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Follow-up checks belong to public health care

Patient referred unlawfully to private doctor at his own expense

The Eye Diseases Clinic belonging to the Helsinki and Uusimaa Hospital District's Helsinki University Central Hospital and the Helsinki University Jorvi Hospital referred a patient to the private sector for follow-up examinations at his own expense. Ombudsman Petri Jääskeläinen deems this action to have been unlawful and recommends that recompense be made to the patient.

In the Ombudsman's view, the patient's constitutionally guaranteed right to adequate health services and good care in the meaning of the Patient Act were not implemented.

The Ombudsman points out that the Eye Diseases Clinic and Jorvi Hospital should have arranged the necessary follow-up checks either themselves or by using the other means provided for in the Act, for example by purchasing follow-up examinations from a private service provider.

"Follow-up checks after a medically justified measure are a necessary part of the treatment totality. They are included in the responsibility of public health care and may not be transferred to a private doctor and for patients themselves to pay for,? is the Ombudsman's view.

If a public health authority can not itself produce a service, it must obtain the service from either another public health authority or a private service producer. If a service is purchased from a private body, the fee the patient must pay for it is the same as on the public side.

Patients have, of course, a right to decide whether to use public or private health care services. However, this freedom of choice presupposes that they have been given correct information that follow-up checks are included in public health care.

The Ombudsman recommended to the Helsinki and Uusimaa Hospital District that it consider how recompense can be made to the patient for the costs caused by its unlawful action. The Hospital district must inform him, by 31.3.2012, of what decision has been made in the matter.

Equality not implemented

The Ombudsman finds the present situation, in which it seems that patients' right to necessary follow-up health checks are not being implemented on a basis of equality in public health care in various parts of Finland, to be unsatisfactory. This is revealed in medical statements by Valvira, the National Supervisory Authority for Welfare and Health and its permanent expert.

For this reason, the Ombudsman takes the view that the uniform treatment principles should be complemented with guidelines concerning the performance of follow-up checks. He has asked Valvira and the Ministry of Social Affairs and Health to inform him, by 31.5.2012, of the measures that they have taken in the matter.

Additional info will be provided by Senior Legal Adviser Kaija Tanttinen-Laakkonen, tel. +358(0)9 432 3377.