Health Systems in Transition - Hungary - World Health Organization ...

Health systems in transition Hungary 53
Moreover, the right of choice is given to patients with regard to some of the
medical services financed by the NHIFA. Since 1992 people are allowed to
choose a family doctor freely, with the restriction that they may change only
once a year. Family doctors are not allowed to refuse patients who live in their
primary care district, but are offered the choice of not accepting applicants from
other districts (1992/3, 1997/9). Similarly, patients can contact specialists from
a variety of disciplines without referral. The patients can choose to be referred
to other health care providers than the providers originally assigned for the
treatment, provided that the chosen provider is willing to accept the patient by
stating this in written form. The chosen provider has to accept the patient unless
there is no financed free capacity, or if the provided care would endanger the
care of the patients who are assigned within the catchment area of the given
provider. Also, patients can request other health professionals to treat them,
but the providers can charge extra fee for this service (1997/9). See sections 5.3
and 5.4 for more details on primary and specialist care.
Co-payments are also due when non-emergency specialist services are
obtained without referral from an authorized medical doctor, normally the
family doctor; or patients choose to go to a provider other than the one they
were referred to; or, finally, patients want to receive more services than the
doctor prescribed (1997/9, 1997/18). See subsection Depth of coverage in section
3.3.1 for more details.
At health policy level, knowledge is limited on: how patients exercise their
choices; whether the levels of information facilitate choice; and how the current
level of choice affects equity and efficiency.
2.9.3 Patient rights
The chief significance of Act CLIV of 1997 on Health came from its declaration
of patient rights, which had not been previously regulated in a comprehensive
manner. The Act also established the institution of patient rights representatives
and the institution of arbitration for resolving disputes between patients and
health care providers (1997/20, 2000/9).
Following the Declaration on the Promotion of Patients’ Rights in Europe
by WHO in 1994, the approved Act CLIV of 1997 on Health incorporated these
rights extensively, together with the patient’s obligation regarding cooperation
with the providers and respect for the rights of the other patients as well as
the medical professionals. The chapters of the defined rights frame one of the
core concepts of the law. Some of these rights have been discussed above in
subsections 2.9.1 and 2.9.2. Partly repeating them here, the following rights were