good governance practices for the protection of human rights

cause of the shortage of such services and the urgency of the patients’ needs. For
example, the Foundation’s 2003 survey showed that the most frequent reason
cited by patients for bribing was to avoid long waiting lists for surgery and to
obtain a sickness certificate.
The first government regulation on the management of waiting lists was adopted
in 1998. It obliged hospitals to keep “waiting lists” and to register patients who
qualified for therapy, but could not be admitted immediately. However, the regulation
did not establish rules for the management of lists. Responding to the need
for greater transparency, the Task Force launched the pilot project “waiting lists
for surgery,” which attempted to establish official lists in cardiology departments.
In 2002, the Task Force conducted and published a review of international practice
in the management of specialized medical services and waiting lists. It also
sent a questionnaire to 120 cardiology wards asking about their current practices
regarding waiting lists. About 40 per cent of clinics responded and 70 per cent
of those stated that they maintained official waiting lists. A majority, 68 per cent,
stated that lists were based on clear medical criteria, but only 23 per cent said
that these criteria were public and available to patients.
The Task Force also increased dialogue with the Ministry of Health to contribute
to the Government’s discussions on the amendment of the Health Management
Organizations Act. Specifically, the Task Force proposed that the Act should lay
down clear criteria for waiting lists, ensure the public’s right to access information,
and provide for citizen supervision of waiting times.
In 2003, the Ministry established an advisory unit of experts, including members
of the Task Force, to work on a system to administer the lists of patients waiting
for specialized medical services. In 2004, the Task Force developed draft regulations
regarding publicly available waiting lists for the rationed medical services,
which were included in the Act on Health Care Institutions adopted by parliament.
As a result of the legislative changes, providers funded by the National
Health Fund are required to set up a register of waiting patients and to adopt
transparent criteria for their management.
Impact on human rights and challenges
The work of the Task Force has raised public awareness about the detrimental
consequences of bribery in the delivery of health services. It has also sparked
debate within the medical community and is largely responsible for the Government
adopting clear criteria for the management of waiting lists.
The Task Force has continued its work and has developed a checklist to assess
draft legislative changes in health-care laws in terms of their implications for corrupt
practices. It also identified the areas in the government draft bill on publicly
financed health care which might lead to corrupt practices. In 2005, the Task
Force developed best procedures for filling managerial positions in the health
service, especially the positions of heads of wards in clinics and hospitals. It is
also developing criteria for fairly evaluating candidates for such posts.
70