, and organizational, administrative, and logistic systems within which health care of population is provided.
II.HEALTH CARE
  1. Priority Health Care Measures
Art. 10

Priority health care measures shall include:

1)activities in promoting health and upgrading health status of population in the Republic;

2)health education in relation to the most common health problems of population in the Republic and methods for their identification, prevention, and control;

3)activities in improving systematic provision of food and drinking water to the population, in line with the specific law;

4)prevention and protection from ecological factors harmful to health, including all measures and activities in protecting, improving, and promoting health conditions of living and working environment and hygienic conditions for life and work of citizens;

5)detection, prevention, and fighting illnesses, injuries, and their consequences on the Republic level;

6)prevention, timely detection, medical treatment, and fighting contagious, chronic non-contagious , and malign illnesses and immunization against main infectious illnesses, as well as prevention and control of local endemic diseases;

7)health care of children and young people until the end of legally prescribed regular education, protection of women in relation to the family planning, pregnancy, giving birth, and maternity;

8)health care (preventive and curative) of citizens over 65 years of age;

9)health care of war veterans, military invalids, civil war invalids, their family members, and beneficiaries of veterans’ allowance, as well as beneficiaries of social protection, in line with specific regulations;

10)upgrading the level of mental health of citizens, medical treatment and rehabilitation of mentally ill persons who are not otherwise insured, as well as hospitalization and medical treatment of mentally ill persons who may do harm to themselves or to their surroundings, in line with the law;

11)health care of physically and mentally handicapped persons;

12)medical treatment of persons on chronic dialysis program;

13)provision of necessary medicinal products and medical devices – essential medicines, in particular;

14)urgent hospitalization and medical treatment of persons whose life is threatened due to an illness or an injury; and

15)establishing cause of death.

  1. Public Interest in the Area of Health Care
Art. 11

Public interest in the area of health care encompasses measures and activities, which contribute to the improvement of living conditions, health, and work of citizens, as well as to the functioning and development of health service.

Public interest in the area of health care shall be provided and implemented on the Republic level and on the level of local self-government units.

Art. 12

The Republic shall cerate conditions for the implementation of health care and conditions for improvement, protection, and preservation of citizens’ health, and it shall harmonize the functioning and development of health services throughout the territory of the Republic.

The Republic shall establish health policy that defines and harmonizes functioning and development of the health system on the territory of the Republic.

Implementing the policy referred to in Par. 2 of this article, the Republic shall:

1)establish the development strategy of health in the Republic that includes measures for the implementation of health policy tasks and objectives, priorities in specific areas of health care, measures for improved efficiency of health care provision, and other measures and activities of strategic relevance for the development and promotion of health care;

2)give incentive to the developing of healthy living habits through tax and economic policy measures;

3)facilitate cooperation with other entities in the health system development and the implementation of priority health care measures through the integrated health system;

4)establish measures in the area of living and working environment that may have an impact on citizens’ health, in line with the specific law;

5)establish standards and norms in the area of health in accordance with scientific achievements, economic possibilities, and general and specific needs of health care beneficiaries;

6)establish health institutions network on the territory of the Republic;

7)develop a program of integration of private and public sector;

8)develop a plan of the human resources development in the area of health care;

9)provide funds, in line with the law.

The Government of the Republic of Montenegro (hereinafter: the Government) shall establish the health policy referred to in Par, 2 of this article and shall carry out duties referred to in Par. 3. Items 1,2,4,6,7 and 9 of this article.

The Ministry competent for health affairs (hereinafter: the Ministry) shall carry out duties referred to in Par. 3, items 3,5 and 8 of this article.

Art. 16

In the area of health care, the Republic shall provide funds from the Budget for:

1)monitoring of the health status of population and identification of health problems in the Republic, as well as for other duties inn the area of public health;

2)implementation of priority health care measures referred to in Art. 10, items 1,2,3,4,10, and 15 of this Law;

3)the implementation of health care measures ordered by the competent state administration authority in emergency situations (epidemics, contagious diseases, physical and chemical accidents, natural disasters and other large disasters, bio-terrorism, and others);

4)illness prevention, health promotion, investigating health problems and risks, and other social-medical activities relevant to the Republic;

5)implementation of promotional programs for the improvement of health of specific most vulnerable population groups, population categories, age groups, and types of diseases that are not included in compulsory health insurance;

6)the planning, organizing, and implementation of activities in fighting alcoholism, smoking, use of drugs, and dependence (addiction) illnesses;

7)the control of health soundness of the air, drinking water, soil, as well as the control of health soundness of food-stuffs and general purpose items and the noise control, as well as protection of ionizing and non-ionizing radiation, if the funds for this purpose are not allocated otherwise, in line with specific regulations;

8)participation in the funding of scientific-research projects in the area of health care;

9)urgent medical assistance to the citizens who are not covered by health insurance;

10)health care of individuals sentenced to imprisonment, as well of individuals to whom the measure of compulsory custody and medical treatment of alcoholics and drug addicts has been pronounced;

11)health care of individuals who are registered as unemployed if the funds for health insurance of these persons is not otherwise provided, in line with the specific law;

12)health care of beneficiaries of social-protection rights, military invalids, civil war invalids, their family members, and veteran allowance beneficiaries if they are not otherwise insured;

13)health care of foreigners and staff of diplomat-consular representative offices, who are provided with health care on the basis of international agreements if such agreements do not regulate differently, as well as of foreigners who stay in the Republic upon invitation of the state authorities, during their stay in the Republic;

14)health care of foreigners with recognized status of refugees and displaced persons, in line with specific regulations and international agreements;

15)health care of foreigners ill with plague, cholera, viral chemoragic fever, or yellow fever, as well as of foreigners – crew members of foreign vessels ill with VD or other illnesses hazardous to health;

16)construction and maintenance of facilities and procurement of medical equipment of high technological value for health institutions founded by the Republic.

Construction of facilities and procurement of equipment referred to in item 16 of this article shall be carried out in accordance with health policy priorities as per method and procedures envisaged by this Law.

Art. 14

The local self-government unit, within its rights and obligations, shall participate in providing conditions for implementation of primary health care on its territory through:

1)proposing and initiating measures in the area of primary health care;

2)participating in the planning and implementing of primary health care development, which is of direct interest for the local population, in line with this Law and other legal acts developed on the basis of this Law;

3)participation in the management of health institutions founded by the Republic on its territory;

4)undertaking other activities in order to improve primary health care, in line with the law.

  1. Health Care Measures in Relation to Work and Working Environment
Art. 15

When planning and performing their activities, legal and private entities shall be obliged to provide conditions for the implementation of health care through the development and application of appropriate technologies that are not health and environment hazardous, as well as for the implementation of measures for health protection and promotion of the employed.

Health care measures in relation to work and working environment, with the aim at providing specific health care of the employed, which shall be provided by the employer, in line with labor legislation, are:

1)prevention and detection of occupational diseases, prevention of injuries at work and administering appropriate first aid;

2)protection of health of the employed who are exposed to specific health hazards at work; and

3)health care measures established by specific regulations.

Art. 16

Specific health care of the employed shall include:

1)medical examinations for the establishment of capability for work;

2)monitoring of health condition of the employed;

3)identification and assessment of health risks at work;

4)general medical check-ups, previous, periodical, and control medical examinations of the employed in regard to their gender, age, and working conditions, incidence of occupational diseases, injuries at work, and chronic diseases;

5)counciling on health, safety, hygiene at work, organization, and protection devices;

6)medical examinations of the employed that are mandatory conducted for the protection from hazardous factors of the living and working environment, protection of consumers or service users and other mandatory medical examinations;

7)organizing and administrating first aid and urgent interventions on the spot and in the working process;

8)assessment of working conditions of particular jobs for the protection from occupational diseases;

9)assessing needs and referring workers who are exposed to health hazards at work and those chronically overtired and physically exhausted workers to health-preventive active rest and early rehabilitation and monitoring results of such rest and rehabilitation;

10)health education of the employed.

The Ministry shall closely establish the scope of measures of specific health care of the employed, with an approval of the ministry competent for labor affairs.

Art. 17

Specific health care of the employed by the employer shall be implemented on the basis of an agreement between the employer and the health institution.

  1. Rights and Obligations of Citizens in the Implementation of Health Care

Art. 18

Implementing health care, each citizen shall be entitled to:

1)equality in overall treatment when implementing health care;

2)free choice of a medical doctor or dentist, in line with the law;

3)health care of standard quality and equal scope, as well as entitlement to possible demurrages for the damage that has been caused by inappropriate health care;

4)urgent medical assistance when necessary, in line with the specific law;

5)free choice among multiple types of medical interventions offered by a MD or a dentist, in line with this Law;

6)correct information on all issues concerning his/her health;

7)refusal to be used as an object of scientific research without his/her consent or any other examination or medical treatment that is not for the purpose of his/her medical treatment;

8)confidentiality of all data related to his/her health;

9)refusal of examination or treatment, including his/her right that, in the course of treatment, requests in a writing to change the MD or dentist following his/her statement that he/she has lost confidence in the doctor who has been treating him/her;

10)refusal of surgical or any other intervention, in accordance with this Law.

The right of choice, acceptance/refusal of specific diagnostic and therapeutic procedures quoted in Par. 1, items 5,7,9, and 10 of this article shall be expressed by citizen’s signature of his/her consent when admitted to the health institution unless he/she is under age or incapable for such act.

If the citizen is not capable to make up his/her decision on choice of medical intervention among offered possibilities and there is an non-postponable intervention at issue, whose non-performing may endanger life and health of the citizen or may cause durable damages, his/her immediate family members or other close relatives shall be authorized to bring such decision.

The consent shall not be mandatory if the obtaining of the consent referred to in the previous paragraph would call for longer period of time, which might endanger the citizen’s life.

The citizen can refuse a surgical intervention if he/she is conscious and oriented in time and space and if he/she is capable to make clear judgements.