Šis įstatymas reguliuoja Lietuvos nacionalinę sveikatos sistemą, jos struktūrą, sveikatos priežiūros, stiprinimo ir atgavimo teisinio reguliavimo ribas

REPUBLIC OF LITHUANIA REPUBLIC OF LITHUANIA L A W ON THE HEALTH SYSTEM The Seimas of the Republic of Lithuania, recognizing, that the health of the population is the greatest social and economic value of society, health is not only the absence of diseases and physical deficiencies, but physical, spiritual and social welfare of people as well, the potential of health and conditions of its maintaining are determined by stability of the development of economic system, guarantees for social security and education of society, employment and sufficient income of the population, provision with dwellings, accessible, acceptable and adequate health care, proper nutrition, quality of work, living and natural environment, as well as by the efforts of the population to promote health, person's efforts to stay healthy may only be promoted by social and economic measures which are acceptable from the point of view of human dignity and the current time, the best possible public health is a necessary prerequisite for the security and prosperity of the State of Lithuania, as well as for creating of an open, just and harmonious civic society; taking into consideration the provisions of the global strategy "Health to Everybody - 2 000", adopted at the 30th Session of the World Health Assembly in 1977, the Ottawa Health Promotion Charter and the National Health Concept of Lithuania; seeking to ensure the in-born human right to enjoy the best possible health, as well as the right to have healthy environment, acceptable, accessible and adequate health care; acting in compliance with the Constitution of the Republic of Lithuania, enacts this Law on the Health System.

Part I

The Health System

Chapter 1

General Provisions

Article 1The Purpose of the Law of the Republic of

Lithuania on the Health System The Law of the Republic of Lithuania on the Health System shall regulate the national health system of Lithuania, its structure, limits of legal regulation of health care, health strengthening and health recovery, fundamentals of establishment of the scope of health activities, organization and management of individual and public health care, health promotion, conclusion of contracts concerning health activities, fundamentals of the liability for violations of legal norms of health activities, rights and duties of the residents and subjects of health activities.

Article 2Legal Regulation of Health Relations

Health relations arising from protection, strengthening and assistance in recovering of individual and public health, as well as relations concerning the implementation of the individual's rights to have the best possible health, protection of health interests of an individual and society, shall be regulated by this Law, other laws on health activities, as well as laws, if they do not contradict the meaning of the above mentioned laws, concerning the structure and institutions of state power and government, local self-government, public organizations, human rights and other social affairs, environmental protection, economy, national defense and internal order, subordinate legislation acts, contracts and agreements concerning health activities and working conditions.

Article 3The Scope of the Legal Regulation of Health

Relations The following shall only be established by the laws of the Republic of Lithuania on health activities:

The Government of the Republic of Lithuania, ministries, state services and state inspectorates shall enjoy the right to adopt within their competence legal acts on the issues of the regulation of health relations, with the exception of those issues which are regulated by the laws concerning health activities. Provisions of legal acts of the Government of the Republic of Lithuania, ministries, state services and state inspectorates, which worsen the conditions of health activities comparing to those conditions which are established by the laws concerning health activities, shall be deemed invalid.

Within their competence, enterprises, institutions and organizations shall have the right to adopt legal acts establishing, in comparison to laws and other legal acts, additional economic and social incentives for citizens to foster their health, for economic entities - to engage in economic- commercial activities beneficial to health, additional support to socially vulnerable groups of the population by compensating the expenses of their health care, additional requirements for implementing of public health care. Provisions of legal acts of enterprises, institutions and organizations which worsen the level of health activities comparing to the level which is established by laws and other legal acts concerning health activities, shall be deemed invalid.

Article 4Health Activities

The health activities shall comprise:

Article 5The Purposes of Health Activities

The purposes of health activities shall be as follows:

Article 6Principles of Regulating of the Health

Activities The following principles shall be applied to the regulation of the relations specified in Article 1 of this Law:

If the relations specified in Article 1 of this Law are not regulated by laws and provisions of legal norms, which regulate similar relations, cannot be applied thereto, the principles set forth in Par. 1 of this Article shall be applied in the settlement of any disputes that may arise.

Chapter 2

The Lithuanian National Health System

Article 7The Foundations of Forming of the Lithuanian

National Health System The foundations of forming of the Lithuanian National Health System shall be as follows:

Article 8The Structure of the Lithuanian National

Health System The Lithuanian National Health System (hereinafter referred to as the LNHS) shall consist of:

Article 9The Executive Bodies of the LNHS

The executive bodies of the LNHS shall be:

Article 10The Managing Bodies of the LNHS

The managing bodies of the LNHS shall be:

The managing bodies of the LNHS shall within their competence supervise and coordinate the health activities of other health activities bodies which do not belong to the LNHS system, according to the procedure established by this and other laws and legal acts.

Article 11The Resources of the LNHS

The LNHS resources shall comprise:

The LNHS resources shall be regulated by this and other laws and legal acts.

A claim to property cannot be made to state or municipal institutions of individual or public health care.

Article 12The LNHS Activities and Services

The activities and a range of services rendered by the LNHS shall comprise:

Article 13Levels of Organizing of the LNHS Activities

The levels of organizing of the LNHS activities shall be as follows:

The primary health activities shall comprise administrative units of municipal territories. It shall be carried out by the LNHS bodies subordinate to municipalities. Other LNHS executive bodies belonging to the levels of organizing of the LNHS activities may within their competence perform this work on a contractual basis.

The secondary health activities shall comprise higher-level administrative units. It shall be carried out by the LNHS bodies of higher-level administrative units. The LNHS executive bodies belonging to the tertiary level of organizing of the LNHS activities may within their competence perform this work on a contractual basis.

The tertiary health activities shall be carried out within their competence by university and academic clinics and other medical treatment centers, which provide specialized and very specialized medical treatment to persons without taking into consideration their places of residence. These LNHS executive bodies may within their competence carry out the primary and secondary health activities on a contractual basis.

The procedure and conditions of implementation of the primary health activities shall be established by laws and other legal acts.

The list of types of the primary, secondary and tertiary health activities and the LNHS executive bodies of health activities which implement them, their competence, procedure and conditions of the secondary and tertiary health activities shall be established by laws and other legal acts.

Article 14The Exclusive Rights of Health

Activities of the LNHS Executive Bodies The LNHS executive bodies shall have the right to provide and carry out:

Article 15Customers of the LNHS Activities and

Rendered Services The main customers of the LNHS activities and rendered services shall be the Government of the Republic of Lithuania, its institutions, local authorities, state and territorial patients' funds, other legal and natural persons.

The limits of the orders for the LNHS activities and rendered services which can be established by the relevant customers of the LNHS activities, shall be regulated by the laws and other legal acts.

Chapter 3

Levels of Health Activities

Section 1

The Required Level of Health Activities

Article 16The Indicators of the Required Level of

Health Activities The required level of health activities shall establish the scope of health activities which are supported by the State or local authorities, necessary conditions for health activities, the list of measures and institutions which are necessary for retaining or maintaining of the already achieved level of public health.

The required level of health activities shall be defined by:

The required level of health activities shall be established taking into consideration the demographic, health and environmental quality indicators and tendencies of changes thereof.

The required level of health activities, with the exception of the indicators of acceptability and adequacy of individual and public health care established in items 1 and 2 of Par.2 of this Article, shall be established by the Government of the Republic of Lithuania on the joint recommendation of the Ministry of Health and the National Health Council.

Article 17The Structure of Individual Health Care

Supported (Free of Charge) by the State and Local Authorities The individual health care supported (free of charge) by the State and local authorities shall comprise:

Article 18Individual Health Care Supported (Free of

Charge) by the State The following shall be attributed to the individual health care supported (free of charge) by the State:

The scope of individual health care (types of individual health care and the list of measures thereof) which is supported by the State, with the exception of the case specified in item 5 of Par.1 of this Article, shall be established by the Government of the Republic of Lithuania on the joint recommendation of the Ministry of Health and the National Health Council.

Article 19Individual Health Care Supported (Free of

Charge) by Local Authorities The following shall be attributed to the individual health care supported (free of charge) by local authorities:

The scope of individual health care (types of individual health care and the list of measures thereof) which is supported by local authorities shall be established by the Government of the Republic of Lithuania on the joint recommendation of the Ministry of Health and the National Health Council.

Local authorities shall have the right, when possible, to establish an additional scope, comparing to the scope established by the Government of the Republic of Lithuania, of individual and public health care supported by local authorities, on the joint recommendation of a physician of the town or district municipality and the community health council.

Article 20Necessary Conditions of Health Activities

The necessary conditions of health activities in the Republic of Lithuania shall be as follows:

Health activities shall comprise only the territory of the State of Lithuania, unless otherwise provided for in international treaties of the Republic of Lithuania.

The procedure and conditions of accrediting for individual, public health care or pharmaceutical activities shall be established by this Law and other legal acts.

The indicators of accessibility of individual health care shall be established by the Government of the Republic of Lithuania on the joint recommendation of the Ministry of Health and the National Health Council. The requirements for the acceptability of individual health care shall be established by laws and other legal acts.

The requirements and norms of adequacy of individual health care shall be regulated by normative documents of standardization, which are prepared by university, academic clinics and centres. Normative documents of standardization which regulate the requirements for adequacy of public health care shall be within their competence prepared by the State Public Health Care Service in the Ministry of Health of the Republic of Lithuania, institutions of control over the health activities conditions in other governmental institutions. These normative documents shall within their competence be approved by the Ministry of Health or the Lithuanian Standardization Agency in the Ministry of Economics.

The necessary conditions of health activities must be ensured by all subjects of health activities. Health activities subjects which do not ensure the established necessary conditions of health activities, shall be liable under laws.

Section II

Contractual Level of Health Activities

Article 21Conditions of Establishing of the

Contractual Level of Health Activities The health activities which do not belong to the required level of health activities shall be attributed to the contractual level of health activities.

The scope and conditions of the contractual level of health activities shall be established by the contract of health activities provided by this Law. The scope and conditions of the contractual level of health activities, determined by the parties to those contracts, must not worsen the required level of health activities.

Article 22A Health Activities Contract and the

Procedure for Concluding It A health activities contract shall be an agreement between a subject or subjects of health activities (contractor or contractors) who have the right to engage into health activities or carry out them and a customer of customers of health activities, by which the subject (subjects) of health activities shall undertake an obligation to carry out health activities of certain scope and types, render a range of services of this field, and the customer (customers) of health activities shall undertake an obligation to pay for the performed work and rendered services.

Article 23The Parties to Health Activities Contracts

Governmental institutions, bodies of administration of local authorities, health insurance institutions, enterprises, institutions, organizations, legal and natural persons may be the parties to the health activities contracts on the one part and legal persons, enterprises without a status of a legal person, accredited for health activities - on the other part.

Article 24Conclusion of a Health Activities Contract

The health activities contract must normally be concluded in writing. It shall be considered concluded, if the parties to the contract agree upon the basic terms and conditions of the health activities contract.

Article 25The Structure, Text and Validity of the

Health Activities Contract The parties to health activities contracts shall establish the structure, chapters and appendices of the contracts.

The text of the health activities contract shall be the terms and conditions of the contract specified by the parties to it, defining the rights and duties of the parties, the procedure for carrying out thereof and the responsibility of the parties, as well as basic terms and conditions of health activities contracts established by this Law.

The parties to the contract cannot establish in the contract such conditions of health activities which would worsen conditions of health activities comparing them with those which are established in this Law, other laws and legal acts. In the case of a dispute concerning application of the terms and conditions of the health activities contract, it shall be settled in the court.

The health activities contract shall become effective on the moment of its signing. Terms of the duration of a contract shall be established upon mutual agreement of the parties.

Article 26Basic Terms and Conditions of the Health

Activities Contract In each contract of health activities, its parties must agree on the following basic terms and conditions:

Item 4 of Par.1 of this Article shall be applied only to private health activities subjects, who have concluded a contract with the LNHS customers concerning performance of work on the required level of health activities.

Article 27Control over the Execution of the Health

Care Contract Control over the fulfilment of obligations of health activities contract shall be carried out by the parties which have entered into such contract. The procedure and time limits for reporting on the fulfilment of obligations under health activities contract, by representative of the parties to the contract shall be set forth in the contract.

Article 28Liability for Failure to Perform the Health

Activities Contract Both parties to the contract shall be liable for performing of health activities contracts.

The grounds for the unilateral termination of health activities contract shall be established by the Civil Code of the Republic of Lithuania.

If the obligations of the health activities contract are not fulfilled or the contract is terminated unilaterally through the fault of the subject of health activities (contractor), losses incurred by health activities customer shall be compensated with the funds of the health activities subject (contractor). If the obligations of the health activities contract are failed to be fulfilled or the contract is unilaterally terminated through the fault of the health activities customer, the losses incurred by the health activities subject (contractor) shall be compensated with the funds of the health activities customer.

Chapter 4

Paid Services in Health Activities Rendered by State and Municipal Institutions of Individual and Public Health Care and Subjects of Pharmaceutical Activities

Article 29Paid Individual Health Care Services

Paid individual health care services shall comprise the following:

The procedure for rendering of paid individual health care services, rates, procedure for paying and reduced charges shall be established by the Government of the Republic of Lithuania on the basis of this Law, Law on State Social Insurance and other laws.

Article 30Paid Pharmaceutical Services

Paid pharmaceutical services shall comprise:

The procedure for rendering of paid pharmaceutical services, rates, procedure for paying and reduced charges shall be established by the Government of the Republic of Lithuania on the basis of this Law and other legal acts.

Article 31Paid Public Health Care Services

Paid public health care services shall comprise:

The procedure for rendering of paid public health care services, rates, procedure for paying shall be established by the Government of the Republic of Lithuania on basis of this Law and other legal acts.

Part II

Health Activities

Chapter 1

Engaging in Health Activities

Article 32The Right to Engage in Health Activities in

the Republic of Lithuania The right to engage in individual or public health care or to apply its measures shall be enjoyed by persons who have received education and special training in institutions preparing these specialists and authorized by the Government of the Republic of Lithuania to issue documents certifying an adequate qualification of an individual or public health care specialist, as well as who are accredited in the manner prescribed by this Law and other legal acts for individual or public health care and who possess the license to engage in these types of activities in the Republic of Lithuania.

The conditions and procedure for accrediting of persons for other types of health activities shall be established by this Law and other laws.

In the procedure established by the Ministry of Health, individual or public health care services may be rendered by foreign individual or public health care specialists only for charity purposes or for the purposes of specialist training, unless otherwise provided for in international treaties of the Republic of Lithuania.

Upon obtaining in the established procedure a license to engage in private practice, specialists of state or municipal institutions of individual or public health care shall have the right to engage in private practice only outside these institutions.

The Ministry of Health shall determine the qualification and the procedure for recognizing of the qualification of persons who have received individual or public health care education, but do not have a special training.

The right to engage in health activities may be taken away only on the basis and in the procedure established by laws.

Article 33Professional Duties, Rights, Professional

Training and Responsibility of Individual and Public Health Care Specialists Laws and other legal acts shall establish main professional duties, rights of individual and public health care specialists, text of the Hippocratic oath and the conditions and manner in which it is taken, procedure for restriction of their practice, as well as the responsibility for the health damage done in the process of health care.

Article 34The Duty of Health Care Specialists to Keep

the Secret of Individual's Health (Medical Secret) Individual or public health care specialists shall be restricted from violating of confidentiality of the information about individual's health, which they have acquired while performing professional duties. The medical ethics requirements for keeping the information about individual's health confidential shall be established by the Ministry of Health.

Chapter 2

Individual Health Care

Section 1

Preventive Medical Aid

Article 36Information Services Regarding Prophylaxis

Questions All those involved in individual health care shall provide information services on issues of disease prophylaxis. The Ministry of Health shall determine the conditions and order of provision of such services.

Article 37Selective Individual Health Examinations

Selective individual health examinations are conducted in accordance with the decision of and the order established by the Ministry of Health.

The Health Information Services shall determine the number of respondents, who shall be subject to selective health examinations, and the methods of collection, accumulation and processing of the statistical information.

Article 38Immuno-prophylaxis and Chemical Prophylaxis

of Communicable Diseases The Ministry of Health shall establish the list of those who must carry out the immuno-prophylaxis and chemical prophylaxis of communicable diseases, as well as the contents, conditions and order of the immuno-prophylaxis and chemical prophylaxis of these diseases.

Compulsory measures of immuno-prophylaxis and chemical prophylaxis may only be applied on the grounds and according to the procedure provided by laws, in the event of an actual threat that they may succumb to particularly dangerous or dangerous communicable diseases.

Medical specialists who are in violation of the requirements of this Article, are held responsible under the laws.

Article 39Prophylactic Examinations

Workers of certain professions and individuals, working in certain fields and lines of production, must submit to a health examination prior to engaging in professional activity and during the course of such activity. The Government of the Republic of Lithuania compiles the list of workers in these professions, jobs and production branches and sectors, as well as the procedure for individuals' prophylactic examinations.

The health of workers of the professions, jobs and production branches and sectors, listed by the Ministry of Health, as well as of those individuals who had associated with those who had contracted the diseases specified on the list of communicable diseases, established by the Ministry of Health, shall be subject to required health examinations.

Medical aid institutions shall within the prescribed time limit, examine the health of:

Workers of the professions, jobs, production branches and sectors, listed and other individuals, who had associated with patients, who had contracted communicable diseases, included on the list of communicable diseases, provided by the Ministry of Health, shall be quarantined and held under observation, for the purpose of having their health monitored, over the period of time, specified by this Law or other laws. In the event these individuals, the persons close to them, or their representatives, do not agree with the doctor's decision regarding isolation and health status observation, these individuals must, in accordance with the established order, be placed under compulsory quarantine and compulsory health observation. The police must, at the request of the institutions of health protection, assist in placing such persons under quarantine.

Individuals working in the professions, branches and sectors of production established by the Government, as well as individuals who have associated with those who had contracted the communicable diseases included on the list provided by the Ministry of Health, who refuse to have their health examined in the prescribed time period, shall be held responsible under the laws.

Section 2

Medical Recovery Aid

Article 40Vital Medical Aid

The following shall be attributed to vital medical aid:

For those individuals, who must be rendered medical aid, in order to save their lives, because of accidents, accidental emergencies, ecological or natural disasters, or due to sudden onset of illness, medical and pharmaceutical specialists, who were present together with the victims or patients at the site of an accident or sudden acute and life-threatening illness, must render first medical aid.

Out-patient medical aid must be provided by:

Urgent in-patient medical aid must be rendered in specialised in-patient medical care institutions or specialised sections of medical aid institutions, for rendering this type of aid.

In the event the life of this individual is seriously endangered, urgent in-patient medical aid may be rendered without the consent of the individual, following a decision by at least two consultant physicians, and having informed the patient, his family members or his representative, and in instances where the victim or suddenly taken ill individual, happens to be a minor, his parents or guardians must be notified of the medical aid rendered to him.

The Ministry of Health shall determine the content of urgent medical care, the basis, conditions, and order of rendering it and the competence of institutions of personal health care, and medical/pharmaceutical specialists on questions of rendering urgent medical aid, in keeping within the allotted fund limits.

The Ministry of Health shall determine the structure, establishment and order of financing, and competence of mobile urgent medical aid services.

Individuals, who are bound by this Law and other legal acts, to furnish vital medical aid, who have by their inaction or actions, contributed to the health damage of victims or individuals experiencing sudden illness, shall be applied disciplinary, administrative, material, and criminal responsibility, as prescribed by laws.

Article 41Application of Diagnostic and Treatment

Measures The scope of diagnostic measures, applied at the medical aid institutions of the Republic of Lithuania, must not be smaller than those prescribed by the lists of obligatory measures in disease diagnostics.

Medical aid specialists shall have the right to choose treatment technologies, in the order prescribed by this Law and other legal acts. The order of application of the treatment technologies shall be established by the normative documents of health care standardisation.

Medication shall be apportioned to diagnostic and treatment measures, provided that it is:

A medical specialist may employ all scientifically substantiated, but not yet registered, in the prescribed order medicines, prophylactics, diagnostic and treatment methods, medical equipment and instruments only in trying to cure the patient and, to save or prolong his life. In this instance, he must obtain permission of the patient, and if the patient is unconscious, or is a minor, of his/her parents, relatives, guardians, or his representative's permission and also, the consent of the ethics commission, of the health aid institution, regarding the use of such individual health care technologies use. This consent must be executed in writing. When the patient is in an unconscious state and there is no information available regarding his relatives, parents, guardians or his/her representatives, these technologies shall only be applied by written consent and with the approval, by at least, two physicians in consultation, as well as that of the ethics commission of the medical aid institution.

The application of compulsory hospitalisation, compulsory diagnostic, and compulsory treatment measures to individuals, shall only be allowed in accordance with the order prescribed by law, in the presence of a genuine threat, that these individuals by actions, or because of the state of their health may cause substantial harm to their own health or life or to that of other persons. Medical experts, who violate these requirements, shall be held responsible in accordance with the order prescribed by law.

Article 42Transfusions of Human Blood and its Products

Human blood for transfusion purposes or blood products' production, may be taken from a donor solely, of the free will and by the consent of the donor. Human blood and its products may only be imported in and transported out of the Republic of Lithuania, for donor purposes, on the basis of agreements concluded with legal persons of foreign countries, by individual health care facilities accredited for this purpose.

The conditions and order of importing into the Republic of Lithuania and exporting from it of human blood and its products, the quantity of donor's blood and its products, intended for individual treatment use, to be imported into the Republic by Lithuanians and foreign nationals, and the conditions and order of conducting tests of human blood and its products in order to ascertain their harmlessness to human health, to be used for transfusion, shall be established by the Ministry of Health.

The conditions and order of taking of human blood for donorship, production of blood products and use of human organs and tissue for transplants, medical research, diagnostics and treatment, order and conditions shall be established by laws.

Individuals in violation of this Article shall be held responsible in accordance with laws.

Article 43Transplantation of Human Tissue and Organs

Human tissues and/or organs may not be objects of commercial transactions and must be used only for transplants or for biomedical research purposes. The purchase or sale of human tissue and/or organs of the human body and the advertisement of such activities, shall be punishable in accordance with the laws.

Conditions and order of the use of human tissues and organs taken from a body, for use in transplantation, medical research, diagnostics and treatment and tissue and/or organ donor rights, are established by laws.

Section 3

Medical Rehabilitation, Nursing , Social Services, Care and Assistance Attributed to Individual Health Care

Article 44Medical Rehabilitation

The conditions and order of Medical rehabilitation of patients, in medical assistance and nursing facilities, patient selection and their dispatching to rehabilitation hospitals and sanatoriums shall be established by the Ministry of Health.

The fundamentals of the invalids' medical rehabilitation organising system shall be established by the Law on Social Integration of Invalids. The conditions and order of medical rehabilitation of invalids is established by the Government of the Republic of Lithuania.

The order of identification of localities suitable for medical (and social) rehabilitation, as resorts, as well as the conditions of resort organisation, shall be established by the Government of the Republic of Lithuania.

Article 45Nursing

Individuals shall be nursed at home, as well as, in medical aid, nursing and social care institutions.

The content, conditions and order of nursing of disabled and senior individuals shall be established by the Government of the Republic of Lithuania.

Article 46Social Services and Social Care Provided

under Individual Medical Care Provision of social services and social care shall be organised within the auspices of individual health care for the purpose of reducing the psycho-emotional stress level and to assist them in fighting stress and ensure their social security.

The social services and social care are managed by the social workers of medical aid institutions.

The order and conditions of the social services kinds and the scope of supplying them, the content of social care of an individuals in health care, as well as the regulations guiding health care social workers, are established by the Government of the Republic of Lithuania.

The order of social workers preparation and the raising of their qualifications is established by Ministries of Social Protection and Labour.

Article 47Services and Other Assistance, Attributed

to Medical Aid The following services and other types of assistance are attributed to medical aid:

The services, as well as other assistance, specified in the first part of this article, shall be attributed to medical aid, provided they:

The medical aid shall not comprise services and products intended for cosmetic or hygienic use, even if they are also beneficial for individual health purposes.

Section 4

Expert Examination of Individual's Health

Article 48Expert Examination of the Health Potential

of an Individual Individual health potential expert examinations shall be performed by health centres. The Ministry of Health shall establish the order of the performance and organisation of this expert examination.

Article 49Medical Expert Examination of Ability To

Work Temporary individual expert examination of work ability shall be performed by medical aid institution doctor or doctors' commission. The order of organisation and performance of this expert examination shall be established by the Ministry of Health.

Article 50Medical and Social Expert Examination

In instances of long-term or permanent disability, a medical and social expert examination shall be performed by a state medical aid institution social and medical commissions and State medical-social expert commissions. The order of approval of regulations and competence of these commissions and their competence is regulated by the Law on Social Integration of Invalids. The medical and social criteria, regarding long-term or permanent work disability, shall be established by the Ministry of Health along with the Ministry of Social Protection and the Ministry of Labour.

Article 51Forensic Expert Medical Examination

The forensic medical expert examination shall be performed based upon the decision of the interrogation bodies, investigation bodies, or per decision by the prosecutor, or court decision, as well. Expert examinations shall be performed by the State Forensic Medicine Service. The order of the expert examination and performance is established by the Government of the Republic of Lithuania.

Article 52Forensic Psychiatric and Forensic

Narcological Expert Examination Forensic psychiatric and forensic narcologic expert examinations shall be conducted based on the decisions by interrogation bodies, investigation bodies, or the prosecutor, as well as court decision. Expert examinations shall be performed by the State Forensic Psychiatric and Forensic Narcological Service.

The order of organisation and performance of the expert examination shall be established by the Government of the Republic of Lithuania.

Article 53Pathoanatomical Expert Examination

Pathoanatomical expert examination shall be performed, following the death of an individual. The conditions and order of the pathoanatomical examination (autopsy) shall be regulated by laws and other legal acts.

Chapter 3

Public Health Care

Article 54Universal Character of Public Health Care

The duty of all natural and legal persons shall be to take care of public health, the aim of which consists in promoting of health, preventing of the deterioration of the quality of consumer goods, food products, drinking water and residential, work, and natural environment, preventing of diseases and traumas, and decreasing the morbidity rate. Legal and natural persons who are in violation of this requirement, shall be held responsible, in accordance with the order established by this and other laws.

Article 55Promotion of Public Health

The promotion of public health shall consist of:

Health propaganda, supporting initiatives of health policy shall be organised through the mass media by the Government of the Republic of Lithuania or municipalities, from the Government or municipality funds. The Government of the Republic of Lithuania shall determine the order and conditions with reference to the health propaganda disseminated through mass information media.

Health knowledge promoting a healthy lifestyle among the population, shall be popularised, consultations on family planning shall be organised in accordance with state and municipality health programs.

Health instruction shall be comprised of the totality of voluntary and compulsory health education measures, as well as physical training and physical culture measures.

The conditions and order of health promotion shall be regulated by this and other laws and legal acts.

Article 56Protection of Public Health

The basis of public health protection shall be comprised of a system of measures limiting harm and danger in living, working and natural environment.

Prevention and limitation of danger and harm to health shall be implemented: by applying:

Raw materials, equipment, machinery, building materials, elements of residential dwelling interiors, food and its packaging, tare, other goods, and drinking water should not incur any risk to health, or else this risk may only be minimal.

Standardisation normative documents of the Republic of Lithuania, which are being prepared by the Ministry of Health, determine requirements for and indices of non-dangerousness and harmlessness to health, working, residential and natural environment.

The types of economic-commercial activities that are detrimental to human health, and their work and living environment, for which a permit must be obtained from the Government of the Republic of Lithuania, or from the State Public Health Care Service, authorised by it, shall be limited through refusals to issue licenses for such activities, in accordance with decisions by the Law on Enterprises.

Economic-commercial activities by enterprises, that have an adverse effect upon people's health, and their working and health environment, must be limited in accordance with the order established by the Law on Enterprises, shall be limited by refusing of revoking the permit (license) for this activity.

The criteria for such revocation and suspension or banning of the above-mentioned activities and the order of granting authorisation to legal persons, shall be established by this Law, the Law on Enterprises and other laws and legal acts.

State agencies and state inspectorates, which are exercising control over public health, shall decide on the harmfulness of the economic-commercial and other activities.

The conditions and order of expert examinations regarding the harmfulness or dangerousness to health of services of economic and commercial and other activities, living, working, or studying conditions, various structures, their designs, technological processes, drinking water, raw materials, machinery and equipment and other goods and services laws and other state acts shall be established by the laws and other legal acts. The lists of goods detrimental or dangerous to health the production and sale of which and supplying of services detrimental and dangerous to health, must be prohibited and limited in accordance with the order established by this Law, and the lists shall be confirmed by the Government of the Republic of Lithuania.

Production quotas of harmful or dangerous goods, whose manufacture must be limited, shall be established by Government agencies, which issue permits (licenses), for the manufacture of such goods.

The order of accreditation in health supervision or pharmaceutical activity and taxation of harmful goods by individual excise amounts, shall be determined by the Government of the Republic of Lithuania.

Article 57Prophylaxis and Control of Contagious

Diseases Those individuals engaged in health activities shall carry out the first, second and tertiary prophylaxis of and exercise control over infectious diseases, within their competence.

The Government of the Republic of Lithuania, ministries and other Government agencies shall guarantee the protection of the territory of the Republic of Lithuania and its population members from the importation and spread of particularly dangerous and dangerous contagious diseases. The Ministry of Health shall approve and update lists of such diseases. The order of application of a system of sanitary-antiepidemic and quarantine measures intended to protect the population from particularly dangerous and dangerous diseases shall be established by the Government of the Republic of Lithuania. Veterinary-sanitary requirements for the prophylaxis of the previously-mentioned diseases shall be established by the Veterinary Law.

In the event of the existence of a threat of appearance or spread of infectious diseases and after the appearance and spread of such, the Government of the Republic of Lithuania, or municipal governments may, in the order prescribed by laws, introduce within appropriate territories, state of emergency measures and regimes regarding work, study, travel and transportation, in order to provide protection from such diseases.

Legal and natural persons, who have violated the established requirements regarding the prophylaxis and control of communicable diseases, shall be held responsible in accordance with the laws.

Article 58Extraordinary Situations Affecting Public

Health Situations that are extraordinary with respect to public health, shall be the circumstances which arise in development of public health, under which the effect of environmental factors cause a sudden:

The territory where the danger of group or mass health damage suddenly arises, is declared a region dangerous to the health of the population, shall be declared by the Government of the Republic of Lithuania a region dangerous to public health.

The territory on which damage is caused to the health of groups of the population, or the health of a large population mass is harmed, is declared by the Government of the Republic of Lithuania an area harmful to public health.

The criterion for determining extraordinary to public health situations, the administration, control, and removal of effects negative to public health and economy, and also the order of their financing, shall be approved by the Government of the Republic of Lithuania.

Article 59Prophylaxis and Control of Non-Infectious

Diseases and Traumas Enterprises, establishments, organisations, medical aid and social rehabilitation and nursing institutions shall control within their competence cases of non-infectious illness, as well as prophylaxis of traumas, morbidity and traumatization.

The conditions and order of prophylaxis and control of occupational diseases and poisoning shall be established by the Law on Safety at Work, other laws and legal acts.

Prophylactic measures and content of traumatization resulting from transport-connected circumstances are established by the Government of the Republic of Lithuania.

The application of measures of secondary and tertiary prophylaxis of non-infectious diseases shall be established by this Law and other legal acts.

Article 60Public Health Control

Public health control shall be exercised by the State and municipalities.

Municipalities shall maintain sanitary control of healthy living environment within their respective territories.

The content of public health control, order of its implementation and the competence of control institutions shall be regulated by this Law, the Law on Veterinary Medicine, Law on Environmental Protection, Law on Labour Protection, other laws and legal acts.

The content and order of sanitary control, which must be conducted by municipalities within their territorial administrative units shall be established by the Government of the Republic of Lithuania on the proposal of the Ministry of Health.

Article 61Suspension of Economic and Commercial

Activities Detrimental to Health State inspections and municipal sanitary inspections, exercising public health control shall have the right to demand that the employer (individual authorised by him) would suspend the work if:

The order of suspension of work due to danger and harm to health causes, is established by this law, Labour Protection Law and other laws.

State inspectorates, controlling public health care, and the municipality sanitary inspectorates, who determine legal act violations of public health care, may apply penalties and economic sanctions, whose order of application and exaction is established by the Code of Violations of Administrative Law, and other laws and legal acts.

Article 62The Functions of Health Activity

Management, Attributed to Public Health Care The functions of health activity, described in Part IV,

Chapter 2,  Articles 86,87,88,89,90,  and 94  are  attributed  to

public health care.

Chapter 4

Pharmaceutical Activities, Traditional Medicine, Folk Medicine and Non-Medical Measures of Health Recovery

Article 63Pharmaceutical Activities

Only legal individuals, enterprises, not holding the status of legal person, natural individuals, who are accredited for this activity, shall have the right to engage in pharmaceutical activities.

The structure of pharmaceutical activity, the legal bases of its organisation and the order and the conditions of accreditation of this activity shall be established by this Law, the Law on Pharmaceutical Activity and other laws and legal acts.

Article 64Traditional medicine, Folk Medicine, Non

Part III

Executive Bodies of Health Activities, the Content of their Rights and Duties

Chapter 1

Executive Bodies of Health Activities, Public Health Care Pharmaceutical Activity Subjects and their Founding

Article 65Individual Health Care, Public Health Care

and Pharmaceutical Activity Entity Founding Founding of individual health care, public health care and pharmaceutical activity shall be regulated by laws and other legal acts.

The public individual health care, public health care institutions, and public pharmacies shall be founded by a decision of the Government of the Republic of Lithuania or upon its order, by the Ministry of Health.

Municipality individual health care and public health care institutions, or pharmacies shall be founded per decision of a municipal council.

Subjects of individual health care, public health care, or pharmaceutical activity, functioning in accordance with the right of private ownership, shall be founded by the decision of the founders themselves, upon obtaining a permit (license) from the Ministry of Health.

Article 66Founding Documents of Individual Health

Care, Public Health Care and Pharmaceutical Activity Subjects Individual health care, public health care, as well as pharmaceutical activity founding documents shall be:

The regulations (bylaws) of individual health care, public health care and pharmaceutical activity subjects are established in accordance with model regulations (bylaws) approved by the Government of the Republic of Lithuania.

Article 67Forms of Ownership and Subjects of Property

Right within Individual Health Care, Public Health Care and Pharmaceutical Activity Forms of ownership, as well as property right subjects within individual health care and pharmaceutical activity, are regulated by the Civil Code.

The property right objects, which are necessary to implement primary health activity, within a municipal territory, shall be assigned in accordance with municipal property laws.

Article 68Types and Range of Economic Activity of

Subjects of Individual Health Care, Public Health Care and Pharmaceutical Activity and Their Nomenclature The type of economic activity conducted by subjects of individual and public health care and pharmaceutical activity, as well as their competence, shall be established by their founders and the laws.

Subjects of individual health care, public health care, as well as pharmaceutical activity, which are being set up and function as State or municipal institutions, and also the types of health activity, that can be carried on solely by them, shall be established by this and other laws.

The range of subjects of individual health care, public health care, as well as pharmaceutical activity, shall be regulated by this Law and other legal acts, in accordance with the health activity carried out by them.

Article 69Registration and Reregistration of State

and Municipal Individual and Public Health Institutions Every state or municipal individual or public health care institution, prior to beginning of its health activity, must be registered in the register whose founder and senior registrar shall be the Ministry of Health. This register shall also be administered by the managerial bodies of municipalities.

The Ministry of Health shall register only individual health care and public health care institutions, founded from state funds, and shall collect and process all data on all individual health care and public health care institutions registered with the municipalities of the Republic of Lithuania.

Municipal administrative bodies shall register, accumulate and process data of individual and public health care institutions, founded on the basis of municipal funds.

In the event, state or municipal individual or public health care institution founding document shall be changed or amended, they must be reregistered in accordance with the established order.

The order of the registration and reregistration of the above, as well as the grounds for refusal to register State and municipal individual or public health care registration and reregistration shall be established by the Government of the Republic of Lithuania.

Article 70Liquidation of State and Municipal

Individual or Public Health Care Institutions and Enterprises Engaged in Health Activities The grounds for liquidation of State or municipal individual or public health care institutions may be:

Grounds for liquidation of enterprises, engaging in health activity, shall be established by the Law on Enterprises.

Chapter 2

Individual Health Care, Public Health Care and Pharmaceutical Activity Entity Rights and Obligations

Article 71The Rights of the Entities of Individual

Health Care, Public Health Care and Pharmaceutical Activities Individual health care, public health care and pharmaceutical activity entities shall have the right to:

Individual or public health care subjects may also have other rights, provided they do not contradict this or other laws, as well as individual health care, public health care of pharmaceutical activity founding documents of the subjects.

Article 72

The Duties of Individual Health Care, Public Health Care and Pharmaceutical Activity Entities The duties of individual health care, public health care and pharmaceutical activity entities shall be as follows:

Individual or public health care subjects may also have other duties, provided they do not contradict this and other laws, as well as their founding documents.

Part IV

Fundamentals of Health Activity Management

Chapter 1

Ways and Means of Health Support

Article 73The Use of State Regulatory Subsidies for

Health Activity Regulation Health relations shall be regulated through application of economic means regulated by laws and other legal acts:

Article 74The use of Special-Purpose Budgetary

Subsidies for the Support of Health Activities The priorities of distribution of special-purpose budgetary subsidies for support of health activities shall be as follows:

The Government of the Republic of Lithuania shall set the specific objects of subsidies.

Article 75Application of Soft Loans

Interest on obtained loans shall be paid out of state or municipal budgets, in accordance with the order established by the Government, to legal and natural persons who are clients of required state or municipal health programs and have approved them in accordance with the established order and to state medicine supply enterprises that have received bank loans for the implementation of such programs or the supply of medicines of the indispensable assortment and other articles of medicinal purpose to Lithuania.

Article 76Order of Fixing the Prices and Tariffs on

the Measures and Services of Required Level of Health Activities The basic prices and tariffs on measures and services of required level of health activities shall be approved by the Government of the Republic of Lithuania or, upon its authorisation, the Ministry of Health. It shall fix them to be uniform throughout the country, upon co-ordinating them with the State Price and Competition Service, the State Patients Fund, State Public Health Care Services, as well as other interested subjects of health activities. In case the Ministry of Health does not agree with the established prices, in the month prior to the end of the current budgetary year, they shall be indexed by the Government of the Republic of Lithuania, at least once a quarter, should the quarterly inflation rate exceed 10 per cent.

Article 77Compensation of Costs of Measures and

Services of Required Level of Health Activities to the Population Individual health care and services shall be provided free of charge to the citizens of Lithuania and persons without citizenship permanently residing in Lithuania, according to basic prices fixed for the indispensable diagnostic measures and medicines and other articles of medicinal purpose of indispensable assortment.

The differences between the basic costs of individual health care, supported by the state or municipalities, shall be covered in accordance with the order established by Law, from the required health insurance funds.

Article 78Compensation of Costs of Other Means and

Services of Health Activities Required from Required Health Insurance Funds The order of compensation of costs from the required health insurance funds, to persons to whom the health care and services supported by the state, are not applied, in accordance with Articles 18 and 19 of the present law, shall be established by the laws and other legal acts.

Article 79Encouragement of Professional Improvement

of Health Care Specialists The costs of raising qualifications or requalification of medical specialists in individual and public health care institution and services of State or municipality shall be compensated from the state and municipal budgets, in accordance with the order and conditions established by the Government of the Republic of Lithuania, provided other laws do not establish compensation for these costs from other sources.

The costs of qualification improvement and requalification of pharmaceutical enterprise specialists shall be covered from the funds of these enterprises.

Article 80Liability Insurance of Enterprises and

Institutions Accredited for Individual Health Care for the Damage Caused to Individuals' Health in the Course of Individual Health Care Enterprises and institutions accredited to provide individual health care must obtain liability insurance for damages caused to individuals', health in the course of individual health care treatment.

The provisions and order of concluding the required insurance agreements, the sources of required insurance and the order of utilisation of these funds by enterprises and institutions accredited to provide individual health care, liability for damages caused, shall be established by the Law on Insurance, other laws and legal acts.

Article 81Support to Health Care Establishments, for

Health Care Program Implementation and Public Health Care The order of support to individual and public health care institutions shall be established by the Law on Charity and Sponsorship.

The costs of individual and public health care with respect to groups of the population whose health is strongly influenced by the health risk factors, except in cases where the risk factors arise from the individual's harmful habits may be covered from state or municipal health program funds. Such population groups shall be identified by the Ministry of Health.

Article 82Support of Programs of Public Organisations

Protecting Public Health Interests The resources of the State Health Fund and the health funds of municipal state funds, enterprises, establishments, organisations, religious establishments and other legal or natural persons may be utilised for the support of action programs of public organisations, who protect public health interests, in the established order. The conditions and order of the support of these funds shall be established by the Government of the Republic of Lithuania.

Article 83Restrictions on Advertising of Goods and

Services Harmful to Health The advertising of alcohol and tobacco products and of other goods and services having a negative effect on health shall be prohibited in the Republic of Lithuania. The procedure for the prohibition or restriction of the advertising of such goods and services shall be prescribed by the laws and other legal acts.

Article 84Application of Economic Sanctions

Economic sanctions may be applied to enterprises upon disclosing violations of legal acts regulating health activities or when legitimate instructions of state inspectorates, state agencies controlling public health care, pharmaceutical activities, quality control of medicines and medicinal substances are not complied with. economic sanctions may also be applied to enterprises when there are cases of concealment of accidents at work, occupational diseases, occupational poisonings, hospital infections or contagious diseases.

The procedure for the application of sanctions in cases referred to in this Article, their collection and appealing against as well as the rate of sanctions shall be set by laws.

Chapter 2

Management Functions of Individual Health Care, Public Health Care, Pharmaceutical Activities and other Health Activities

Article 85Restrictions on Making Available to the

Public of Information Concerning the Health of an Individual The availability of information on the health of an individual may be restricted only in cases provided by laws when such information represents a secret of individual's health ( medical secret). The criteria of a secret of individual's health (medical secret) shall be established by laws.

It shall be prohibited to announce information concerning individual's health through the mass media without his/ her written consent. Protection of information on the health of an individual stored in computers must ensure its confidentiality.

The requirements for the protection of confidentiality of information concerning individuals' health, which is stored in computers belonging to subjects of health activities shall be set by the Ministry of Health.

Persons who violate confidentiality of such information shall be liable under the laws.

Article 86Public Health Information and its

Monitoring Information concerning public health must be available to the public without restrictions and it may not be considered the State secret.

The system of public health monitoring shall be established in the Republic of Lithuania for the observation of public health, physical, chemical and biological factors of health, health care requirements and resources, accessibility and adequacy of health care , and registering of information on these issues.

The monitoring of public health shall be conducted by the ministries, other state-run institutions, municipalities, enterprises and health care facilities within the scope of their competence.

The public monitoring of public health shall be conducted by the State Public Health Care Service.

The content, structure, charges for public health monitoring, the procedure for its conducting and the procedure for making the monitoring data available to the public , as well as the scope of competence of the subjects of public health monitoring shall be established by the laws and regulations.

Article 87Expert Examination of Public Health

Public health expert examination shall be carried out for the purpose of assessment of the data of the public health monitoring.

Such expert examination shall be carried out by the ministries , other governmental institutions,municipalities, enterprises and health care institutions within the scope of their competence.

The state public health expert examination shall be carried out and the conclusions shall be presented by the Ministry of Health and the State Public Health Care Service as well as other legal persons authorised by the Government.

The fundamentals and content of public health expert examination, the procedure for its financing, conduct and making available to the public of its findings, charges, and competence of the subjects of public health expert examination shall be established by the laws and other legal acts.

Article 88Planning of Health Activities

Programme planning shall form the basis for the planning of health activities in the Republic of Lithuania.

The Seimas of the Republic of Lithuania shall approve, on the proposal of the Government, the objectives of health activities, the indices of health level to be achieved on the national scale and the Health Programme of Lithuania for the period of at least 10 years. The structure of the Lithuanian Health Programme as well as the procedure for its preparation, financing, implementation, and control shall be governed by the regulations approved by the Government of the Republic of Lithuania.

For the fulfilment of the tasks defined in the Health Programme, the Government, ministries, other government institutions, and municipalities shall prepare relevant government, sector or municipal comprehensive or special-purpose programmes, or shall provide for the measures for the implementation of these tasks in other social and economic development programmes.

The procedure for the preparation, approval, financing, implementation and supervision of the health programmes shall be governed by the regulations approved by the Government of the Republic of Lithuania.

Article 89Standardisation of Health Care and

Pharmaceutical Activities Conditions for the implementation of individual and public health care and the quality of medicines must be in conformity with the requirements set by the standardisation normative documents of the Republic of Lithuania.

Such documents shall be prepared by the institutions of the health care system and shall be approved by the Ministry of Health or the Lithuanian standardisation service under the Ministry of Economics.

In such cases where the quality of health care is not regulated by standardisation documents, the requirements set for the health care conditions may be legalised by the acts issued by the Ministry of Health.

Legal and natural persons who do not meet the requirements set by the standardisation normative documents shall be liable under the laws.

Article 90Accrediting of Legal and Natural Persons

for Health Activities The right to engage in health activities shall be granted to persons who have received special training and licences in accordance with the procedure prescribed by this Law, other laws and legal acts. The right to provide specific health care services shall be granted to persons who have been issued certificate ( a document confirming the right to render specific services) in the manner prescribed by the laws of the Republic of Lithuania.

The right to engage in health activities shall be granted to legal persons and enterprises without the right of a legal person that have received permit to engage in such activities in the manner prescribed by this Law, other laws and legal acts.

Individual or public health care licences, certificates and permits shall be issued or revoked by the State Service of Accrediting for Health Care under the Ministry of Health.

The procedure for the issue, registration and revocation of licences, certificates and permits shall be regulated by this Law, other laws and legal cats. A licence to engage in health activities shall state the type of an institution, financing sources, profit distribution, and the procedure for furnishing information about its activities to the public. Permits (licences) and certificates shall be issued on the basis of the structure of the types of health activities established by this Law.

The disputes concerning the issuing, registration and revocation of licences, certificates and permits shall be settled in court.

Health activities carried out by unaccredited natural persons and enterprises without the rights of a legal person shall be illegal. Natural and legal persons who engage in illegal health activities shall be liable under the laws.

Professional organisations of medical and pharmaceutical employees may participate in the accrediting activities of health care facilities and pharmaceutical enterprises, and their employees according to the procedure established by this Law and other legal acts.

Article 91Control over the Implementation of

Necessary Conditions of Individual Health Care Administration of every facility of individual health care must conduct a local medical audit of the adequacy and accessibility of individual health care. The procedure for the local medical audit shall be established by the Ministry of Health.

A patient willing to be sure in the adequacy of medical service rendered to him, with the exception of cases of first aid, shall have the right to apply to a physician selected by him, who, at the written request of the patient, may agree to carry out individual medical audit. The conditions, content and procedure of the individual medical audit, as well as other conditions shall be established by laws and other legal acts.

State medical audit shall be conducted by the State Medical Audit Inspectorate under the Ministry of Health and the State Patients' Fund. The content of the state medical audit and the procedure thereof shall be established by the Government of the Republic of Lithuania.

Article 92Organising of Scientific Research into

Health Activities The criteria for the applied and fundamental bio-medical research shall be determined by the Ministry of Health in conjunction with the Lithuanian Scientific Board.

The priorities of the applied bio-medical and public health research shall be identified, ordered, financed and controlled by the Ministry of Health.

The priorities of the fundamental bio-medical and public health research shall be identified, ordered, financed and controlled by the Lithuanian Scientific Board.

It shall be prohibited to conduct bio-medical research without the approval of the Lithuanian Committee for Medical Ethics. The requirements set for the ethics of biomedical research and the procedure for their control shall be established by the Law on Ethics of Bio-medical Research.

Research into health activities shall be conducted pursuant to the agreements concluded in the manner prescribed by the Civil Code.

Article 93Organising of Training and Qualifications

Improvement of Health Care and Pharmaceutical Specialists The Ministry of Health and professional organisations of health care specialists shall be concerned within the scope of their competence with the training and qualifications improvement of health care and pharmaceutical specialists.

A register of health care and pharmaceutical specialists shall be established for the registration of health care and pharmaceutical specialists, the manager of which shall be the Ministry of Health.

The procedure for the qualifications improvement of individual and public health care specialists and of pharmaceutical specialists shall be established by the Ministry of Health upon co-ordination with the professional organisations of health care and pharmaceutical specialists.

Article 94Evaluation of Health Care Technologies

The subjects of individual and public health care shall be prohibited from applying the unevaluated technologies of individual and public health care, with the exception of cases provided by this Law.

The procedure for such evaluation shall be established by the Government of the Republic of Lithuania.

So that the acquisition of expensive individual or public health care technologies out of the state budget or municipal budgets would be justified, the state-run or municipal health care institutions must provide economic and social grounds for the acquisition of such technologies to the State Medical Audit Inspectorate under the Ministry of Health. The cost limits of such technologies shall be set by the Ministry of Health.

Article 95Procedure for the Application of Individual

and Public Health Care Technologies Only the medicines, prophylactic, diagnostic and treatment methods, medical equipment and instruments that are duly registered in the Republic of Lithuania may be applied for individual or public health care. Medicines that are not registered in the Republic of Lithuania may be used only if there are documents evidencing their registration in foreign countries, as well as on other grounds provided by this and other laws. Such medicines shall be used as prescribed by the Ministry of Health.

The procedure for the evaluation and registration of individual and public health care technologies shall be established by this and other laws and legal acts.

Chapter 3

Financing of Health Activities

Article 96The Base Amount of Financing of the LNHS

Activities The base amount of the financing of the LNHS activities including the funds of state budget and municipal budgets and the funds of the compulsory health insurance funds must, according to the calculation methods prescribed by the Government, account for 5 % of the value of the GDP each year.

Article 97The Grounds for the Financing of Executive

Bodies of the LNHS Activities The executive bodies of the LNHS activities shall be financed on the following bases:

The basis for the financing of works performed on the compulsory public health care level shall be the conditions referred to in items 1 and 2 of part 1 of this Article.

Article 98Sources of Financing of the Facilities

Engaged in Health Activities The state-run or municipal facilities of individual and public health care accredited for certain types of health activities shall be financed from the following sources:

The procedure for the financing of state-run and municipal facilities of individual and public health care , state-owned enterprises accredited for certain types of health activities from the funds of state budget and municipal budgets shall be established by the Government of the Republic of Lithuania.

The private subjects accredited for health activities shall be financed from the following sources:

Subsidies from the state budget and municipal budgets may be allocated to private persons and facilities accredited for the individual and public health care, for the purpose of ensuring required level of works and services, accordance with the procedure established by the Government or a local authority.

Resources of the State Health Fund and Municipal Health Funds may be allocated for the implementation of health programmes.

Article 99Financial Activities of State-run and

Municipal Health Care Facilities State-run and municipal health care facilities shall independently determine their cost structure other than labour costs. The rates of labour costs shall be approved by the Government of the Republic of Lithuania.

The terms of the payment of salaries for state-run and municipal individual and public health care facilities without exceeding the established norms shall be set forth in the Law on Collective Disputes and Collective Agreements.

Article 100Procedure for Financing of Public Health

Monitoring and Public Health Expert Examination The enterprises whose business or other activities make a harmful effect on health and have an adverse effect on living and working environment must incur the costs of monitoring of such impact (health care monitoring) and public health expert examination, which are carried out by the State Health Care Service under the Ministry of Health and its subdivisions.

The enterprises the business activities of which or any other activities cause harm to human health and the quality of living and working environment shall be determined by the State Hygiene Inspectorate at the State Public Health Care Service.

Article 101Financing of Scientific Research into

Health Activities The funds of the state budget allocated for health care may also be applied for the financing of applied research into health activities. Budgetary funds allocated for science and technical progress shall be applied for the financing of scientific fundamental research into health activities.

Article 102The State Health Fund

The State Health Fund shall be established for the accumulation of resources for the financing of government health programmes and for the support of the programmes of activities of non-government organisations that protect public health interests. The State Health Fund shall be established by the Government of the Republic of Lithuania.

The sources of the funds of the State Health Fund shall consist of:

Article 103Municipal Health Funds

Municipal Health Funds shall be established for the purpose of accumulation of resources for the financing of public health care programmes and for the support of the programmes of activities of non-government organisations protecting the public health interests. Municipal Health Funds shall be established and their budget of expenditures shall be approved by Municipality Council.

Model statutes of the Municipal Health Funds shall be approved by the Seimas of the Republic of Lithuania.

The sources of the funds of the Municipal Health Funds shall include:

Article 104

Health Funds of Enterprises, Institutions, Organisations, Confessions, and other Legal and Natural Persons Enterprises, institutions, organisations, confessions, other legal and natural persons shall have the right to establish Health Funds for the financing of health programmes and support of health institutions. The procedure for the formation and liquidation of these Health Funds as well as the application of their resources shall be set forth in their statutes that shall be approved by the Government of the Republic of Lithuania. The budget of expenditures of this Fund shall be approved by its founder (founders).

The resources of the Health Funds of enterprises, institutions, organisations, confessions and other legal and natural persons shall consist of:

Article 105Financing of Pharmaceutical Activities

The sources of financing of pharmaceutical activities shall include:

Part V

Competence of the Managing Bodies of the LNHS

Chapter 1

Competence of the State Managing Bodies of the LNHS

Article 106Basic Powers of the Government of the

Republic of Lithuania in Managing Health Activities The Government of the Republic of Lithuania shall manage and regulate health activities by:

Article 107Basic Powers of the Ministry of Health in

Managing Health Activities The Ministry of Health shall:

The Ministry of Health shall manage other matters pertaining to health activities in conjunction with other ministries in compliance with to Articles 108 and 109, and shall perform other regulatory functions provided for in this Law, other laws and the regulations of the Ministry.

Article 108General Competence of the Ministries and

Government Institutions in Health Matters The ministries and government institutions shall:

Article 109Special Competence of other Ministries

when Dealing with Issues of Health Activities The matters pertaining to the policy of the protection of patients' rights, liability for hazard and harm to health shall be administered by the Ministry of Health and the Ministry of Justice within the scope of their competence.

The matters pertaining to foreign humanitarian relief and technical assistance to health system shall be managed by the Ministry of Foreign Affairs and the Ministry of Health.

The matters pertaining to the prevention of traffic accidents and harm done to health by reason of criminal activities shall be managed by the Ministry of Transport and the Ministry of Internal Affairs.

The matters pertaining to individual health care in the penitentiary sphere shall be managed by the Ministry of Internal Affairs and the Ministry of Health within the scope of their competence.

The matters pertaining to individual health care of the officers of internal affairs and police, as well as other persons equated with them shall be managed by the Ministry of National Defence, the Ministry of Internal Affairs and the Ministry of Health within the scope of their competence.

The matters concerning health insurance policy, assessment of harm to health, medical and social examination, integration of social services and social care into the health care system and safety at work shall be managed by the Ministry of Social Security and Labour and the Ministry of Health within the scope of their competence.

The matters concerning the liability insurance of institutions and enterprises accredited for the individual health care, for harm done to health when providing health care, shall be managed by the Ministry of Finances and the Ministry of Health.

The matters concerning the maintenance of the environment suitable for human health shall be managed by the Ministry of Environmental Protection and the Ministry of Health.

The matters concerning the supply of the population with