Ministry of Health of the Republic of Latvia
The Ministry of Health of the Republic of Latvia was established on 1 February 2003.
Ministry of Health is the leading government authority in the health sector and it is responsible for public health, health care and pharmacy.
The Ministry of Health develops the national health policy, as well as organizes, coordinates and monitors its implementation. In order to secure execution of these functions the Ministry of Health develops regulations and policy planning documents, evaluates projects developed by other institutions, represents state interests in foreign and international institutions, informs the society about health policies and about the work of other health care institutions, as well as develops and defends national positions in the field of health care in the European Union.
Since June 16, 2016 Minister for Health is Anda Čakša.
The mission and vision of the Ministry of Health
The mission of the Ministry of Health is to improve health of the public, to educate the society on the importance of healthy lifestyle in preservation of health by holding educational events on prevention, by ensuring accessibility of high quality health care for every individual, as well as by continuing the improvement and development of medical education and science.
The vision of the Ministry of health is a governmental institution focused on cooperation and development, with motivated, costumer-oriented experts, who assist patients in receiving the best possible health care services.
Health care system in Latvia is based on the residence principle.
Negative list of benefits – the state pays for all services except those that are excluded from the scope.
Health care benefits are available at the state, municipality and private inpatient and outpatient health care institutions.
A patient should pay a contribution in order to receive health care.
Patient from the state budget and his own co-payments is provided with:
-General practitioner and his team provided health care and preventive visitation once a year;
-Specialist’s provided health care:
- Laboratory analysis and medical manipulations with the family doctor’s or specialist’s referral;
- Health care in the day stationary;
- Home care;
- Assistance of emergency medicine brigade;
- Emergency medical assistance in the hospitals and trauma centres;
- Health care in the emergency medical hospitals by providing more specialists support and necessary examinations;
- Care in the hospitals after treatment phase in the emergency medical hospitals, as well as in cases of exacerbation of chronic diseases;
- Rehabilitation after the treatment phase in the emergency medical hospitals or dynamic surveillance of the medical rehabilitation;
- Reimbursed medicines and medical devices.
The availability of health care services in Latvia is regulated by the Medical Treatment Act. It states that state-funded health care services may be also received by third country nationals with the permanent residence permits in Latvia. It is possible to receive the state-funded health care services only in those medical institutions that have an agreement with the National Health Service (NHS). Information on these medical institutions is available at the Internet site of the NHS. If you wish to check whether a particular medical institution has an agreement with the NHS, we advise you to contact the NHS.
If you have a temporary residence permit in Latvia you and your children are not entitled to the state-funded medical assistance and you will have to pay for these services yourself, using a health insurance policy where possible. If you use your health insurance policy, the costs of the health care services will be compensated according to the insurance conditions of your health insurer.
If you are a spouse of a Latvian citizen or a Latvian non-citizen with a temporary residence permit, you can receive care services for pregnant women and assistance in childbirth free of charge.
Receiving of emergency medical care is available to everyone in situations where the person’s health and life are under a threat. For third country nationals who are staying in Latvia with a temporary residence permit the emergency care is covered by the health insurance policy. The only exception is Ukrainian citizens and pensioners of the Russian Federation who may receive the emergency medical care free of charge under an agreement stipulated in an intergovernmental treaty.
To call for the emergency care in Latvia you have to call 113 or 112. It might be necessary to produce the health insurance policy in order to receive the emergency care therefore it is advisable that you always carry it with you.
PRIMARY HEALTH CARE
The permanent residents of Latvian, including foreigners with permanent residence permits, may enjoy health care services at a lower cost, provided the specialist physician is visited with a referral from the general practitioner. If you have a referral from the general practitioner or another specialist physician you can receive a state-funded consultancy from the specialist physician or diagnostic examination and pay only the patient fee. If you have a temporary residence permit the state does not ensure state-funded health care services for you and you have to cover the full cost of the visit to the specialist yourself or by means of your health insurance.
Registration with a general practitioner is not compulsory because primary health care services may be received from all physicians who provide the primary health care services. If you decide to register with a general practitioner you can do so both at the doctor’s office or at home if the doctor has arrived for a home visit. If you pay for health care services privately or through an insurance company you can choose freely the doctor and the medical institution where to receive health care services. Furthermore, you can also visit a specialist physician at once, without a referral from the general practitioner. The fee for the service in the case of a private visit may differ with different institutions and also for the services provided by different specialists (on average 20 – 60 EUR).
In accordance with Cabinet Regulation No. 1529 “Procedures for Organizing and Financing Health Care”, Article 83 provides primary health care services in the country:
83.1. Rīga (Rīga, Jūrmala, Ādažu county, Babītes county, Baldones county, Carnikavas county, Garkalnes county, Inčukalna county, Krimuldas county, Ķekavas county, Mālpils county, Mārupes county, Olaines county, Ropažu county, Salaspils county, Saulkrastu county, Sējas county, Siguldas county , Stopiņu county );
83.2. Kurzeme (Liepāja, Ventspils, Aizputes county, Alsungas county, Brocēnu county, Dundagas county, Durbes county, Engures county, Grobiņas county, Jaunpils county, Kandavas county, Kuldīgas county, Mērsraga county, Nīcas county, Pāvilostas county, Priekules county, Rojas county, Rucavas county, Saldus county, Skrundas county, Talsu county, Tukuma county, Vaiņodes county, Ventspils county);
83.3. Latgale (Daugavpils, Rēzekne, Aglonas county, Ciblas county, Dagdas county, Daugavpils county, Ilūkstes county , Kārsavas county, Krāslavas county, Līvānu county, Ludzas county, Preiļu county , Rēzeknes county, Riebiņu county, Vārkavas county, Viļānu county, Zilupes county);
83.4. Vidzeme (Valmiera, Alojas county, Alūksnes county, Amatas county , Apes county, Baltinavas county, Balvu county, Beverīnas county, Burtnieku county, Cēsu county, Cesvaines county, Ērgļu county , Gulbenes county, Jaunpiebalgas county, Kocēnu county, Līgatnes county, Limbažu county, Lubānas county, Madonas county, Mazsalacas county, Naukšēnu county, Pārgaujas county, Priekuļu county, Raunas county, Rugāju county, Rūjienas county, Salacgrīvas county, Smiltenes county, Strenču county, Valkas county, Varakļānu county, Vecpiebalgas county, Viļakas county);
83.5. Zemgale (Jelgava, Jēkabpils, Aizkraukles county, Aknīstes county, Auces county, Bauskas county , Dobeles county, Iecavas county, Ikšķiles county, Jaunjelgavas county, Jēkabpils county, Jelgavas county , Kokneses county , Krustpils county, Ķeguma county, Lielvārdes county, Neretas county, Ogres county, Ozolnieku county , Pļaviņu county, Rundāles county , Salas county , Skrīveru county, Tērvetes county, Vecumnieku county, Viesītes county).
State Emergency Medical Service
emergency medical aid – sudden illness or trauma presenting a threat to one’s life. To receive emergency medical aid in Latvia, call 113 or 112!
You can call for emergency medical help by calling the direct emergency number 113 or the European emergency telephone number 112.
When to call 113?
Call 113 immediately in a life threatening emergency. Including, but not limited to:
- loss of consciousness, cramps, no breathing
- serious injury
- severe bleeding
- sudden chest pain
- sudden, severe pain in any part of the body
- sudden weakness and can not feel one side of the body
- significant shortness of breath
Will I have to pay?
In a life threathening situation citizens of Latvia and several other countries are eligible for free emergency medical help provided by SEMS, including:
- citizens of European Union (EU) and Europe Economic Area (EEA) and their children if both personal identification and European Health insurance card (or valid subsitute certificate) are presented
- citizens of Swiss Confederation residing in Latvia due to employement or as self-employed and their family members (must present and ID and a document confirming the person’s relationship with public authority or company registered in Latvia)
- Ukranian citizens and their children (Ukranian ID must be presented)
- Ukranian rezidents and their children (ID and a permanent rezidence permit must be presented)
- persons who have granted a permenant rezidence permit in Latvia (ID and rezidence permit must be presented)
- refugees and their children (document stating a refugee status granted by Latvian Republic must be presented)
- persons with alternative status and their children (a document stating subsidary protection granted by Latvian Republic must be presented)
In case you do not belong to any of the groups mentioned above or can not present the required documentation for any reason at the time of emergency, you will be served a bill for Eur 93,91 (paid using bank transfer within 30 days).
Since we do understand it might be difficult to present the required documentation at the time of emergency, you may appeal to SEMS within 2 weeks after the emergency and present the documentation (alternatively you may send a scanned version to firstname.lastname@example.org)
Primary healthcare – at this level, a patient first meets with a provider of healthcare services. The Ministry of the Interior shall bear the cost of asylum seeker’s primary health care services.
Primary healthcare is provided by family doctors, paediatricians, nurses, assistant doctors, obstetricians and dentists. Together with a certified nurse or certified assistant doctor, a family doctor is able to provide healthcare at the family doctor’s practice or at your place of residence. A person with a temporary residence permit may freely choose what family doctor or specialist they visit.
To register with a family doctor, two copies of an agreement are filled out. If the patient is unhappy with their relationship with the family doctor, they may register with a different family doctor at any time.
Almost all doctors in Latvia are able to provide advice in a foreign language (Russian, English), however, one should check this before signing up at a doctor!
Inpatient residence at a hospital is a paid service.
Healthcare services in Latvia are provided by state, municipal, and private institutions (health centres, clinics, hospitals and doctors’ private practices).
Before you go to a doctor to receive state-covered healthcare services where only the patient’s contribution is paid, you can verify whether a given doctor or healthcare institution provides state-covered treatment by calling the toll-free number 80001234. More detailed information is available on www.vmnvd.gov.lv.
AVAILABILITY OF HEALTHCARE SERVICES
Healthcare services are available in each municipality within Latvia. Secondary healthcare and highly specialised healthcare services are available mainly in major cities
Twenty-four hour emergency assistance is provided by any regional hospital:
Pauls Stradiņš Clinical University Hospital,
Pilsoņu iela 13, Rīga;
Phone number: 67069280 ; http://www.stradini.lv/lv
Rīga East University Hospital,
Gaiļezers Clinic, Hipokrāta iela 2, Rīga;
Daugavpils Regional Hospital,
Vasarnīcu iela 20, Daugavpils;
+371 654 05 252;
Liepāja Regional Hospital,
Slimnīcas iela 25, Liepāja;
+ 371 63403250, 63403255;
Northern Kurzeme Regional Hospital,
Inženieru iela 60, Ventspils;
+371 636 24665;
Jumaras iela 195, Valmiera;
Rūjienas iela 3, Valka;
Valdemāra ielā, Rūjienā.
+ 371 64202603;
Jelgava City Hospital,
Brīvības bulvāris 6, Jelgava;
+ 371 63021802
HEALTH INSURANCE POLICY
The Latvian laws state that foreigners may arrive and stay in Latvia if they have a valid health insurance policy that guarantees coverage of costs related to health care in Latvia. You have to produce your health insurance policy in order to receive the temporary residence permit. The term of validity of the policy should not be shorter that the foreigner’s expected period of stay in Latvia and it should guarantee at least the following health care services:
- emergency medical care;
- treatment of a critical condition that is threatening to life and health at hospital;
- transporting to the nearest medical treatment institution in both of the abovementioned cases;
- transporting to return to the country of origin in the event of a severe illness or death.
Health insurance of a private individual may be a solution for receiving of more advantageous health care services. However, it should be taken into account that different insurance companies may have different insurance conditions and offer different coverage of the costs of health care services. It is possible that health care services that are not covered by one insurer are covered fully or partly by another insurer. Therefore we advise that you contact several insurance companies before purchasing your health insurance policy in order to find the insurance conditions that suit you best. You should also find out at the insurance company what you have to do when you wish to use your policy.
ACQUISITION OF MEDICINES
In ensuring the rights of patients, differential treatment based on a person’s race, ethnic origin, skin colour, gender, age, disability, state of health, religious, political or other persuasion, national or social origin, property or marital status or other circumstances is prohibited. Differential treatment shall include the direct or indirect discrimination of a person, infringement of a person or an implication to discriminate him or her ( Law On the Rights of Patients).
Medicines may be purchased at pharmacies. To buy some medicines, a doctor’s prescription is required, other medicines are sold over the counter. Before taking a medicine, please consult with a doctor or pharmacist (pharmacy employee).
How to behave in a hospital:
What you can or cannot do upon arrival at a hospital is specified in the “Internal Code of Conduct for Hospital Patients”. These rules may vary from hospital to hospital, according to their specifics. The Internal Code of Conduct mainly specifies:
- general rules;
- the procedure for admission to the hospital;
- the treatment process;
- payment types and procedures to be made by the patient;
- rights of the patient;
- responsibilities of the patient;
- hospital hygiene rules;
- hospital patients’ schedule;
- the procedure for visiting hospital patients;
- catering arrangements;
- patient property issues;
- procedures for submission of patient proposals and complaints;
- patient activity restriction aspects.
For the specific Hospital Internal Code of Conduct, see links provided in the previous section.
Duties of Patient
(1) A patient has a duty to take care of his or her health.
(2) If the state of health of the patient allows it, he or she has a duty to become actively involved in medical treatment and to provide the attending physician with information within the limits of his or her abilities and knowledge:
1) which is necessary for ensuring medical treatment;
2) regarding his or her diseases, which may endanger the life or health of other persons;
3) regarding previously provided consents and refusals in relation to medical treatment; and
4) regarding any changes to the state of health, which have occurred during medical treatment.
(3) The internal rules of procedure of a medical treatment institution and the instructions of the medical practitioner are binding to the patient.
(4) When registering in a medical treatment institution or receiving medical treatment, a person shall, upon the request of a medical practitioner, present a personal identification document, except in the case when emergency medical care is provided to the patient and he or she is unable to present such document due to his or her state of health. The patient shall present the personal identification document as soon as it is possible.
(5) A patient has a duty to pay for the received health care services in accordance with the procedures laid down in the laws and regulations regarding the organisation and financing of health care.
(6) When implementing his or her rights, a patient and a person representing the patient has a duty to respect the rights of other patients ( Law On the Rights of Patients).
Right to Information
(1) A patient has the right to information regarding the opportunities for the receipt of health care services and the procedures for the payment for health care services. This information shall be available to the public.
(2) A patient has the right to know the given name, surname, position, profession, specialisation and qualification of attending physicians and other medical practitioners involved in the health care process.
(3) A patient has the right to receive information regarding his or her state of health from the attending physician, including regarding the diagnosis, the plan for medical treatment, examination and rehabilitation of the disease, the prognosis and consequences, the functional restrictions caused by the disease and the opportunities for prophylaxis, as well as the right to receive information after examinations and surgical or other type of invasive intervention performed within the framework of medical treatment regarding the results of the medical treatment, regarding the previously unforeseen outcomes and the reasons thereof.
(4) A patient has also the right to receive information regarding medical treatment from other medical practitioners involved in his or her medical treatment in accordance with their competence.
(5) A patient shall be provided with information in a comprehensible manner, explaining medical terms and taking into account the age, maturity and experience of the patient.
(6) A patient has the right, after medical treatment or termination of any phase thereof (for example, discharge from a medical treatment institution), to receive information regarding the medical services provided to him or her and the justification for the termination of medical treatment, as well as the results of diagnostic examinations and functional assessments (extracts, true copies and copies), instructions and recommendations in relation to further treatment and social services and, if necessary due to the state of health of the patient, to receive a referral to another medical treatment institution for continuation of medical treatment.
(7) Information need not be provided to a patient only in such case if such information or facts are at the disposal of the physician that the receipt of the information significantly threatens the life or health of the patient or other persons.
(8) A patient has the right to refuse the receipt of the information referred to in this Section. He or she shall express his or her refusal thereof in oral or written form or by such actions which unequivocally confirm this ( Law On the Rights of Patients, https://likumi.lv/doc.php?id=203008).
A patient has the right to receive, in a manner that they understand, the doctor’s information, about their diagnosis, examination and treatment plan, and other treatment methods, prognosis and treatment process. A patient may fully or partly refuseoffered examinations or treatment, confirming such refusal with their signature. Complaints regarding the quality of healthcare services may be submitted to the Health Inspectorate (www.vi.gov.lv).
Regardless of their status, all residents of Latvia have access to free doctor’s advice via telephone, provided in Latvian, English and Russian languages. The service is provided by the National Health Service (Nacionālais Veselības dienests, NVD) on business days from 17.00 till 8.00, as well as round the clock on weekends and holidays. To receive this service, call 66016001.
Further information about the healthcare system in Latvia can be obtained from the National Health Service website www.vmnvd.gov.lv, as well as by calling 80001234 on business days from 8.30 till 17.00 or by writing to email@example.com.
The largest children’s all-purpose healthcare facilities in Latvia are in Riga: the Children’s hospital in Tornakalns and Children’s hospital at Gailezers (www.bkus.lv).
Rights of Minor Patients
(1) Medical treatment of a minor patient (up to the age of 14 years) shall be permissible if his or her lawful representative is informed thereof and has given his or her consent. The minor patient has the right to be heard and according to his or her age and maturity to participate in the taking of the decision related to the medical treatment.
(2) Medical treatment of a minor patient (from the age of 14 years) shall be permissible if his or her consent has been received, except that laid down in Section 7, Paragraph eight of this Law.
(3) If a minor patient (from the age of 14 years) refuses to give his or her consent for medical treatment, but to the physician’s mind the medical treatment is in the interests of this patient, the consent for the medical treatment shall be given by the lawful representative of the minor patient.
(4) A minor patient has the right to receive information comprehensible to his or her age and maturity from a medical practitioner.
Consent of the Orphan’s Court
(1) If the lawful representative of a minor patient refuses to give his or her consent for the commencement of medical treatment or if the lawful representatives are unable to agree regarding the commencement of medical treatment, or if the whereabouts of the lawful representative of the minor patient is unknown to the physician, but he or she regards that the commencement of medical treatment is in the interests of this patient, the permission for medical treatment, on the basis of a motivated submission of the physician, may be given by the Orphan’s Court within three working days after receipt of the motivated submission of the physician, except in the case referred to in Paragraph two of this Section.
(2) If the physician considers that immediate commencement of medical treatment is necessary in the interests of the minor patient, but the lawful representative of the patient refuses to give his or her consent or if the lawful representatives are unable to agree regarding the commencement of medical treatment, or if the whereabouts of the lawful representative of the minor patient is unknown to the physician, the decision to commence medical treatment shall be taken by the doctors’ council. The doctors’ council shall inform the Orphan’s Court regarding the decision taken within three working days according to the jurisdiction determined in this Section.
(3) The consent for medical treatment of a minor patient shall be given by the Orphan’s Court of the local government, in the territory of operation of which the place of residence of both parents or guardian of the patient has been declared.
(4) If the place of residence of the parents of a minor patient has been declared in the administrative territories of different local governments, the Orphan’s Court, in the territory of operation of which the place of residence has been declared for the parent with whom the patient is living, shall give the consent for his or her medical treatment.
(5) If the parents or guardian of a minor patient have no declared place of residence, the Orphan’s Court of the local government, in the territory of operation of which the parents or guardian of the patient actually live, shall give consent to his or her medical treatment.
(6) If sole custody of one parent has been established for a minor patient, the consent to his or her medical treatment shall be given by the Orphan’s Court, in the territory of operation of which the place of residence has been declared by the parent in whose sole custody this patient is.
(7) If the parents of a minor patient are not known, or if this patient is a foundling, the consent to his or her medical treatment shall be given by the Orphan’s Court, in the territory of operation of which the respective patient has been found.
( Law On the Rights of Patients, https://likumi.lv/doc.php?id=203008).