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Obzretie sa za súborom diskusií UNIVERSITATIS DISPUTATIONE 2012


 | 18.12.2012 | komentárov: 309

Komora pre medicínske právo MEDIUS realizovala od 23.10.2012 až do 5.12.2012 unikátny projekt UNIVERSITATIS DISPUTATIONE 2012. Pozostával z diskusií, ktoré boli rozdelené do tematických okruhov: 1. diskusia – Bolo by možné liečiť bez liekov? 2. diskusia – Je najlepší liek lacný liek? Kvalita vs. obmedzenosť zdrojov. 3. diskusia – Môže byť reklama liekom pre liek? 4. diskusia – „Čo ťa nezabije, to ťa posilní“ – Platí to aj v zdravotníctve?

Obrazok V rámci prvej diskusie sa naši ctení diskutéri, ktorými boli doc. ThDr. Ing. Inocent-Mária V. Szaniszló, Ph.D., ďalej výkonný riaditeľ v Slovenskej asociácii farmaceutických spoločností orientovaných na výskum a vývoj (SAFS) Ing. Bc. Štefan Mesároš, PhD., vedúci oddelenia pre vonkajšie vzťahy firmy Novartis MUDr. Igor Novák, MPH., vedúci sekcie a zástupca riaditeľa v Štátnom ústave pre kontrolu liečiv MUDr. Pavol Gibala, CSc. a právnik a vedúci Odboru právneho, personalista a člen vedenia spoločnosti Nemocnica Košice-Šaca a.s.1. súkromná nemocnica JUDr. Dušan Podolský.
Celá diskusia prebiehala v príjemnej a otvorenej atmosfére, ktorú umocnili diskutéri svojimi odbornými znalosťami o ktoré sa podelili s publikom.

Druhá diskusia sa odohrávala taktiež vo výbornej atmosfére, hostia z publika sa intenzívne zapájali do debaty diskutérov, ktorými boli bývalý minister zdravotníctva a v súčasnosti poslanec NRSR MUDr. Ivan Uhliarik, zakladateľka Spoločnosti Parkinson Slovensko Zuzana Michálková, zakladateľ občianskeho združenia Slovenský pacient Ing. arch. Radoslav Herda, prednosta Ústavu patologickej fyziológie LF UPJŠ Košice prof. MUDr. Oliver Rácz, CSc. a predstaviteľ Právnickej fakulty z Katedry Ústavného a správneho práva UPJŠ v Košiciach JUDr. Štefan Kseňák, PhD.
Téma bola naozaj veľmi pútavá a zaujímavá pre každého z prítomných hostí, keďže sa diskutovalo o doplatkoch v rámci zdravotnej starostlivosti. V tomto smere sa JUDr. Kseňák vyjadril, že pokiaľ ide o doplatky,  aj  z rozhodovacej praxe Ústavných súdov vyplýva, že právo na zdravotnú starostlivosť nemožno vykladať ako právo na absolútne bezplatnú starostlivosť.  Zástupkyňa pacientskej organizácie Zuzana Michálková nám priblížila postavenie pacientov trpiacich chronickou chorobou, ktorá je pre nich radikálnou zmenou života. Poslanec NRSR Ivan Uhliarik ako ďalší rečník vyjadril názor, že „aj najlacnejší liek je zbytočný, ak ho pacient neužíva“, preto by sa malo predchádzať predovšetkým zbytočnému predpisovaniu liekov a ich plytvaniu. To rozprúdilo živú diskusiu publika, v rámci ktorej zástupca Kardioklubu Košice vyjadril názor, že vyhadzovanie liekov nie je bežné najmä v prípade chronicky chorých pacientov, ktorí sú na liečbu liekmi odkázaní.  Pokiaľ ide cenu kvalitných liekov, z pohľadu pána MUDr. Uhliarika je takýto liek nadštandard, za ktorý má pacient zaplatiť, pretože z verejného poistenia nie je možné hradiť úplne všetko.
Diskusia plynulo prešla ďalšími otázkami a najmä otázka zapojenia pacientov do procesu kategorizácie liekov poukázala na rozdielne názory najmä medzi MUDr. Ivanom Uhliarikom a zástupcom pacientov Ing. arch. Radoslavom Herdom. Ak podľa názoru pána poslanca Uhliarika je zásada verejnosti dostatočne zabezpečená, tak Ing. arch. Herda by bol za účasť predstaviteľov pacientov v Komisii. Túto časť diskusie uzavrel profesor Rácz, podľa jeho názoru by mala byť úlohou Komisie efektivita, nie dosiahnutie čo najnižších doplatkov.
Ako ste si mohli prečítať, diskutéri sa snažili zodpovedať  aktuálne témy a publikum sa aj vďaka svojej aktivite pri kladení otázok dozvedela mnoho.

Dva týždne na to nasledovala tretia diskusia, v rámci ktorej pozvanie prijali ďalší významní hostia, akými boli advokátka, zakladajúca členka Národného centra práva duševného vlastníctva a odborná asistentka na Katedre občianskeho práva JUDr.Renáta Bačárová, PhD., LL.M., šéfredaktor a zakladateľ najčítanejšieho a najstaršieho slovenského špecializovaného filmového portálu Kinema.sk Mgr. Peter Konečný, zástupkyňa Štátneho ústavu pre kontrolu liečiv, Mgr. Eva Siminská, ktorá sa venuje dozoru nad reklamou liekov a ďalším právnym otázkam týkajúcich sa klinického skúšania liekov, sprístupňovania informácií, registrovania liekov, dohľadu nad zdravotníckymi pomôckami a správnej lekárskej praxe a zástupkyňa generálneho riaditeľa farmaceutickej spoločnosti MUDr. Zuzana Barlíková.
Diskusia sa niesla v uvoľnenom prostredí a JUDr. Bačárová priblížila a vysvetlila publiku pojmy, ako reklamné preháňanie, možnosť udelenia nútenej licencie, či klamlivá reklama. Taktiež sa hostia dozvedeli od Mgr. Siminskej, že reklamu liekov upravuje Zákon o reklame, avšak MUDr. Barlíková zo svojej praxe poukázala na skutočnosť, že tento zákon neupravuje reklamu na zdravotné pomôcky. Prostredníctvom dataprojekcie pán Mgr. Konečný prezentoval reklamy na lieky z rôznych krajín, pričom komentoval spoločne s ostatnými diskutujúcimi ich kvalitu a nápaditosť, vďaka čomu publikum pochopilo, že na lieky sa preferuje skôr funkčná, než kreatívna reklama
Diskusia pokračovala a rozobralo sa aj používanie názvu lieku v reklame, v rámci tejto otázky odborníci – diskutéri upozornili, že je potrebné rozlišovať reklamu pre laika a reklamu pre odborníka. Diskutéri spomenuli niekoľko príkladov z praxe v súvislosti s touto témou, na základe ktorých poslucháčom ozrejmili tieto rozdiely, ako aj určitý precedens v spojitosti s článkom, v ktorom bol spomenutý názov lieku.
Hostí z publika zaujímala otázka, či by niektoré reklamy na lieky nemali byť zakázané. Nielen pán Mgr. Konečný má problém pri animovaných reklamách na lieky pre deti.
Medzi ďalšími otázkami z publika zarezonoval dotaz, ako je to s povinnosťou registrovať reklamu na ŠUKL. To zodpovedala jednak pani Mgr. Siminská, tak aj JUDr. Bačárová tak, že nie je možné fyzické vzorky prekontrolovať, ale ŠUKL si ich má právo vyžiadať, zodpovednosť má prebrať subjekt, ktorý reklamu dáva do obehu na základe zásady neznalosť zákona neospravedlňuje.
Diskusia strhla poslucháčov k aktívnemu dotazovaniu, na ktoré diskutéri radi a vyčerpávajúco odpovedali.

Nakoniec nasledovala štvrtá, posledná diskusia, v rámci ktorej boli diskutérmi riaditeľ Nemocnice – Šaca a.s. 1. súkromná nemocnica MUDr. Vančík, CSc., prvý prodekan a prodekan pre spoluprácu s praxou na FaF UK doc. PharmDr. Ján Klimas, PhD., 1. viceprezident Slovenskej lekárnickej komory PharmDr. Ondrej Súkeľ a advokát, partner advokátskej kancelárie h&h Partners JUDr. Ivan Humeník, CSc.
Diskutéri sa pozastavili nad skutočnosťou, že na Slovensku sú lekárnici degradovaní len na odovzdanie liečiva, lieku pacientovi a chýba akákoľvek lekárenská starostlivosť bežná zo severských štátov. MUDr. Juraj Vančík, PhD. poukázal na trend, podľa ktorého napr. v USA budú mať pre chronické choroby manažérov, ktorí budú manažovať, ako a kedy má chronický pacient liek užívať a na Slovensku urobili z lekárnikov „predajcov“. Slovensko má k dispozícii vysokoškolsky vzdelaných lekárnikov a boli degradovaní na úroveň predajcov liekov
Diskusia sa rozprúdila hneď v úvode, v rámci ktorého JUDr. Humeník otvoril tému náhrady škody, zodpovednosti v zdravotníctve. Ako pán advokát zhrnul, ak lekár použije liek a vznikne nejaká škoda na zdraví pacienta, ktorá vzniknúť nemala, nastupuje zodpovednosť lekára, príp. lekárnika za škodu. V tomto mu oponoval MUDr. Vančík, CSc., podľa jeho názoru nemôže byť lekár zodpovedný, keďže neporušil žiadny profesionálny aspekt. Ani pán prodekan s týmto názorom sa nestotožnil, pretože pacient bol upozornený v informovanom súhlase o možnosti, že sa pri užití lieku môžu vyskytnúť nežiaduce účinky.
Diskutéri pri zodpovedaní otázky financovania zdravotníctva poukázali na fakt, že zdravotná starostlivosť je vysoko nákladná a pacient bude musieť byť viac stiahnutý do financovania zdravotníctva a odvody nebudú môcť pokrývať všetko. Ako publiku predniesol doc. PharmDr. Ján Klimas, PhD., všetky legislatívne zmeny majú svoj účinok. Tým prirodzeným je terapeutický účinok, t.j. odstránenie problému a všetky ostatné účinky sú nežiaduce. Taktiež sa diskutovalo aj o princípoch, ktoré vládnu v zdravotníctve a ako bolo povedané, vládne v zdravotníctve len princíp zisku napriek tomu, že každý štát má regulačné mechanizmy na oddelenie princípu zisku a sociálneho princípu, ktorým je vyliečiť pacienta a zabezpečiť zdravotnú starostlivosť.
Aj táto, posledná diskusia bola plná otázok, ktoré diskutéri zodpovedali a  s hosťami z publika rozoberali otázky, ktoré v diskusii odzneli aj po jej ukončení.

Chceli by poďakovať generálnemu partnerovi projektu, ktorým bola Slovenská asociácia farmaceutických spoločností orientovaných na výskum a vývoj (SAFS), bez ich pomoci a kladného postoja k tejto akcii by sme nemohli tento projekt tak úspešne realizovať.
Taktiež naše hlboké ďakujeme patrí partnerovi Nadácia Tatra banky, odborným partnerom Univerzitná nemocnica L. Paustera Košice, Právnická fakulta UPJŠ, Lekárska fakulta UPJŠ a zároveň chceme poďakovať primátorovi mesta Košice MUDr. Richardovi Rašimu, PhD., MPH., ktorý prevzal záštitu nad týmto projektom.

Ako ste sa mohli dozvedieť, projekt UNIVERSITATIS DISPUTATIONE 2012 určite nesklamal a svojou odbornosťou, uvoľnenou a príjemnou atmosférou a záujmom mladých, v budúcnosti úspešných lekárov či právnikov nás príjemne prekvapil, potešil a naštartoval nás do ďalších úspešných projektov, na ktoré Vás už teraz srdečne pozývame, a to už najbližšie na konferenciu Aké princípy vládnu zdravotníctvu? v apríli 2013. Pre bližšie informácie navštívte stránku www.konferencia.medius.sk




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