Act of 2 July 1999 No. 64 relating to Health Personnel etc.

Publisert under: Regjeringen Bondevik II

Utgiver: Helse- og omsorgsdepartementet

Act of 2 July 1999 No. 64 relating to Health Personnel etc.

(The Health Personnel Act)

(with amendments made previous to 1 July 2002)

UNOFFICIAL TRANSLATION

Table of Contents

Chapter 1. Objective of this Act, its scope and definitions

§ 1 Objective of this Act

§ 2 Scope of this Act

§ 3 Definitions

Chapter 2. Requirements to professional conduct for health personnel

§ 4 Responsible conduct

§ 5 Use of assistants

§ 6 Use of resources

§ 7 Emergency health care

§ 8 Duty of abstinence

§ 9Ban relating to the receiving of gifts while acting in a professional capacity

§ 10 Information to patients etc.

§ 11 Requisition of medicinal products for which a prescription is required

§ 12 Examinations in connection with a criminal offence

§ 13 Marketing

§ 14 Ordering of health personnel to participate in duty rota

§ 15Requirements to medical reports, medical certification etc.

Chapter 3. Requirements to the organisation of facilities

§ 16 Organisation of facilities providing health care and internal control

§ 17 Information on matters which may endanger patient safety

Chapter 4. Special rules in connection with authorisation

§ 18 Notification of health personnel’s practice

§ 19 Notification to employer of any subsidiary source of income and other engagement in other practice or enterprise

§ 20 Insurance

Chapter 5. Duty of confidentiality and the right of disclosure

§ 21 General rule relating to the duty of confidentiality

§ 22 Consent to give information

§ 23 Restrictions in the duty of confidentiality

§ 24 Information following a person’s death

§ 25 Information to co-operating personnel

§ 26 Information to the management of a facility and to administrative systems

§ 27 Disclosure of information when acting as an expert

§ 28 Information to employers

§ 29 Information for other purposes

Chapter 6. Duty of disclosure etc.

§ 30 Information to the supervising authority

§ 31 Information to emergency units

§ 32 Information to the social welfare service

§ 33 Information to the children’s welfare service

§ 34 Information in connection with driver’s licences and pilot licences

Chapter 7. Notification requirements

§ 35 Notification of births

§ 36 Notification of deaths

§ 37 Notification to health registers etc.

§ 38 Notification of severe injury to persons

Chapter 8. Duty relating to documentation

§ 39 Duty to keep patient records

§ 40 Requirements to the contents of patient records

§ 41 Duty to provide patient access to records

§ 42 Correction of patient records

§ 43 Deletion of information in patient records

§ 44 Patient records on the wrong person

§ 45 Transfer and release of and access to patient records and information therein

§ 46 Electronic patient records

§ 47 Use of notes on patients and patient records as evidence

Chapter 9. Conditions relating to the granting of authorisation, licence and certificate of completion of specialist training

§ 48 Authorisation

§ 49 Licence

§ 50 Border licence

§ 51 Conditions relating to the granting of a certificate of completion of specialist training

§ 52 International agreements

Chapter 10. Granting and expiration of authorisation, licence and certificate of completion of specialist training

§ 53Granting of authorisation, licence and certificate of completion of specialist training

§ 54 Expiration of authorisation, licence and certificate of completion of specialist training

Chapter 11. Reactions etc. to breach of the provisions of this Act

§ 55 Request for assessment of possible breach of duty

§ 56 Warning

§ 57 Revocation of authorisation, licence or certificate of completion of specialist training

§ 58 Suspension of authorisation, licence or certificate of completion of specialist training

§ 59 Limiting of authorisation

§ 60 Order of examination by experts

§ 61 Voluntary renouncement of authorisation, licence or certificate of completion of specialist training

§ 62 New authorisation or licence

§ 63 Loss of the right to require medicinal products in group A and B

§ 64 Suspension of requisition rights

§ 65 Reduction of period of loss of requisition rights

§ 66 Information to employers and to other countries

§ 67 Punishment

Chapter 12. The Norwegian Board for Health Personnel and the Norwegian Pharmacy Appeals Board

§ 68 the Norwegian Board for Health Personnel and the Norwegian Pharmacy Appeals Board

§ 69 Organisation of the Norwegian Board for Health Personnel

§ 70 Executive processing work by the Norwegian Board for Health Personnel

§ 71 Judicial review

§ 72 (Repealed.)

Chapter 13. Miscellaneous provisions

§ 73 Compensation of loss upon suspension and revocation

§ 74 Use of protected title

§ 75 Entry into force

§ 76 Transitional provisions

§ 77 Repeal of and amendments to other Acts

Chapter 1. Objective of this Act, its scope and definitions

§ 1Objective of this Act

The objective of this Act is to contribute to safety for patients and quality within the health service as well as trust in both health personnel and the health service.

§ 2Scope of this Act

This Act applies to health personnel and facilities where health care is being provided.

The King stipulates regulations relating to the application of this Act to Svalbard and Jan Mayen and may lay down special provisions out of regard for the local conditions. To the extent determined by the King in regulations, this Act shall apply to persons onboard Norwegian ships engaged in foreign trade, to Norwegian civil aircraft in international traffic and to installations and vessels at work on the Norwegian continental shelf and within Norwegian rescue area.

§ 3Definitions

For the purpose of this Act, the term health personnel shall mean:

  1. Personnel with an authorisation pursuant to section 48 or a licence pursuant to section 49,
  2. Personnel in the health services or in pharmacies who perform acts as mentioned in the third paragraph,
  3. Pupils and students who in training as health personnel perform acts as mentioned in the third paragraph.

The Ministry may in regulations determine that the Act or certain provisions of this Act shall apply to further specified personnel not included under the first paragraph.

The term health care shall mean any act that has a preventive, diagnostic, therapeutic, health-preserving or rehabilitative objective and that is performed by health personnel.

The term health institution shall mean an institution that is governed by the Specialist Health Service Act and the Municipal Health Services Act.

(Amended by Act of 21 Dec. 2000 No. 127 (in force 1 Jan. 2001 in accordance with Decree of 21 Dec. 2000 No. 1359).)

Chapter 2. Requirements to professional conduct for health personnel

§ 4Responsible conduct

Health personnel shall conduct their work in accordance with the requirements to professional responsibility and diligent care that can be expected based on their qualifications, the nature of their work and the situation in general.

Health personnel shall act in accordance with their professional qualifications, and assistance shall be obtained and patients shall be referred on to others if this is necessary and possible. If the patient’s needs so indicate, the profession shall be performed through co-operation and inter-action with other qualified personnel.

Upon co-operation with other health personnel, the medical practitioner and the dentist shall make decisions in matters concerning medicine or dentistry respectively in relation to examinations or treatment of the individual patient.

The Ministry may in regulations determine that certain types of health care shall only be provided by personnel with special qualifications.

§ 5Use of assistants

Health personnel may in their work assign certain tasks to other personnel if it is considered safe to do so based on the nature of the assigned task, the qualification of the assigned personnel and the guidance that is being provided.

Pupils and students shall as a rule only be assigned tasks based on their need for training.

§ 6Use of resources

Health personnel shall ensure that the health care does not mean unnecessary loss of time or unnecessary expenses to patients, health institutions, the National Insurance Scheme or to others.

§ 7Emergency health care

Health personnel shall immediately provide the health care they are capable of when it must be assumed that the health care is of vital importance. Pursuant to the limitations laid down by the Patients Rights Act section 4-9, necessary health care shall be given, even if the patient is incapable of granting his consent thereto, and even if the patients objects to the treatment.

When in doubt as to whether the health care is of vital importance, health personnel shall perform the necessary examinations.

This duty does not apply to the extent that other qualified health personnel undertakes the responsibility to provide health care.

§ 8Duty of abstinence

Health personnel may not consume alcohol or other intoxicating substances during working hours.

Medicinal products that are necessary due to illness are not considered to be intoxicating substances pursuant to the first paragraph. Health personnel using such products shall as soon as possible notify their employer thereof.

The Ministry may in regulations determine that health personnel may be required to provide a breath analyser test, blood test or a similar test upon suspicion of breach of the first paragraph and may give provisions relating to a ban on consumption of intoxicating substances for a fixed period of time prior to going on duty.

§ 9Ban relating to the receiving of gifts while acting in a professional capacity

Health personnel may not on behalf of themselves or on behalf of others accept gifts, commission, service or other benefits that are suitable to affect the services provided by health personnel unduly.

Health personnel may furthermore not accept gifts, commission, services or other benefits from patients, unless the gift etc. is of insignificant value.

The Ministry may in regulations stipulate further provisions relating to what benefits that are included under the first and second paragraph.

§ 10Information to patients etc.

The health care provider shall give information to persons entitled thereto pursuant to the Patients Rights Act section 3-2 to section 3-4. In health institutions information in accordance with the first sentence, shall be given by the person whom the institution designates thereto.

The Ministry may in regulations stipulate further provisions relating to the duty of information.

§ 11Requisition of medicinal products for which a prescription is required

Medical practitioners and dentists only may make a requisition for medicinal products for which a prescription is required. The Ministry may in regulations determine that other health personnel holding an authorisation or licence may be granted a limited right of requisition.

The Ministry may in regulations stipulate further provisions relating to the requisition of medicinal products including provisions relating to the design as well as the filling in of prescriptions and requisition forms. It may also be determined that certain medicinal products shall be exempt wholly or in part from this right.

§ 12Examinations in connection with a criminal offence

A medical practitioner, nurse or medical laboratory technologist shall, upon request from the police, take a blood test or perform similar examinations of persons suspected of a criminal offence while under the influence of alcohol or other intoxicating or narcotic substance when this is in accordance with statutory law and may be performed without danger.

A medical practitioner shall upon request from the prosecuting authority perform a physical examination of suspects in a criminal case when such an examination has been decided pursuant to section 157 of the Criminal Procedure Act. Furthermore a medical practitioner shall upon request from the relevant prison governor perform a physical examination of an inmate in a prison facility when such an examination is decided pursuant to the provisions of the Prison Act section 30 a.

A medical practitioner, nurse or medical laboratory technologist is under no obligation to perform examinations pursuant to the first and second paragraph of:

  1. Spouse, registered gay partner, person who lives with the person in question in a relationship resembling that of marriage or a gay partnership, fiancé(e), relatives whom the relevant person descends from or whom descends from him in a direct line, siblings or people who are equally closely related through marriage or partnership. A relationship based on adoption or fostering is considered equal to that of kinship.

2. Person whom the relevant health personnel is providing medical treatment for.

The Ministry may in regulations stipulate further provisions relating to the duty to perform examinations pursuant to this section, including the stipulation of provisions relating to the limitation of this duty and on exemptions.

(The Prison Act was repealed by Act of 18 May 2002 No. 21 relating to Execution of Sentences etc. (The Execution of Sentences Act) which entered into force 1 March 2002. Cf. now the Execution of Sentences Act section 29.)

§ 13Marketing

Marketing of health services shall be responsible, factual and sober.

Upon marketing of facilities providing health care, the first paragraph shall apply correspondingly.

The Ministry may in regulations stipulate further provisions on the marketing of health care, including provisions relating to a ban on certain types of marketing.

§ 14Ordering of health personnel to participate in duty rota

The Ministry may determine that health personnel shall participate in duty rota at their place of residence or their place of work.

The Ministry may stipulate further provisions relating to the implementation etc. of duty rota.

§ 15Requirements to medical reports, medical certification etc.

Anyone who issues medical certification, medical reports etc. shall be careful, precise and objective. A medical report etc. shall be correct, and contain only such information that is necessary for its intended purpose. Health personnel that are disqualified pursuant to the Public Administration Act section 6 shall not issue a medical report, medical certification etc.

Chapter 3. Requirements to the organisation of facilities

§ 16Organisation of facilities providing health care and internal control

Facilities providing health care shall be organised in such a way that health personnel are able to comply with their statutory duties.

The Ministry may in regulations stipulate further provisions on the organisation of facilities providing health care and on internal control.

§ 17Information on matters which may endanger patient safety

Health personnel shall of their own accord provide information to the supervising authorities on matters that may endanger patient safety.

Chapter 4. Special rules in connection with authorisation

§ 18Notification of health personnel’s practice

Health personnel holding an authorisation or licence in private practice shall notify the municipality or the regional health enterprise upon opening, taking over or entering a practice governed by this Act. Notification shall also be given upon the termination of practice.

The Ministry may in regulations stipulate further provisions relating to the type of information that shall be provided, when it shall be provided, and how it shall to be registered and passed on to a central register.

(Amended by Act of 15 June 2001 No. 93 (in force 1 Jan. 2002 in accordance with Decree of 14 Dec. 2001 No. 1417).)

§ 19Notification to employer of any subsidiary source of income and other engagement in other practice or enterprise

Health personnel holding an authorisation or licence shall of their own accord inform their employer of any subsidiary sources of income and engagements, ownership interests etc. in other practice or enterprise, which may come into conflict with the interests of the main employer.

In addition, the employer may demand that health personnel holding an authorisation or licence provide information on any health care practice which the health personnel provide as a self-employed person, for other employers or providers of assignments in Norway or abroad, as well as ownership interests and collaboration etc.

Information relating to the name as well as the nature and extent of their subsidiary source of income or engagement shall be provided.

This provision does not limit the obligation to provide information on subsidiary sources of income pursuant to an agreement or other statutory provisions.

§ 20Insurance

Health personnel with an authorisation or licence running a private practice shall have insurance as security to cover the economic liability to patients that may arise in connection with the performance of their profession.

The Ministry may in regulations stipulate further provisions relating to the obligation to have insurance.

Chapter 5. Duty of confidentiality and the right of disclosure

§ 21General rule relating to the duty of confidentiality

Health personnel shall prevent others from gaining access to or knowledge of information relating to people’s health or medical condition or other personal information that they get to know in their capacity as health personnel.

§ 22Consent to give information

The duty of confidentiality pursuant to section 21 is not to prevent information from being made known to the person that the information directly relates to, or to others, to the extent to which the person who is entitled to confidentiality gives his consent thereto.

For persons below 16 years of age, the provisions of the Patients Rights Act section 4-4 and section 3-4 second paragraph, shall apply correspondingly for consent granted in accordance with the first paragraph.

For persons over 16 years of age, who are incapable of considering the question of consent for reasons as mentioned in the Patients Rights Act section 3-3 second paragraph, their next of kin may grant consent pursuant to the first paragraph.

§ 23Restrictions in the duty of confidentiality

The duty of confidentiality pursuant to section 21 is not to prevent:

  1. information from being made known to a person who already have previous knowledge of the information,
  2. information from being provided when there are no valid interests to indicate secrecy,
  3. information from being passed on if the need for protection must be regarded as being adhered to if identifying characteristics have been omitted,
  4. information from being passed on if exceptional private or public grounds make it legitimate to pass on the information, or
  5. information from being passed on in accordance with rules laid down in or pursuant to law when it has been expressly stated or clearly presumed that the duty of confidentiality shall not apply.

§ 24Information after a person’s death

The duty of confidentiality pursuant to section 21 is not to prevent information relating to a deceased person from being passed on if weighty grounds so indicate. Upon assessment of whether information shall be provided, the assumed will of the deceased, the nature of the information, as well as the interests of his next of kin and the interests of society shall be considered.

A person’s next of kin is entitled to access into the patient records relating to a deceased person unless special grounds indicate otherwise.

§ 25Information to co-operating personnel

Unless the patient objects thereto, confidential information may be given to co-operating personnel when this is necessary in order to provide responsible health care.

The duty of confidentiality pursuant to section 21 is furthermore not to prevent personnel who are providing assistance with electronic processing of such information, or who is providing servicing or maintenance of equipment, from gaining access to such information, when such assistance is necessary in order to comply with statutory requirements for documentation.

Personnel as mentioned in the first and second paragraph are subject to the same duty of confidentiality as health personnel.

§ 26Information to the management of a facility and to administrative systems

The health care provider may give information to the management of a facility when this is necessary in order to provide health care, or for the purposes of internal control or for the purposes of quality assurance of the service. The information shall in as far as possible be given without identifying characteristics.

The health care provider shall not be prevented by the duty of confidentiality pursuant to section 21 from providing the patient administration of the relevant facility with the patient’s birth registration number, information relating to diagnosis, possible needs for assistance, offer of services provided, admittance and release dates as well as relevant administrative data.

The provisions relating to the duty of confidentiality shall apply correspondingly for personnel employed in patient administration.

§ 27Disclosure of information when acting as an expert

The duty of confidentiality pursuant to section 21 is not to prevent health personnel acting as experts from giving information to the person or body that have assigned them as experts, if the information has been received in the process of carrying out this assignment and the information is significant for the assignment.

Anyone acting as an expert shall make the patient aware of the assignment and what it entails.

§ 28Information to employers

The Ministry may stipulate regulations relating to the access to pass on information relating to the medical condition of an employee to his employer to the extent that the information concerns the employee’s suitability for a certain type of work or assignment.

§ 29Information for other purposes

The Ministry may determine that information may or shall be provided for use in research, and that the duty of confidentiality pursuant to section 21 shall not prevent this from taking place. To such a decision, conditions may be attached. The provisions relating to the duty of confidentiality pursuant to this Act shall apply correspondingly to anyone who receives this information.

The Ministry may in regulations give further provisions relating to the use of confidential information in research.

The Ministry may in regulations regulate the right of health personnel to release and use confidential information for purposes other than health care when the patient has granted his consent thereto. This applies to purposes such as insurance and credit institutions etc.

Chapter 6. Duty of disclosure etc.

§ 30Information to the supervising authority

Health personnel shall grant the supervising authority access to the premises of the facility and provide all the information which is considered to be necessary in order to carry out supervision of the health personnel’s activities. Notwithstanding the duty of confidentiality, the health personnel shall release the documents, sound and picture recordings etc. required by the supervision authority.

§ 31Information to emergency units

Health personnel shall notify the Police or the Fire Services when this is necessary in order to prevent serious injury or damage to person or property.

§ 32Information to the social welfare service

The health care provider shall in his work pay attention to matters which should lead to measures from the social welfare service, and shall by his own accord provide the social welfare service with information on such matters after having obtained the patient’s consent thereto, or in so far that the information can be provided notwithstanding the duty of confidentiality pursuant to section 21.

Notwithstanding the duty of confidentiality pursuant to section 21, the health personnel shall provide information to the social welfare service, when there is reason to believe that a pregnant woman is abusing intoxicating substances in such a way that it is highly probable that the child will be born with defects, cf. the Act relating to Social Welfare Services section 6-2a. Upon order from the agencies responsible for the implementation of the Act relating to Social Welfare Services, the health personnel shall also provide such information.

Health institutions shall appoint one person who is responsible for the release of such information.

§ 33Information to the children’s welfare service

The health care provider shall in his work pay attention to matters, which could lead to measures from the children’s welfare service.

Notwithstanding the duty of confidentiality pursuant to section 21, the health personnel shall of their own accord provide the children’s welfare service with information when there is reason to believe that a child is being maltreated in the home or is being subjected to other forms of serious neglect, cf. the Act relating to Children’s Welfare Services section 4-10, section 4-11 and section 4-12. The same applies to cases where a child has demonstrated prolonged and severe behavioural problems, cf. the aforementioned Act, section 4-24.

Upon order from the agencies responsible for the implementation of the Act relating to Children’s Welfare Services, the health personnel shall also provide such information.

Health institutions shall appoint one person who is responsible for the release of such information.

§ 34Information in connection with driver’s licences and pilot licences

Medical practitioners, psychologists or optometrists who find that a patient holding a driver’s licence for motor vehicles or a pilot licence for aircraft does not fulfil the necessary medical requirements, shall encourage the patient to hand in his licence. If the patient’s medical condition is presumed not to be of a temporal nature, the health personnel as mentioned, shall report this to the public authorities in accordance with further provisions laid down by the Ministry in regulations.

The Ministry may in regulations stipulate further provisions on the implementation of and to supplement the first paragraph, and may also stipulate that the provisions of the first paragraph shall apply correspondingly to patients who serve outside aircraft, if their service is significant to the safety of aviation.

Chapter 7. Notification requirements

§ 35Notification of births

Medical practitioners or midwifes shall notify the National Population Register of births. The notification shall contain information on who the father of the child is pursuant to the provisions of the Children Act sections 3 and 4 or whom the mother has named as the child’s father in cases where paternity has not been resolved. The Ministry may in regulations determine that such notifications shall also contain additional information.

If the paternity has not yet been resolved or if the parents are not living together, the notification of birth shall be sent to both the National Population Register and the maintenance enforcement officer.

Notification of birth shall be issued even if the child is stillborn.

Medical practitioners or midwifes shall notify the Medical Birth Registry of deliveries and termination of pregnancies following the twelfth week of pregnancy in accordance with regulations laid down pursuant to the Personal Health Data Filing System Act.

(Amended by Act of 18 May 2001 No. 24 (in force 1 Jan. 2002 in accordance with Decree 18 May 2001 No. 502).)

§ 36Notification of deaths

Medical practitioners shall issue certificates of deaths that they acquire knowledge of in their practice. The Ministry stipulates regulations relating to the certificates.

Medical practitioners who have issued medical certification of death or who have provided health care to a person prior to his death shall provide the municipal medical officer with the necessary information relating to the cause of death.

The municipal medical officer shall pass the information on to the Causes of Death Register.

If there is reason to suspect that a person did not die of natural causes, the medical practitioner shall notify the Police thereof in accordance with regulations laid down by the Ministry.

If investigations have been instigated in order to determine if death occurred by a criminal offence, the medical practitioner shall provide the court with information that is relevant to the case provided the court requests it.

§ 37Notification to health registers etc.

The King may order health personnel holding an authorisation or licence to provide information to personal health data filing systems in accordance with regulations laid down pursuant to the Personal Health Data Filing System Act.

(Amended by Act of 18 May 2001 No. 24 (in force 1 Jan. 2002 in accordance with Decree 18 May 2001 No. 502).)

§ 38Notification of severe injury to persons

Health personnel holding an authorisation or licence shall as soon as possible submit a notification in writing to the county medical officer of severe injury to a patient caused by the rendering of health care, or of injury inflicted upon one patient by another. Notifications of incidents that could have lead to severe injury to persons shall also be submitted.

The notification requirements for health personnel pursuant to the first paragraph do not apply if the health institution is subject to the notification requirements of the Specialist Health Service Act section 3-3.

(Not in Force, see Decree of 1 Dec. 2000 No. 1199.)

Chapter 8. Duty relating to documentation

§ 39Duty to keep patient records

The health care provider shall enter or record information as mentioned in section 40 in a patient record for the individual patient. The duty to keep patient records does not apply to co-operating personnel providing care in accordance with instructions or guidance from other health personnel.

Health institutions shall designate one person with superior responsibility for the individual patient record including making decisions relating to what information is to be entered into the patient record.

The Ministry may in regulations instruct health personnel as mentioned in the first paragraph to keep a separate record that remains with the patient himself (patient’s own records).

§ 40Requirements to the contents of patient records etc.

The patient records shall be kept in accordance with good professional conduct and shall contain relevant and necessary information about the patient and the health care, as well as the information that is required in order to comply with the notification requirements or the duty of disclosure laid down in or pursuant to law. The records shall be easy to comprehend for other qualified health personnel.

It shall be evident from the records who has entered the information into the patient records.

The Ministry may in regulations stipulate further provisions relating to the contents of patient records and responsibility for the records pursuant to this provision including provisions relating to storage, transfer, cessation and destruction of patient records.

(Amended by Act of 21 Dec. 2000 No. 127 (in force 1 Jan. 2001 in accordance with Decree of 21 Dec. 2000 No. 1359).)

§ 41Duty to provide patient access to records

The health care provider shall provide access to the patient records to anyone entitled thereto pursuant to the provisions of the Patients Rights Act section 5-1.

In health institutions the person with superior responsibility for patient records pursuant to section 39 shall make sure that access is provided pursuant to the first paragraph.

§ 42Correction of patient records

Health personnel as mentioned in section 39 shall upon demand from the person whom the information relates to, or of their own accord, correct wrongful, deficient or improper information or comments in patient records. Correction shall be carried out through re-entering the information of the patient records, or by adding a dated correction in the records. Corrections shall not be made by deleting information or comments.

If a demand for correction is refused, the demand for correction and the reasons for its refusal shall be entered into the patient records.

Refusals of demands for correction may be appealed to the county medical officer, who, after obtaining a statement from the Data Inspectorate, determines whether corrections can be made.

The Ministry may in regulations stipulate further provisions relating to correction pursuant to this provision.

§ 43Deletion of information in patient records

Upon demand from the person whom the information in the patient record relates to, or of their own accord, health personnel as mentioned in section 39 shall delete information or comments in the patient record, if this can be done without implications to public interest, if it is not contrary to the provisions in or pursuant the Archives Act sections 9 or 18, and:

  1. the information is wrong or misleading and felt to be a burden for the person they relate to or
  2. the information clearly is not necessary in order to provide health care for the patient.

If a demand for deletion is refused, the demand for deletion, and the reasons for the refusal shall be entered into the patient records.

Refusals of demands for deletion may be appealed to the county medical officer. A statement must be obtained from the Data Inspectorate. If the county medical officer is of the opinion that deletion may be contrary to the Archives Act sections 9 or 18, a statement shall also be obtained from the National Archives of Norway.

The Ministry may in regulations stipulate further provisions relating to deletion pursuant to this provision.

(Amended by Act of 21 Dec. 2000 No. 127 (in force 1 Jan. 2001 in accordance with Decree of 21 Dec. 2000 No. 1359).)

§ 44Patient records on the wrong person

Upon demand from the person whom the information relates to, or of their own accord, health personnel as mentioned in section 39, shall delete patient records, or information or comments in patient records that have been recorded on the wrong person, unless public interest indicate that such deletion should not take place. The provisions of section 43 second to fourth paragraph shall apply correspondingly.

§45Transfer and release of and access to patient records and information therein

Unless the patient objects thereto, health personnel as mentioned in section 39 may give the patient record or information therein to others who provide health care pursuant to this Act when this is necessary in order to provide health care in a responsible manner. It shall be evident from the patient record that other health personnel have been given access to the patient records pursuant to the first sentence.

The Ministry may in regulations stipulate further provisions to supplement the first paragraph and may include among them that other health personnel may be given access to patient records, also in cases not included under the first paragraph.

§46Electronic patient records

Patient records may be kept electronically.

The King may in regulations stipulate further provisions relating to the use of electronic patient records, including setting up requirements relating to instruction and measures that shall ensure that any outsiders do not gain knowledge of or access to the records.

(Amended by Act of 21 Dec. 2000 No. 127 (in force 1 Jan. 2001 in accordance with Decree of 21 Dec. 2000 No. 1359).)

§ 47Use of notes on patients and patient records as evidence

In legal or administrative cases relating to the professional conduct of health personnel, notes recorded in patient records, patient records and patient record material may be required for the purpose of being presented as evidence, either as originals, or as certified photocopies or printouts.

Chapter 9. Conditions relating the granting of authorisation, licence and certificate of completion of specialist training

§ 48Authorisation

Authorisation pursuant to this act is granted to the following categories of health personnel:

a) Emergency Medical Technician (Ambulansearbeider)

b) Pharmacy Technician (Apotektekniker)

c) Audiologist (Audiograf)

d) Medical Laboratory Technologist (Bioingeniør)

e) Occupational Therapist (Ergoterapeut)

f) Pharmacist (Farmasøyt)

g) Chiropodist (Fotterapeut)

h) Physiotherapist (Fysioterapeut)

i) Medical Secretary (Helsesekretær)

j) Auxiliary Nurse (Hjelpepleier)

k) Midwife (Jordmor)

l) Chiropractor (Kiropraktor)

m) Clinical Nutritionist (Klinisk ernæringsfysiolog)

n) Medical Practitioner (Lege)

o) Care Worker (Omsorgsarbeider)

p) Optometrist (Optiker)

q) Prosthetist (Ortpediingeniør)

r) Orthoptist (Ortoptist)

s) Cardiovascular Perfusionist (Perfusjonist)

t) Psychologist (Psykolog)

u) Radiographer (Radiograf)

v) General Nurse (Sykepleier)

w) Dental Health Secretary (Tannhelsesekretær)

x) Dentist (Tannlege)

y) Dental Hygienist (Tannpleier)

z) Dental Technician (Tanntekniker)

æ) Social Educator (Vernepleier)

The right to be granted an authorisation following an application belongs to anyone who:

  1. has passed an examination in the relevant subject at a Norwegian university or college or through occupational training at a secondary level,
  2. has completed practical training in accordance with regulations laid down by the Ministry,
  3. is under 75 years of age and
  4. is not considered to be unfit for the profession.

The right to be granted an authorisation following an application also belongs to anyone who:

  1. has passed an examination in a foreign country which is recognised as being equally as good as the equivalent Norwegian examination,
  2. has passed an examination which is recognised in accordance with agreement on mutual recognition pursuant to section 52, or
  3. has otherwise proven to possess the necessary skills.

The Ministry may in the regulations decide that categories of health personnel that are not included under the first paragraph may be granted authorisation following an application. Upon decision, emphasis shall be on the consideration for patient safety, the contents and objective of the relevant education, the extent to which the relevant profession is carried out independently, as well as considerations relating to the harmonisation between Norway and other countries.

The Ministry may in regulations stipulate additional requirements for the granting of authorisation for each individual category of health personnel, including that the requirement shall also apply to those who already have an authorisation or public certification at the time of entry into force of these regulations.

(Amended by Act of 21 Dec. 2000 No. 127 (in force 1 Jan. 2001 in accordance with Decree of 21 Dec. 2000 No. 1359).)

§ 49Licence

Health personnel, who do not have the right to an authorisation pursuant to section 48, may be granted a licence following an application. A licence may only be granted to health personnel that are considered to be suited in accordance with the type of licence granted, and the tasks it covers.

A licence may also be granted to health personnel who has passed an examination in a foreign country, which has been recognised in accordance with an agreement on mutual recognition pursuant to section 52.

The licence may be limited in time, to a certain position, to certain types of health care or otherwise.

The Ministry may in regulations stipulate additional requirements related to the granting of a licence and the conditions attached to it, including that the requirements shall also apply to those who already have a licence at the time of entry into force of these regulations.

§ 50Border licence

Publicly employed and authorised health personnel in Sweden and Finland working along the Norwegian border can carry out their work in Norwegian municipalities along the borders without an authorisation or licence pursuant to sections 48 and 49.

§ 51Conditions relating to the granting of a certificate of completion of specialist training

The Ministry may stipulate regulations on the conditions relating to the approval of authorised health personnel as specialists within a limited area in the field of health, including that the requirements shall also apply to those who already have a certificate of completion of specialist training at the time of entry into force of these regulations.

§ 52International agreements

Based on agreements with other countries relating to mutual recognition, authorisation, licence and certificates of completion of specialist training may be granted to aliens.

The Ministry may in regulations stipulate further provisions to supplement the first paragraph, and may among them stipulate special requirements for recognition that are necessary in order to comply with international agreements.

Chapter 10. Granting and expiration of authorisation, licence and certificate of completion of specialist training

§ 53Granting of authorisation, licence and certificate of completion of specialist training

The Norwegian Directorate for Health and Social Welfare grants authorisations, licences and certificates of completion of specialist training subject to further stipulated remuneration. The Ministry may in regulations instruct the individual educational institution and others with educational responsibility to grant authorisations for education where practical training (turnustjeneste), cf. section 48 second paragraph litra b, is not required. The Directorate may delegate the authority to grant certificates of completion of specialist training to private professional associations.

The Norwegian Directorate for Health and Social Welfare may refuse to grant an applicant authorisation, licence or certificate of completion of specialist training if circumstances exist that would have provided grounds for revocation pursuant to section 57.

A decision pursuant to the preceding paragraph of this provision is an individual decision pursuant to the Public Administration Act.

If there is reason to believe that grounds for revocation exist, the Norwegian Directorate for Health and Social Welfare may order health personnel to undergo examinations as described in section 60.

(Amended by Act of 21 Dec. 2000 No. 127 (in force 1 Jan. 2001 in accordance with Decree of 21 Dec. 2000 No. 1359), Act 21 Dec. 2001 No. 119 (in force 1 Jan. 2002 in accordance with Decree of 21 Dec. 2001 No. 1524) and Act 28 June 2002 No. 62 (in force 1 July 2002 in accordance with Decree of 28 June 2002 No. 638).)

§ 54Expiration of authorisation, licence and certificate of completion of specialist training

Authorisation, licence and certificate of completion of specialist training expire when the holder turns 75 years of age. The professional title may however still be used.

Health personnel over 75 years of age may however be granted a licence or certificate of completion of specialist training subject to certain conditions, cf. section 49 fourth paragraph and section 51.

(Amended by Act of 21 Dec. 2000 No. 127 (in force 1 Jan. 2001 in accordance with Decree of 21 Dec. 2000 No. 1359).)

Chapter 11. Reactions etc. to breach of the provisions of this Act

(Heading amended by Act of 21 Dec. 2000 No. 127 (in force 1 Jan. 2001 in accordance with Decree of 21 Dec. 2000 No. 1359).)

§ 55Request for assessment of possible breach of duty

A person, who is of the opinion that provisions relating to duties stipulated in or pursuant to this Act have been breached in his disfavour, may request an assessment of the matter from the supervising authority. The patient may act through a representative. The request is to be sent to the county medical officer.

A representative pursuant to the first paragraph is the person who has the authority to lodge a request on behalf of others, or who is competent to grant consent pursuant to the provisions of the Patient Rights Act, chapter 4. A person holding power of attorney, who is not a lawyer, shall present a written authorisation.

The county medical officer shall consider the views put forward in the request, and may also address other matters than those put forward in the request.

If the county medical officer is of the opinion that a reaction should be imposed pursuant to the provisions of chapter 11, the case shall be sent to the Norwegian Board of Health. The third paragraph shall apply correspondingly to the handling of the case by the Norwegian Board of Health.

The supervising authority shall give the person who lodged the request information on the result of the case, as well as a brief presentation of the grounds for this result.

The Ministry may in regulations stipulate further provisions relating to the rules of procedure for the supervising authority, and may stipulate provisions on time limits for the lodging of a request pursuant to this section.

(Amended by Act of 21 Dec. 2000 No. 127 (in force 1 Jan. 2001 in accordance with Decree of 21 Dec. 2000 No. 1359).)

§ 56Warning

The Norwegian Board of Health may give a warning to health personnel who intentionally or negligently contravenes duties stipulated in this Act or provisions pursuant to this Act, if the breach of duty is liable to endanger the safety of the health service or impose a considerable burden on patients.

A warning is an individual decision pursuant to the Public Administration Act.

(Amended by Act of 21 Dec. 2000 No. 127 (in force 1 Jan. 2001 in accordance with Decree of 21 Dec. 2000 No. 1359).)

§ 57Revocation of authorisation, licence or certificate of completion of specialist training

The Norwegian Board of Health may revoke an authorisation, licence or certificate of completion of specialist training if the holder is unfit to practice his profession in a responsible manner for reasons of severe mental illness, mental or physical impairment, prolonged absence from the profession, use of alcohol or narcotics or substances with a similar effect, a gross lack of professional insight, irresponsible conduct, gross breach of duty pursuant to this Act or provisions stipulated in accordance with this Act, or due to behaviour considered to be incompatible with professional conduct.

Authorisation, licence or certificate of completion of specialist training may be revoked if the holder in spite of a warning fails to comply with statutory requirements.

An authorisation, licence or certificate of completion of specialist training may also be revoked if the conditions stipulated in regulations in accordance with section 48, section 49 or section 51 have not been met.

An authorisation, licence or certificate of completion of specialist training that have been granted on the basis of a similar certificate in another country, may be revoked if the certificate granted in the other country is no longer valid.

Revocation is an individual decision pursuant to the Public Administration Act.

§ 58Suspension of authorisation, licence or certificate of completion of specialist training

If there is reason to believe that the conditions for revocation are present, and the health personnel is considered to be endangering the safety of the health service, the Norwegian Board of Health may suspend authorisation, licence or certificate of completion of specialist training pending a final decision in the case. The suspension may apply for a period of six months and may be extended once for an additional period of six months.

Suspension is an individual decision pursuant to the Public Administration Act.

§ 59Limiting of authorisation

The Norwegian Board of Health may limit the authorisation so that it only applies to the performance of certain activities under certain conditions.

Such limitations may be stipulated in cases where health personnel in spite of the fact that the conditions for revocation are present, are considered to be suited to perform activities within a limited field under supervision and guidance.

A decision relating to the limiting of authorisation is an individual decision pursuant to the Public Administration Act.

§ 60Order of examination by experts

In cases where revocation of authorisation, licence or certificate of specialist training is to be considered, the Norwegian Board of Health may order health personnel to undergo a medical or psychological examination by experts.

The Norwegian Board of Health may suspend authorisation, licence or certificate of completion of specialist training so long as the order given pursuant to the first paragraph is not complied with.

§ 61Voluntary renouncement of authorisation, licence or certificate of completion of specialist training

Health personnel may themselves renounce their authorisation, licence or certificate of completion of specialist training by submitting a written statement to this effect to the county medical officer. The document granting authorisation, licence or certificate of completion of specialist training shall if possible be handed in at the same time.

§ 62New authorisation or licence

The Norwegian Board of Health may grant health personnel who have lost their authorisation, licence or certificate of completion of specialist training by revocation or voluntary renouncement, a new authorisation, licence or certificate of completion of specialist training if the relevant health personnel is able to prove that he is suited thereto. The new authorisation may be limited pursuant to section 59.

Refusal of an application for a new authorisation or licence is an individual decision pursuant to the Public Administration Act.

§ 63Loss of the right to require medicinal products in Group A and B

If medical practitioners’ or dentists’ requisition of medicinal products is considered to be irresponsible, the Norwegian Board of Health may revoke the right to require such medicinal products wholly or in part for a period of time, or permanently. The same applies to other health personnel who in regulations laid down pursuant to section 11 have been granted a limited right to require medicinal products.

Health personnel may themselves renounce the right to require medicinal products as mentioned in the first paragraph by submitting a written statement to this effect to the county medical officer. A renouncement is binding for the period of time for which it has been granted.

If the conditions for revocation are still present upon expiry of the time limit pursuant to the first paragraph, the Norwegian Board of Health may make another decision pursuant to the first paragraph.

When medical practitioners or dentists do not themselves have the right to require medicinal products in group A and B, the municipal medical officer, chief consultant or the county dental officer shall require the medicinal products that are necessary for the relevant medical practitioner or dentist in his practice. They may also grant approval to other health personnel to carry out requisitions.

A decision relating to the revocation of the right to require medicinal products is an individual decision pursuant to the Public Administration Act.

§ 64Suspension of requisition rights

If there is reason to believe that the conditions for a revocation of requisition rights are present, and health personnel is considered to be endangering the safety of the health service, the Norwegian Board of Health may suspend the right to require medicinal products as mentioned in section 63, pending a decision in the case, but not exceeding six months. If the health personnel delay the case, the suspension may be extended for an additional period of six months.

A decision relating to the suspension of the right to require medicinal products is an individual decision pursuant to the Public Administration Act.

§ 65Reduction of period of loss of requisition rights

If it is found to be safe to do so, the Norwegian Board of Health may return the rights to health personnel to require medicinal products in group A and B prior to the time when the stipulated period expires.

Refusal of this type of application is an individual decision pursuant to the Public Administration Act.

§ 66Information to employers and to other countries

The Norwegian Board of Health shall notify the employer of warnings, revocations, voluntary renouncement or suspension of authorisations, licences or certificates of completion of specialist training or requisition rights or limiting of authorisation. The term employer also includes any public authority that the relevant health personnel have entered into an agreement with relating to the running of a practice.

If the health personnel run an independent practice with an agreement relating to the running of a practice, the Norwegian Board of Health shall give the relevant public authority advance notice when there are legitimate reasons to suspect that the conditions for the aforementioned measures are present, and the decision will influence the possibilities to comply with the agreement.

Upon revocation, voluntary renouncement and suspension of authorisations, licences, certificates of completion of specialist training, requisition rights or upon limiting of authorisation, the Norwegian Board of Health shall notify the countries that Norway by international law is required to inform.

§ 67Punishment

Anyone who intentionally or by gross negligence contravenes the provisions of this Act, or who aids and abets thereto, shall be punished by fines or a term of imprisonment not exceeding three months.

Public prosecution will be instituted if it is in the public interest or by petition by the Norwegian Board of Health.

Chapter 12. The Norwegian Appeals Board for Health Personnel and the Norwegian Pharmacy Appeals Board

(Heading amended by Act of 21 Dec. 2000 No. 127 (in force 1 Jan. 2001 in accordance with Decree of 21 Dec. 2000 No. 1359).)

§ 68the Norwegian Appeals Board for Health Personnel and the Pharmacy Appeals Board

A Norwegian Appeals Board for Health Personnel (Statens helsepersonellnemnd - HPN) is established. In cases governed by the Pharmacy Act, the Board shall refer to themselves as the Norwegian Pharmacy Appeals Board (Apotekklagenemnd - AKN).

The Norwegian Appeals Board for Health Personnel is the administrative appeals body for decisions pursuant to sections 53, 56-59 and 62-65. The Pharmacy Appeals Board is the administrative appeals body for decisions as stipulated in the Pharmacy Act section 9-1 first paragraph.

(Amended by Act of 21 Dec. 2000 No. 127 (in force 1 Jan. 2001 in accordance with Decree of 21 Dec. 2000 No. 1359).)

§ 69 Organisation of the Norwegian Appeals Board for Health Personnel

The Norwegian Appeals Board for Health Personnel shall be an independent body with high expertise within the fields of health and law that is appointed by the Ministry for three years at a time.

The Norwegian Appeals Board for Health Personnel shall consist of three members of the legal profession, one of whom shall be the head of the Board, as well as three members with a background as health professionals and one lay representative.

The Norwegian Appeals Board for Health Personnel may appoint two experts to assist in each individual case.

The Ministry may in regulations stipulate further provisions relating to the organisation of the Norwegian Appeals Board for Health Personnel.

§ 70Executive processing work by the Norwegian Appeals Board for Health Personnel

The Ministry may in regulations lay down further provisions relating to the executive processing to be carried out by the Norwegian Appeals Board for Health Personnel.

§ 71Judicial review

Decisions by the Norwegian Appeals Board for Health Personnel pursuant to sections 53, 56-59 and 62-65 may be brought before the courts that may review all aspects of the case.

Cases are to be reviewed pursuant to the provisions of the Civil Procedure Act, chapter 30. By order of the court it may be decided that decisions pursuant to the provisions of the first paragraph shall not come into effect pending a final decision in the case, or before a final judgment has been reached.

Notwithstanding these provisions, decisions may be brought before the Parliamentary Ombudsman.

(Amended by Act of 21 Dec. 2000 No. 127 (in force 1 Jan. 2001 in accordance with Decree of 21 Dec. 2000 No. 1359).

§ 72 (Repealed by Act of 21 Dec. 2000 No. 127 (in force 1 Jan. 2001 in accordance with Decree of 21 Dec. 2000 No. 1359).)

Chapter 13. Miscellaneous provisions

§ 73Compensation for loss upon suspension and revocation

If decisions relating to suspension or revocation prove to be invalid or set aside for other reasons, compensation for loss may be claimed pursuant to the general provisions relating to the statutory provisions relating to damages.

§ 74Use of protected title

Holders of authorisation, licence or certificate of completion of specialist training only are entitled to use such job titles characteristic of the relevant group of health personnel.

No one must unrightfully make use of or announce activities in such a way as if to give the impression that the person concerned has been granted an authorisation, licence or certificate of completion of specialist training.

The Ministry may in regulations give further provisions relating to which titles are protected pursuant to this section.

§ 75Entry into force

This Act shall enter into force at the time determined by the King. The King may determine that certain provisions of this Act shall enter into force at different times.

(The Act entered into force 1 Jan. 2001 with the exception of section 38, in accordance with Decree of 1 Dec. 2000 No. 1190.)

§ 76Transitional provisions

Regulations etc. laid down pursuant to Acts repealed or amended upon entry into force of this Act shall apply to the extent that they are not contrary to this Act or regulations stipulated pursuant to this Act.

Persons who, upon entry into force of this Act, holds an authorisation, public certification as health personnel, licence or certificate of completion of specialist training, shall keep their authorisation, certification, licence or certificate of completion of specialist training pursuant to this Act.

The Ministry may stipulate regulations relating to the implementation of this Act including transitional provisions.

(Amended by Act of 21 Dec. 2000 No. 127 (in force 1 Jan. 2001 in accordance with Decree of 21 Dec. 2000 No. 1359).)

§ 77Repeal of and amendments to other Acts

From the time of entry into force of this Act, the following Acts are repealed:

1) Act of 13 July 1956 relating to physiotherapists etc.

2) Act of 8 January 1960 No. 1 relating to certification of nurses.

3) Act of 11 June 1971 No. 54 relating to orthetists and prosthetics and sale of orthopaedic appliances

4) Act of 23 June 1972 No. 69 relating to certification of psychiatric nurses

5) Act of 9 March 1973 No. 13 relating to certification of psychologists

6) Act of 14 June 1974 No. 47 to relating to certification of health personnel

7) Act of 13 June 1980 No. 42 relating to medical practitioners

8) Act of 13 June 1980 No. 43 relating to dental practitioners

9) Act of 26 April 1985 No. 23 relating to midwifes