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Comparative analysis of the Serbian and German legislation on emergency medical services

Wolfgang Tiede, Christine Simon
2009 SEER. Journal for Labour and Social Affairs in Eastern Europe. Journal of the European Trade Union Institute  
The political developments in Serbia and the hostilities and economic sanctions of the nineties resulted in a significant deterioration of the economy. These circumstances gave rise to damage to and neglect of the infrastructure, as well as of the administrative structure of the country. Hence, it is not surprising that the present population health standard of Serbia is, although similar to other central and eastern European countries, still below that of western Europe. In view of this
more » ... view of this background, the article will firstly describe the present Serbian legislation on emergency medical services. Subsequently, it comments on the German legislation on emergency medical services as an exemplar of the respective regulation of a western European state. Based on these descriptions and with reference to EU legal standards, a comparison between the two legislations is drawn. The article concludes with recommendations for possible improvements to the Serbian legislation on emergency medical services. The Serbian legislation regulating the emergency medical services (EMS) is found in legal provisions at different levels and is, therefore, quite fragmented. The Health Care Law as well as the Health Insurance Law form the legal basis and these define the functioning and organisation of EMS in Serbia. Moreover, there are several subordinated regulations, such as the Network plan for health institutions, the Rule book on the conditions and the means of internal organisation of health institutions or the Rule book on detailed conditions for the performance of health activities in the health institutions and other forms of health services. These regulate the structure of health care units as well as the medical personnel required for the performance of emergency medical care (EMC). The Rule book on the content and scope of rights to health care lists, among other issues, the health care services which should be provided in emergency medical cases as well as their scope. In addition, the Rule book on the quality criteria and methodology explanation for the procedures of reporting by health institutions on the mandatory quality criteria of health care prescribes, amongst others, the quality criteria which should be followed when performing EMC at primary, secondary and tertiary levels of health care. The Rule book on the practical training and the expert examination of health workers and medical associates and the Rule book on specialisation and advanced specialisation of health workers and medical associates regulates the education and training of health care workers in different areas of health care, including EMC. There is also a codex of professional ethics defining the rights of patients and the duties of physicians. The number of regulations regarding EMS emphasises the great importance which is basically attached to this issue. In order to prove whether the respective provisions meet the demands one should made of an efficient EMS, the particular regulations are examined more closely in the next few sections. Health care law As mentioned before, the Health Care Law (HCL) is the legal foundation of EMS in Serbia. It regulates the different ways of performing EMS and how this is organised. These issues are not laid down in one place but can be found in the following provisions of the HCL. Obligation to provide emergency medical care In its introductory provisions within the chapter 'Social care for the health of the population', the HCL obliges not just EMS units to provide EMC, but also the whole society. By this, it means the Republic of Serbia, by providing financial coverage from the health insurance or budgetary resources (Art. 11, HCL; Article 22, Health Insurance Law (hereinafter HIL); and Article 23 of the Rule book on the content and scope of rights to health care covered by health insurance financial resources and on co-payment for 2009); employers, by providing first aid in the case of industrial injury and by providing conditions for EMC (Art. 14, prov. 1, bullet 12, HCL); and individuals, by providing first aid, as well as accessibility to the EMS unit to injured or ill people in urgent cases and within the limits of their own knowledge and possibilities. Comparative analysis of the Serbian and German legislation on emergency medical services 2/2009 South-East Europe Review 275 https://doi.
doi:10.5771/1435-2869-2009-2-263 fatcat:q4mv4zrzyvaklccx6qv57m5jue