Vastuu terveyden- ja sairaanhoidon johtamisesta julkisessa terveydenhuollossa ja vastaavan lääkärin asema
Avainsanat:
terveyspalvelut, järjestäminen, lääkärit, toimivalta, virkavastuuAbstrakti
Responsibility for the oversight of health and medical care within public health care and the position of the physician-in-charge
Section 57 of the Finnish Health Care Act stipulates that there must be a physician-in-charge in every public health care unit. The duty of the physician-in-charge is to lead and supervise the health and medical care in the health care unit, i.e. the content of health care services. The physician-in-charge works alongside the organisation’s official bodies and public officials, and the management structure of public healthcare thus forms a matrix based on law. The management tasks of the health care organisation must be arranged in such a way that they do not obstruct the physician-in-charge in performing their statutory duties. The responsible physician’s official authority must be understood as a directive power existing alongside the organisation’s administrative management system. In practice, the physician-in-charge does not manage individual health care professionals but gives binding directives to all professionals regarding treatment methods and processes.
In addition to the authority based on the Health Care Act, the physician-in-charge may have delegated authority based on the Wellbeing Services County Act. The basis of jurisdiction affects the appealability of the decisions made by the physician-in-charge and should be considered in the appeal instructions related to the decisions. As a rule, decisions based on the Health Care Act are not subject to appeal, but decisions based on the Wellbeing Services County Act can be appealed.
The position of the physician-in-charge forms one element in the legislation securing adequate health services, based on Constitution Act § 19.3. Since the provision of health services is ultimately based on the treatment decisions made by physicians and the physician’s autonomy, the organisation of health services cannot be left solely to the decision-making of elected officials. Ensuring the equality of treatment also requires the management and supervision of physicians’ decision-making.
