Office of the commissioner for fundamental rights of hungary

The obligation of the state deriving from Article II of the Fundamental Law of Hungary was only partially satisfied in healthcare institutions because different norms apply to workers present in the operating rooms as employees, and to patients receiving healthcare services there – Commissioner for Fundamental Rights Dr. Ákos Kozma concluded in his report.

The Ombudsman gathered information from the press and following the signal of a Member of Parliament, and went on to conduct a comprehensive ex officio inquiry in connection with the existing regulations for health and safety at work in the operating rooms of healthcare institutions (as special places of work) with respect to the air environment figures. He also inquired into which authority has competence to check the implementation of the relevant regulations for health and safety at work, and whether such monitoring is indeed conducted.

In his report on case No. AJB-4849/2021, Dr. Ákos Kozma established that concerning the harmonization of regulations for health and safety at work and those for patient safety, the state has determined the fundamental requirements for safe work without risks to health. These are contained in the Act on Health and Safety at Work, as well as in the (SzCsM-Eüm) Joint Decree of the Ministry of Social and Family Affairs and the Ministry for Health No. 3/2002 (8 February) on the minimum level of occupational safety requirements at workplaces. That provision, however, which is based on the objective institutional protection duties deriving from Article XX of the Fundamental Law, which is laid down in Section 4 of the Act on Health and Safety at Work, and according to which the rules of safe work without risks to health must be determined so as to ensure that their implementation provide appropriate protection not only for employees but also for those staying within the range of the work area and for those using services, as well as the obligation of the state aimed at the provision of safe care to patients, deriving from Article II of the Fundamental Law, were only partially satisfied. The reason for this is that different norms apply to workers present in the operating rooms as employees and to patients receiving healthcare services there.

According to the Commissioner’s position, a possible pragmatic remedy to the regulatory and monitoring shortcomings revealed could be if the professional content laid down in the Chief Medical Officer’s methodological letter on the prevention of surgical site infection appeared on the statutory level (e.g. in a minimum decree) in such a way that it could be checked by a healthcare administrative organ; moreover, if it was specifically determined in legislation on health and safety at work (in consideration of the professional content of the above letter), what environmental limit values should entail the suspension of work.

In order to prevent the future occurrence of the fundamental-rights-related improprieties exposed, and with respect to the system of criteria elaborated in his report, Dr. Ákos Kozma asked the Minister for Human Capacities to consider adding appropriate air-conditioning and ventilation installations to the physical requirements of operating units in ESzCsM Decree No. 60/2003 (20 October) on the professional minimum requirements for the provision of health services. Furthermore, he also proposed that following the assessment of their adequacy, installations capable of ensuring the requirements of safe work without risks to health, and also respecting patient safety should begin their operation. The Ombudsman asked the Minister for Innovation and Technology to consider specifying in legislation on health and safety at work those environmental limit values in the case of which work must be suspended in operating units. He also urged that when monitoring health and safety at work, they pay special attention to checking the temperature of operating rooms, especially in the summer period.

For the report, please click on the following link: AJB-4849/2021.