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food products of good nutritional and biological value, veterinary control and supply of consumers with veterinary medicines shall be managed by the Ministry of Agriculture and the Ministry of Industry and Trade.

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The matters concerning transport and road ecology shall be managed by the Ministry of Transport.

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The matters concerning the improvement of the quality of goods shall be managed by the Ministry of Industry and Trade.

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The matters concerning the supply of the population with good quality drinking water and the matters concerning the policy of healthy dwelling space shall be managed by the Ministry of Construction and Urban Planning.

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The matters concerning the promotion of health at educational establishments and improvement of teachers' qualifications in health promotion shall be managed by the Ministry of Education and Science in conjunction with the Ministry of Health, within the scope of their competence.

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The matters of state registers of health activities, preparation of classifiers, the policy of computerisation of health system shall be managed by the Ministry of Communications and Informatics and the Ministry of Health within the scope of their competence.

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State statistics about health activities shall be managed by the Department of Statistics under the Government of the Republic of Lithuania and the Ministry of Health.

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Chapter 2

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Competence of Municipalities and their Institutions in Matters of Health Activities

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Article 110Competence of the Municipal Council in

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Matters of Health Activities The Municipal Council shall:

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1)approve the primary health care development programme, other comprehensive and purpose -oriented programmes of a local authority and control their implementation;
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2)approve the municipal budget for health activities and the accounts of its performance;
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3)approve the contracts concerning health activities concluded by the local authority;
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4)establish the methods and measures of health support and the procedure for their application;
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5)form the Municipal Health Fund, approve the accounts of the funds utilised and control their application;
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6)form health council of the local community, appoint its chairperson and its regulations;
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7)establish, reorganise or liquidate local primary health care institutions, pharmaceutical enterprises and perform the functions of their founders;
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8)establish the powers of enterprises, institutions and organisations that are under their jurisdiction, in the sphere of individual and public health care;
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9)revoke the decisions and directives of the municipal board, the mayor, and the elders, as well as the decisions of committees, commissions, health board of a local community and of other institutions formed by the Council that are not in compliance with the laws on health activities or the decisions of municipal Council concerning the issues of health activities; and
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10)exercise other powers in the sphere of health activaties established by the laws and other legal acts.
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Article 111Competence of the Mayor of a Municipality

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or the Municipal Board in Matters of Health Activities The Mayor of the municipality or the Municipal Board shall:

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1)organise the implementation of the Lithuanian Health Programme, state health programmes and other health programmes, the programme of the primary health care development, the preparation of municipal comprehensive and purpose- oriented draft programmes, as well as the implementation of the programmes approved by the Municipal Council, the laws on health activities and other legal acts in the territory of a municipality;
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2)ensure, within the scope of its competence , the required level of health activities in the territory of the municipality and organise the supervision of the maintenance of such level;
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3)organise primary health activities;
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4)organise the implementation of the health support established by the Municipal Council;
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5)conclude contracts concerning health care pursuant to this Law and other legal acts, submit them to the Municipal Council for approval, and control how they are being complied with;
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6)perform the functions of a customer of designing, construction, and major repairs of primary health care facilities belonging to the municipality by the right of ownership;
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7)organise the medical audit of primary health care establishments belonging to the municipality by the right of ownership;
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8)organise supervision of the implementation of patients' rights at the individual health care establishments of primary level;
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9)on basis provided by laws, prohibit enterprises from engaging in business activities, revoke licences issued in the prescribed manner to legal and natural persons to engage in such activities; and
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10)exercise other powers in the sphere of health activities established by laws and other legal acts.
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Article 112Competence of a City/ District Physician

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in the Matters of Health Activities The city/district physician shall be appointed and dismissed from office by the Municipal Council.

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Medical specialists who have passed examinations in health economy, health law, management and organising of health activities may be appointed to the post of a city or district municipality physician. The board of examiners shall be formed and the programme shall be drawn by the Minister of Health.

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The city/ district municipality physician shall run the subdivision of health activities of the municipality the number of the employees of which shall be determined by the local authority.

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The city /district municipality physician shall:

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1)perform the functions of the mayor of the municipality or the Municipal Board, referred to in items 1, 2, 3, 5,7 and 8 of Article 111 of this Law; and
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2)exercise other powers in the sphere of health activities provided for in the regulations of the subdivision of health activities of the municipality, approved by the mayor of the municipality or Municipal Board.
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Article 113Competence of the Physician of the Higher

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Level Administrative Unit of the Territory when Dealing with Health Matters The physician of the higher level administrative unit of the territory shall be appointed and dismissed by the Government of the Republic of Lithuania on the recommendation of the Minister of Health. The physician of the higher level administrative unit of the territory shall be concurrently the director of the Regional Public Health Centre of the State Public Health Care Service.

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The physician of the higher level administrative unit of the territory shall:

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1)supervise the implementation of health activity laws, other legal acts, Lithuanian Health Programme and government health programmes, and facilitate the implementation of municipal health programmes in the higher level administrative unit of the territory;
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2)generalise the application practice of government regulatory measures of health relations in a higher level administrative unit of the territory and prepare proposals to the State Committee on Health Affairs with regard to their preparation and improvement;
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3)co-ordinate the issues concerning the establishment, reorganisation, or liquidation of the secondary health care establishments with the Administration of the higher level administrative unit of the territory and the Ministry of Health;
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4)supervise how the Administration of the county discharge the functions of the customer of construction and major repairs of secondary health care facilities;
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5)supervise the activities of the individual health care establishments of the secondary level and arrange their audit;
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6)organise the supervision of the implementation of patients' rights at an individual's health care institutions of the secondary level; and
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7)exercise other powers of health activities established by laws and other legal acts.
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For the discharge of his functions, the physician of the higher level administrative unit of the territory shall have at his disposal specialists and auxiliary personnel the structure and number of which shall be determined by the Government of the Republic of Lithuania.

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Chapter 3

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Institutions Co-ordinating the LNHS Activities

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Article 114The National Health Board

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The National Health Board shall be self-regulating institution co-ordinating health policy. The National Health Board shall be formed and shall operate in compliance with the regulations approved by the Seimas of the Republic of Lithuania.

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The National Health Board shall consist of: 1/3 representatives of the community health boards, 1/3 representatives of non- government organisations that defend the interests of public health, 1/3 specialists of public health care. The activities of the National Health Board shall be financed out of the state budget.

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The National Health Board shall: co-ordinate on the state level:

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1)health promotion policy;
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2)alcohol control policy;
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3)tobacco control policy;
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4)drug control policy;
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5)public health protection policy;
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6)disease prophylaxis and control policy; approve draft government health programmes within the scope of their competence; approve the scope of health activities of required level, draft indicators of the health level targeted by the government, the drafts of the Lithuanian Health Programme; prepare and each year submit to the Seimas of the Republic of Lithuania the report on the state of public health and health policy implementation; discharge other functions assigned to it under this and other laws and regulations of the Board.
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The National Health Board shall have the right:

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1)to obtain from the Government of the Republic of Lithuania, ministries, other governmental institutions, managing bodies of municipalities, enterprises, institutions, and organisations draft legal acts, draft programmes, and other information necessary for the discharge of functions established by this Law and the Statute of the Board;
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2)to conduct, within its competence, expert examination of laws, other legal acts, draft programmes of social and economic development and submit its findings to those who prepared the programme;
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3)to provide, within its competence, consultations to the Seimas of the Republic of Lithuania, the Government, ministries, other governmental institutions;
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4)to form expert commissions for the discharge of the functions of the Board.
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Article 115The State Health Commission

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The State Health Commission under the Government of the Republic of Lithuania is an institution co-ordinating the planning of health support and implementation at the ministries and other governmental institutions as well as enforcement of the laws on health activities and other legal acts.

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The State Health Commission shall be formed and its regulations shall be approved by the Government of the Republic of Lithuania. The activities of the State Health Commission shall be financed out of the state budget.

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The State Health Commission shall co-ordinate the planning and implementation of the following spheres of health support:

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1)health promotion of the population;
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2)environmental protection, environmental hygiene, safety at work, labour hygiene, and labour medicine;
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3)nutrition hygiene and labour medicine;
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4)alcohol, tobacco and drug control;
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5)prevention of traumas;
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6)control and prophylaxis of infectious diseases; co-ordinate the enforcement of laws on health activities and other legal acts, generalise their application practice, co- ordinate their preparation at the ministries and other government institutions, submit proposals to the Government of the Republic of Lithuania concerning their preparation and improvement, as well as submit draft regulations to the Government of the Republic of Lithuania; conduct expert examination of government programmes for social and economic development, of government investment programmes, conceptions, laws, and other legal acts and submit proposals to the authors of these projects on issues that are within their competence; on the instructions of the Government, conclude health support contracts between the Government of the Republic of Lithuania and local authorities.
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The State Health Commission shall have the right:

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1)to obtain draft laws and other legal acts, draft programmes, and other information from the Government of the Republic of Lithuania, ministries, other government institutions, managing bodies of municipalities, enterprises, institutions, and organisations ,necessary for the discharge of functions established by this Law and the regulations of the Commission;
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2)to conduct, within its competence, expert examination of laws, other legal acts, draft programmes of social and economic development and submit their findings to those who prepared the programme ;
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3)to provide, within its competence, consultations to the Government of the Republic of Lithuania, ministries, government institutions, managing bodies of municipalities;
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4)to take part in the considerations of health support issues when they are discussed at managing bodies of municipalities, interested ministries, and other government institutions and to submit proposals concerning the resolution of these issues;
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5)to form temporary or permanent expert or other specialist groups for the resolution of issues assigned to the competence of the commission.
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Article 116Community Health Board

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Community Health Board is an independent institution co- ordinating health activities under the Municipal Council. This Board shall be formed and its regulations shall be approved by the Municipal Council. Community Health Board shall consist of:

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1/3 of health care specialists, 1/3 of the representatives of enterprises, institutions, organisations of a municipality, 1/3 of the representatives of the NGO that defend public health interests. The activities of the Community Health Board shall be financed out of the municipal budget.

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Community Health Board shall : coordinate in the territory of municipality:

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1)health promotion policy;
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2)alcohol control policy;
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3)tobacco control policy;
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4)drug control policy;
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5)public health protection policy; and
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6)infectious diseases prophylaxis and control policy; approve municipal primary health care development and other municipal programmes; examine, submit, in accordance with its competence, issues to the municipal council, municipal board, and the chief executive (the mayor); perform other functions assigned to it in accordance with this Law, other laws and the regulations of the Council.
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The municipal community health council shall have the right to:

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1)receive from the managing institutions, and enterprises, institutions and organisations within the territory of the municipality information necessary for the performance of the functions provided for by this Law and the regulations of the Council;
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2)carry out, in accordance with its competence, expert examinations of managerial decisions adopted by the municipal council and municipal managerial bodies as well as to draft municipal socio-economic development programmes and to present its conclusions to the bodies preparing such programmes;
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3)provide consulting, in accordance with its competence, to the municipal council, municipal managerial bodies, and economic entities;
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4)form expert commissions for the performance of the functions of the Council; and
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5)delegate its representatives to the National Health Board.
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Chapter 4

\n

Special Managing Bodies of the LNHS

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Article 117State Tobacco and Alcohol Control Agency

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under the Government The State Tobacco and Alcohol Control Agency under the Government shall be established and its regulations shall be approved by the Government of the Republic of Lithuania. The Agency shall be a legal person. Its activities shall be financed from the State Budget.

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The State Tobacco and Alcohol Control Agency shall:

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1)licence the production, sale and import of alcohol and tobacco;
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2)control the compliance with the laws on tobacco and alcohol control by economic entities; and
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3)perform other functions prescribed by other laws and the regulations of the Agency.
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Article 118State Public Health Care Service under the

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Ministry of Health The State Public Health Care Service under the Ministry of Health shall be established and its regulations shall be approved by the Ministry of Health.

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The State Public Health Care Service under the Ministry of Health shall:

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1)perform the functions of regional divisions of the Ministry of Health for the management of public health care in the higher-level administrative units of the territory;
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2)on the instruction of the Ministry of Health, establish, in conjunction with municipalities, priority development trends of primary health care;
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3)carry out public health monitoring and public health expert examination;
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4)on the instruction of the Ministry of Health prepare standardisation normative documents for the regulation of public health care;
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5)in accordance with the procedure and on the grounds established by laws and other legal acts, issue permits to engage in economic-commercial activities; and
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6)perform other functions prescribed by other laws and the regulations of the Service.
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Article 119State Medicines Control Agency under the

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Ministry of Health The State Medicines Control Agency under the Ministry of Health shall be established and its regulations shall be approved by the Ministry of Health. The Agency shall be a legal person.

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The Agency activities shall be financed from the State Budget.

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The State Medicines Control Agency under the Ministry of Health shall:

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1)accredit legal and natural persons for pharmaceutical activities;
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2)licence the production, sale and import of medicines;
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3)register medicines;
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4)control the quality of medicines and medicinal substances;
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5)exercise control over pharmaceutical activities;
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6)carry out monitoring of pharmaceutical activities (collecting, accumulating, processing and disseminating information concerning medicines and their production, import, sale and export); and
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7)perform other functions established by other laws and the regulations of the Service.
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Article 120State Legal Medicine Service under the

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Ministry of Health The State Legal Medicine Service under the Ministry of Health shall be established and its regulations shall be approved by the Ministry of Health. The Service shall be a legal person.

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The activities of the Service shall be financed from the State Budget.

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The State Legal Medicine Service under the Ministry of Health shall:

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1)on the instruction of bodies of inquiry or interrogation and court, carry out expert examinations and investigation in the area of legal and forensic medicine;
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2)perform other functions provided for by laws and regulations of the Service.
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Article 121State Legal Psychiatry and Narcological

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Service under the Ministry of Health The State Legal Psychiatry and Narcological Service under the Ministry of Health shall be established and its regulations shall be approved by the Ministry of Health. The Service shall be a legal person. The activities of the Service shall be financed from the State Budget.

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The State Legal Psychiatry and Narcological Service under the Ministry of Health shall:

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1)on the instruction of bodies of inquiry or interrogation and court, carry out expert examinations in the area of forensic medicine, legal psychiatry and narcology;
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2)perform other functions provided for by laws and regulations of the Service.
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Article 122State Service of Accrediting for Health

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Care Activities under the Ministry of Health The State Service of Accrediting for Health Care Activities under the Ministry of Health shall be established and the regulations of the Service shall be approved by the Ministry of Health. The Service shall be a legal person. The activities of the Service shall be financed from the State Budget.

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The State Service of Accrediting for Health Care Activities under the Ministry of Health shall:

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1)control whether health care institutions, the areas and equipment of enterprises comply with the requirements of standardisation normative acts;
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2)carry out monitoring of medical audit data and data concerning the control of health care acceptability;
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3)issue legal and natural persons with licences, certificates or permits to engage in health care activities or revoke said documents in accordance with the established procedure; and
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4)perform other functions established by the regulations of the Service.
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The State Service of Accrediting for Health Care Activities under the Ministry of Health shall have the right to demand:

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1)that natural and legal persons should present information and documents necessary for the performance of its functions;
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2)that the unaccredited health care institutions, services, agencies, enterprises, their structural subdivisions should be reorganised in compliance with the requirements prescribed by standardisation normative documents of health care activities into health care institutions, pharmaceutical enterprises of another type in accordance with the nomenclature as approved by the Ministry of Health; and
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3)that legal persons who issued permits (licences) to enterprises to conduct economic-commercial activities should revoke said permits in accordance with the established procedure if the enterprises are not accredited for public health care activities.
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Article 123State and Territorial Patients Funds

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State and territorial patients funds shall accumulate, in accordance with the established procedure, health insurance contributions and other legally acquired funds, ensure payment for (purchase of) individual health care services, control the costs and quality thereof, provide means for the implementation of municipal health programmes, perform other functions provided by law and regulations of the funds.

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Article 124Professional Organisations of Individual

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and Public Health Care and Pharmaceutical Workers Professional organisations of individual and public health care and pharmaceutical workers shall participate, in accordance with the procedure established by this Law, other laws and other legal acts, in the activities of the National Health Board and municipal community health councils, in the accrediting of natural and legal persons for health activities, in the management of enterprises and institutions accredited for health activities, shall take care of the improvement of their members' qualifications and conclude collective agreements concerning work and terms and conditions of payment for it.

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Chapter 5

\n

Institutions Exercising Control over the Conditions of the LNHS Activities

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Article 125State Hygiene Inspectorate at the State

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Public Health Care Service The State Hygiene Inspectorate at the State Public Health Care Service shall be established and its regulations shall be approved by the Ministry of Health. The Inspectorate shall be a legal person. Its activities shall be financed from the State Budget.

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The State Hygiene Inspectorate at the State Public Health Care Service shall:

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1)exercise state hygiene control;
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2)control compliance with the laws on health care and with the standardisation normative documents;
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3)grant permits for the carrying out of work related to land lot utilisation, construction and reconstruction, for introducing new raw materials, technologies, means of production, recipes, for selling products and consumer goods;
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4)impose sanctions on natural and legal persons who do not comply with the requirements of legal acts on health activities; and
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5)perform other functions prescribed by laws, other legal acts and regulations of the Inspectorate.
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Article 126State Medical Audit Inspectorate at the

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Ministry of Health The State Medical Audit Inspectorate at the Ministry of Health shall be established and the regulations of its activities shall be approved by the Ministry of Health. The Inspectorate shall be a legal person. Its activities shall be financed from the State Budget.

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The State Medical Audit Inspectorate at the Ministry of Health shall:

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1)control and analyse economic efficiency of activities of health care institutions;
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2)control the compliance by natural and legal persons with the health care quality requirements prescribed by standardisation normative documents;
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3)control the compliance by state-run and municipal health care institutions with the health care accessibility requirements; and
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4)perform other functions prescribed by the regulations of the Inspectorate.
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Article 127Lithuanian Committee on Medical Ethics

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The Lithuanian Committee on Medical Ethics shall be established and the regulations of its activities shall be approved by the Ministry of Health. The Lithuanian Committee on Medical Ethics shall be a legal person. Its activities shall be financed from the State Budget.

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The Lithuanian Committee on Medical Ethics shall:

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1)control whether natural and legal persons who either carry out or are engaged in individual health care comply with the medical ethics requirements set by laws and standardisation normative documents;
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2)issue permits for biomedical research; and
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3)perform other functions established by the Committee regulations.
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The Lithuanian Committee on Medical Ethics shall have its regional divisions in higher-level administrative units of the territory.

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Article 128Medical Ethics Commissions of Health Care

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Institutions Medical ethics commissions of health care institutions shall supervise the compliance with the requirements of medical ethics by specialists of individual health care.

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Medical ethics commissions of health care institutions shall be formed and shall function in accordance with the regulations approved by the Ministry of Health.

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Article 129Municipal Sanitary Inspectorate

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Municipal sanitary inspectorate is a specialised division of municipal administration which controls sanitary conditions within the territory of the municipality.

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The tasks, competence and structure of the inspectorate, the rights and duties of its officials, the contents and procedure of sanitary control shall be regulated by regulations approved by the Government of the Republic of Lithuania on the recommendation of the Ministry of Health The sanitary requirements shall be regulated by standardisation normative documents prepared and approved by the State Hygiene Isnpectorate.

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Article 130Patients' Rights Supervision Officials

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Municipal boards, chief executives (mayors) must appoint patients' rights supervision officials (controllers). The staff norms with respect to such officials shall be approved by the municipal Council, however, their number must be not less than 2 per municipal territorial administrative subdivision. The patients' rights supervision controllers must explain to patients their rights regulated by this Law and other laws, help patients when they apply with complaints concerning violations of necessary health care conditions or infringement of their rights in health activities, and must examine the patients' complaints.

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The State Service of Accrediting for Health Care Activities shall appoint controllers for supervising the patients' rights who shall supervise the manner in which health care institutions of secondary and tertiary health care levels guarantee the patients' rights.

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The procedure for protecting the patients' rights and for the supervision thereof shall be regulated by this Law, other laws and legal acts.

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The competence of patients' rights supervision controllers shall be regulated by the regulations approved by the Government of the Republic of Lithuania.

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Article 131Competence of other Health Activities

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Control Institutions in the Issues Pertaining to Health Activities Competence of other health activities control institutions (State Veterinary Service, State Labour Inspectorate, etc.) in the issues pertaining to health activities shall be established by laws, other legal acts and the respective regulations of the above institutions.

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Part VI

\n

The Contents of Rights and Duties of Individuals and Economic Entities in Health Care Activities

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Chapter 1

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Rights and Duties of Individuals in Health Care Activities

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Article 132The Rights of the Population in Health

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Activities The residents of the Republic of Lithuania shall have the right to:

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1)have a healthy and safe physical and social environment as well as information about any danger existing in the environment;
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2)be provided with safe raw materials, articles. goods and services;
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3)have information about health care institutions and services, and health care services provided by them;
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4)receive information concerning their health and guarantees concerning the confidentiality of said information;
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5)have acceptable, accessible and adequate health care;
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6)choose, in accordance with the established procedure, a health care specialist, health care institution, type of health care, or refuse any of the above, unless the law provides otherwise;
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7)have free medical care (state-supported health care);
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8)receive state-established support in protecting, recovering and strengthening health; and
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9)take part, in accordance with the procedure established by this Law, in determining the priority trends of health care development, in controlling the accessibility and adequacy of health care.
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Parents, adoptive parents, guardians or tutors of minors or legally incapable persons shall have the right to choose for their children, adopted children, or wards health care specialists, health care institutions, types of health care or refuse any of the above, unless the law provides otherwise.

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Only citizens of the Republic of Lithuania and stateless persons who are permanently residing in the Republic of Lithuania shall have the right to free medical care (state-supported individual and public health care and services) state-established assistance in protecting, recevering and strengthening their health.

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The procedure and conditions of health protection for foreigners shall be specified by international agreements to which the Republic of Lithuania is a party.

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Article 133Rights of the Population in the Health

\n

Activities The residents of the Republic of Lithuania must:

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1)take care of the health of their children (adopted children, wards) who are under age, and their elderly parents;
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2)refrain from violating health-related rights of other persons; and
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3)protect the environment from harmful effects.
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Persons who violate the requirements of this Law shall be liable under law.

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Article 134The Duty of Individuals to Provide First

\n

Aid in Case of Accidents and Acute Dangerous Diseases Workers of professions, places of employment or spheres of activities that are on the list determined by the Government of the Republic of Lithuania as well as amateur drivers of motor vehicles who happen to be present at the sites of accidents or acute dangerous diseases together with the victims or sick persons must without delay provide first aid to persons in need of such aid because of an accident or acute dangerous disease.

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The qualification requirements of training the above persons to provide first aid and the procedure and conditions of testing first aid skills shall be established by the Government of the Republic of Lithuania.

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Persons who are obligated under this Law and other legal acts to provide first aid and who by their failure to act or by their actions increase the damage to the health of the victims or persons who have fallen acutely ill shall be held liable under law.

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Chapter 2

\n

The Rights and Duties of Enterprises, Institutions and Organisations in the Sphere of Health Activities

\n

Article 135The Rights of Enterprises, Institutions

\n

and Organisations in Health Activities Enterprises, institutions and organisations shall have the right to:

\n
1)conclude agreements on health activities in accordance with the procedure established by this Law and other legal acts;
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2)set up, in accordance with the procedure established by this Law and other legal acts, funds for health activities
\n
3)establish, in accordance with the procedure established by law, subjects of individual or public health care, or pharmaceutical activities and perform the functions of their founder, establish their own structural subdivisions which carry out personal or public health care; and
\n
4)organise the preparation of health programmes and finance their implementation with resources from the health funds established by them or with other legally acquired resources.
\n

Enterprises, institutions and organisations may also have other rights provided that they are in compliance with this Law and other laws and founding documents.

\n

Article 136The Duties of Enterprises, Institutions

\n

and Organisations in the Sphere of Health Activities In their economic-commercial or other activities enterprises, institutions and organisations must :

\n
1)ensure, in accordance with their competence, the required level of health care activities;
\n
2)carry out the requirements set in the standardisation normative documents of health care;
\n
3)timely notify health care institutions, services and the population of the danger to their health which arises as a result of the activities pursued, products manufactured or goods sold by them;
\n
4)ensure healthy and safe conditions of work ;
\n
5)prevent the imminent danger to the environment, limit the scope of danger and harm to the environment;
\n
6)protect people against contagious diseases spread by food or drinking water, or invasions of such diseases, as well as against food poisoning, and implement measures to restrict the spreading of contagious diseases;
\n
7)organise and pay, in accordance with the established procedure, public health monitoring and expert examination;
\n
8)organise health care of their workers and employees; and
\n
9)compensate for the damage to health and environment caused by their actions.
\n

Enterprises, institutions and organisations may also have other duties, provided that they are in compliance with this Law and other laws as well as their founding documents.

\n

The implementation of rights and performance of duties in the sphere of health activities by enterprises, institutions and organisations must not violate the rights of other natural and legal persons.

\n

Enterprises, institutions and organisations which violate the requirements of this Article shall be liable under law.

\n

Part VII

\n

Liability for the Violations of Legal Norms Regulating Health Activities

\n

Article 137Liability for the Violation of Legal Norms

\n

Regulating Health Activities Natural and legal persons who do not comply with the requirements of legal norms regulating health activities shall be liable under law.

\n

Article 138Compensation for the Damage Caused to

\n

Health Legal and natural persons who by their actions or failure to act cause damage to human health must compensate for the losses sustained by reason of the damage caused to health, and in the event of the person's death - must compensate for the losses to his family and other persons. Unless the law provides otherwise, losses resulting from health damage shall be assessed in accordance with the amounts and methods applied with respect thereto and approved by the Government of the Republic of Lithuania; the assessed sums shall be collected by bringing a suit. The procedure for compensating for damage shall be determined by the Civil Code, other legal acts.

\n

The procedure of compensating for the losses incurred due to health damage to persons insured against accidents at work (and in the event of death of the victim - to his family and other persons) and the amount of such compensation shall be established by the Law on Accident Insurance.

\n

The terms and procedure for compensating patients for the losses sustained while having their health cared for (and in the event of their death - for making said compensation to their dependants) shall be regulated by laws and other legal acts.

\n

Article 139Liability to Compensate Health Care State

\n

Services, State Inspectorates, Health Care Institutions and Legal Persons for the Expenses Incurred due to Damage Caused to Health Caused by Unlawful Actions Legal and natural persons who by their unlawful actions cause damage to human health must compensate state services and state inspectorates of health care, health care institutions, other legal persons for the expenses incurred by them by reason of unlawful actions of said legal and natural persons and expenses which are connected with establishing and diagnosing individual and group cases of contagious diseases included in the list compiled by the Government of the Republic of Lithuania, food poisoning, occupational diseases and poisoning as well as with the treatment, nursing and feeding of persons ill with the above diseases at health care institutions, their medical and social rehabilitation, provision of prosthetic appliances and social assistance, implementation of measures to restrict the spreading of the above diseases and liquidation of their consequences for human health and economy, unless they prove that the damage to human health was due to vis majeur or deliberate malice of the victims.

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In the cases specified in part one hereof compensation for the expenses incurred by state services and state inspectorates of health care, health care institutions and other legal persons shall be collected either by mutual agreement between the parties or by filing a suit, upon prior assessment of the amount of claims in accordance with the actual expenses of the claimant or the party which submits material claims.

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Article 140Compensation of Moral Damage

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Persons who violate the requirements of acceptability of health care, confidentiality of information concerning individual health (a person's medical secret) must compensate for the damage caused to the person.

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While determining the amount of moral (non-property) damage in terms of money, the court shall take into account the property status of the person guilty of the damage, the degree of seriousness of the offence and other circumstances, however, in any case the amount may never exceed 500 minimum monthly wages.

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Article 141Liability for Illegal Engagement in or

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Carrying out of Health Care and Pharmaceutical Activities Illegal engagement in health care and pharmaceutical activities or unlawful performance thereof shall incur economic sanctions on legal persons and administrative responsibility on officials or citizens, or responsibility provided for in the Civil Code.

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Part VIII

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Final Provisions

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Article 142Basic Principles of International

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Cooperation of the Republic of Lithuania in the Sphere of Health Activities While cooperating with other states and international organisations in the sphere of health activities, the Republic of Lithuania must guide itself by the following principles:

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1)ensuring that by their economic-commercial activities the enterprises of the Republic of Lithuania do not inflict harm on the persons residing in the territories of other states;
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2)providing the interested parties with objective and reliable information on health;
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3)endeavouring to implement the global strategy of the World Health Organisation \"Health to Everybody\"; and
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4)cooperating in the liquidation of the negative consequences of ecological catastrophes, accidents and natural disasters on the health of the society.
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Article 143The Law on the Health System of the

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Republic of Lithuania and International Agreements In the event that an international agreement to which the Republic of Lithuania is a party prescribes requirements other than those established by this Law, the provisions of the international agreement shall prevail.

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Article 144As Used in the Law on the Health System of

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the Republic of Lithuania:

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Health means physical, mental and social welfare of society.

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Health protection means observation of factors which are hazardous to health, timely establishment of any danger to health, prevention or restriction of the harmful effects of the physical and social environment.

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Health recovery means restoration of health potential by applying medical aid, nursing, medical and social rehabilitation.

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Health strengthening means the sum total of obligations, measures and actions undertaken by state power and government bodies, local authorities and the public which helps to increase and use more rationally health care resources and to control the people's health.

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State targeted health level means indicators of public health level determined by the state for a definite period, the achievement of which level is guaranteed by the state.

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Health system means the system of management of matters related to health comprising health activities, executive and managing entities of health activities.

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Required level of health activities means basic scope of health protection of the population, and the recovery and strengthening thereof, which provide the initial position for the planning of health activities development.

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Individual health care means the activities of natural and legal persons accredited by the state the aim whereof is to timely diagnose and prevent health disorders of individuals and help them recover and strengthen health.

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Public health care means protection and stregthening of health of the society or its individual groups.

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Pharmaceutical activities means the activities of natural and legal persons regulated by the Law on Pharmacy.

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Health support means the system of legal, social and economic measures established by the state and programmes of activities of non-government organisations which support health protection and health recovery, and promote the strengthening of individual and public health.

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Primary health care means non-specialised qualified individual health care, mental health care, and non-specialised public health care provided at the place of residence.

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Secondary health care means specialised individual health care provided by the health care institutions of the higher-level administrative units of the territory, specialised public health care provided in the higher-level administrative units by the subdivisions of the state services and state inspectorates assigned by the state.

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Tertiary health care means very specialised individual health care, very specialised public health care provided by central individual and public health care institutions.

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Acceptability of health care means health care conditions which ensure the conformity of health care services to the principles of medical science and requirements of medical ethics and which have been recognised in accordance with the procedure established by the state.

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Accessibility of health care means health care conditions which ensure economic, communications and organisational accessibility of individual health care services to an individual or the public and which have been recognised in accordance with the procedure established by the state.

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Adequacy of health care means health care conditions which ensure the quality and effectiveness of health care services and which have been recognised in accordance with the procedure established by the state.

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Health care and services supported by the state and local authorities means individual and public health care of the types and in the scope established by the state the conditions and full coverage of costs whereof is guaranteed by the state or local authorities.

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Standardisation of health care means regulation of health care quality requirements and indicators in normative documents.

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Standardisation normative documents of health care means legal acts which establish the requirements, norms and standards for health factors, health care and its quality.

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Medical audit means expert examination and control of accessibility and adequacy of health care services.

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Accrediting of natural and legal persons and enterprises without the status of a legal person for health care or pharmaceutical activities means activities established by the state whereby the right to engage in or carry out health care or pharmaceutical activities is either granted or cancelled.

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Health programme means a plan for the development of priority health relations the purpose whereof is to approve comparative effectiveness of alternative measures of health activities, and applied and fundamental research, and to optimise the use thereof.

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Health promotion means the aggregate of state regulation and civic initiative, social marketing, social advertising, health education and propaganda, which develops a healthy life style, informs the public about the conditions of health and health care problems.

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Health education means the activities carried out by health care institutions the purpose whereof is to educate individual groups of the population to protect and strengthen health.

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Public health control means a form of public health management, either established by the state or developed independently, directed at identifying, on the basis of indicators of public health monitoring, negative shifts in the health and health care levels which are regulated by standard acts as well as in the health care quality indicators, and to shape appropriate management decisions.

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Control of health care resources means state-regulated activities of natural and legal persons directed at ensuring optimum use of material and economic health care resources.

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Public health monitoring means a state-established or independent system of observation and analysing of public health requirements, health care resources, health development, health care level, and the etsablished indicators of health care quality and environmental conditions.

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Public health expert examination means making an analysis of public health monitoring data and forecasts of public health development trends, interpreting the received data in the manner established by standard acts and determining the damage done to public health and public health care.

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Individual health care technologies means medicines, methods of prophylaxis, diagnostics and treatment, medical equipment and instruments.

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Article 145Coming into Force of this Law

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Article 3, part 2 of Article 10, Article 11, parts 5 and 6 of Article 13, part 3 of Article 15, part 4 of Article 16, part 2 of Article 18, part 2 of Article 19, parts 4, 5, 6 and 7 of Article 20, item 1 of part 1 of Article 29, part 2 of Article 30, part 2 of Article 31, Articles 32, 33 and 34, part 2 of Article 35, Article 36, part 2 of Article 37, Article 38, parts 1, 2, 4, and 5 of Article 39, parts 2, 6, and 7 of Article 40, parts 2, 3, 4, and 6 of Article 41, parts 3, 4 and 5 of Article 42, Article 43, Article 44, part 2 of Article 45, parts 2 and 3 of Article 46, Article 48, Article 49, Article 50, Article 51, Article 52, Article 53, parts 2, 3, and 5 of Article 55, Article 56, parts 2, 3, and 4 of Article 57, part 2 of Article 58, parts 3 and 4 of Article 59, parts 3 and 4 of Article 60, Article 61, part 2 of Article 63, Article 64, part 1 of Article 65, Article 66, parts 2 and 3 of Article 68, Article 69, Article 70, Article 73, Article 74, Chapter 1 of Part 4, part 3 of Article 85, part 5 of Article 86, part 4 of Article 87, parts 2, 3, and 4 of Article 88, parts 2, 3, and 4 of Article 89, Article 90, Article 91, parts 1, 2, 3, and 4 of Article 92, parts 2 and 3 of Article 93, Article 94, Article 95, Article 96, parts 2 and 4 of Article 98, part 1 of Article 99, part 1 of Article 102, part 2 of Article 103, part 1 of Article 104, Article 105, Article 108, Article 109, Article 112, Article 113, part 1 of Article 114, part 2 of Article 115, part 1 of Article 116, part 1 of Article 117, part 1 of Article 118, part 1 of Article 119, part 1 of Article 120, part 1 of Article 121, part 1 of Article 122, Article 123, part 1 of Article 125, part 1 of Article 126, part 1 of Article 127, part 2 of Article 128, parts 2 and 3 of Article 129, parts 3 and 4 of Article 130, part 2 of Article 133, Article 134, parts 1, 2, and 3 of Article 138, Article 139, and Article 141 of the Law on Health System of the Republic of Lithuania shall come into force in accordance with the procedure established by the Resolution of the Seimas of the Republic of Lithuania \"Regarding the Implementation of Articles Specified in Article 145 of the Law on Health System of the Republic of Lithuania\", and prior to the approval of the legal acts set forth in the above Articles, the effective legal acts shall apply.

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I promulgate this Law passed by the Seimas of the Republic of Lithuania.

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Algirdas Brazauskas President of the Republic Vilnius 19 July 1994 No.I-552

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