Violator: Ministry of Health

Violation: Article 3 of the Human Rights Ombudsman Act (ZVarCP) – Principle of good governance

Summary

The Ombudsman found that, since the entry into force of the Healthcare Quality Act, individuals have been unable to access extraordinary quality supervision. This can be attributed to inadequate legislation which abolished the competences of the Medical Chamber of Slovenia while failing to provide an appropriate solution for the period until the Public Agency for Quality in Healthcare becomes fully operational. The Ombudsman concluded that the Ministry of Health violated the principle of good governance and at the same time created legal uncertainty. In doing so, it jeopardised the principle of the rule of law as defined in Article 2 of the Constitution of the Republic of Slovenia. In view of the above, the Ombudsman expected the Ministry of Health to immediately take steps to regulate the issue described.

Details

In 2025, the Human Rights Ombudsman of the Republic of Slovenia (the Ombudsman) examined in detail the issue of the implementation of extraordinary professional supervision or extraordinary quality supervision, i.e. supervision of the professionalism, quality and safety of work at healthcare providers and the obligation to report warning hazardous events.

The Ombudsman addressed this matter as a broader issue of importance for the protection of human rights and fundamental freedoms and for ensuring legal certainty for citizens in the Republic of Slovenia. The issue was also examined on the basis of an initiative received from a complainant who, following the death of a close relative, had been attempting for several months to obtain extraordinary quality supervision, but had been unsuccessful despite contacting a number of authorities, including the Ministry of Health (MZ).

The MZ took more than two months to respond to the complainant. The Ombudsman considered such a lengthy response time unacceptable, particularly in view of the sensitivity of the issue that led the complainant to contact the Ministry. In addition, the Ombudsman assessed the content of the Ministry’s response as inadequate. The response contained a number of misleading explanations, including a referral to regular professional supervision carried out by the Medical Chamber of Slovenia, which is conducted on the basis of the Chamber’s annual programme and does not represent a mechanism of legal protection or a procedure that the complainant could effectively use to address specific allegations concerning the conduct of a healthcare provider.

It should also be emphasised that the MZ did not refer the complainant to the Public Agency for Quality in Healthcare (the Agency), i.e. the body actually competent for carrying out extraordinary quality supervision in healthcare.

In view of the above, the Ombudsman found that the MZ had violated the principle of good governance and recommended that the Ministry ensure that its employees are familiarised with the procedures provided for in the applicable legislative framework regarding the implementation of supervision and that they provide correct and accurate information within appropriate time limits.

During the examination of the initiative and the broader issue of the implementation of extraordinary quality supervision, the Ombudsman also found that there were serious concerns regarding the Agency’s functioning in practice. Although the MZ stated that the Agency had been established and was “operational”, it also explained that the procedure for obtaining the Minister’s consent regarding the manner of conducting quality supervision procedures was still ongoing.

From this information, the Ombudsman understood that the legal basis for carrying out quality supervision had not yet been fully established, which led to the conclusion that extraordinary supervision in individual cases had not been carried out since the entry into force of the Healthcare Quality Act (ZZKZ) on 18 December 2024.

The Ombudsman therefore requested clarifications from the MZ and the Agency regarding the possibilities available to patients and their relatives to request extraordinary quality supervision, specifically which body they may address, within what time frame they may expect the supervision to be carried out, and when the Agency will begin performing quality supervision. The Ombudsman also expected a response regarding the conclusion that extraordinary quality supervision has not been carried out since the entry into force of the ZZKZ, as well as information on the adoption of all legal bases necessary for the Agency’s full operation, particularly when the Minister’s consent would be granted and the relevant regulations adopted.

From the MZ’s response, the Ombudsman understood that, despite previous assurances, the Agency was in fact not yet operational and will begin operating once all the conditions for its full functioning are fulfilled. These include the establishment of IT support, the organisational structure and the strengthening of staffing capacities, which are currently underway. The MZ also informed the Ombudsman that the regulations necessary for the Agency’s operation are still being prepared and that, until they are adopted and published, the implementation of quality supervision will not be possible. The Ombudsman also raised the issue of the Agency’s functioning at a meeting with the Minister of Health in November 2025, at which the Ombudsman received assurances that the Agency was operational and that individuals could address it in relation to requests for quality supervision.

The Ombudsman welcomed these assurances. However, in light of publicly available information indicating that the necessary regulations had not yet been adopted and that quality supervision could therefore not be carried out, the Ombudsman had reasonable doubts as to whether the Agency was in fact fully operational. Nevertheless, taking into account the assurances received at the meeting, the Ombudsman referred the complainant to the Agency in good faith, expecting that her request for extraordinary quality supervision would be examined in accordance with the applicable legal framework and, above all, that the complainant’s request would not be rejected due to the Agency’s actual lack of operational capacity. The Ombudsman is still awaiting information on how the complainant’s request was handled.

In view of the above, the Ombudsman found that individuals have been unable to access extraordinary quality supervision since the entry into force of the ZZKZ. This situation can be attributed to inadequate legislation which abolished the competences of the Medical Chamber while failing to provide an appropriate solution for the period until the Agency becomes fully operational.

The Ombudsman therefore concluded that the MZ violated the principle of good governance and at the same time created legal uncertainty, thereby jeopardising the principle of the rule of law (Article 2 of the Constitution of the Republic of Slovenia). In view of the above, the Ombudsman expected the MZ to immediately take steps to regulate the issue described.

The MZ expressed its commitment to ensuring legal certainty and the effective functioning of quality supervision mechanisms in healthcare. However, it did not confirm the de facto functioning of the Agency. On the contrary, it explained that the relevant regulations enabling the effective functioning of this body have not yet been adopted, which is contrary to the assurances received by the Ombudsman at the meeting. 9.4-49/2025