Health Act (GesG) (GESG)

1. This Act regulates public healthcare.

2. It aims, taking into account personal responsibility and economic efficiency, to promote, protect, maintain, and restore health. Health is the state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.

3. Provisions related to healthcare in other cantonal decrees as well as in inter-cantonal, federal, and international law remain reserved.

1. The Cantonal Council influences the cantonal health policy within the scope of its competencies.

1. The Executive Council is the supreme health authority of the canton.

2. It appoints the cantonal bodies in accordance with §§ 5-10 of this Act. It may delegate the tasks of the cantonal bodies mentioned in §§ 6-10 of this Act, in whole or in part, to third parties.

3. It prepares at least every six years a planning report on health care in the canton and submits it to the Cantonal Council for comments in accordance with § 79 of the Cantonal Council Act of June 28, 1976. The report includes the strategic goals and principles of the canton in health care and outlines the needs for outpatient and inpatient health care for the population and the resources to ensure it. Service providers are to be adequately involved in the preparation.

1. The Department of Health and Social Affairs implements the cantonal health policy. It exercises oversight over the public health system. For this purpose, it has at its disposal the cantonal bodies mentioned in §§ 5-12 of this law.

2. It enforces international and inter-cantonal agreements as well as federal and cantonal laws and regulations in the area of public health. The competence of other authorities remains reserved.

1. The Government Council may appoint commissions for professional advice or for specific matters.

1. The Cantonal Physician shall fulfill the duties assigned to him or her by federal and cantonal legislation. He or she shall advise the Department of Health and Social Affairs.

1. The Cantonal Veterinarian fulfills the responsibilities assigned to him or her by federal and cantonal legislation. He or she advises the Department of Health and Social Affairs.

1. The Cantonal Chemist fulfills the duties assigned to him or her by federal and cantonal legislation. He or she advises the Department of Health and Social Affairs.

1. The Cantonal Pharmacist fulfills the duties assigned to him or her by federal and cantonal legislation. He or she advises the Department of Health and Social Affairs.

1. The Cantonal Dentist fulfills the duties assigned to him or her by the cantonal legislation. He or she advises the Department of Health and Social Affairs.

1. The official physicians perform the duties assigned to them by federal and cantonal legislation. The competent authority appoints them in the appropriate number.

2. ...

1. The official veterinarians perform the duties assigned to them by the federal and cantonal legislation. The competent authority appoints them in the appropriate number.

2. ...

1. The Municipal Council is the local health authority. It exercises supervision over public health within its municipal area. It may delegate its duties and powers, in whole or in part, to a local health commission or to other third parties.

2. The local health authority of the municipality is particularly entrusted with the following tasks

a. the monitoring of environmental and residential hygiene,

b. the implementation of measures against health-damaging emissions of all kinds,

c. the assistance in the enforcement of health police measures by cantonal authorities.

1. Municipalities may elect a municipal physician for their responsibilities in healthcare.

2. The competent authority may assign the functions of an official physician to the municipal physician.

1. The Government Council may delegate specific tasks and powers of food inspection to the municipalities through regulation, in particular the appointment and remuneration of food inspectors as well as meat inspectors.

1. A license to practice a profession (license) is required for anyone who, under their own professional responsibility

a. Diagnoses and treats diseases, injuries, or other disorders of the mental and physical health of humans and animals according to the findings of recognized sciences or within the scope of scientific research,

b. Practices a profession that is listed as a service provider in health insurance law,

c. Performs joint manipulations with impulses, manufactures visual aids and dental prostheses, or treats sick, injured, or otherwise health-impaired individuals with instrumental interventions that injure the skin,

d. * Applies, dispenses, and manufactures medicinal products; excluded from this is the application and dispensing of complementary medicine products,

e. * Engages in an activity regulated by a federal diploma in naturopathy.

2. Subject to the licensing requirement are the professions that require a license according to the Medical Professions Act[4], the Health Professions Act[5], or the Psychology Professions Act[6] of the Confederation, as well as other professions subject to a licensing requirement in accordance with § 36.

3. The competent authority may prohibit the exercise of non-licensable activities if they endanger life and limb. The government council regulates the rights and obligations in the exercise of non-licensable activities, particularly the scope of activity, by regulation. For non-dangerous interventions, it may waive the licensing requirement under paragraph 1c.

1. Members of university-level medical professions and other healthcare professions who are authorized to practice in other cantons do not require a permit

a. if they are consulted by the treating professional in the Canton of Lucerne on a case-by-case basis,

b. * for professional visitation activities from their place of activity.

2. Sections 18a and 19 of this law apply mutatis mutandis.

1. The license to practice the profession with personal professional responsibility shall be granted if the applicant

a. * meets the professional requirements demanded by legislation,

b. * is trustworthy and provides physical and psychological assurance for flawless professional conduct, and

c. * possesses the necessary knowledge of the German language.

d. * ...

1. The authorization may be subject to conditions of a professional, temporal, or spatial nature or with stipulations insofar as this is required to ensure a high-quality healthcare provision.

1. The permit shall be revoked if the conditions for its issuance are no longer fulfilled, or if facts are subsequently discovered that would have necessitated its refusal.

a. * ...

b. * ...

c. * ...

d. * ...

e. * ...

2. If the person holds a professional practice permit in another canton, the competent authority shall inform the supervisory authority of that canton.

3. ...

1. The Authorization Expires Upon

a. the death of the holder,

b. the revocation,

c. the written declaration of waiver by the holder to the competent authority.

2. ...

1. In the event of a breach of professional duties, the provisions of this law, or implementing provisions thereto, the competent authority may impose the following disciplinary measures

a. a warning,

b. a reprimand,

c. a fine of up to 20,000 Swiss francs,

d. a prohibition on independent professional practice under one's own professional responsibility for a maximum of six years (temporary prohibition),

e. a permanent prohibition on professional practice under one's own professional responsibility for all or part of the scope of activities.

2. For the breach of professional duties under § 24 paragraph 1b, only disciplinary measures under paragraph 1a-c may be imposed.

3. A fine may be ordered in addition to a prohibition on professional practice under one's own professional responsibility.

4. The competent authority may restrict, impose conditions on, or revoke the authorization during the disciplinary proceedings.

5. If the competent authority initiates disciplinary proceedings against a person holding the authorization of another canton, it shall inform the supervisory authority of that canton thereof.

1. The competent authority shall suitably publish the issued permits, their revocation or other cessation, as well as the imposed professional bans, as soon as the corresponding decisions are legally binding.

1. The authority responsible for deciding on the exemption from professional secrecy pursuant to Article 321 Number 2 of the Swiss Criminal Code is the competent authority.

2. Persons who are obligated to maintain confidentiality are exempt from professional secrecy for the enforcement of disputed claims arising from the treatment relationship towards the assigned collection agency and the competent authorities.

1. The holder of the permit must personally carry out the authorized activity.

2. The competent authority may approve a representative with sufficient training in the event of illness, during vacation, or in other justifiable temporary hindrances.

3. Provisions regarding assistance are reserved.

**1. License Holders Must Adhere to the Following Professional Duties:**

a. They must practice their profession diligently and conscientiously, adhering to the limits of the competencies acquired through education, training, and further training.

b. They must deepen, expand, and improve their professional knowledge, abilities, and skills in the interest of quality assurance through lifelong continuing education.

c. They must uphold the rights of patients.

d. They must engage in advertising that is objective, meets public needs, and is neither misleading nor intrusive.

e. They must exclusively safeguard the interests of patients when collaborating with other health professionals and act independently of financial incentives.

f. They must maintain professional confidentiality in accordance with applicable regulations.

g. They must obtain professional liability insurance commensurate with the nature and extent of the risks associated with their activities.

**2. Additional Professional Duties Imposed by the Federal Government Remain Reserved.**

1. In the practice of their profession, practitioners must respect the rights of patients, such as the duty to inform, the right to self-determination, and the right to access their own medical records.

2. Incurably ill and dying individuals are entitled to appropriate care and the alleviation of their suffering and pain according to the principles of palliative medicine and care.

3. Patients contribute to the successful course of their treatment within their abilities. In particular, they provide the license holder with as complete information as possible about their health condition and follow the instructions to which they have consented.

1. License holders are required to maintain records of their professional practice.

2. The government council shall determine the retention period for the records by regulation.

3. In the event of cessation of activity, the obligation to retain records pursuant to paragraph 2 shall continue. The license holder must ensure that the records are managed in accordance with professional secrecy and accessible to entitled patients.

4. If compliance with the prescribed record retention cannot be ensured, the competent authority may order that the records be held by an entity designated by it, at the expense of the license holder or their heirs.

1. Authorization holders must immediately report extraordinary deaths to the law enforcement authority.

2. They are entitled to report and provide information to the law enforcement authority regarding observations and circumstances that suggest a committed or impending crime or offense against life and limb, public health, or sexual integrity.

1. The remuneration for the services provided by healthcare professionals shall be subject to explicit or implicit agreement. The government council may, after consulting the relevant professional organizations, establish tariffs that shall apply in the absence of an agreement.

2. The provisions of social insurance law remain reserved.

1. The canton may operate educational and training institutions for healthcare professions itself or commission third parties to do so.

2. It may support educational and training institutions for healthcare professions as well as internship positions through financial contributions.

1. University Medical Professions as per § 16 paragraph 2 include doctors, dentists, chiropractors, pharmacists, and veterinarians.

2. Should the federal government designate additional professions in the healthcare sector as university medical professions, the governing council shall list them in a regulation and, if necessary, establish the specific rights and duties associated with practicing the profession, particularly regarding the scope of activities or the obligation to make their services available to the public.

1. Physicians, dentists, and veterinarians may operate a private pharmacy with the approval of the competent authority.

2. The competent authority grants approval if the proper storage, monitoring, and dispensing of medications is ensured.

3. The requirement for approval does not apply to the direct application of medications to patients nor to dispensing in emergencies and during house calls.

4. Holders of a private pharmacy are permitted to dispense medications solely for their own practice needs. Retail sales and supplying to resellers are prohibited.

5. Patients and animal owners may demand that they obtain medications from a public pharmacy or another retail outlet. They must be informed of this option in an appropriate manner.

1. Individuals who practice a university-level medical profession with their own professional responsibility are obligated to provide assistance in emergencies.

2. Physicians, dentists, veterinarians, and pharmacists who hold a permit pursuant to § 16 are additionally required to personally participate in emergency services. The emergency services shall be regulated by the professional associations. If the emergency service is inadequate, the Department of Health and Social Affairs may mandate the necessary measures.

3. The professional associations are authorized to demand a compensatory fee from physicians, dentists, veterinarians, and pharmacists who are obligated to perform emergency services but do not do so. This fee is 1.5 percent of the income subject to AHV from the medical professional activity, but a maximum of 5000 francs per year.

4. The costs of emergency treatment are primarily to be borne by the patient and secondarily by the community obligated to provide support. This is without prejudice to maintenance and support obligations of family members and relatives. The government council shall provide further regulations by ordinance.

1. The competent authority may permit individuals who practice a university-level medical profession with their own professional responsibility to employ assistants.

1. The Government Council regulates the specific rights and obligations of individuals who practice a university-level medical profession with their own professional responsibility, particularly the scope of activities, by means of an ordinance.

1. The government council determines the other professions in the healthcare sector that are subject to the licensing requirement according to § 16 paragraph 1 and regulates the details, namely the professional requirements for the license and the specific rights and duties in the practice of the profession, particularly the scope of activities, by ordinance.

1. A permit is required for the operation of

a. * hospitals and maternity homes,

b. * outpatient medical, dental, and chiropractic facilities,

c. public pharmacies and hospital pharmacies,

d. other organizations and facilities that require cantonal approval under the Federal Health Insurance Act of March 18, 1994, such as home care and nursing organizations (Spitex),

e. drugstores.

2. The provisions of this law concerning private pharmacies and operating permits based on other regulations remain reserved.

1. The permit is granted if the establishment

a. designates a responsible professional who holds a permit according to § 16,

b. possesses the necessary professional staff to provide the services,

c. * is equipped for the provision of the offered services,

d. * offers assurance of compliance with operational regulations, is appropriately organized, and ensures the professional independence of those persons who practice an activity requiring a permit under their own professional responsibility,

e. * has an appropriate quality assurance system.

2. For hospital pharmacies, the requirements of § 31 apply accordingly.

3. The government council regulates the details by decree.

1. Organizations for nursing care and home assistance must be approved by the municipality in which they are located. Other enterprises are approved by the competent cantonal authority.

2. Enterprises requiring approval are subject to the supervision of the approving authority.

1. The provisions of §§ 18a-22 and 24-28 shall apply mutatis mutandis to the licensed establishments in the healthcare sector.

1. The details concerning the cantonal hospitals are governed by a specific law.

1. An autopsy may be performed if the deceased person has given their consent or if the next of kin gives consent on their behalf. The government council shall regulate the details by ordinance.

2. Special orders from the Department of Health and Social Affairs or the criminal investigation authorities remain reserved.

1. The removal of organs, tissues, or cells of human or animal origin as well as the handling of products made from them (transplantation products) intended for transplantation into humans are governed by the provisions of the Transplantation Act of October 8, 2004.

2. ...

3. ...

1. The canton may take measures and provide contributions to relevant projects and institutions to enhance the quality and cost-effectiveness of healthcare provision and to promote security of supply within the framework of budgetary credits. It ensures regular evaluation.

2. The provisions of the Federal Act on Health Insurance (KVG) remain reserved.

1. The canton and the municipalities shall ensure an adequate provision of basic palliative care within the scope of their responsibilities.

2. They shall jointly operate a specialized mobile service for palliative care. They may delegate this task to private or public service providers. The costs shall be equally borne by the canton and the municipalities. The share of each municipality is calculated based on the permanent resident population of the previous year according to the surveys by Lustat Statistics Lucerne.

1. Health promotion aims to improve the health status of individuals, the general population, and specific groups of people.

2. Prevention aims to avert certain diseases and accidents and to reduce their frequency and severity. It includes measures for the early detection of diseases and the mitigation of the consequences of diseases and accidents.

1. The canton and the municipalities engage in prevention and health promotion, particularly in the areas of exercise, nutrition, and addiction. The cantonal sports promotion is governed by the Law on the Promotion of Sports and Exercise (Cantonal Sports Promotion Law) dated December 9, 2013.

2. The canton may, within the framework of budgetary credits, provide contributions to institutions active in the field of prevention and health promotion.

3. The joint promotion of institutions according to paragraph 2 by the canton and the municipalities takes place within the framework of the association according to § 23 of the Social Assistance Act dated March 16, 2015.

4. The Department of Health and Social Affairs may conduct voluntary medical prevention examinations and take voluntary preventive measures for those affected.

1. Smoking in indoor areas of public facilities is prohibited according to the provisions of the Federal Act on Protection from Passive Smoking of October 3, 2008.

2. The Lucerne Police impose fines for violations of federal regulations that they observe during their activities and to which the ordinance fine procedure is applied.

1. The sale of tobacco products to persons under the age of 16 is prohibited.

2. Operators of vending machines must ensure that access to tobacco products by persons under the age of 16 is made impossible.

1. Municipalities shall ensure adequate maternal and paternal counseling.

2. They may delegate this task to private institutions or municipal associations.

1. The canton provides comprehensive pregnancy counseling. It may delegate this function to private institutions.

2. Persons involved in pregnancy counseling pursuant to Paragraph 1 are subject to official secrecy regarding facts they become aware of in the course of fulfilling their duties, as stipulated in Article 320 of the Swiss Criminal Code.

3. The provisions of the Swiss Criminal Code concerning professional secrecy remain reserved.

1. The municipalities ensure the regular school medical examination of all children at the kindergarten level and of compulsory primary and secondary school age.

2. The examination is mandatory. The child's legal representative may have the examination conducted by the school doctor or, at their own expense, by another doctor.

3. The measures proposed by the school doctor are voluntary for those affected. If necessary, the government council can declare them mandatory.

4. The municipalities bear the costs of the children's examination by the school doctor.

5. In canton schools, private schools, as well as cantonal special schools or special school homes, the canton ensures the necessary school medical care for preschool and compulsory school children.

1. Municipalities shall ensure regular dental prophylaxis and examination, as well as the possibility of treatment, for all children at the kindergarten level and of compulsory primary and secondary school age.

2. Dental prophylaxis and examination are mandatory. The child's legal representative may have the examination conducted by the school dentist or, at their own expense, by another dentist. Treatment is voluntary. It may be carried out by the school dentist or by another dentist.

3. Municipalities shall bear the costs of dental prophylaxis and examination of children conducted by the school dentist. Parents shall bear the costs of treatment. If the school dentist conducts the treatment, the municipality of the parents' civil residence may, upon a justified request, wholly or partially cover the costs.

4. In cantonal schools, private schools, and cantonal special schools and special school homes, the canton shall ensure the necessary school dental care for preschool and school-age children.

1. ...

1. To increase the knowledge about cancer diseases among the population, the canton maintains a cantonal cancer registry. In this registry, all necessary data regarding cancer diseases, namely malignant and semi-malignant tumors, in the Canton of Lucerne are systematically recorded. This includes, in particular, all new cases, the stages and progressions of the diseases, as well as information on therapies conducted and the quality of life.

1. The Cantonal Council designates the operator of the cantonal cancer registry. It may assign this task to a cantonal office or to the Lucerne Cantonal Hospital. The provisions of the Information Technology Act of March 7, 2005, must be observed.

2. The operator of the cantonal cancer registry must possess the general authorization from the Expert Committee for the disclosure of professional secrecy for research in the field of medicine or healthcare pursuant to Article 321bis of the Swiss Criminal Code.

3. With the approval of the Cantonal Council, it can also operate the cancer registry for other cantons.

1. The registration of cancer cases in the cantonal cancer registry is governed by the Federal Act on the Registration of Cancer Cases (Cancer Registration Act) of March 18, 2016, and its implementing ordinances. Insofar as these do not contain specific provisions regarding data protection, the operator must comply with the general data protection regulations of the canton as well as those of the general authorization in accordance with Article 321bis of the Swiss Criminal Code when processing personal data.

2. The operator is authorized to disclose the data necessary for quality assurance, together with the AHV insurance number, to the competent authorities of cantonal early detection programs.

1. The operator of the cantonal cancer registry shall implement appropriate technical and organizational measures to prevent unauthorized access. They shall establish access regulations, specifically detailing which individuals may access non-anonymized personal data, for what purpose, and under what conditions. No access shall be granted to persons who do not work for the cantonal cancer registry.

2. Employees who have access to the non-anonymized data are subject to confidentiality and are required to sign a corresponding declaration.

1. The canton may conduct pilot projects to test electronic health services (e-health services). These projects may include an extended use of the insured card in the mandatory health care insurance beyond the purpose outlined in Article 42a, paragraph 2, and the usage possibilities according to Article 42a, paragraph 4 of the Federal Health Insurance Act.

2. For pilot projects, the systematic use of the AHV insurance number is permitted.

3. The government council regulates the specifics of each pilot project by issuing an ordinance. In particular

a. it establishes the framework, purpose, and time limitation of the pilot project,

b. it designates the cantonal authority responsible for conducting the pilot project,

c. it ensures that the participants take part voluntarily,

d. it specifies the data processed within the scope of the pilot project,

e. it regulates access rights to personal data,

f. it ensures the evaluation of the pilot project.

4. The provisions of the Cantonal Data Protection Act of July 2, 1990, must be observed.

1. The government council may take measures against communicable diseases, such as public vaccinations.

2. The measures are voluntary for the individuals concerned. If necessary, the government council may declare them mandatory.

3. Federal legal provisions and measures remain reserved.

1. Medicinal products, including blood and blood products, as well as medical devices, are considered remedies.

1. The traffic with therapeutic products is subject to state control.

2. For the manufacturing, placing on the market, and approval procedure, import and export, foreign trade, distribution, prescription and dispensing, advertising and price comparisons, clinical trials with therapeutic products on humans, as well as market surveillance and the conduct of inspections, the provisions of the Federal Act on Medicinal Products and Medical Devices (Therapeutic Products Act) of December 15, 2000, and the Pharmacopoeia apply.

3. In connection with the import and export of narcotics by ill travelers, the cantonal physician is authorized to process particularly sensitive personal data, insofar as this is necessary due to international agreements.

1. The competent authority grants the authorization for the mail-order trade in medicinal products.

2. The authorization requirements are governed by the federal therapeutic products legislation.

1. The government council shall determine by regulation which appropriately trained professionals, in addition to physicians, veterinarians, and dentists, are allowed to administer prescription medications. Furthermore, it shall specify in the regulation the extent of the dispensing authorization.

2. The competent authority shall grant the authorization

a. * ...

b. to individuals who manufacture medications according to the Formula magistralis, the Formula officinalis, or their own formula in accordance with Article 9, paragraphs 2a, b, and c of the Therapeutic Products Act.

3. The prerequisites and scope of the authorizations according to paragraph 2 are governed by the federal therapeutic products legislation.

1. The responsibility for funeral services lies with the municipalities.

2. The government council regulates the specifics by ordinance, particularly pertaining to the examination of corpses, the types of burials, as well as the supervision of cemeteries and their establishment.

**1. The Competent Authority and the Bodies Pursuant to Sections 6-10 of This Law are Authorized to Conduct Inspections and Order the Seizure of:**

a. *Facilities or equipment that are prohibited or have been used for a prohibited activity,*

b. non-compliant, defectively produced, spoiled, illegally advertised, or unlawfully intended to be distributed medicinal products, as well as associated packaging and containers,

c. substances that are used in the production of such medicinal products,

d. unauthorized promotional materials intended for unlawful distribution.

**1bis.** They may close operations or premises used for or have been used for a prohibited or health-endangering activity.

**1ter.** For the fulfillment of their duties, they shall be granted access to the premises, facilities, and records at any time and be provided with information. Persons who are bound by confidentiality are released from the professional secrecy obligation vis-à-vis the competent authority.

**2.** The competent authority decides on the use of the seized items. It orders the return when there is no longer any danger. If a permanent danger is expected, it orders the utilization or destruction. The owner receives the proceeds from the utilization after deduction of the costs.

**3.** Reserved are the right of control and the powers of confiscation according to the federal legislation on therapeutic products and the authorities of criminal justice.

1. Anyone who intentionally or negligently violates Sections 16, 27 Paragraph 1, 31 Paragraphs 1, 4 and 5, 32 Paragraphs 1 and 2, 34, 37, 42, 43, 48, 58 Paragraph 2, or 60 Paragraph 1ter of this Act or the corresponding enforcement provisions, or assists in their violation, shall be punished with a fine, unless special penal provisions are applicable.

1. Appeals against decisions by the competent authority regarding permits, disciplinary measures, the release from professional secrecy, the right of control, and seizure are permissible through an administrative court appeal.

2. In addition, the provisions of the Law on Administrative Justice of July 3, 1972, apply.

1. The following enactments are hereby repealed

a. Health Care Act (Gesundheitsgesetz) of June 29, 1981, except for §§ 62-66 and § 74,

b. School Dental Care Act of May 15, 1946.

2. Until new regulations are enacted, the existing ones shall remain in force, insofar as they do not conflict with this Act and with federal legislation.

1. If a profession in the healthcare sector is no longer subject to licensure under this law, the issued license shall expire upon the enactment of this law.

2. If it remains subject to licensure, the license issued prior to the enactment of this law shall remain valid.

**1. Persons who, prior to the entry into force of the amendment to this law dated October 26, 2020, have pursued an activity under their own professional responsibility, which is newly regulated by a federal diploma in naturopathy and did not require a license, may continue to practice their profession for a maximum of five years without a license after the entry into force of this amendment. The government council shall regulate the transitional recognition of training for activities regulated by a federal diploma in naturopathy by ordinance.**

**2. Outpatient medical, dental, and chiropractic facilities, which are newly subject to the licensing requirement according to § 37 paragraph 1b, must apply for an operating license within two years from the entry into force of the amendment to this law dated October 26, 2020.**

1. The Executive Council determines the commencement.

2. The law is subject to an optional referendum.