Press Conferences

12. 11. 200814:16

Press Conference after the Meeting of the Government, Held on Wednesday 12th November 2008

Jakub Stadler, Deputy Head of the Press Unit: Good afternoon ladies and gentlemen, welcome to the press conference after today's meeting of the government. I welcome the 1st Deputy Prime Minister and the Minister for Regional Development, Mr. Jiří Čunek and the Minister of Health, Mr. Tomáš Julínek. The press conference will be a bit shorter as further programme will follow. I ask the 1st Deputy Prime Minister to inform us on today's meeting.

Jiří Čunek, 1st Deputy Prime Minister and Minister for Regional Development: Good afternoon. It would be a long introductory speech if I informed you on it; the government dealt with comments on laws of the health service sphere. As we are going to speak about them I will not specify them now. You have the programme of the meeting of the government at your disposal and I would like to say that only the Draft of the State Cultural Policy for 2009-2014 was withdrawn. The other items were debated and I will not specify them. I will wait for your questions, if any.

Jakub Stadler, Deputy Head of the Press Unit: I ask Mr. Minister Julínek to take the floor.

Tomáš Julínek, Minister of Health: The government had a great portion of health service laws on its agenda; it means the first part of the health service reform. I would like to point out that there are laws which rectify our legal environment and they are in compliance with the Programme declaration of the Government. They also deal with unsolved problems of the Convention on Biomedicine, which means the rights of patients, duties of health service providers, the legal framework for specific services; I mean the Bill on Health Services, the Bill on Specific Health Services, the Bill on Medical Emergency Services, the Bill amending the Act on Public Health Insurance and the fifth law is the Bill amending Certain Act Relating to Adoption of the Act on Health Services, Act on Specific Health Services and the Act on Medical Emergency Service, which amends in particular the terminology. It means that for example rights of mothers with children are clearly specified so that they could be hospitalized; the act also newly stipulates specific services, in particular in the spheres of genetics and sterilization; it stipulates for example rights of women for information concerning the sterilization. All this is unambiguously stipulated in the Act on Special Services. We agreed in advance that we would suspend these laws so that we would have a possibility to discuss them at political committees and to take into consideration certain requirements, which were rather beyond of the standard legislative procedure and which had occurred. That was such a prediction. A should also state that most of comments which occurred in the standard legislative procedure, I mean comments of the individual ministries, were settled or we agreed that we would take them into consideration thanks to that suspension. My ministry met those comments, we agreed on compromises and we explained our views. We could have stated under certain circumstances, if those laws had not been so sensitive, that these laws were approved by the government. It is necessary to take into consideration the fact that they are sensitive legal norms and moreover, we have a shaky majority in the Chamber of Deputies, and we know that some of deputies are still in doubts. That is why it is necessary to give them chance to put forward their objections, to explain them impact on these laws and to persuade them on the fact that these impacts are positive. Therefore it was agreed that coalition partners would meet. It is just a proposal. Nevertheless, I hope that working groups will meet and that coalition partners will confirm it, so that objections and comments of the KDU-ČSL which were put forward at yesterday's meeting could be settled. A similar situation is in case of the Green Party. These laws will be clearly specified so that some political problems, if any, which might hamper the approval procedure in the Chamber of Deputies, might be solved on the highest coalition level. Also certain compromises, if any, could be reflected in these laws. Thus, I would like to distinguish the meeting of the government from the second round of negotiations. While the debate at meeting of the government was quite standard, there were three or four comments on each of those laws which was normal, there are always some comments on complicated laws, the second round should ensure higher chances for their approval in the Chamber of Deputies. That was a general description of these laws. If I am to anticipate certain problems relating to the Bill on Specific Health Services, I am of the opinion that it is necessary to get representatives of the KDU-ČSL and the Green Party on a single spot. As far as the Bill on Specific Health Services is concerned, we have tried to meet requirements of the KDU-ČSL. I can mention so called abortion tourism. It will not be possible to enable abortion all women, but only citizens of the EU and the abortion is related to the permanent residency. It is not possible to allow the abortion tourism in the Czech Republic. Also requirements concerning the informing statutory representatives on the pregnancy termination are included in the law, as well as possibilities to have recourse to a court of law in case of different opinions of the statutory representative and the person under legal age. There are also issues included which concern embryos, there is clearly stipulated there that in case of human embryos it is not possible to manipulate with it any longer, that in case of artificial insemination the embryo must be under special regime, if necessary, there is a right for burying such embryos and there is also stipulated that embryos must be separated from the waste. All those matters which I mentioned here, and not all of them were mentioned, was taken into consideration before the meeting of the government and I confirmed that it would be included in the text.

Jakub Stadler, Deputy Head of the Press Unit: Thank you. Now there is time for your questions. Mladá fronta Dnes.

Mladá fronta Dnes: Good afternoon. What was the result of the debate on the item no. 9 – the Bill amending the Act on Road Traffic like? What concrete changes were adopted? Thank you.

Jiří Čunek, 1st Deputy Prime Minister and Minister for Regional Development: This law was submitted in two different versions. One variant included the proposal for Friday's ban of truck transport between 14:00 and 18:00 o'clock and the other, which was finally agreed by the Deputy Prime Minister Bursík and the Minister of Transport Řebíček, included the ban between 15:00 and 18:00 o'clock. It was just a question of time. Then there was one more significant issue there concerning the procedure of exception permission; it would be simplified.

Jakub Stadler, Deputy Head of the Press Unit: The TV Nova.

TV Nova: I have a question to Mr. Minister. Some members of the KDU-ČSL and the Green party are still complaining that not all comments of theirs were met. They say that some of them were met in such a way that you stated: "it is not possible to change it, the Ministry of Health agrees". The second question – they complained about standards as it was not clear what the standard health care was like and what the above-standard care was like. It was not specified clearly in the law and people did not know how much money they would have to pay for such health care.

Tomáš Julínek, Minister of Health: I must definitely insist on the fact that the entire comment procedure has been quite standard and it took several months. The preparation of laws usually takes two years and each ministry tries to maintain the legal norm in a functional state. Sometime it is necessary to state that a comment is not possible to meet because of impairing the framework of the law in question. We are responsible for proper function of laws, so that they really could serve people. If we met every comment, we would prepare bad law. We tried to meet those comments which were possible to be met and we did it in many cases. When I remember the Czech Medical Chamber and the comment procedure, 90% of their comments were met. It is possible to prove it as we have records on this fact. It is true that some of members then claim that their comments were not met. But the comment procedure cannot be done like this; every minister may conform that. It does not concern any lack of good will to meet comments. For example if it is a dispute on the issue whether free choice of a medical practitioner or a free choice of health care provider should be included in the law. We pointed out that the term provider was in compliance with the terminology of the European Union and that it was also in compliance with the Act on Health Services. Thus the right for free choice of health care provider and medical practitioner, if he/she is the provider, was maintained. If we stipulated in the law that people can choose any medical practitioner it would mean that I could ask widely-known Professor Pafko to remove a splinter from my body. It is not an extreme case. It is possible to do anything in politics. If a sentence was of such a character that it could hamper approval of the law that will brings lots of positive aspects and that changes the health care in the Czech Republic, then I am willing to include it in the law. Nevertheless, in the first phase, when I try to protect the text of a law I must state that that such a right is not enforceable. In spite of the fact that it is finally included in the law, based on a comment of somebody, the author of the comment must know that it cannot happen. A patient cannot to choose the concrete medical practitioner in the real life. That is why we have been trying to submit a legal norm which would be applicable in a real life. That is why we are always trying to avoid including such clauses in our laws; nevertheless, that clause was neither catastrophic nor impassable.

Jakub Stadler, Deputy Head of the Press Unit: Thank you, now the last but one question, please. The Czech Radio.

Czech Radio Radiožurnál: Mr. Minister, I have a question concerning the same issue. You mentioned that working group which should try to reach an agreement with your coalition partners. Who are members of that group? How long should it work and when the government will debate these laws again?

Tomáš Julínek, Minister of Health: The basis for the oncoming negotiation must be the existing objections and comments which have already been put forward. They cover about 40 pages in case of the KDU-ČSL and about 15 pages in case of the Green Party. These comments have already been met; nevertheless, we must return to them once more. The working group is a single purpose group the task of which is to select those problem issues and to prepare them for the coalition negotiation. I really insist on the fact that those laws as a whole are correct, that they do not impair the Czech health care sphere. The point is that it is necessary to explain them and to make them clear for all those who have a feeling that they were omitted. Nevertheless, I am of the opinion that they did not. It is very important for the coalition to agree on those laws because I insist on the fulfilment of the Programme Declaration of the Government on fulfilment of the Coalition Agreement and the point is to refute any doubts. This is the principal task of that commission. Mr. Prime Minister included these laws into the agenda of the next meeting and we would have to manage all negotiations by that time.

Jakub Stadler, Deputy Head of the Press Unit: Thank you, the last question, the Czech News Agency.

Kateřina Krausová, Czech News Agency: I have a question both to the Deputy Prime Minister and the Minister. Mr. Deputy Prime Minister, how do you content with that alteration, with that compromise which occurred today concerning the Act on Specific Health Services? And I would like to ask Mr. Minister if he has any guarantees that there will no other requirements arise after reaching that compromise.

Jiří Čunek, 1st Deputy Prime Minister and Minister for Regional Development: Well, as to the Act on Specific Health Services, it is true that lots of those objections have the only one leitmotiv, not only the abortion tourism or greater liberalization, but we insist on observance of the existing law. In this respect, I am of the opinion that Mr. Minister has done a lot of work. I can just say on it that the devil is hidden in a detail. Mr. Minister said that the law did not impair the Czech health care. Our objective is not to impair citizens. It is necessary to lead a discussion of those experts and to discuss these comments which have not been met, and to explain some issues, impacts of which remain unclear, as well as links to other laws. It is quite possible that lots of problems will be solved during the discussion or a consensus will be reached that will result in a change of the law. I do not want to anticipate, the discussion will have to be held. Our comments will be handed over to Mr. Minister, as we have agreed, and we will discuss them.

Tomáš Julínek, Minister of Health: Can you repeat that question to me, please? Well, it concerned guarantees. I certainly do not have any guarantees as the course of the procedure indicates. If I had them, there would not be necessary to hold another round of negotiations. Nevertheless, it is a very sensitive issue; it is a great change for everybody. Nobody has prepared such a change here since 1990´ and this is a rectification of our legal order as far as the most essential issues are concerned. That is why it brings about lots of questions, doubts and scepticism. We must to refute them and to do our best for it. I suppose that the most complicated part of the discussion will be held on so called standard and above-standard. I would like to point out that in the existing Act no. 48 there is not mentioned when there is a claim for free of charge health service and neither health care providers not health insurance companies agonize over it. It is proved that a citizen sometime does not get health care which would correspond to his/her health state. We have repeated it several times. It is not a problem of specialized services, because he who suffers from leukaemia is usually treated in a specialized centre in case of correct diagnosis. Nevertheless, not all the seniors who suffer from apoplexy get an adequate treatment in an adequate health service facility. There are lots of evidences of it, and I could continue with other diseases. That is why we incorporated in the amendment to the Act no.48, which was a harmonization legal norm, a general formulation concerning this claim and we would have to explain it at the meeting. We insist on this formulation as it gives patients higher certainty that they will be treated in compliance with claims resulting from the health insurance. There are also clauses in which it is unambiguously stated that a medical practitioner is obliged under penalty to offer free of charge variant of such a treatment. It also means that we can pay an extra charge for above-standard treatment, material or services which I regard as a progress in the Czech health service sphere which has been awaited for a long time, and which has a positive impact. It does not mean restriction of free of charge health care resulting from the public health insurance. On the one hand it means guaranty of health care and on the other hand it means a possibility to pay extra charges, not bribery. It is an anti-bribery measure and it prevent us from giving sponsor's gifts or something like that which is degrading and which happens nowadays. I am convinced that space is opening for supplementary insurance about which we have been talking today. I regard it as a definitely positive aspect. There is an enchanted key often looked for in these clauses, but the opposite is true. All that is incorporated in the Act on Health Services as there is a duty of the Ministry of Health stipulated to publish in the Bulletin health care standards and health care standards which are compensated and about which deputy Hovorka often speaks. He does not see it there as part of it is incorporated in the Act on Health Services and the way of cost cover is in the Act no. 48 in the submitted wording. In the appendix to this Act there is stated for example that ambulance car is covered in the same way as it was before, that amalgam filling is covered as it was before, and so on. The only one essential change is inoculation against pneumococcus for children. From this point of view, the cost cover standards are described in the Act no. 48 as well as they was described before. There is a guarantee added that everyone has claim, which is legally enforceable, for treatment according to the state of health, state of science knowledge, according to one's need and all that is described in the Act. It was not stipulated in it before.

Jakub Stadler, Deputy Head of the Press Unit: Ladies and gentlemen, thank you for your attention and patience, ... and the Deputy Prime Minister wants to add something.

Jiří Čunek, 1st Deputy Prime Minister and Minister for Regional Development: I promised one of you to provide information on a law and I would like to provide it in the framework of this press conference. It concerns the transfer of property to the respective self-governing unit. It concerns flats that are worth half a billion crowns - this is an account value - which will be transferred from the Ministry of Defence to the City of Prague. This bill was not approved for the second time and was returned to be remade. The reason was that we know that the Prague municipality would sell this property to applicants and it would gain much higher amount of money. There was long debate held because there were lots of seniors in Prague who had no free flats to move in as they lived in flats that had been returned to restituents and these seniors did not have money enough to be able to pay rent. We came to the conclusion that the Prague municipality could solve this problem as it would get the money. The second matter – that space in front of the Czernin Palace is the property of the City of Prague and the Ministry of Foreign Affairs pays rent for it. According to the material submitted by Mr. Minister Schwarzenberg it amounts to 30 million crowns for the last five years. We want to arrange a settlement between the ministry and the City of Prague which would cover this space on the one hand and flats on the other hand. This is all from my side concerning this issue. As to the information of Minister Julínek, I firmly believe that all the coalition parties will be trying to reach an agreement and that this effort will be successful. Mr. Minister is on the one hand convinced that those laws are good, but on the other hand he will have to persuade on it all participants of negotiations.

Jakub Stadler, Deputy Head of the Press Unit: Thank you for your information. Good-bye.