Private Health Care Institutions in Serbia

Private practice in health care

The fact that more and more health workers, encouraged by various motives, are starting their independent health care activities, has aimed focused on the form of performing health care activities as an independent health care worker or more of them together.

The Law on Health Care (“Official Gazette of the RS”, No. 25/2019” “the Law”) performs the basic division of forms of performing health care activities into health care institutions and private practice.

Having in mind the more complex systematics of legally prescribed conditions for performing the activities of health institutions, and thus more investment-intensive and expensive, activities in the form of private practice is a form are more accessible to an individual health worker for the mentioned reasons.

The Law stipulates that private practice may be established in the following forms:

1) doctor’s office (general, specialist and sub-specialist);

2) dental practice (general and specialist);

3) polyclinic;

4) laboratory (for biochemistry with hematology and immunochemistry, microbiology with virology, pathohistology with cytology);

5) pharmacy private practice;

6) outpatient clinic (for health care and rehabilitation);

7) laboratory for dental technology.

The same Law prescribes who exactly can be the founder of a private practice.

Private practice can be established by an unemployed health worker, as well as a health worker benefiting from an old-age pension, who meets the following conditions:

1) to have general health ability;

2) that he has acquired appropriate higher education in the health profession, appropriate secondary education in the health profession or specialization if they are requested;

3) that he has passed the professional exam;

4) to have obtained or renewed the license, in accordance with the Law;

5) that he has not been sentenced by a final court decision for an intentional criminal offense to one year of imprisonment or a heavier sentence, or to imprisonment for a criminal offense against human health, until the conviction is deleted in accordance with the relevant law; imposed a security measure in accordance with the Criminal Code, namely: compulsory psychiatric treatment and custody in a health institution, compulsory psychiatric treatment at liberty, compulsory treatment of drug addicts, compulsory treatment of alcoholics, prohibition of calling, activities and duties due to which he cannot perform health activities, that the decision of the competent body of the chamber did not impose one of the disciplinary measures prohibiting the performance of health activities in accordance with the law governing the work of the chambers of health workers, during the imposed safety measure or prohibition measure;

6) to meet other conditions determined by the Law.

The founder of private practice independently performs the activity as an entrepreneur, so in terms of economic aspects of private practice, the Law on Companies is applied.

After the procedure of obtaining consent for performing health activities by the health inspection within the Ministry of Health, the founder of private practice registers in the form of an entrepreneur before the Business Registers Agency and is entered in the register of entrepreneurs, so the day of entry in the register is considered as the day of the beginning of conducting activities.

The Law prescribes, and the Rulebook on detailed conditions for performing health care activities in health care institutions and other forms of health care service (“Official Gazette of RS”, No. 43/2006, 112/2009, 50/2010, 79/2011, 10/2012 – other ordinance, 119/2012 – other ordinance, 22/2013 and 16/2018” “the Rulebook”), for each form of private practice elaborates in detail the requirements regarding:

1) Prescribed types and number of health workers with acquired appropriate higher or secondary education, with a license of the competent chamber, and for performing certain tasks and with appropriate specialization or sub-specialization, in employment for an indefinite period of time;

2) Prescribed diagnostic, therapeutic and other equipment for safe and modern performance of health activities for which the private practice is established;

3) Prescribed premises for performing health care activities for which a private practice has been established;

4) Prescribed types and quantities of medicines and medical devices necessary for performing the health activity for which the private practice is established.

Obtaining consent for performing health activities

After providing all the prescribed conditions for the work of a private practice (in terms of staff, space, equipment and medicines primarily), the founder addresses the Ministry of Health, Sector for Inspection Affairs, Health Inspection Department with a request to assess the fulfillment of conditions for health activities. The request is attached on the prescribed form.

The documentation that is attached to the Request for determining the conditions for performing health activities by the health inspector is as follows:

1) Identity card of the founder – copy and original for inspection;

2) Medical certificate of general health

3) Proof of education of the founder – a photocopy of the diploma of the graduated faculty or school of health care and a certificate of passing the professional or specialist exam (original documents for inspection);

4) License of the competent chamber of health workers (photocopy, with original for inspection);

5) Proof of employment status (certificate of the National Employment Service or the Republic Pension and Disability Insurance Fund that no insurance contributions are paid for the founder);

6) For a health worker, an old-age pension beneficiary – a decision on pension and a certificate from the Republic Pension and Disability Insurance Fund that the founder (and the required staff) are not paid insurance contributions;

7) Certificate of the competent court for the founder that he has not been convicted of an intentional criminal offense to one year or more imprisonment, or to imprisonment for a criminal offense against human health, until the conviction is deleted in accordance with the relevant law, that a final court decision did not impose a security measure in accordance with the Criminal Code, namely: compulsory psychiatric treatment and custody in a health institution, compulsory psychiatric treatment at liberty, compulsory treatment of drug addicts, compulsory treatment of alcoholics, prohibition of calling, activities and duties due to which he cannot perform health activities, that the decision of the competent body of the chamber did not impose one of the disciplinary measures prohibiting the performance of health activities in accordance with the law governing the work of the chambers of health workers, during the imposed safety measure or prohibition measure;

8) Certificate of the competent chamber that the founder has not been imposed by the decision of the competent body of the chamber one of the disciplinary measures prohibiting the performance of health activities;

9) Proof of correctness of the provided prescribed equipment (for new equipment – warranty card, for used – certificate of authorized service technician on correctness of equipment);

10) Proof of the legal basis for the use of space (proof of ownership – excerpt from the list of real estate or lease of space – lease agreement for business premises);

11) Sketch of the space;

12) Proof of payment of appropriate republic administrative fees.

The general deadline for making a decision on the submitted request is 60 days, and the decision on the request is made by the individual health inspector.

After making a decision and issuing consent for performing health activities, the founder of a private practice submits an application to the Business Registers Agency for registration of the founder of a private practice as an entrepreneur.

Finally, it should be noted that the Law and the Rulebook in certain segments are at odds, given that the Law is newer than the Rulebook, and thus created legal gaps that must be filled by adopting a new Rulebook, which according to the latest information is in preparation.