Latvia

Health systems in transition
Latvia
(28%) compared with those from non-Latvian speaking households (21%).
Fewer younger respondents (under age 50) felt they had all the information they
needed (20%) compared to older respondents (30%). In addition, respondents
from vulnerable social groups believed they were in a slightly better position
with respect to information (27%) compared with non-vulnerable social groups
(24%). Those who responded that they have all the necessary information were
more likely to be from households that reported having sufficient income to
meet their health care costs.
The same survey results indicate that 40% of respondents receive their
information about health care services from “nowhere”; the next largest group
(24%) from the mass media, and the next largest (23%) from health workers.
Complaint procedures (mediation, claims)
The main institution whose task is to accept and check complaints is the State
Health Inspectorate (the former State Quality Control Inspectorate for Expert
Examination in Health Care and Ability to Work), under the Ministry of
Health. The 1997 “Law on Medical Care” assigned this responsibility to the
Inspectorate, which, with the help of experts, is to decide on the appropriateness
of complaints, and has the right to fine or penalize providers, or transfer
complaints to the state prosecutor’s office. In 2005, of 1309 complaints received
by the Inspectorate, 243 were returned as sound. In 118 cases medical staff
were administratively penalized.
In addition, the 1997 “Law on Medical Care” along with other legislation
specify provisions for the possibility of investigations into medical negligence
by law enforcement bodies and by means of court litigation.
According to the WHO Regional Office for Europe, this is an area that is
not satisfactorily covered by the existing legislation (WHO Regional Office
for Europe 2002). It is argued that the precise task of the Inspectorate, its
functions, human resources structure and outcomes dissemination to medical
practitioners, hospitals and citizens are not clear enough. Moreover, there is no
adequate procedure for making complaints, no system to appeal a complaint,
and no system for receiving compensation outside of the court system.
Further, results of a survey indicate that Latvians are not well informed
about complaints procedures (CIET 2002). Only 21% of respondents knew
how to make a complaint about services received within the statutory system.
Knowing how to make a complaint was associated with having knowledge
about entitlements in health care: 30% of those with information about statutory
services knew how to make a complaint, compared to 18% of those without
adequate information. Moreover, there was no association between the use
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