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charset="utf-8" Content-Transfer-Encoding: 8bit ________________________________ Saatja: Karmen Joller - SOM Saadetud: kolmapäev, 07. oktoober 2026 13:49 Adressaat: Ülle Madise - OKK Koopia: Õiguskantsleri Kantselei - OKK Teema: Patsiendisaladuse kaitse Tere, Ülle! Justiits- ja Digiministeerium ja Sotsiaalministeerium on koostöös ette valmistanud kriminaalmenetluse seadustiku ja teiste seaduste muutmise seaduse (ametiprivileegid) eelnõu. Tehtavate muudatustega soovime luua süüteomenetluses selgema ja terviklikuma ameti- ja kutsesaladuse kaitse süsteemi. Terviseandmete saamiseks täpsustame menetluskorda. Meile on oluline, et terviseandmed oleksid kaitstud ning nende väljastamine toimuks selgetel alustel. Eelnõu sisu osas on meil justiits- ja digiministriga ühtne arusaam ja soovime sellega peagi edasi liikuda Vabariigi Valitsuse istungile, kuid eriarvamus on tänase seadusandluse tõlgendamisel. See tõlgendus saab takistuseks selge kommunikatsiooni tegemisel ja on juba palju segadust külvanud. IKÜM (GDPR) alusel tohib andmeid töödelda kas isiku nõusolekul või seaduse alusel. Seda rõhutab ka Riigikohtu 1-20-5071 lahend: 23. Ebaseaduslik on igasugune patsiendisaladuse avaldamine, mille jaoks ei ole kas patsiendi nõusolekut või seadusest tulenevat selget alust, mis omakorda võib olla kahetine - kas andmete avaldamist lubav või selleks kohustav. 25. Kohustus patsiendisaladuse avaldamiseks võib tuleneda mõnest valdkondlikust õigusaktist. Sellisel juhul on seadusandja otsustanud, et avalik huvi on olulisem patsiendi huvist hoida tervishoiuteenuse osutamise käigus avaldatud andmed saladuses. Näiteks sätestab nakkushaiguste ennetamise ja tõrje seaduse § 4 lg 9, et tervishoiuteenuse osutaja peab informeerima kohalikku omavalitsust eriti ohtlikku nakkushaigust põdevast nakkushaigest, kes on teistele ohtlik, keeldunud ravist või rikkunud ravirežiimi, kui see on vajalik isiku kinnisesse asutusse paigutamiseks. LasteKS § 27 lg 1 paneb aga igaühele kohustuse teatada abivajavast lapsest, sotsiaalhoolekande seaduse § 13 kohustab mh tervishoiutöötajat teatama sotsiaalhoolekannet vajavast isikust või perekonnast ja surma põhjustamise tuvastamise seaduse (SPTS) § 5 lg 3 kohustab kuriteokahtluse korral teavitama inimese surmast viivitamata uurimisasutust või prokuratuuri. PPA-l on õigus andmeid saada selle normi alusel ja TEHIK-ul kohustus väljastada: TTKS § 593. Tervise infosüsteemi andmetele juurdepääsu võimaldamine ja tasu (7) Lisaks käesoleva paragrahvi lõikes 6 sätestatule väljastatakse isikuandmeid üksnes andmesubjekti enda nõusolekul, ilma andmesubjekti nõusolekuta teadus- ja ajaloouuringu ning riikliku statistika vajadusteks või süüteo- või kohtumenetluses tõe väljaselgitamiseks või käesoleva seaduse § 56 lõike 1 punkti 12 alusel moodustatud arstliku ekspertiisikomisjoni otsuse tegemiseks, Terviseametile ja Andmekaitse Inspektsioonile nende ülesannete täitmise tagamiseks, Kaitseministeeriumile kaitseväeteenistuse seaduses ja Kaitseliidu seaduses sätestatud terviseseisundi hindamise üle järelevalve tegemiseks ning muul juhul, kui tervise infosüsteemist andmete väljastamine või edastamine on seaduses sätestatud. PPA ja KAPO viisid läbi teenistusliku kontrolli terviseandmete kasutamise üle. Kontroll tuvastas, et valdav enamus päringuid olid korrektsed, õiguspärased ja põhjendatud. Raporti kokkuvõte kirjeldab, et terviseandmete päringute praktika on ebaühtlane. PPA leiab, et TEHIK-ust andmete küsimiseks on PPA-l selge seaduslik alus, mis võimaldab süüteomenetluses andmeid saada ka inimese nõusolekuta, kuigi PPA suunis näeb üldjuhul ette nõusoleku küsimise. Kõige ebaselgem on X-tee kaudu Tervisekassa infosüsteemist andmete pärimine, sest nõusoleku küsimus ei ole õiguslikus aluses selgelt reguleeritud ning kontroll tuvastas nõusolekunõude rikkumisi retsepti- ja töövõimetusandmete pärimisel. Selguse peaks looma juba Riigikogu menetluses olev eelnõu, mis näeb ette Tervisekassa andmekogu ja retseptikeskuse liitmist tervise infosüsteemiga. Kõige rohkem küsib PPA terviseandmeid otse tervishoiuasutustelt. Nõusolekuta päringud on teatud juhtudel lubatud, kuid kontroll tuvastas korduvaid juhtumeid, kus päringud ei olnud kehtiva õiguse järgi korrektsed. Teenistusliku kontrolli tulemusena sõnastati peamised soovitused, mille eesmärk on korrastada terviseandmete pärimist reguleerivat õigusruumi, ühtlustada praktikat, tõsta ametnike teadlikkust, tugevdada sisekontrolli ning arendada infosüsteemide võimekust terviseandmete töötlemise paremaks dokumenteerimiseks ja kontrollimiseks. Teenistusliku kontrolli valmimise ajaks oli juba tegeletud koordinaatorite kaudu uurijate teadlikkuse tõstmisega, nelja silma reegli rakendamise ning juhiste täpsustamisega. SoM seisukoht: Kehtivat TTKS sätet tuleb täita ja see on praegu andmete väljastamise õiguslik alus. TEHIK-ul ei ole alust keelduda andmete väljastamisest, kui PPA esitab põhjendatud andmepäringu. Senikaua, kuni norm ei ole põhiseadusvastaseks kuulutatud või muudetud, on tegemist kehtiva õigusega. Siseriiklik õigus täpsustab IKÜM-i. IKÜM alusel peabki siseriiklik õigus andmete töötlemise aluse sätestama. IKÜM põhimõtted kehtivad sinna juurde. Kui leitakse, et TTKS alus on patsiendisaladuse või andmete töötlemise kaitseks liiga lai, tuleb muuta seadust. Kuni seaduse muudatus ei ole jõustunud, ei saa olemasolevat väljastamisalust käsitada nii, nagu seda ei oleks olemas. Samal ajal ei vabasta säte andmetöötlejat kohustusest väljastada üksnes eesmärgi saavutamiseks (süüteo tõe väljaselgitamiseks) vajalike andmetega. Sama kohustus on ka andmete küsijal, lähtudes eesmärgipärasuse ja minimaalsuse printsiibist. Õiguslik vaidlus ongi nüüd selles, kas norm on üldse kohaldatav ja kas võib olla liiga avar ja laialt tõlgendatav. Nii andmete andja kui andmete küsija peavad lähtuma IKÜM-st ning küsima ja väljastama andmeid minimaalselt. Norm kaitseb täna avalikku huvi. Ühiskond soovib, et süüteod saaksid lahendatud. EL üldmäärus kehtib meie TTKS normi kõrval, kuid siseriiklik õigus peabki EL õigust täpsustama ja eraldi aluse andma. Meie arusaamise järgi see Riigikohtu lahend ei lükka ümber TTKS § 59³ lõikes 7 sätestatud andmete väljastamise alust, vaid Riigikohtu enda käsitlus toetab järeldust, et selge erinormi olemasolul võib patsiendisaladusega kaitstud andmeid avaldada. Kuidas peaksime täna kehtivat õigusruumi tõlgendama? Kas TEHIK-ul on alus keelduda kõikide terviseandmete väljastamisest uurimisasutustele? Vajame hinnangut edasiste sammude planeerimiseks, et tagada terviseandmete ja patsiendisaladuse kaitse. Kuna ka avalikkuse huvi antud teema vastu on suur, siis oleme tänulikud võimalikult kiire vastuse eest. 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