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all of the directors as soon as practicable and return the governance functions to the board of
directors. The exercise of powers under this section shall be by notice in writing to the board of
directors and the notice shall be tabled in the Kosovo Assembly for information.
50.25 The Ministry of Health shall publish on its website all service agreements and contracts in their
entirety, with all health service providers, within 10 days of concluding the service agreements and
contracts.
The transition provisions need to allow of gradual implementation of new structures and requirements.
Consequential amendments
There will be consequential amendments required including the Public Finance Act to deal with the
new class of Health Sector Public Enterprises.
Other changes to the Health Law
Suitable transition provisions should be put in the Health Law. Some of the suggestions above take
time to implement and require capability to be developed.
The provisions drafted above do not provide for the role of the Health Insurance Fund at this stage as
that can be provided for later when its role is clearer.
This note has focused on the provisions relating to setting up Health Sector Public Enterprises and
has not considered other aspects of the Health Law that may need to be refined. Some areas
include:
The intention of the Working Committee to split the Kosovo Clinical Centre into three separate
autonomous clinics (section 75). They would need a clear organisational status with a
governance and accountability framework with clear roles and responsibilities which is
unclear from the current draft.
The Health Law is not clear enough about the role of the Ministry of Health in policy, strategy,
and monitoring in primary care and other sectors and the proposed changes to the law does
not improve this situation.
Primary health care centres appear to be expanding into secondary care under the proposed
changes to section 29. Has this been carefully assessed to ensure it is likely to improve the
efficiency and effectiveness of service?
The Working Group discussed the issues relating to public and private practice including
various proposals to deal with the current conflicts of interest. It is suggested that the
conflicts of interest be assessed in detail and various possible solutions to dealing with them
be considered. Some may require changes to laws but some will have contract, managerial,
information provision, monitoring, auditing and other solutions.
The Working Group has suggested a 2010 date for commencing the Health Insurance Fund‟s
operations. This appears a highly unlikely target date.
A suggested change to the Health Law involves exempting a large group of people from copayments.
Co-payments can be very useful in modifying behaviour and should not be
excluded in such a broad way. For example higher copayments for casual visits for
treatments in secondary care can be set at a higher level than copayments for the treatment
in primary care.
There is a proposed provision that uninsured people will pay for services at “economic
prices.” What does this mean? It would be better to simply say they will pay and not to put
other requirements in the law (like economic price). The Ministry of Health and providers will
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