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FIFTH
SECTION
CASE OF EVELYNE DEIWICK v. GERMANY
(Application
no. 17878/04)
JUDGMENT
STRASBOURG
11 June 2009
This judgment will become
final in the circumstances set out in Article 44 § 2
of the Convention. It may be subject to editorial revision.
In the case of Evelyne Deiwick v. Germany,
The
European Court of Human Rights (Fifth Section), sitting as a Chamber
composed of:
Peer
Lorenzen,
President,
Rait
Maruste,
Karel
Jungwiert,
Mark
Villiger,
Isabelle
Berro-Lefèvre,
Mirjana
Lazarova Trajkovska,
Zdravka
Kalaydjieva,
judges,
and Claudia
Westerdiek, Section
Registrar,
Having
deliberated in private on 19 May 2009,
Delivers
the following judgment, which was adopted on that date:
PROCEDURE
- The
case originated in an application
(no. 17878/04) against the
Federal Republic of Germany lodged with the Court
under Article 34 of the Convention for the Protection
of Human Rights and Fundamental Freedoms (“the Convention”)
by a German national, Mrs Evelyne
Deiwick
(“the applicant”), on 15 May 2004.
- The
applicant was represented by Mr Hans-Jürgen Deiwick, her
husband. The German Government (“the Government”)
were represented by their Agent, Mrs A. Wittling-Vogel,
Ministerialdirigentin, of the Federal Ministry of Justice.
- On
9 January 2008 the
President of the Fifth Section decided to give notice of the
application to the Government. It was also decided to rule on the
admissibility and merits of the application at the same time
(Article 29 § 3).
- On
7 February 2008, on account of the fact that Judge Renate Jaeger, the
judge elected in respect of Germany, withdrew from sitting in the
case (Rule 28 of the Rules of Court), the respondent Government,
pursuant to Rule 29 § 1 (a), informed the Court that they had
appointed in her stead another elected judge, namely Judge Mark
Villiger.
THE FACTS
I. THE CIRCUMSTANCES OF THE CASE
- The
applicant was born in 1936 and lives in Hamburg.
- At
the material time the applicant was working as a general practitioner
in Hamburg.
A. Administrative proceedings
- On
31 August 1993 the review board at the Hamburg Regional Medical
Association (Prüfungsausschuss bei der Kassenärztliche
Vereinigung Hamburg), after having examined the applicant's
economic efficiency (see “Relevant domestic law and practice”
below), decided to reduce by 15% the fees payable to her for the
first quarter of 1993 and as far as initial check-ups were concerned.
It argued that the fees claimed for her initial check-ups exceeded
the average for that category by 72% and that there was thus a
presumption of a lack of economic efficiency which the applicant had
failed to rebut. Instead of 33,200 euros (EUR) the applicant was
therefore awarded a reduced sum of EUR 32,200 in quarterly fees.
- By a letter dated 8 November 1993 the applicant lodged
an administrative appeal.
- On 20 October 1994 the appeal board at the Hamburg
Medical Association (Beschwerdeausschuss bei dem
Prüfungsausschuss der Kassenärztlichen Vereinigung
Hamburg – “the appeal board”) dismissed her
appeal. It also held that the applicant had failed to rebut the
presumption of her lack of economic efficiency by demonstrating any
particularities of her practice or consequent savings justifying the
remuneration claimed for initial check-ups. That decision was served
upon the applicant on 25 January 1995.
B. Proceedings before the Hamburg Social Court
- By a letter dated 20 February 1995 the applicant
appealed to the Hamburg Social Court.
- On 8 March 1995 the court requested the appeal board
to submit its pleadings.
- In April 1995 the AOK Hamburg, a public
health-insurance company, requested a third-party summons
(Beiladung).
- On 4 July 1995 the applicant requested the court not
to schedule the hearing before mid-September 1995.
- On 9 August 1995, following a reminder from the court,
the appeal board submitted that the claim should be dismissed,
referring to the reasons stated in its decision. It also asked for an
extension of the time allowed for submitting additional observations.
- On 5 September 1995 the court issued a third-party
summons to the Hamburg Medical Association and the health-insurance
funds.
- On 3 June 1996 the applicant requested the court not
to schedule a hearing between 24 June and 19 July 1996.
- On 30 May 1997 the court scheduled the hearing for
17
September 1997.
- On 17 September 1997, at the hearing, the court
requested the appeal board to supply further information as regards
reductions of the fees paid to the applicant in previous quarters.
- On 5 November 1997 the appeal board submitted the
information requested.
- In her reply of 13 February 1998 the applicant
requested that further inquiries be carried out as to the facts. She
also complained about the length of the proceedings.
- In March 1998 the court suggested that the appeal
board and the third parties submit further observations.
- In April 1998 the appeal board filed its pleadings.
- On 23 June 1998 the applicant requested the court not
to schedule the hearing before 15 September 1998.
- On
7 July 1998 the court scheduled the hearing for 7 October 1998. The
AOK, a further insurance company, a regional insurance association
and also the Hamburg Medical Association were summoned as interested
parties.
- On
7 October 1998 it dismissed the applicant's claim. It held that the
appeal board had complied with its duty to provide clarification. It
also confirmed the finding that the applicant had failed to rebut the
presumption of her lack of economic efficiency as regards initial
check-ups.
C. Proceedings before the Hamburg Social Court of
Appeal
- By a letter dated 13 November 1998 the applicant
appealed to the Hamburg Social Court of Appeal.
- On 2 March 1999 the appeal board filed submissions in
reply.
- On 29 April 1999 the court served those submissions on
the applicant and the third parties.
- On 27 July 1999 the applicant requested the court not
to schedule the hearing before mid-September 1999.
- Between the end of November and mid-December 1999 the
court moved to a new address.
- In April 2000 the applicant's newly appointed lawyers
requested access to the files.
- Following a renewed request of 4 July 2000 the court
requested them first to submit the form of authority.
- On 24 July 2000 the applicant requested the court not
to schedule the hearing before the end of September 2000.
- On 31 July 2000 the applicant's lawyers submitted the
form of authority.
- On 2 October 2000, following a direction of 21
September 2000 to that effect, access to the files was granted.
- On 6 November 2000, at the court's request, the
applicant's lawyers informed the court about her intention to make
further observations.
- Following two reminders from the court, the lawyers
informed the court in March 2001 that they would no longer be
representing the applicant.
- Following a request by the court, the applicant
informed it in
June 2001 that she would make further submissions
and that she was on holiday in August 2001.
- On 18 June 2001 the applicant submitted further
observations, including applications for the taking of evidence.
- The same day the court requested the parties to
indicate whether they agreed with a rapporteur's decision.
- In a letter dated 4 September 2001 the applicant
refused to give her consent.
- On 20 December 2001 the court scheduled the hearing
for 27 March 2002.
- On 22 February 2002 the applicant asked the court to
adjourn the hearing since she had to undergo an operation. Owing to
her illness she could not pursue her claim for one year.
- On 20 January 2003 the court scheduled the hearing for
4 February 2003.
- On 4 February 2003 the Hamburg Social Court of Appeal
dismissed her appeal. It also held that the value of the subject
matter of the litigation was EUR 1,000 and refused leave to appeal.
D. Proceedings before the Federal Social Court and the
Federal Constitutional Court
- On 30 March 2003 the applicant appealed against the
refusal of leave to appeal.
- On 11 September 2003 the Federal Social Court
dismissed that appeal.
- On 17 October 2003 the applicant lodged a
constitutional complaint.
- On 25 November 2003 the Federal Constitutional Court
refused to accept her constitutional complaint for adjudication.
II. RELEVANT DOMESTIC LAW AND PRACTICE
A. Action for failure to act
- Section 88 of the Social Courts Act provides:
“(1) Where no decision has been made regarding an
application for the performance of an administrative act within a
reasonable time and without sufficient grounds, a court action shall
be admissible six months after an application for the performance of
the administrative act has been submitted. ...
(2) The same applies where no decision on an
administrative appeal was made, providing that three months shall
apply as a reasonable time-limit.”
B. Remuneration of panel doctors
- Remuneration of panel doctors does not involve a
direct transaction between the doctor and the insured patient, or
between the doctor and the patient's statutory health-insurance fund,
but between the doctor and the competent Regional Medical
Association. On a quarterly basis the doctor submits an invoice for
services rendered, which are worth a certain number of points
(indicated in the uniform assessment standard (einheitlicher
Bewertungsmaßstab – “EBM”)). The fees
actually paid depend on the amount the relevant Regional Medical
Association has received from the public health-insurance funds and
further factors such as practice budgets and case group averages.
- In order to ensure the proper allocation of the
(limited) financial means, the review board at the Regional Medical
Association, which is composed of three members of the Regional
Medical Association and three members of the statutory insurance
funds, reviews the economic efficiency of general practitioners by
assessing whether the services rendered have been medically
necessary, effective, in line with the recognised quality standards
and proportionate to the costs produced (section 106 §§ 1
and 2 of the Fifth Book of the German Social Code). Section 106 § 3
of the Code furthermore provides for possible reduction of the fees
payable, in particular in cases of repeated inefficiency.
THE LAW
I. ALLEGED VIOLATION OF ARTICLE 6 § 1 OF THE
CONVENTION
- The applicant complained that the length of the
proceedings had been incompatible with the “reasonable time”
requirement laid down in Article 6 § 1 of the Convention, which
reads as follows:
“In the determination of his civil rights and
obligations ..., everyone is entitled to a ... hearing within a
reasonable time by [a] ... tribunal...”
- The
Government contested that argument.
A. Admissibility
- The
Government contended that the applicant had not exhausted domestic
remedies as regards the complaint about the length of the
proceedings. They argued that in the preliminary proceedings she
could have brought a complaint for failure to act under section 88 of
the
Social Courts Act, which would have been an effective
challenge to the length of these preliminary proceedings.
- The
applicant contested this view.
- The Court notes that the appeal board rejected the
applicant's administrative appeal on 20 October 1994, about 11 months
after she had lodged the appeal on 8 November 1993. In view of this
comparatively short period (see, by contrast, Glüsen v.
Germany, no. 1679/03, §§ 13-15 and 67, 10 January
2008) and bearing in mind that an action for failure to act would
have deprived the applicant of one level of supervision and a
(potentially favourable) decision by the appeal board –
which in fact was what happened in previous proceedings brought by
the applicant before the appeal board – the Court considers
that in the instant case the applicant could not have been expected
to bring such an action.
- It follows that the Government's objection on this
account must be dismissed.
- The
Court moreover notes that this complaint is not manifestly
ill-founded within the meaning of Article 35 § 3 of the
Convention.
It further notes that it is not inadmissible on any
other grounds. It must therefore be declared admissible.
B. Merits
1. Period to be taken into consideration
- The
Court notes that the relevant period started to run on 8 November
1993, when the applicant lodged her administrative appeal, and ended
on 25 November 2003, when the Federal Constitutional Court rendered
its decision. It thus lasted 10 years and 17 days for one level
of compulsory administrative appeal and four levels of jurisdiction.
2. Reasonableness of the length of the proceedings
(a) The parties' submissions
- The
applicant maintained that the overall duration of the proceedings was
in breach of the “reasonable time” requirement laid down
in Article 6 § 1 of the Convention. She
emphasised that the Government had failed to give any pertinent
explanation for the years 1995 to 1997.
The applicant admitted
that she had caused a delay of one year owing to her illness. In her
view, however, her repeated requests for a hearing not to be
scheduled during the summer holidays had not contributed to the
length of the proceedings and had merely been aimed ensuring the
smooth progress of the case. The applicant also conceded that the
case was of a certain complexity.
- The
Government argued that the case was complex since the remuneration of
panel doctors was subject to highly complicated rules.
They also
pointed out that in the administrative and social court proceedings a
number of persons and corporations had been involved and had had to
be summoned as interested parties (Beiladungserfordernis).
- The
Government moreover considered that a period of two years and eight
months was clearly attributable to the applicant. In this connection
they relied in particular on her numerous and repeated requests not
to schedule a hearing in the summer holidays, the failure of her
lawyer to file further submissions as announced, her delayed answer
as regards the proposal for a decision by the judge rapporteur, and
also her illness.
- As
regards the authorities' conduct, the Government conceded that a
delay of several months had been caused by the Social Court of
Appeal's move to new premises.
- The
Government lastly emphasised that the proceedings had been only of
minor importance to the applicant since merely EUR 1,000 had been at
issue, whereas she had been granted the amount of EUR 32,000.
(b) The Court's assessment
- The
Court reiterates that the reasonableness of the length of proceedings
must be assessed in the light of the circumstances of the case and
with reference to the following criteria: the complexity of the case,
the conduct of the applicant and the relevant authorities and what
was at stake for the applicant in the dispute (see, among many other
authorities, Frydlender v. France [GC], no. 30979/96, §
43, ECHR 2000-VII).
- The
Court observes at the outset that the proceedings concerned the
question whether the reduction of the applicant's quarterly fees in
1993 was justified on the ground that she had failed to work
efficiently in economic terms, a question which is subject to a
complex procedure and rather complicated rules. It also notes that a
number of entities were summoned before the social courts as
interested parties. The Court therefore agrees with the parties that
the case was of a certain legal and factual complexity.
- As
regards the applicant's own conduct, the Court refers firstly to the
above findings that the applicant could not have reasonably been
expected to bring an action before the Social Court for failure to
act
(see paragraph 57 above). The Court observes, moreover, that,
while it is true that the applicant repeatedly requested the national
courts not to schedule a hearing in the summer, there is no
indication that the courts in fact intended to do so during this
time. The Government did not submit anything to the contrary. Only in
1998 did the Social Court take account of the applicant's request to
that effect, and a delay of about one month is therefore attributable
to her. Further delays of altogether almost two years were caused by
the applicant before the Social Court of Appeal on the ground that
she delayed the submission of the form of authority, her announced
observations and her statement as regards a decision by the judge
rapporteur, and finally also owing to her illness.
- Turning
to the conduct of the domestic authorities, the Court observes in
particular that more than two and a half years elapsed before the
first hearing took place before the Hamburg Social Court –
which, moreover, merely resulted in the court's finding that further
information was needed – and that the final decision was taken
only after another year. No explanation of this considerable period
of inactivity, apparently caused mainly by the excessive workload of
the appeal board, has been given by the Government. In particular,
except for one reminder in August 1995,
the Social Court does not
appear to have set any time-limits in order to ensure the progress of
the proceedings. The Social Court of Appeal also caused substantial
delays of more than 18 months – in particular on account of its
move and its belated granting of access to the files.
- As
to what was at stake for the applicant in the dispute, it is true
that the issue in these proceedings was the reduction by a mere 15%
of the applicant's quarterly fees concerning initial check-ups
(corresponding to EUR 1,000), whereas the applicant had been awarded
fees in the amount of EUR 32,200 for the first quarter of 1993.
In this respect, the Court therefore agrees with the Government that
the case did not require any particular diligence.
- Nevertheless, assessing the circumstances of the
case as a whole and in view notably of the time during which the
proceedings were pending before the Hamburg Social Court, the Court
considers that in the instant case the length of the proceedings
failed to meet the “reasonable time” requirement. There
has accordingly been a breach of
Article 6 § 1 of the
Convention.
II. OTHER ALLEGED
VIOLATIONS
- The
applicant further complained under Article 6 of the Convention that
the proceedings had been unfair, and under Article 8 and
Article
1 of Protocol No. 1 about the reduction of her quarterly fees in
1993.
- The
Court has examined the remainder of the applicant's complaints as
submitted by her. However, having regard to all the material in its
possession, and in so far as these complaints fall within its
competence, the Court finds that they do not disclose any appearance
of a violation of the rights and freedoms set out in the Convention
or its Protocols. It follows that this part of the application is
manifestly ill-founded and must be rejected pursuant to Article 35 §§
3 and 4 of the Convention.
III. APPLICATION OF ARTICLE 41 OF THE CONVENTION
- Article
41 of the Convention provides:
“If the Court finds that there has been a
violation of the Convention or the Protocols thereto, and if the
internal law of the High Contracting Party concerned allows only
partial reparation to be made, the Court shall, if necessary, afford
just satisfaction to the injured party.”
A. Damage
- The
applicant claimed EUR 1,000 in respect of pecuniary damage and EUR
20,000 in respect of non-pecuniary damage.
-
The Government contested these claims, arguing in particular that the
pecuniary damage claimed had not been caused by the length of the
proceedings.
- As
regards the applicant's claim in respect of pecuniary damage, the
Court notes that the alleged damage related to the outcome of the
proceedings and consequently was not caused by the length of the
proceedings as such. It therefore dismisses this claim.
- The
Court, on the other hand, considers that the applicant must have
sustained non-pecuniary damage. Ruling on an equitable basis, it
awards her EUR 500 under that head.
B. Costs and expenses
- The
applicant also sought EUR 1,160 corresponding to her lawyer's fees in
the proceedings before the Federal Social Court.
-
The Government objected to the reimbursement of these costs, also
arguing that they were not caused by the length of the proceedings.
- The
Court agrees with the Government that the costs do not relate to the
violation it has found. It thus dismisses the claim for costs and
expenses.
C. Default interest
- The
Court considers it appropriate that the default interest should be
based on the marginal lending rate of the European Central Bank, to
which should be added three percentage points.
FOR THESE REASONS, THE COURT UNANIMOUSLY
- Declared the complaint concerning the excessive
length of the proceedings admissible and the remainder of the
application inadmissible;
- Held that there has been a violation of Article
6 § 1 of the Convention;
- Held
(a) that
the respondent State is to pay the applicant, within three months
from the date on which the judgment becomes final in accordance with
Article 44 § 2 of the Convention, EUR 500 (five
hundred euros),
plus any tax that may be chargeable to him, in
respect of non-pecuniary damage;
(b) that
from the expiry of the above-mentioned three months until settlement
simple interest shall be payable on the above amount at a rate equal
to the marginal lending rate of the European Central Bank during the
default period plus three percentage points;
- Dismissed the remainder of the applicant's claim
for just satisfaction.
Done in English, and notified in writing on 11 June 2009, pursuant to
Rule 77 §§ 2 and 3 of the Rules of Court.
Claudia Westerdiek Peer Lorenzen
Registrar President