The government has proposed amendments to the Anti-Corruption Act, including an exception to procedural restrictions for doctors. Under the proposed law, doctors would in future also be allowed to treat relatives.
Although the Anti-Corruption Act failed to pass the Riigikogu on its first attempt and sparked extensive debate over provisions concerning procedural restrictions, the bill is now returning for reconsideration.
According to a 2024 report by the University of Tartu’s RAKE Center for Applied Social Sciences, doctors were the professionals most frequently reported by Estonian residents as having requested bribes. However, the study found that only 2 percent of residents and 3 percent of business owners surveyed said they had been asked for a bribe.
The definition of a doctor in the Anti-Corruption Act currently under discussion remains somewhat ambiguous. In some cases, healthcare workers are considered public officials under the law, while in others they are treated as private individuals.
With the new legislation, the government wants to create an exception for healthcare workers regarding violations of procedural restrictions.
Justice Minister Liisa Pakosta (Eesti 200) said that under the current law, procedural restriction violations can arise in situations where society generally does not consider anything improper to have occurred.
“The purpose of the amendment is to avoid situations where doctors, in the course of their ordinary medical work, are completely unjustifiably subjected to the Anti-Corruption Act,” Pakosta said, referring to the section of the bill concerning healthcare workers.
Under the current rules, doctors are considered public officials when issuing sick leave certificates, determining incapacity for work, writing prescriptions or referring patients for examinations. The same conditions apply to physiotherapists, clinical psychologists and speech therapists when they provide treatment and are registered in the healthcare management information system.
A medical professional at work. Source: Ken Mürk/ERR
The new law would also make it easier for doctors to treat their relatives.
“Put simply, a family doctor could also treat their own child living in the same area, rather than the child having to travel to another city,” Pakosta explained.
Until now, the main source of confusion in the law has been where the line is drawn between a doctor acting as a public official and as a private individual.
“The exception does not extend to all activities carried out by doctors. For example, when issuing various certificates that are not directly necessary for treating an illness, injury or poisoning or when participating in a public procurement committee, a doctor would still be considered a public official,” Pakosta said.
Estonian Medical Association has been after the change for years
Tallinn Deputy Mayor Riina Solman (Isamaa) recently drew media attention over receiving expedited medical care after a receptionist at the city-owned East Tallinn Central Hospital recognized her. Solman later wrote on social media that she received faster treatment because she was “not an insignificant person.” She later deleted the post.
According to Heli Paluste, a healthcare network expert at the Ministry of Social Affairs, it is difficult to draw broad conclusions based on individual cases.
“Legislation clearly states that the timing of a patient’s appointment must primarily depend on the seriousness of their medical condition. Waiting lists are permitted only if immediate care cannot be provided and postponement will not worsen the patient’s condition, the course of the illness or the prognosis. Therefore, even an apparently ‘faster’ appointment may be due to medical necessity rather than personal connections,” she explained.
Under the code of ethics approved by the Estonian Medical Association, doctors are required to follow eight ethical principles. The fourth principle states that doctors must treat all patients equally, without being influenced by religious, national, social or political factors.
Doctor’s stethoscope next to a laptop. Photo is illustrative. Source: National Cancer Institute/Unsplash
According to Katrin Rehemaa, executive director of the Estonian Medical Association, the new law would simply make doctors’ work less burdensome.
“Doctors do not have time during appointments to determine whether a patient is a related person with whom treating them could inadvertently result in breaking the law. Patients, meanwhile, are not always able to find another family doctor or specialist,” Rehemaa explained.
The association already appealed to the Riigikogu in 2019 regarding the rules on violations of procedural restrictions. In its letter, it emphasized the same point Rehemaa reiterated to ERR now: although no healthcare worker in Estonia has ended up in court for treating a relative, nobody wants to be the first.
“So it is still not permitted to move someone ahead in the treatment queue because of personal connections and doctors must continue to comply with procedural restrictions in matters such as public procurements,” Rehemaa said.
In addition to doctors, the government also wants to create exceptions to procedural restriction violations for researchers and lawyers under the proposed law.
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