site.btaParliament Allows Nurses and Midwives to Run Their Own Practices

Sofia, June 4 (BTA) - The National Assembly allowed doctors'
assistants, nurses, midwives and rehabilitation therapists to
set up a new type of medical treatment establishments. Passing
amendments to the Medical Treatment Establishments Act on second
 reading, the MPs resolved that a medical treatment
establishment can be a stand-alone entity in which medical
specialists provide medical and healthcare services,
manipulations and disease prevention on their own. They can
perform healthcare and medical activities in a patient's home
when the patient's condition requires that.

A group healthcare practice may be run by a commercial
corporation or a cooperative established by doctors' assistants,
 nurses, midwives and/or rehabilitation therapists who have at
least three years' experience in the respective field and are
registered in accordance with Article 40 of the Medical
Treatment Establishments Act. Such registration will be carried
out by the CEO of the Executive Agency for Medical Supervision.

The organization, activities and internal order of group
healthcare practices will be regulated by rules endorsed by the
manager of the respective medical treatment establishment.

The BSP for Bulgaria parliamentary group objected to the
amendments. A controversy broke out among the MPs about how to
regulate the scope of the work of medical specialists and who
should pay them. Health Committee Chair Daniela Daritkova (GERB)
 explained that the amendments will regulate types of services
which are already being provided by nurses, doctors' assistants
and rehabilitation therapists. This will ensure proper control,
she noted.

The National Assembly also resolved that state and municipal
hospitals and cancer centres should apply financial activity
standards which include rules for setting the wages of medical
staff in accordance with the Labour Code.

Furthermore, the approved amendments set administrative
penalties for medical treatment establishments. An establishment
 which delays or fails to provide information to the National
Council on Prices and Reimbursement of Medicinal Products about
a medicine whose therapeutic effect is being monitored, will
incur a pecuniary penalty of 500 to 1,000 leva. A second offence
 will carry a penalty of 1,500 to 3,000 leva. The size of the
penalties depends on whether the offender is a sole proprietor
or a legal entity.

Georgi Mihailov (BSP for Bulgaria) disapproved of a requirement
for the above-mentioned type of information to be provided
within 24 hours. He argued that the information system is still
very cumbersome, which creates a possibility for administrative
manipulation of medical treatment establishments.

The Council of Ministers will be in charge of designating, on a
proposal by the Health Minister, a state-run medical treatment
establishment to provide medical services to officials
travelling domestically or abroad under the National Service for
 Protection Act and leaders of international organizations and
institutions visiting Bulgaria.

The transitional and final provisions of the approved Act
Amending the Medical Treatment Establishments Act also entail
changes to the Transplantation of Organs, Tissues and Cells Act.
 One of the changes consists in expanding the scope of persons
who may express a will to donate, by adding collateral relatives
 up to the fourth degree, including relatives by adoption, but
not earlier than three years after the adoption.

Other provisions regulate swap transplants. Put simply, a swap
transplant is a barter of organs between two families who fail
to find a compatible donor within their own kin.

The Executive Agency for Medical Supervision will exercise
control over the import, export and exchange of organs.

The new legislation further regulates the import of transplant
organs from third countries under agreements signed with
Bulgaria, and organ exchange with EU member states and
Switzerland.

Exporting transplant organs to third countries is allowed when
there are agreements which expressly define the terms and
procedures for export, but only if there is no matching
recipient in the European Union, the European Economic Area or
Switzerland.

The export of tissues and cells, including egg cells, sperm
cells and zygotes (fertilized egg cells), is allowed on
condition that domestic demand for such tissues and cells has
been met and the receiving institution is duly recognized in the
 respective country. RI/RY/VE