Complaints about health care

In the event that an individual believes that he or she has not been provided with adequate medical care, or that there has been a delay in providing necessary quality treatment, or that necessary treatment has been refused, he or she has the undeniable right to file a complaint. If an individual is dissatisfied with the conduct of a doctor or his or her style, considers the information provided to be inadequate or even suspects that there has been a neglect of necessary treatment, or that there has been a surgical error, he or she may also file a complaint.

1. What is the procedure for filing a complaint?

Filing a complaint is often one of the last steps in a situation where you are dissatisfied with the way your health care was provided or the outcome. But you should try to exhaust all other options to remedy the situation. It may be that the cause of the problem is a minor misunderstanding, incompetence or, in the worst case, the unwillingness of the health care provider to explain everything in full detail. Minor issues should be resolved in person, and as soon as possible.

If you are not satisfied with your medical care, you should discuss your concerns with your treating physician, and the chief physician is also obligated to listen to these concerns, as well as senior executives (directors or deputy directors).

In serious cases, it is more effective to lodge a complaint in writing, which will ensure you receive a written response within a time limit. Complaints can also be made by telephone, fax or email.

According to the law on medical services, a complaint can be filed with the doctor or the head of the medical facility. If the complainant disagrees with the way the complaint is resolved, the complaint can be filed with the relevant administrative body that issued the license to provide medical services, i.e. in most cases the prefecture, within whose administrative territory the medical facility is located.

In case of suspicion of professional misconduct or unethical behavior of a doctor or dentist you can file a complaint with the Czech Medical Society, or the Czech Dental Society, or another professional organization, such as the professional guarantee body, which is obliged to study your request.

The law on medical services does not explicitly provide for the possibility of filing a complaint with the health insurance company, but this does not exclude the filing of a complaint. The health insurance company may investigate errors, if it has a contract with the hospital, general hospital or doctor. Through its medical examiner, the insurance company examines the basis of the treatment process, mainly considering the process and provision of drugs and medical services, whether the necessary services were correctly charged and whether the type of medical care corresponds to the patient's health condition.

2. The relevant agencies may file a complaint.

1. The healthcare provider, i.e. the physician, chief physician, director, etc. The healthcare provider reviews the complaint and sends a response letter to the patient. The complaint should be resolved within 30 to 60 days of receipt.
2. The relevant administrative body that has granted the license to provide medical services to the physician concerned (regional authority, Prague City Hall, Ministry of Justice, Ministry of the Interior, Ministry of Defence, if the physician is the founder of the medical establishment). The complaint is filed with this administrative body in case of disagreement with the resolution of the physician's complaint.
3. The Czech Medical Society, the Czech Dental Society, or other professional organizations handle complaints related to professional misconduct or suspected unethical behavior by doctors.

Complaints about unethical or unprofessional conduct by a doctor can be filed within one year of the incident. Complaints can be filed not only by the injured patient, but by anyone (relatives). Complaints must be in writing and must be resolved within 6 months of receipt.

If the patient does not agree with the outcome of the complaint, he/she may file an appeal within 15 days of receiving the decision of the inspection board, the appeal will be decided by the Honorary Council of the Czech Medical Association. The doctor or an authorized member of the inspection board may appeal this decision.

The health insurance company, if it has signed a contract with a hospital, general hospital or doctor, especially in cases where it is necessary to check the basis of the treatment process, mainly the process and provision of medicines and medical services, consider whether the care provided corresponds to the care paid to the insurance company, whether only necessary services are paid, and whether the type of medical care corresponds to the patient's health condition. The insurance company can intervene in cases where the doctor or medical staff refuses to perform treatment within the scope of paid care.

Complaints are resolved in accordance with administrative procedures, with a maximum resolution time of 60 days.