Dear Mojca

I am a medical radiation advisor at Ministry of Social Affairs, which operates as Ministry of Health as well in Estonia.

I replied to the questionnaire in the letter below with blue text, so that it can be easier to distinguish. If you have any additional questions, please do not hesitate to contact me.

With kindest regards

Dear Sir/Madam,

The Research Section of the National Assembly of the Republic of Slovenia is preparing a comparative overview on the organisation and regulation of radiology services in EU member states. The study is being prepared to support evidence-based decision-making within the Slovenian Parliament.
The purpose of the study is to examine how radiology services are organised, including the role of public and private providers, the regulation of private provision, and mechanisms aimed at safeguarding the public interest and preventing conflicts of interest.

We know we are asking a lot, but we would be very grateful for your support and for any time and effort you would be willing to devote to answering our questions. Your expertise and insights would greatly contribute to the quality and comprehensiveness of the comparative analysis. We would appreciate it if you could provide answers to the following questions and, where possible, indicate relevant legislation, official documents, or other sources.

1. Organisation of radiology services

How are radiology services organised and provided in your country?

Please indicate:

•        whether radiology services are provided mainly by public hospitals, private providers, or a combination of both; Both private and public hospitals provide radiology services
•        whether private providers form part of the publicly funded healthcare network; Publicly funded healthcare can buy services from private hospital. This is done based on the contract, where the extent of service is appointed for every year
•        whether there are significant differences between different types of radiological services (e.g. diagnostic radiology, interventional radiology). Interventional radiology is not provided by private hospitals, as I know. Only diagnostic radiology is available there.

2. Role of private providers and their participation in the publicly funded healthcare system

Can private providers of radiology services provide services financed through the public healthcare system? Yes

If yes:

•        on what legal or contractual basis do they provide such services (e.g. contracts with public health insurance funds, concessions, public procurement procedures); Contracts with public health insurance fund
•        are there specific conditions that private providers must meet in order to participate in the publicly funded system; Private hospitals should address the tender rules to apply for national funding
•        are there any restrictions regarding the scope of private provision of radiology services? There is no restrictions. Private hospital has to comply to all the same legislative regulations, as public hospitals

3. Dual practice of radiologists and prevention of conflicts of interest

Are radiologists allowed to work simultaneously in the public and private sectors? Yes

If yes:

•        are there any specific restrictions or conditions applicable to such dual practice; No
•        what mechanisms are in place to prevent conflicts of interest (e.g. patient self-referral, ownership of diagnostic centres, provision of services for multiple providers, other safeguards)? Public hospitals generally know about ohter activities their employees perform outside the public sector. It is hard to hide anything in a small country like ours. Therefore public hospital as an employer regulates this area and activities and takes measures to avoid conflict of interest

4. Special status and regulation of radiology services

Does legislation or other regulation provide radiology services, or specific types of radiological services, with a special status due to their importance for the public interest? Whole public hospital can be recognized as a vital service provider and radiology is just part of it.

If yes:

•        please provide a brief description of the relevant arrangements and the applicable legal basis. Unfortunately I have no extensive knowledge in this topic to proovide detailed description

5. Ensuring accessibility of radiology services

Does your country use specific measures to ensure access to radiology services or to reduce waiting times? No, not on a national level.

If yes:

•        what role do private providers play in ensuring accessibility;
•        are there specific programmes, contractual arrangements, or other measures aimed at increasing access to radiology services?

6. Additional information

Are there any other specific features of the organisation or regulation of radiology services in your country that you consider relevant for a comparative analysis?

Thank you ...

Wishing you a pleasant summer.

Kind regards,

Mojca