CYIL vol. 12 (2021)

Jindřich Psutka CYIL 12 (2021) 2. Embedding the provision of emergency medical services in the national legislation of the Czech Republic The ambulance service is one of the health services in the sense of Act No. 372/2011 Coll., On health services [cf. § 2 (2) letter d)] 8 The basic source regulating the functioning of the ambulance service in the Czech Republic is Act No. 374/2011 Coll., On the ambulance service (hereinafter “ZZSl”) 9 This Act primarily defines the conditions for the provision of emergency medical services and the rights and obligations of the provider of emergency medical services. However, it also focuses on the obligations of providers of acute inpatient care to ensure the connection of the health services they provide to the emergency medical service and on the conditions for ensuring the readiness of the emergency medical service provider to deal with emergencies and crisis situations (§ 1 ZZSl). The position of the emergency medical service is defined relatively strictly in the legal regulation. It is a health service that cannot be provided by a private entity. Its provider can only be a contributory organization established by the region. It is a public legal entity, which the region establishes as a subject of public law by law for the area of activity, the scope, structure and complexity of which require an independent legal personality. The establishment of a medical rescue service (as well as ensuring its uninterrupted availability) is a legal obligation of the region. No one other than the region, including the state or the municipality, can establish a medical rescue service. Regions must provide this health service around the clock to the appropriate extent, quality and availability. In the territory of the region, the emergency medical service is provided by only one provider. 10 It is an entity whose activities are not primarily aimed at achieving a profit that is financially and organizationally connected to the region. By delegating to the regions the exclusive right, but at the same time the exclusive obligation to provide one of the types of health services (i.e the emergency medical service), 11 at the same time, it withdrew this possibility from all other entities. No one else has this authorization and may not carry out activities interchangeable with the performance of the emergency medical service (cf. § 17 and § 26 ZZSl). The form of regulation is also related to the fact that providers of medical rescue services are one of the basic components of the 8 Cf. for example ŠUSTEK, Petr In ŠUSTEK, Petr, HOLČAPEK, Tomáš et al. Zdravotnické právo [Health Law]. Wolters Kluwer, Praha 2016, p. 42 et seq. 9 Of course, the functioning of the emergency medical service is also affected by a number of other regulations addressing, for example, the professional competence of members of intervention groups, reimbursement of costs, health insurance, etc. 10 However, it should be noted that a provider of emergency medical services established by another region may also participate in the provision of emergency medical services on the basis of a concluded contract (usually with regard to better accessibility of the place from the territory of a neighboring region). The emergency medical service provider may also be used by the external medical service provider to ensure the activities of ground field teams. It should always be a provider authorized to transport patients of urgent care under the Health Services Act (§ 14 (1) ZZSl). The validity of such an agreement requires the prior consent of the region, which is the founder of the relevant regional emergency medical service. In practice, however, the arrangement of such assistance is rather exceptional. 11 In this regard, it should be noted that in professional discussions it is possible to record partial critical responses to the transfer of the performance of the emergency medical service to the regions. The reason is its inclusion among the basic components of the integrated rescue system (see below). It is therefore argued that better coordination of the integrated system would correspond to a more centralized concept of a similar set organizational structure as in the case of the Fire and Rescue Service of the Czech Republic.

448