CYIL vol. 12 (2021)

Jindřich Psutka CYIL 12 (2021) followed in an appropriate quality and with appropriate timelines, 16 led the state to exclude this type of health service exclusively from the competence of a public entity established and organized by the region, while excluding all other entities from the provision of this service. The nature of the provided medical rescue service, especially its urgency and urgency, then significantly limits the patient‘s free decision during the provision of this medical service. The patient has the option of refusing to provide emergency medical services. However, it cannot choose between its providers or influence the legally envisaged mechanism of this health care. 3. Framework Agreement between the Czech Republic and the Federal Republic of Germany on cross-border cooperation in the field of emergency medical services It has already been stated that the Framework Agreement between the Czech Republic and the Federal Republic of Germany on cross-border cooperation in the field of emergency medical services (No. 53/2014 Coll.i.t.) Sets out the basic framework for cooperation between emergency medical services. The aim is to continuously improve the availability and quality of health care in the border region. The framework character leaves room for further specification of cooperation in the form of agreements on cross-border cooperation at the regional level (these arrangements are foreseen in Article 4 of the Framework Agreement) 17 . For the Czech- Saxon border area, such an Agreement on cross-border cooperation of emergency medical services was concluded between the Ministry of the Interior of the Free State of Saxony and the Karlovy Vary, Ústí nad Labem and Liberec regions on 25 November 2015. agreed on the one hand by the Ministry of Interior, Construction and Transport of the Free State of Bavaria and the Pilsen, Karlovy Vary and South Bohemian regions on the other hand on October 3, 2016. With regard to only partial differences in content, the two arrangements affecting cooperation in the Czech-Bavarian borderland (hereinafter also referred to as the “Cooperation Agreement”). The core of the amendment to the Framework Agreement lies in the setting up of the basic mechanism for cross-border cooperation. According to Article 4 (3) of the Framework Agreement, this is to consist of sending an outreach group to the place of intervention. It is always sent on the basis of a request for cooperation from the relevant medical operating center of one of the contracting parties. 18 The request must be accepted by the relevant medical operating center of the other Contracting Party. The outreach group provides urgent medical care to a patient who is in a medical condition that leads or may lead to serious or permanent disabilities or death. Care is provided by the outreach group at the site of the intervention, as well as during the transport of the patient to 16 The availability of the ambulance service is determined mainly by the plan to cover the territory of the region with the exit bases of the ambulance service (§ 5 (1) ZZSl). The plan for covering the territory of the region with exit bases should be set so that the place of the event on the territory of individual municipalities and city districts can be reached from the nearest exit base within 20 minutes (§ 5 (2) ZZSl). 17 On the Czech side, regions neighboring the Federal Republic of Germany (ie the Liberec Region, the Ústí nad Labem Region, the Karlovy Vary Region, the Plzeň Region and the South Bohemian Region) are authorized to conclude cross-border cooperation agreements, and the Ministries of the Federal State of Bavaria and the Free State of Saxony on the German side. In agreement with the municipal founders and payers of these services and for the Free State of Bavaria also with the Association of Contracted Physicians of Bavaria. 18 Pursuant to Article 4 (1) of the Cooperation Agreement, the request shall be submitted by fax or other means of communication agreed by the operational centers on a bilingual form annexed to the agreement.

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