CYIL vol. 12 (2021)

CYIL 12 (2021)

The impact of the adoption of the Framework Agreement…

3. Conclusion It is obvious that even after the adoption of the Framework Agreement, the scope of the emergency medical service remains governed by the territorial principle (basically it is based on the regional organization of the Czech Republic). The adoption of the Framework Agreement did not in any way limit or weaken the obligation of the Czech emergency medical service to cover the entire territory of the Czech Republic with this service. In other words, this obligation was not transferred to the German border states. The framework agreement is aimed only at acute cases where coverage by the Czech side is not possible in that particular case (e.g with regard to several simultaneous events), or at least coverage by the German side is faster due to the proximity of the event to the border. Thus, the Framework Agreement does not cover situations where, without activating cross-border cooperation, a patient is transported, for example, by the ambulance service of one Contracting State to a medical facility in the territory of the other Contracting State. There is no system of a unified or unified organization of rescue services. The adoption of the Framework Agreement did not directly result in the abolition of duplicate emergency service departure groups in the border area nor in the establishment of new ones in order to better cover the border area of ​the neighboring state, etc. Without activating the cooperation according to the Framework Agreement, it is necessary to provide urgent pre-hospital care in the territory of the Czech Republic to any natural person with a serious disability or in direct danger of life using national regulations. It does not matter what the nationality or nationality of the person concerned is, what language the person speaks or whether he is properly insured. It is obvious that the given rules also apply to cases where urgent assistance is provided in the Czech territory by the ambulance service to a patient who is a citizen of the Federal Republic of Germany or has his / her residence in its territory. Neither a German national has the possibility to choose the provider of emergency medical services or the provider of acute inpatient care to which he will be transferred [§ 29 (2) letter a) Act No. 372/2011 Coll.]. The ambulance service operating in the Czech Republic is not obliged to follow its choice or wish. The Czech national legislation does not give the ambulance service the possibility to transport patients to the Federal Republic of Germany – subject to the fulfillment of the conditions of some of the circumstances precluding illegality (especially extreme emergency). It is obvious that in such a case, however, it will always be an exception to the rule and not a system solution. The system is set up (or should be) so as to eliminate the risks of a patient‘s wrong decision in a mentally often demanding situation and at the same time to ensure proper urgent pre-hospital care in the most accessible, best and fastest form possible throughout the Czech Republic. The described very narrow concept of providing urgent health care by the emergency medical service in the border area in many ways clearly does not fully meet the requirements or ideas of the providers of this service and in many cases the ideas of the patients themselves. However, the agreed form of cooperation is not the result of a mistake or omission in negotiating the Framework Agreement. This is clearly a deliberate concept. The close focus of the Framework Agreement is desirable. This also follows from the fact that the Framework Agreement is basically focused on the cooperation of two providers of emergency medical services. Providers of other health services (especially providers of follow-up acute inpatient care) are affected only to the extent to which their activities build

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