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PharmDr. Ondrej Sukeľ
PharmDr. Ondrej Sukeľ graduated from the Faculty of Pharmacy of the Comenius University in Bratislava in 2001. In 2004 he has acquired specialization in the field of pharmacy at Slovak Medical University. Since 2006 is an healthcare provider in public pharmacy Don Bosco in Humenne.
At the present time he operates as the 1.st vicepresident of the Slovak Chamber of Pharmacists and regional specialist in the field of pharmacy of the county of Prešov. He is a member of the advisory board of expert-informative journal "Lekárenské listy" and regular lecturer of continious education programms. His publishing and lecturing activities are focused on regulation of pharmacist profession and health-care providing, making and application of medical legislation, and questions of professional ethics.
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Analysis of Developments in Pharmaceutical Care Since 1989
The 1989 political system change essentially affected all areas of social relationships. One significant modification of the healthcare system lied in allowing health services to be provided by non-government health facilities, which was accompanied by privatisation of existing facilities.
Section 11 of the former Act No. 20/1966 on the care of people’s health entrusted the competence to provide health services solely to the government. Said Act was amended in September 1991 (Act No. 419/1991), extending the authorisation to provide health services to non-government health facilities and other government health facilities. Terms and conditions of the provision of health services were to be regulated by a special act. Until the adoption of such act, health facilities were allowed to provide care on the basis of a licence obtained from the Ministry of Health, subject to terms and conditions established by the Ministry.
Accordingly, the Ministry of Health issued the Principles of Healthcare Provided by Non-government Health Facilities that stipulated, inter alia, rules for the establishment of the first ever non-government pharmacies in the Slovak Republic. Despite not being an act of general application, the Principles introduced a legal situation whose implications have been deter-mining the creation of pharmaceutical legislation up to the present time.
Legislation regulating pharmaceutical care as part of the general healthcare system should be viewed and assessed from a number of perspectives. The provision of healthcare is an activity involving a significant proportion of information asymmetry, and elimination of its potential negative impact on a client (patient) is the ambition of the defined legislative restrictions and the system of competent authorities. The societal developments since 1989 have resulted in determination of three principal pharmaceutical care regulation areas.
1. The area of qualification requirements for the profession of pharmacist, including definition of professional competences and the different competence levels;
2. The area of conditions for obtaining a licence to provide pharmaceutical care (operate a pharmacy);
3. The area of medical product pricing and regulation of its stages.
Each of the above areas is regulated by an array of pieces of legislation of varying legal force. Their assessment helps to estimate expected trends in the health legislation development. Also, a sufficiently long time has expired since the profound social changes and application of multiple reform methods, which enables evaluation of consequences of the different legislative steps.
The following conclusions can be derived from available data:
1. Slovak pharmaceutical legislation ranks amongst those most liberal within the EU;
2. Since the social changes in 1989, qualification requirements for the profession of pharmacist have been systematically lowered;
3. Control mechanisms for the provision of pharmaceutical care are inadequate;
4. There is in fact no selfregulatory body for healthcare professions;
5. The medical product pricing requires a fundamental reform and separation of the pharmaceutical service rating from the price of a medical product as such;
6. In light of international experience, efforts towards monopolisation of pharmaceutical care can be expected;
7. In order for the system to be effective, the application of so called pharmaceutical care models should be supported by the government and health insurance funds.
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