Recursos Contra esta Decisión

and the order of which they are presented does not have an independent significance for

the substantial nature of these laws and regulations. That the Company may be affected by

amendments to the applicable regulations is indicated in the section “Risk factors”.

Sweden

Procurement acts

In Sweden there are primarily two acts which regulate procurement of private welfare services; the Public Pro- curement Act (Sw. LOU), and the Act on System of Choice (Sw. LOV).

The Public Procurement Act (2007:1091)

The Public Procurement Act, which regulates the major- ity of the public procurements in Sweden, regulates how authorities may act when purchasing goods and services from private companies. Authorities must choose the com- pany that has the best price and/or best fulfils the require- ments set in the tender concerning for example quality. The Act aims to increase the efficient use of public funds, promoting high quality procurement and guaranteeing transparent procurement processes and equal opportuni- ties for companies and other associations to offer their goods and services in public tenders. The principles on non-discrimination, equal treatment, transparency (open- ness and predictability), proportionality and mutual recog- nition, has to be observed by the procuring authorities in all tenders.

The Act (2008:962) on System of Choice

The Act on System of Choice was introduced in 2009 and established a framework for procurement of public ser- vices where the clients themselves may choose their pro- vider among those that the customer (the local authority) has procured. It is up to every local authority to decide if and in what manner the Act on System of Choice is to be implemented and procured. The system of choice is most common within home care but also occurs within nursing homes and care homes and daily activities for people with disabilities. All approved providers must be selectable for those clients that has the possibility of utilising the

service. The act aims to open up parts of the local author- ity’s operations for competition through letting the client choose between providers in the system of choice.

Operational acts

Below follows a general summary of applicable laws and regulations which are of fundamental importance for the conducting of the Company’s operations.

Social Services Act (2001:453, Sw. SoL)

Constitutes the foundation for the whole social services and defines the local authorities obligations within care for older people and care. Regulates the local authorities responsibility towards individuals and aims to free and develop vulnerable individuals’ and groups’ own resources. The operations, conducted within the scope of the law, are to be based on respect for people’s autonomy and integrity. Health and Medical Services Act (1982:763, Sw. HSL)

Regulates activities which aim to medically prevent, investigate and treat illness and injuries which also includes home health care, medical transport and han- dling of deceased people. The act stipulates that the whole population has a right to good health and care on equal terms and that the care must be provided with respect for people’s equal worth and for the individual’s dignity. Act (1993:387) concerning Support and Service for Persons with Certain Functional Impairments (Sw. LSS)

Supplements the Social Services Act and the Health and Medical Services Act and ensures individuals with major and permanent functional impairments support and ser- vice to facilitate their daily life. The overall objective for support and service according to LSS is that the individual shall have the possibility to live in the same way as other people, despite functional impairments.

SWEDEN

Outsourcing agreements under Framework

agreements under

The Public Procurement Act (2007:1091, Sw. LOU)

Health and Medical Services Act

(1982:763, Sw. HSL) Lex Maria

Social Services Act (2001:453, Sw. SOL) Lex Sarah

Lex Sarah

Lex Sarah is the colloquial term for Section 3 Chapter 14 of the Social Services Act, which stipulates that anyone who conducts operations within care for older people or people with disabilities must monitor that they get high quality care and live under safe conditions. The act fur- ther stipulates that an employee that recognises or becomes aware of a serious anomaly in care must immediately report this to the Health and Social Care Inspectorate (Sw. IVO). Lex Maria

Lex Maria is the colloquial term for the obligation to report which follows from Section 5 Chapter 3 of the Patient Safety Act (2010:659). Care providers are according to the Patient Safety Act obligated to systematically work with patient safety concerns and health care professionals are obligated to conduct their duties in accordance with scien- tific research and proven experience. The Patient Safety Act imposes requirements for care providers to report serious injuries which are incurred through care or risk for serious injuries in care to the Health and Social Care Inspectorate, so called Lex Maria reports. Care provid- ers must further inform a patient who has suffered harm within the care that they may report complaints to the Health and Social Care Inspectorate and request com- pensation under the Patient Damages Act or according to the pharmaceutical insurance, if the damage is related to pharmaceuticals. According to the Patient Safety Act, any- one may submit complaints to the Health and Social Care Inspectorate. All complaints are processed and decisions are communicated in writing by the Health and Social Care Inspectorate. A decision by the Health and Social Care Inspectorate may entail that a care provider or the care professionals acts or omissions are in conflict with legislation or other regulations or is inappropriate with respect to patient safety. The obligation to report entails that a care provider is obligated to report to the Health and Social Care Inspectorate if a patient in connection with health care is affected by, or risks being affected by, a serious harm or illness.

Finland

Procurement acts

In Finland, there are mainly two models for procurement of private welfare services; the Public Procurement Act (348/2007) and the Act on Service Vouchers in Social Wel- fare and Health Care Services (569/2009).

The Public Procurement Act (348/2007)

The objective of the act is to enable more efficient use of public funds, promote high quality procurement and guar- antee equal opportunities for companies and other associa- tions to offer goods, services and construction contracts at bidding procedures for public procurement. According to the act, the government, local authorities and other pro- curement units have to invite private service providers to submit tendering bids.

The Act on Service Vouchers in Social Welfare and Health Care Services (569/2009)

The objective of this act is to increase options for clients and patients, improve access to services and to promote collaboration between local authorities’ care and health care, local authorities’ business and private providers by using service vouchers in care and health care services. The act applies to care and health care services organised by local authorities. With the service voucher, the client or patient can choose to seek care and health care from private providers that have been approved by the local authorities.

Operational acts

The Social Welfare Act (1301/2014)

This act applies to local authorities’ care and the objective of this act is to promote and maintain welfare and social security. The act further aims to decrease inequality and promote participation and to secure necessary, sufficient and high quality social services on equal grounds. The act has for the most part replaced the previous Social Welfare

FINLAND

The Primary Health Care Act (66/1972)

The Occupational Health Care Act

(1383/2001) Act on Health Care Professionals (559/1994) The Act on Service Vouchers in Social

Welfare and Health Care Services (569/2009)

Act on the Status and Rights of Patients (785/1992)

The Social Welfare Act (1301/2014)

Act on Specialised Medical Care

(1062/1989) Act on Qualification Requirements for Social Welfare Professionals (272/2005) The Public Procurement Act (348/2007) Act on the Position and Rights of the Social _{Welfare Client (812/2005)}

The Disability Services Act

(380/1987) Act on Professionals in the Social Welfare (817/2015)

Health Care Act

(1326/2010) Act on Preservation of Health (763/1994) Private Social Services Act

(922/2011)

Act (710/1982) but certain parts of the previous legislation remain in force until the end of 2015. These sections relate to the division of power and competences between the Ministry of Social Affairs and Health, the Regional State Administrative Agencies and local authorities; activities relating to employment of people with disabilities; duty of the local authorities to arrange social care services; use of certain coercive means as part of social care; inspections of premises of social care and consequences for possible neglect in the arrangement of social care by local authority entities. (Sections 27 d, 27 e, 40 and 41 Chapter 2 as well as Chapters 5 and 8).

The Primary Health Care Act (66/1972)

This act relates to promotion of health, including prevent- ing diseases and accidents, which is focused on the individ- ual, the population and the living environment and health care for the individual. Issues relating to public health are also stipulated in the below mentioned Health Care Act (1326/2010).

The Disability Services Act (380/1987)

The objective of this act is to promote the conditions for individuals with disabilities to live and be active as equal members of the society and to prevent and remove the dis- advantages and obstacles caused by the disability. The Act on Specialised Health Care (1062/1989)

This act regulates the local authorities’ responsibility for municipal residents who are in need of specialised health care.

The Occupational Health Care Act (1383/2001)

This act regulates the employer’s responsibility to arrange for occupational health care as well as the content in and implementation thereof. The objective of the act is that the employer, the employees and the occupational health care provider commonly shall promote the prevention of diseases and accidents in connection with providing their occupational duties. The act further aims at promoting health and safety at work and the employees’ health, working and functional capacity at different stages in working life as well as the activities of the working com- munity.

Health Care Act (1326/2010)

This act applies to the implementation and content of health care services for the provision of which local author- ities are responsible under the Primary Health Care Act (66/1972) and the Act on Specialised Medical Care (1062/1989), unless otherwise provided. Section 26 Chap- ter 3 (Oral and dental care) regulates the local authorities’ responsibilities concerning oral and dental care for their residents.

Private Social Services Act (922/2011)

This act is applied to producing, realising and supervising private social services. The aim of the act is to ensure that the client’s right to good quality social services is realised when using private social services.

Act on the Position and Rights of the Social Welfare Client (812/2005)

This act is applied to social welfare arranged by both the

the act or any other act). The aim of the act is to promote client orientation as well as confidentiality in the client relationship and the client’s right to good treatment and service in the social welfare.

Act on the Status and Rights of Patients (785/1992)

This act concerns the position and rights of the patient when arranging care and health care services. Act on Professionals in the Social Welfare

(817/2015) (Valid as of March 1, 2016)

This act aims to promote client safety and the right of the care client to good care and treatment by (1) ensuring that care professionals referred to in this act have the educa- tion required by the professional activities, sufficient professional competency and such abilities required by the professional activities and the opportunity to develop and maintain the professionalism; (2) promoting the coopera- tion of the care professionals and forming an appropriate assignment structure taking note to the client’s needs for service; and (3) arranging the monitoring of the profes- sional activities of the care professionals.

Act on Qualification Requirements for Social Welfare Professionals (272/2005)

This act is applied to qualifications that are required of care professionals, unless otherwise provided elsewhere in the law. The purpose of this Act is to promote the right of care clients to quality care and to good treatment by requiring that care professionals shall have the necessary education and training as well as be familiar with the area of their work.

Act on Health Care Professionals (559/1994)

This act aims to promote the safety of patients and to improve the quality of health care services by (1) ensuring that a health care professional referred to in this Act has the education and training necessary for the practice of the profession, other adequate professional qualifications and other knowledge and skills necessary for the practice of the profession; (2) organising the supervision of health care professionals within health care; and (3) facilitat- ing professionally appropriate cooperation between and appropriate employment of health care professionals. Act on Preservation of Health (763/1994)

This act aims to maintain the health of the population as well as the individual and prevent, diminish and remove such factors in the living environment that may cause a health hazard (health preservation).

Supervision to protect clients and patients

Finland has so far not had a direct equivalent to Swe- den’s Lex Sarah or Lex Maria. Instead every client and patient has been entitled to report any abuses in the care and health care through the Authorisation and Supervi- sion Agency for the Social and Health Care (“Valvira”) or through the Regional State Administrative Agencies (“AVI”). Valvira handles the supervision in health care at a national level, while AVI handles the supervision at a regional level. As of January 1, 2016 care professionals will be subject to duty to report abuses in care as Sections 48 and 49 Chapter 5 of the Social Welfare Act (1301/2014) enter into force. The content of the duty to report resem-

Norway

Procurement acts

Lov 16. juli 1999 nr. 69 om offentlige anskaffelser (”anskaffelsesloven”)

The act regulates how public entities must act when pro- curing goods and services from private companies. The act aims at enabling efficient use of public funds, promoting high quality procurement and guaranteeing transpar- ent procurement processes and equal opportunities for companies and other associations to offer their goods and services in public tenders.

Operational acts

Lov 24. juni 2011 nr. 30 om kommunale helse- og omsorgstjenester m.m. (”helse- og omsorgstjenesteloven”)

The act regulates the local authorities’ overall responsibil- ity for care and health care services towards the citizens. To ensure the citizens’ right to receive care and health care services, the local authorities must ensure that the care and health care institutions’ activities are planned, imple- mented, evaluated and adjusted to meet the requirements established by laws and regulations.

Lov 2. juli 1999 nr. 63 om pasient- og brukerrettigheter (”pasient- og brukerrettighetsloven”)

The act aims at securing the citizens’ equal access to high quality care and health care services. The act aims at promoting a trustful relationship between the patient/cli- ent and the provider of care and health care services, and further to safeguard the respect for the patient/client’s life, integrity and human decency. The rights set forth in this act must be read in conjunction with the corresponding obligations of the care and health care professionals in the Norwegian Health Professionals Act (Nw: Helseper- sonelloven).

Lov 2. juli 1999 nr. 64 om helsepersonell m.v. (”helsepersonelloven”)

The act regulates the rights, obligations and responsibili- ties of professionals and personnel providing care and health care services. The purpose of the act is to promote and secure patients’ safety, quality in care and health care services and the integrity of the care and health care pro- fession.

Privacy acts

Lov 20. juni 2014 om behandling av helseopplysninger ved ytelse av helsehjelp (”pasientjournalloven”)

The act regulates care and health care institutions’ obliga- tions when handling and processing personal health data. The purpose of the act is to safeguard the patients’ right to privacy, safety and the right to be informed and to par- ticipate in their treatment. The act also aims at providing patients with good quality care and health care, by facili- tating effective methods for care and health care profes- sionals and personnel to obtain necessary personal health information regarding their patients.

Danmark Procurement acts

Danish law contains a number of Acts and Ministerial Orders on public procurement which is thus relevant for Attendo.

Bekendtgørelse om fremgangsmåderne ved indgåelse af offentlige vareindkøbskontrakter, offentlige tjenesteydelseskontrakter og offentlige bygge- og anlægskontrakter (BEK nr 712 af 15/06/2011)

The Ministerial Order implements Directive 2004/18/EC on the coordination of procedures for the award of public works contracts, public supply contracts and public service contracts. Home care are considered as annex II B-ser- vices, which means that procurement is subject to less regulation. Contracting authorities are always required to uphold the principles of transparency and equal treat- ment. Any selection shall be based on objective, factual and non-discriminatory criteria.

A new Danish Public Procurement Act implementing the new procurement directive was expected to become effective in October this year. As a consequence of the calling of election in June this year the bill was however repealed. A new bill is expected to be introduced in Octo- ber this year, it is however still uncertain how this will affect the procurement of home care.

Operational acts

Lov om social service (Serviceloven) (LBK nr 1053 af 08/09/2015) The act regulates the responsibility of the local authorities and the regions respectively for the offering of counselling and support to prevent social problems, the offering of general services and the meeting of needs resulting from reduced functional capability or special social problems. The local authorities are responsible for the care for older people.

Sundhedsloven (LBK nr 1202 af 14/11/2014)

The act regulates the responsibility of the local authori- ties and the regions respectively for care and health care services towards the citizens. The act aims at securing that the citizens have equal access to high quality care and health care services. The act is based on that the citizens should have equal access to care and health care, that the services are of high quality, that patients should have the freedom of choice and that the waiting times should be short.