On March 28, 2006, CSD organized a public discussion devoted to the incorporation in the Constitution of the ombudsman institution as well as to the specialized ombudsmen in Bulgaria. Representatives of the National Ombudsman Office, the Public Mediator of the Sofia Municipality and his deputy, NGO representatives, experts and media attended the discussion.
In her opening speech, Dr. Maria Yordanova, Director of the CSD Law Program underlined the yearlong efforts of CSD for popularizing the ombudsman institution in Bulgaria, for the legislative regulation of the ombudsman, and, subsequently, the incorporation of the institution in the Constitution and, recently, for studying the possibilities for establishing specialized institutions for citizens’ rights protection.
Ms. Dragomira Paunova, Project Assistant at CSD Law Program, presented the activities of CSD in researching the possibilities for establishing the institution of the health ombudsman in Bulgaria and the two options being discussed: the establishment of a special healthcare ombudsman (on a national level or at each medical establishment) or the institution of a specialized unit within the office of the national ombudsman. She pointed out that at the current stage in the development of the institution in Bulgaria, the internal specialization within the office of the National Ombudsman is the recommended option. The office of the national ombudsman, being a recognized institution already, disposes of the necessary capacity to act successfully in this area.
Ms. Rossitsa Totkova, Director of Quality of Life and Development Department at the national ombudsman’s office, acquainted the participants with the general work of the institution and especially her department for the protection of the human rights, including in the area of the healthcare. She expressed her opinion that the introduction of control over the healthcare field is of great importance for each citizen. According to her, the efforts in the current situation shall be focused on further strengthening of the national ombudsman as an institution being now in the initial stage of its development. She pointed that the experts of the office of the national ombudsman not only examine each individual complaint but also, knowing that many people are affected by ill practices, are trying to outline the emerging common problems.
Ms. Totkova underlined the efforts to maintain the fundamental principles in the work of the National Ombudsman – independence and transparency. As successful steps in this direction, she pointed out the signing of a protocol for cooperation with the parliamentary Combating Corruption Committee, the provided opportunity for the ombudsman to visit and protect the rights of the persons detained in prison, the creation of public committees to discuss important social issues (such a committee was established for cooperation with the employers’ organizations). Regarding the transparency, she said that the first annual report of the national ombudsman is being prepared and will be presented soon to the National Assembly. The electronic public register of the complaints is almost ready and the citizens will be able to follow through it the progress of the complaints they have submitted to the ombudsman.
Special attention was given to the possibility permitted by the current legal framework for the local administration to interfere with the work of the local public mediators. This practice goes against the fundamental principle of independence in the work of such institutions. According to Ms. Totkova, this undermines the efficient protection of the citizens’ rights and a more detailed regulation of the activities of the local public mediators by the Law on Local Self-Government and Local Administration or by other means is required.
Regarding the question pro or contra the introduction of a healthcare ombudsman Ms. Totkova pointed out that the citizens are in great need of protection of their rights to access quality medical services. She said that the question whether this protection shall be provided by the office of the national ombudsman or by a specialized institution has to be carefully examined. The problems within the field of healthcare are significant, but the fragmentation of a newly born institution is not quite likely to lead to their resolution. She also indicated the problems created by the provisions of the Law on the Health Insurance which puts citizens in unequal position and identical problems are resolved in different way, the situation being the hardest in smaller or distant town and villages. There are no criteria for efficient assessment of the quantity and the quality of the medical services provided. In her statement she also mentioned the problems in the work of the territorial expert medical commissions. The willingness to develop the capacity of the national ombudsman to examine complaints concerning the healthcare, was expressed, including the establishment of a specialized structure or team along with or within the framework of the three departments already existing, namely “Quality of Life and Development” which examines complaints related to the healthcare and the children; “Administration and Administrative and Public Services”; and “Fundamental Rights and Freedoms”.
In her statement Prof. Nora Ananieva, Head of the Public Legal Studies Department at the Varna Free University, supported the Ms. Totkova’s view and added that she does not question the need of the creation of specialized ombudsmen, such as the healthcare ombudsman, but the problem is what would be the source of authority of such an ombudsman. Similar is the case of the local public mediators as well as the provisions of the two draft laws on the rights and the obligations of the patients, where the source of authority is “internal” and the independence of those institutions may be easily compromised. Concerning the upcoming amendments of the Constitution, Ms. Ananieva expressed her favorable opinion on the opportunity given to the national ombudsman to refer a matter to the Constitutional Court, which would make up to a high extent for the lack of individual constitutional complaint in Bulgaria. Even though the amendments do not include the right of the ombudsman to initiate bills, she pointed out that he will be able to count on every Member of Parliament’s right to initiate bills. This possibility may be applied in cases where from individual complaints and researches conducted by the ombudsman, a problem which requires legislative solution can be singled out, e. g., currently such an issue is the donation of human organs.
Mr. Dimitar Markov, Project Coordinator of the Law Program of the Center for the Study of Democracy, presented the upcoming constitutional amendments related to the ombudsman institution. Even though those amendments are belated and insufficient, Mr. Markov explained that they will guarantee the independence of the institution. He also acquainted the participants with the CSD proposals for constitutional amendments, which include three main groups of amendments: aimed at guaranteeing the stability and independence of the institution; aimed at introducing specific powers which cannot be provided for by a regular law; and strengthening the institution of the local public mediator and its interaction with the national ombudsman.
According to Mr. Angel Stefanov, Sofia municipality public mediator, before broadening the area of activity of the ombudsman, the powers of the institution shall be increased. According to him, the professionalism of the administration and the legal culture of the citizens are crucial to the activity of an ombudsman.
Ms. Valentina Taneva, Sofia municipality deputy public mediator, explained that almost every complaint is related to social and healthcare problems. The office of the Sofia municipality public mediator has approached the Minister of Economy and Energy, Mr. Rumen Ovcharov and Ms. Emilia Maslarova, Minister of Labor and Social Policy with proposals for reform concerning the system of territorial expert medical commissions and the National Expert Medical Commission; the proposals are aimed at creating a uniform register and the centralization of the commissions’ activity. According to Ms. Totkova, the parliament must appoint a deputy national ombudsman, dealing with healthcare issues.
Answering the question of Ms. Radiona Nikova from the Child Protection Agency whether complaints related child protection issues have been submitted to the national ombudsman, Ms. Rossitsa Totkova explained that there are such complaints with the major issue concerned being child-parent relations. The office of the national ombudsman is preparing a public discussion on different problems in connection with child protection and family environment issues. She underlined the work of the ombudsman to unite the efforts of the institutions and the civil society for solving the problems. Special attention was given to the active cooperation with the Center for the Study of Democracy and the provided by CSD expert opinions and publications.
The last publication of the CSD “The Health Ombudsman - Best Practice and Prospects for Bulgaria” was also presented and disseminated among the participants of the discussion. The publication contains an overview of the good practices and the experience in the United Kingdom, Australia, Switzerland and Israel. The edition includes also a detailed summary of a discussion in relation with two draft laws concerning the institution of the health ombudsman and the comments and the recommendations on them of the experts of the Center for the Study of Democracy.