Hungary: Whether doctors are obligated to report serious or crime-related injuries; requirements and procedures to obtain medical reports within Hungary, including who can obtain them; whether they can be obtained from abroad, including requirements and procedures [HUN103946.E]

Research Directorate, Immigration and Refugee Board of Canada, Ottawa

This Response to Information Request is being issued to incorporate information received on 29 November 2011 from the Embassy of the Republic of Hungary in Ottawa. It replaces HUN103824.EF of 4 October 2011.

Reporting obligations

In correspondence with the Research Directorate, lawyers from two different law firms in Budapest stated that doctors must notify the police when they have treated a person for crime-related injuries (Attorney at Law 24 Aug. 2011; Lawyer 8 Sept. 2011). According to one of the lawyers, doctors must complete a report and submit it to the police (ibid.). Upon receipt of the report, an appropriate police department or station has to then start an investigation (ibid.). The Hungarian Helsinki Committee (HHC), a non-profit organization that monitors the enforcement of international human rights norms in Hungary, indicates in its correspondence with the Research Directorate that, according to the Act XLVII of 1997 on the Handling and Protection of Medical and Related Personal Data, a doctor "shall immediately report" a patient's personal information (name, gender, place and date of birth, mother's name, place of residence and social security number) to the police if the patient suffered serious bodily harm "presumably as a consequence of a crime" (HHC 25 Sept. 2011). However, HHC notes that Act CLIV of 1997 on Health does not mention the reporting of crimes among the responsibilities of the medical staff (ibid.).

In correspondence with the Research Directorate, an official of the Embassy of the Republic of Hungary in Ottawa indicated that according to the Act on protection and management of medical data, if a patient suffered an injury as a result of a criminal offense and his or her recovery in hospital takes more than eight days, the doctor is obliged to submit a written report, which includes the personal data of the patient, to the police immediately (Hungary 29 Nov.2011). If the report reaches the police while the person is still in hospital, the consent of the patient to transmit the data is not required; however, the patient needs to be informed of it (ibid.). He or she may obtain a photocopy of the report (ibid.).

Concerning injuries resulting from domestic violence, Act LXXII of 2009 Concerning Restraining Orders Applicable Because of Violence Between Related Persons (Ch. II, Sec. 2 (1) and 2 (2)) states that health-care service, [translation] "in particular, district-nurse services, family physicians or family paediatricians," are [translation] "[u]nder a duty to report to an agency responsible for the coordination of family-protection measures if they become aware of a danger of violence between persons" (Hungary 2009).

Obligation to report injuries to minors

A doctor at the Rozsakert Medical Center in Budapest indicated to the Research Directorate during a 8 September 2011 telephone interview that she would only submit a report to the police if the injured person were a minor (under the age of 18) (Rozsakert Medical Center 8 Sept. 2011). The HHC also stated that "doctors have a strong legal obligation to report cases of violence against a minor (under 18) to the police (or to the child protection body in less serious cases)" (HHC 15 Sept. 2011).

Moreover, the HHC indicated that, according to Article 17 of the Child Protection Act (Act XXXI of 1997), "the doctor and the medical staff are members of the (early) warning system in which everybody is obliged to report cases violating or threatening the physical or mental health and well being of a child" (ibid.). However, the HHC noted that "the practice shows several cases of non-fulfillment of the obligation" (ibid.).

Obtaining medical records

The official from the Hungarian embassy said that medical records are to be kept by hospitals and clinics for at least 30 years (Hungary 29 Nov.2011), whereas the doctor said that medical records are kept by hospitals and clinics for 50 years (Rozsakert Medical Center 8 Sept. 2011). The lawyer also noted that "[h]ospitals and clinics are required to keep registration, including documents of all observations, diagnosis, [and] treatments" for an unlimited period of time (Lawyer 8 Sept. 2011).

There are several laws that govern hospital records in Hungary: Act CLIV of 1997 on Health (Hungary 1997; Attorney at Law 24 Aug. 2011); Act XLVII of 1997 on the Handling of Medical and Other Related Data (Hungary n.d.; Lawyer 8 Sept. 2011); and Act LXIII of 1992 on the Protection of Personal Data and the Publicity of Data of Public Interest (Hungary 1992).

According to the Act CLIV of 1997 on Health,

[translation]

  1. [t]he a patient shall have the right to
    1. be informed of the management of the data related to the medical treatment,
    2. become acquainted with the health care data relating to him,
    3. gain access to the medical record and to receive copies thereof at his own expense,
    4. be given a discharge summary upon discharge from the healthcare institution (Section 137),
    5. receive a written summary or abridged opinion of his health data for justified purposes, at his own expense. ...
  1. In the course of health care delivered for his current condition, a patient shall have the right to give written authorization to a person designated by him to inspect the medical record relating to him and to have copies made thereof.
  2. Following the conclusion of the patient's medical treatment, only the person being authorized by the patient in a fully conclusive private deed shall have the right to inspect the medical record and to have a copy made thereof. (Hungary 1997, Sec. 24)

In order to obtain medical records, an individual must contact the hospital or clinic personally or make a formal written request (Lawyer 8 Sept. 2011; HHC 25 Sept. 2011). According to the HHC, if the request is made after the end of the treatment, the patient can grant authority to another person to act on his or her behalf to obtain a copy of the medical records (ibid.). This authorization should be a "handwritten document or a document signed by two witnesses" (ibid.). The official at the Hungarian embassy stated that the authorization should be written in Hungarian (Hungary 29 Nov.2011). There is no specific format for the authorization, but it should include information such as the personal data of the proxy and the subject of the authorization (ibid.). It should be signed by the requestor in the presence of two witnesses (ibid.).

However, according to the lawyer, when a person leaves a hospital or a clinic, he or she is "normally" given "a so-called closing report" (Lawyer 8 Sept. 2011). The HHC also indicates that patients receive a final report at the time of their departure from a hospital (HHC 25 Sept. 2011). There are some instances when patients receive other medical documents, besides the final report (ibid.).

The HHC states that victims of violence can obtain a medical report from any doctor or a hospital (15 Sept. 2011). Moreover, if a "victim of a crime is sent to the hospital by the police, the report is free of charge; otherwise, issuing of the report costs approximately 16 USD" (HHC 15 Sept. 2011).

Without providing further details, the lawyer noted that if the person making the request is outside of the country, he or she may formally grant another person access to the medical records through a local attorney (Lawyer 8 Sept. 2011). The doctor also said that written authorization, which includes personal information, such as date of birth, as well as the signatures of the requester and of the proxy, is required to obtain medical records from abroad (Rozsakert Medical Center 8 Sept. 2011). According to the Hungarian embassy, an individual can formally grant another person access to his or her medical records, but an authorization made abroad will become legally binding in Hungary only if a competent Hungarian authority abroad (an embassy or a consulate) endorses it (Hungary 29 Nov.2011).

This Response was prepared after researching publicly accessible information currently available to the Research Directorate within time constraints. This Response is not, and does not purport to be, conclusive as to the merit of any particular claim for refugee protection. Please find below the list of sources consulted in researching this Information Request.

References

Attorney at Law, Budapest, Hungary. 24 August 2011. Correspondence with the Research Directorate.

Hungary. Embassy of the Republic of Hungary, Ottawa. 13 December 2011. Correspondence with the Research Directorate.

_____. Embassy of the Republic of Hungary, Ottawa. 29 November 2011. Correspondence with the Research Directorate.

_____. 2009. Act LXXII of 2009 Concerning Restraining Orders Applicable Because of Violence Between Related Persons. (Harvard University) Translation by the Translation Bureau, Public Works and Government Services Canada. <http://www.hsph.harvard.edu/population/domesticviolence/hungary.domviolence.09.mht> [Accessed 31 Aug. 2011]

_____. 1997. Act CLIV of 1997 on Health. (Office of the United Nations High Commissioner for Human Rights) <http://www2.ohchr.org/english/bodies/cescr/docs/E.C.12.HUN.3-Annex10.pdf> [Accessed 5 Sept. 2011]

_____. 1992. Act LXIII of 1992 on the Protection of Personal Data and the Publicity of Data of Public Interest. (United Nations Refworld) <http://www.unhcr.org/refworld/country,LEGAL,,,HUN,,4c34b0352,0.html> [Accessed 8 Sept. 2011]

_____. N.d. Hungarian Parliamentary Commissioner for Data Protection and Freedom of Information. "Relevant Legislation - National Legislation." <http://abiweb.obh.hu/dpc/index.php?menu=gyoker/relevant/national> [Accessed 15 Sept. 2011]

Hungarian Helsinki Committee (HHC). 25 September 2011. Correspondence with the Research Directorate.

_____. 15 September 2011. Correspondence with the Research Directorate.

Lawyer, Budapest, Hungary. 8 September 2011. Correspondence with the Research Directorate.

Rozsakert Medical Center, Budapest, Hungary. 8 September 2011. Telephone interview with a doctor.

Additional Sources Consulted

Oral sources: Attempts to contact representatives at the following organizations were unsuccessful: Hungarian Association for Migrants (Menedék ), the Institute of National Health Reserve, MAV Hospital, Medicover Health Care Center, National Centre for Healthcare Audit and Inspection, National Institute for Health Development, National Institute of Primary Health Care, National Public Health and Medical Officer Service, Office of Authorisation and Administrative Procedures of the Ministry of Health, Social and Family Affairs.

Internet sites, including: Centre for Biomedical Ethics and Law; Embassy of the Republic of Hungary in Ottawa; Embassy of the United States in Budapest; Hungary - Hungarian National Emergency and Ambulance Service, Institute of National Health Reserve, Ministry of Health, National Centre for Healthcare Audit and Inspection, National Institute for Health Development, National Institute of Primary Health Care, National Public Health and Medical Officer Service.