E-TJERA

Objected to the blocking of diplomas for medical students, the full decision of the Constitutional Court is revealed

Objected to the blocking of diplomas for medical students, the full decision of

The full decision of the Constitutional Court regarding the decision to annul parts of the government's decision on the forced employment of young doctors leaving the Faculty of Medicine for 5 years has been revealed.

Full decision; 
(V-1/24)
Constitutional Court of the Republic of Albania, composed of: Holta Zaçaj, Chairperson, Marsida Xhaferllari, Fiona Papajorgji, Elsa Toska, Sonila Bejtja, Sandër Beci, Ilir Toska, Genti Ibrahimi, Marjana Semini, members, with Secretary Enina Kotoni, on 21.12.2023, considered in a public plenary session case no. 1 (Nj) 2023 of the Basic Register, which belongs to: APPLICANT: A GROUP OF DEPUTIES OF THE PARLIAMENT OF THE REPUBLIC OF ALBANIA (NOT LESS THAN ONE FIFTH OF THE DEPUTIES), represented by lawyers Semir Sali and Esmeralda Maillard (Ndoci), with authorization . A GROUP OF STUDENTS OF THE MEDICAL FACULTY OF TIRANA UNIVERSITY OF MEDICINE, represented by lawyers Semir Sali and Esmeralda Maillard, with special power of attorney.
INTERESTED SUBJECTS: ASSEMBLY OF THE REPUBLIC OF ALBANIA, represented by Mimoza Arbi and Gazmend Bici, with authorization. COUNCIL OF MINISTERS, represented by Herald Jonuzaj, Voltisa Koçi and state attorney Irma Qosja, with authorization. PURPOSE: Repeal of Article 4, points 1, letter "c", 2, letter "b", 3,
letter "b" and Article 5, first sentence, of Law no. 60/2023, dated 21.07.2023 "On the special treatment of students who follow the integrated study program of the second cycle "General Medicine" in public institutions of higher education", as incompatible with the Constitution of the Republic of Albania. Decision of the Constitutional Court Requesting: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of Medicine of the University of Medicine in Tirana Suspension of the implementation of law no. 60/2023, dated 21.07.2023 "On the special treatment of students who follow the integrated study program of the second cycle "General Medicine" in public institutions of higher education", until the entry into force of the decision of the Constitutional Court . LEGAL BASIS: Articles 4, 17, 18, 26, 49, 57, 131, point 1, letters "a" and "f" and 134, point 1, letters "c" and "i", of the Constitution of the Republic of Albania (Constitution); articles 4 and 14 of the European Convention on Human Rights (ECHR) and article 2 of Protocol no. 1 of her; law no. 8577, dated 10.02.2000 "On the organization and functioning of the Constitutional Court of the Republic of Albania", amended (law no. 8577/2000). The CONSTITUTIONAL COURT, after hearing the relator of the case, Marjana Semini, considered the written submissions of the petitioners, who have requested the acceptance of the request, the written objections of the interested entities, the Assembly of the Republic of Albania (the Assembly) and the Council of Ministers, who have requested the rejection of the request, the written opinions of the Commissioner for Protection from Discrimination (Commissioner) and the University of Medicine Tirana (UMT), as well as discussed the case as a whole, NOTES:
The circumstances of the case
1. On 21.07.2023, the Assembly, based on the proposal of the Council of Ministers and in accordance with the accelerated parliamentary procedure, approved the law no. 60/2023 "On the special treatment of students who follow the integrated study program of the second cycle "General Medicine" in public institutions of higher education" (law no. 60/2023). This law was published in Official Gazette no. 123, dated 16.08.2023 and entered into force 15 days after its publication.
2. With the aim of preserving human resources, health professionals in
the country, but also increasing their interest to work in the public health sector as part of
increasing investments in health, law no. 60/2023 has provided a mechanism through which
, for students following the integrated study program of the second cycle "Medicine and
Decision of the Constitutional Court
of Inquiry: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of the University of Tirana
General Medicine" in public institutions of higher education are offered a special treatment, which, in the
sense of Article 3, point 1, of the law, includes their priority employment after the end of
studies, as well as the right to benefit from social housing programs.
3. This treatment benefits both the candidate who is newly admitted to the integrated
study program of the second cycle "General Medicine" in public institutions of higher education,
as well as the student from the second year to the fourth academic year and from fifth or sixth year student
(intermediate student) in this program, when he agrees to sign
an agreement with the ministry responsible for education, the ministry responsible for health and
the institution of public higher education. According to the agreement, the student must work in the
medical profession after completing his studies for, respectively, no less than five years, three years and two
years in health institutions in the Republic of Albania, as well as accept the official passing of
the relevant education diploma from the public institution of higher education, where he completed
his studies, to the health institution where he is employed until the "payment of
employment obligations" according to the term, namely five, three and two years, with the right to
withdraw after fulfilling the employment obligation university degree (Article 4, point 1, letter "c", point 2,
letter "b", point 3, letter "b", of law no. 60/2023). Meanwhile, the student who does not agree to
sign the agreement according to the provisions of points 2 and 3 of article 4, pays the full amount
of the cost of studies (Article 5 of Law No. 60/2023).
4. For the implementation of these measures, several by-laws have been approved, namely decision
no. 527, dated 07.09.2023 of the Council of Ministers for determining the methodology of the cost of
studies for the integrated study program of the second cycle "General Medicine" in
public institutions of higher education; circular decision no. 109, dated 06.10.2023 of the
UMT Academic Senate and decision no. 62, dated 09.10.2023 of the Board of Administration of UMT
for the approval of the study cost of the integrated study program of the second cycle "
General Medicine" at UMT. According to these acts, it results that the cost of studying the
integrated study program of the second cycle "General Medicine" is 248,975 (two hundred and forty eight
thousand nine hundred and seventy five) lek per student.
5. On 19.10.2023, a group of deputies of the Assembly, in the capacity of the constitutional subject
no less than one fifth of the deputies (the petitioner), addressed the Constitutional Court (Court)
with a request aimed at repealing Article 4, points 1 , letter "c", 2, letter "b", 3, letter
"b" and Article 5, first sentence, of Law no. 60/2023, as well as the suspension of its implementation until the entry
into force of the final decision of the Court.
Decision of the Constitutional Court
Requesting: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of the University of Medicine Tirana
6. On 20.10.2023 a group of students of the Faculty of Medicine in UMT,
specifically citizens Anxela Gjini, Alesia Cara, Diora Hoxha, Argisa Troka, Xesika
Xhebexhiu, Juri Taullau, Sindy Allamani, Isabela Tabaku, Dea Guri, Natali Bliu, Joel Plaku, Mikel
Seferi, Reant Kullaj, Brunelio Fejzulla, Viki Zaçlli, Rei Haluli, Feruze Agalliu, Oresti
Çaça, Marjo Rabiaj, Paulo Qesargjoni, Endi Muçi, Arbëri Shehu, Samuel Dërka, Thimi Shkarpa,
Kristina Çelanji, Athina Prifti, Almira Tota, Zino Veleshnja, Erdi Podo, Angela Miraka, Gani
Krrashi, Klevi Gugallja, Flavio Elezi, Ledion Mane, Eugen Lazaj, Igli Hoxhaj, Arlind Kasëmi
(the petitioner or a group of students), have addressed the Court with an individual constitutional appeal with the
same object.
7. With the decisions of 08.11.2023, the panels of the Court have decided to transfer these
cases for review to a public plenary session. Likewise, given the nature of
the claims presented in the request, as well as the constitutional rights involved in this matter,
the receipt of a written opinion by the Commissioner and the UMT has been evaluated.
8. Pursuant to article 19, point 2, of the Regulation on Judicial Procedures of the
Constitutional Court, article 1, point 2, of law no. 8577/2000 and Article 57 of the Code of Civil Procedure,
the Meeting of Judges, with the decision dated 14.11.2023, decided to combine the cases into
a single case. By decision of the same date, the Meeting of Judges has decided to
suspend the implementation of law no. 60/2023, until the entry into force of the final decision of
the Court.
II
Claims in the Constitutional Court
9. The petitioners have claimed that the contested legal provisions violate:
9.1. The principle of legal security, guaranteed by Article 4 of the Constitution, as students
attending the integrated program of the second cycle at the Faculty of Medicine at UMT
are violated as a result of the obligations provided for in the contested provisions of Law
no. 60/2023, since the signing of the agreement requires the official transfer of
the relevant diploma from the public institution of higher education to the
health institution, where the graduated students are employed until the payment of
employment obligations according to the relevant deadlines, while those who do not agree to
agreement, have the obligation to pay the full value of the cost of studies. Intermediate students have expectations of tuition fees
not increasing exponentially .
Students with an average above grade 6 have the same expectation
to benefit from the halved tuition fee. Disputed Provisions
Decision of the
Inquiring Constitutional Court: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of the University of Medicine of Tirana
have brought about a serious deterioration of the legal situation of students who wish to
maintain the status quo. Students, especially those who follow the intermediate years, have
made the calculations on the basis of the full cost of studies, as well as their
economic possibilities to afford the payment of the corresponding fee each year before starting
their studies. The sudden change of the fee, quintupling or tenfolding it,
also violates the principle of predictability of the law. The deterioration of the economic
and legal situation of students who do not wish to enter into an agreement does not serve
the public interest, since the provision of health services will not be achieved by the payment of the
full value of the cost of studies for these students, but will go to items of
different of the budget. Similarly, limiting the
withdrawal of diplomas does not serve the public interest either.
9.2. The right to work and the right to education, guaranteed by Articles 49 and 57 of the
Constitution, contrary to the criteria of Article 17 of the Constitution, since:
9.2.1. Apart from the criterion of limitation by law, none of the other
constitutional criteria that allow limitation are fulfilled. It does not respond either to the public interest or
to the objectives of the law no. 60/2023 and the measures used are harsher than
necessary to achieve the required objective. Students who refuse to enter into
agreements have their right to education and other acquired rights violated.
The legislator does not give any logical reason why students who want to maintain the status
quo should pay the full cost of the study, which constitutes an
economic sanction, risking a decrease in the number of students who follow the
"General Medicine" program in the institutions public institutions of higher education, in favor of
private institutions of higher education. The legislator has increased the tuition fees
up to their full cost without a legitimate purpose.
9.2.2. The restriction is not proportionate to the situation that dictated it, violating
the principle of proportionality. The objective of the legislator is not
sufficiently important to justify the limitation of the right.
The provision of Article 5 of the law does not respond to its main objective, which concerns
the provision of medical staff in the long term. There is no
emergency situation and there is no decrease in the number of doctors in relation to the population.
The means used are not necessary, which means that the goal could be
achieved by other means and other economic or social incentives, without violating the
fundamental rights of students. The guarantee of medical service has no
Decision of the
Inquiring Constitutional Court: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of the University of Medicine Tirana
regarding the payment of the full value of the cost of studies, so the intervention
is not suitable for the realization of the intended purpose and does not affect it.
The economic sanction established in Article 5 of Law no. 60/2023 forces
students in economic hardship to agree to sign the agreement
or punishes students who refuse to sign it by
exponentially increasing the tuition fee. The measures are not reasonably related
to the objective, are arbitrary, unfair and based on
alogical evaluations.
9.2.3. Even the measure of keeping the diploma to enable the implementation of the law is e
unjustifiable, since the state has all the legal means to guarantee the implementation
of the agreement signed with the students. The right of every student to
receive a diploma after completing his studies is a fundamental right that cannot
and should not be linked to the success of the implementation of the agreement, which
is the burden of the legislator and is non-transferable to the individual.
9.3. The principle of equality before the law and non-discrimination, guaranteed by Article 18 of
the Constitution, since exponentially increasing the tuition fee for
students who choose not to sign the agreement, Article 5 of Law no. 60/2023
indirectly discriminates against students who are not financially able to pay this
amount, giving them two options that contradict their will, i.e. to
sign an agreement or to stop their studies. This article will have
unacceptable consequences in terms of the guarantee of Article 18 of the Constitution for protection against
discrimination due to economic status, as students in difficult
economic situations will be forced to enter into agreements to accept (de facto)
forced labor, while their colleagues will be able to "save" by paying
higher tuition fees. The law provides for positive discrimination for students who
agree to sign an agreement according to its article 4, while the opposite happens for
those who do not agree to sign it. It also discriminates students who
currently benefit from reduced tuition fees due to high grades, such as students
studying in public higher education institutions, in relation to those in
non-public higher education institutions, who are not included in the field of the implementation
of this law.
9.4. The right not to be subjected to forced labor, guaranteed by articles 26 and
49 of the Constitution and article 4, point 2, of the ECHR, after putting before the election for
Decision of the Constitutional Court
Applicant: A group of deputies of the Assembly (no less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of the University of Medicine Tirana
signing the agreement, according to article 4 of law no. 60/2023, of students who
wish to maintain the status quo and have not volunteered to sign
it, or otherwise have to face the full value of the cost of studies
according to its article 5, constitutes a threat of punishment of any kind for them. This is a case
par excellence where this category of students is forced through economic means
to perform forced labor against their will. Even for students who sign
the burden agreement is disproportionate, as they have the obligation to work for 2
to 5 years, depending on the academic year they attend at the time of signing it
.
10. The interested entity, the Assembly, failed as follows:
10.1. The allegation of violation of the principle of legal certainty is unfounded. Law no.
60/2023 respects the free will of each candidate or student to decide whether
to benefit from the rights defined in this law by signing the
agreement or to bear the fee of studies up to the level of their cost
. The right acquired by intermediate students following the integrated program
of the second cycle is not affected, as the new fees refer to future
academic years and do not have retroactive effects. This category of students will be
included as part of the implementation of the law for meeting the needs for doctors, in
order to cover the citizens with the highest quality health service. The contested provisions
do not provide for changes to the rules during the academic process, but
the changes are for the future, without infringing the rights acquired at the start of
the academic year for each category.
10.2. The allegation of the violation of the right to work and the right to education, guaranteed by
Articles 49 and 57 of the Constitution, contrary to the criteria of Article 17 of
the Constitution, is unfounded, since:
10.2.1. The provisions of Article 55, point 1 and Article 59, point 1, letter "c", of the Constitution
are related to an important and fundamental right provided for in
Article 21 thereof, which is the right to life. Health care related to this right
is not an innovation brought by the current Constitution, but has deep roots in
our legal tradition, starting with decision no. 103, dated 15.04.1938 of
the General Assembly of the State Council, following the statute of 1946
and the Constitution of 1976. The law meets the criteria of Article 17 of
the Constitution, as the right to health care aims to protect the right to
Decision of the
Inquiring Constitutional Court: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of the University of Medicine Tirana
life, therefore the state has a public interest to intervene in this aspect, as
there is a high enough need to guarantee the complementation of
public health services with human resources. The purpose of the legislator during the drafting and
approval of the law no. 60/2023 has been to ensure a fair relationship between
the imposed restriction and the public interest.
10.2.2. As far as the criterion of proportionality is concerned, the public interest in guaranteeing the
medical service for the population prevails over the expectation of the students,
who are currently pursuing the study program in medicine, to continue
the remaining time of the study with the same treatment and conditions that have existed until now
. This expectation cannot be prioritized over the general interest in
providing the health service as a whole.
10.2.3. The contested provisions pursue a legitimate aim. The petitioners do not
refer to any concrete provisions of the Constitution for violating the essence of rights
and freedoms or the provisions of the ECHR or for exceeding the limitations
provided by the latter. None of the categories of students are
denied the right to education, on the contrary, they are invited to benefit from the
special treatment that constitutes the very purpose of the law. The alternatives presented by the law are
related to the right of the student to choose whether he wants to benefit from
the facilities that are created by signing the agreement to work in the
medical profession after completing his studies in health institutions in the country.
The provisions of the law have been drafted in accordance with the needs dictated in the country. The state
guarantees the education of students in the field of medicine according to legal provisions,
covering a part of the relevant costs. The law guarantees the employment of
graduated doctors and there is no violation of the essence of the right to work, nor
exceeding the limitations provided for in the ECHR.
10.3. The allegation of violation of the principle of equality before the law and non-discrimination
is unfounded, since through the disputed provisions the legislator has offered
different options for all students of higher education in medicine.
Contrary to what the petitioners claim, each of the students is free to
freely choose the option that suits them best, according to their preferences. Providing
alternatives to choose from and the choice each student will make does not constitute
discrimination.
Decision of the
Inquiring Constitutional Court: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of the University of Medicine in Tirana
10.4. The allegation of the violation of the right not to be subjected to forced labor
is unfounded, as it is not a question of "forced labor", in the sense of Article 26
of the Constitution and Article 4, point 2, of the ECHR. The disputed provisions
guarantee the right of every individual to freely choose the profession he wants,
in accordance with the provisions of the legislation in force. The provisions of articles 4 and
5 of the law no. 60/2023 constitute a legitimate restriction, which responds to the needs and
high public interest in guaranteeing the provision of health services, as one of the
basic human rights defined in Articles 55 and 59 of the Constitution.
"Employment" is also considered the period of long-term specialization, regardless of the type
of quota obtained, where a part of the students, in addition to completing the specialization in the
relevant health structures, contributing to their professional development,
also fulfill the obligation as a period of employment in Albania.
11. The interested entity, the Council of Ministers, has failed as follows:
A) For legitimization
11.1. The group of students of the Faculty of Medicine at UMT is not legitimized, as it has not
exhausted the effective legal remedies available, in the sense of article 131, point 1,
letter "f", of the Constitution and law no. 8577/2000. This petitioner must raise
claims at all levels of ordinary jurisdiction, allowing
the ordinary courts to assess whether the challenged provisions
present constitutional problems, then referring the case to the Court
through incidental adjudication.
B) For the foundation of the request
11.2. The claim of violation of the principle of legal certainty does not find support in the
constitutional provisions. It is unclear, since there is no presentation of
arguments regarding the serious deterioration of the right to education and work
by the law under review, which has brought consequences that contradict the very intention of
the legislator, deform it or damage their effectiveness . The global COVID-19 pandemic
has generated negative effects, so recovery policies
must be reshaped. Law no. 60/2023 was drafted in accordance with the
main strategies in the country, specifically with the policy goals in the fields of education,
health and employment according to the National Strategy for Development and Integration
2022-2023, the National Education Strategy 2021-2026, the National
Health Strategy 2021-2030, approved by VKM. The tuition fee, which was
the Decision of the Constitutional Court
of Inquiry: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of the University of Medicine of Tirana
about 45,000 ALL/year, with calculation according to the new methodology is about 240,000
ALL/year, a value that corresponds to the cost of a student of the Faculty of Medicine in
the state budget. The law is supportive for the students of the Faculty of Medicine,
since by signing the agreement they can benefit from the right not to
pay the financial obligations related to the payment of the study fee during
the years that they will follow the study program of the second cycle. General medicine
", as well as other facilities. The disputed legal provisions
respect the free will of the student to decide for himself whether he will benefit from
the rights defined in this law by signing the agreement or otherwise
bear the fee of studies up to the level of their cost. The public interest
in guaranteeing the medical service for the population prevails over the
expectations of the applicants. This expectation cannot take priority over the
general interest in life insurance and the health service as a whole.
11.3. The allegation of violation of the right to work and the right to education, guaranteed
by Articles 49 and 57 of the Constitution, contrary to the criteria of Article 17 of
the Constitution, is unfounded, since:
11.3.1. Law no. 60/2023 helps to keep local talent in the
Albanian health system, preventing their departure abroad. The right to education
is not denied, but is interwoven with specific temporary obligations to
support health needs. The contested provisions do not affect the essence
of the right to education, since each of their subjects has the right to choose whether
they want to benefit from the facilities created by signing the agreement or
otherwise respond to the obligations that arise for the payment of tuition fees. the study.
Through these provisions, the fastest possible employment of
medical students is aimed, forcing the employing institutions to comply with this
legal provision, which in case of non-compliance within one year from the moment of
birth of the right to employment for students is considered fulfilled.
11.3.2. There is no violation of the right acquired even by intermediate students, because the fees
in case of non-signing of the agreement refer to future academic years
and do not have retroactive effects. Basically, the legal provisions are challenged due
to the imposition of a heavy monetary sanction, which is related to the by-laws
that have determined the value of the cost of studies, which can become the subject of
review in the courts of ordinary jurisdiction and not in this Court. Law
Decision of the Constitutional Court
Applicants: A group of members of the Assembly (not less than 1/5 of the members) and a group of students of the Faculty of
Medicine of the University of Medicine Tirana
no. 60/2023 has a temporary effect, as it extends its effects for the period from
the academic year 2023-2024 to the academic year 2027-2028.
Other measures have been taken by the state in terms of health care, but regardless of the
implemented policies, there is an immediate need to comprehensively address the phenomenon of
doctors leaving the system and the country.
11.3.3. The criteria of limitations provided for in Article 17 of the Constitution have been respected,
as the intervention was carried out through a law approved by the Assembly, for
public interest, imposing the relevant obligations. The challenged provisions
aim to strike a balance between the interests of students and those of
public health. The public interest in guaranteeing the medical service for the population
prevails over the expectation of the applicants, which cannot have priority.
11.4. The allegation of violation of the principle of equality before the law and non-discrimination is
unfounded, as the legislator aimed to protect the highest public interest to
guarantee the fulfillment of the needs for human resources in
health institutions. The law is in harmony with the provisions of Article 6 of Law no. 10221,
dated 04.02.2010 "On protection from discrimination", amended (law no.
10221/2010) and in this particular case the otherwise legalized treatment is legitimized.
The disputed provisions are not discriminatory, since the doctor's profession is
necessary for the public interest, which is the health of the population. They define
in a transparent way the criteria that must be fulfilled to benefit from the
special treatment and this definition is a general obligation, not based on
economic criteria, but on the responsibility towards the health system and medical education in the
country. The legal provisions do not intend to discriminate those students who are not in an
economic condition to pay, but define an obligation that is linked to
academic and professional income after completing studies. The contested provisions
do not entail differential treatment, but provide for objective criteria
that apply equally to all students, who still have the freedom to choose
their institution of study, while those who do not wish to receive
special treatment are not forced to study in public institutions. Likewise
, law no. 60/2023 does not provide for discrimination against students of
non-public institutions, as it operates within a certain field of competence and
in the context of the specific needs of public education. It protects and creates the conditions
to realize the highest public interest, acting with the means and
Decision of the Constitutional Court
Request: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of Tirana University of Medicine
the appropriate legal mechanisms, in proportion to the situation that dictated it. There are
other laws or by-laws of this nature, as well as in other states
we find similar provisions in the internal legislation.
11.5. The claim about the violation of the right not to be subjected to
forced labor is also unfounded, since the disputed provisions do not fulfill any of
the conditions established by the European Court of Human Rights (ECtHR) to
qualify as forced labor the employment of students who agree to sign
the agreement provided for in Article 4 of Law no. 60/2023. These forecasts
are not unfair, as they are not related to any punishment or any
personal characteristics of the students. They do not constitute an oppressive obligation and do not
create any unfair relationship with the abilities and opportunities of the students. Fulfilling the
legal conditions is not punitive, but brings financial support to those
who register or follow the integrated program of the second cycle in medicine, without
burdening their economic position. The law is oriented towards supporting
public interests in health, ensuring a sufficient number of
trained doctors to serve the citizens. The legal provisions give students
the freedom to choose the conditions for special treatment and the obligation of employment
after completing their studies in a way that respects the freedom and will of
the individual.
III
The process in the constitutional trial
A. For the continuation of the measure of suspension
12. The petitioners have also requested the suspension of the implementation of the contested provisions of
law no. 60/2023 until the final decision is issued by the Court, claiming that
the risk of students making a forced choice for reasons related to their
economic situation and against their will is real and the negative consequences that follow if the law
is applied are serious and irreversible for students who wish to maintain the status quo.
13. With the decision of 14.11.2023, the Meeting of Judges, after considering
request, in accordance with the provisions of Article 45 of Law no. 8577/2000, has decided
its acceptance, suspending the implementation of the contested provisions of law no. 60/2023 until the entry into
force of the final decision of the Court.
Decision of the
Inquiring Constitutional Court: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of the University of Medicine in Tirana
14. The interested entity, the Council of Ministers, in the minutes of 11.12 .2023 addressed to
the Court, requested the removal of the measure of suspension, as the requirements of Article 45 of
Law no. 8577/2000 and the applicants have not presented concrete and real arguments regarding the
actual consequences that should be prevented and the risk of possible consequences resulting
from the implementation of the disputed provisions that affect their interests, which constitutes the
essential criterion for suspension of the implementation of the contested act.
15. The interested entity, the Assembly, in the public plenary session of 21.12.2023, submitted
a preliminary request for the lifting of the suspension measure, as it does not justify the requirements of
Article 45 of Law no. 8577/2000. According to him, the petitioners have not presented concrete and
real arguments regarding the immediacy and actual consequences that should be prevented or
the risk of possible consequences resulting from the implementation of the contested provisions of law no.
60/2023. Yes, according to the Assembly, the Court should reevaluate the need for suspension, as this may
bring legal uncertainty in the health and medical education sector, as well as negative effects
on the planning and functioning of the medical system.
16. Article 45, point 1, of law no. 8577/2000 provides that the Court, mainly or at
the request of the party, when it assesses that the implementation of the law or the act may bring consequences that affect
state, social or individual interests, as the case may be, by decision of the Meeting of Judges or
in a plenary session orders the suspension of the law or act. The suspension continues until the
final decision of the Court enters into force. In the conditions where the suspension is an
extraordinary measure, the Court notes that its imposition is related to the assessment of the consequences or effects of the
implementation of the act. These consequences must not only be real, i.e. in progress, but also
severe, to the extent that they go beyond the normal measure of limitation, especially in terms of
urgency.
17. Based on this provision, after listening to the parties in the process and considering
their claims for the continuation of the measure of suspension, the Court, taking into account the consequences that
may come for the students who follow the integrated program of the second cycle at the Faculty of
Medicine at UMT from the implementation of the disputed provisions, since they are current and real
and in the sense of article 45 of the law no. 8577/2000 justify the continuation of the measure of suspension
imposed by the decision dated 14.11.2023 of the Meeting of Judges.
IV
Evaluation of the Constitutional Court
B. For the legitimization of the petitioners
Decision of the
Petitioning Constitutional Court: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of the Tirana University of Medicine
B.1. For legitimation ratione personae
B.1.1. For the legitimization of a group of deputies
18. The Court has assessed the issue of legitimization (locus standi) as one of the
main aspects related to the initiation of a constitutional process. The Constitution, in its Article 134, point
1, has exhaustively defined the circle of constitutional subjects that are legitimated to
set in motion the constitutional jurisdiction.
19. No less than one fifth of the deputies of the Assembly is a subject provided for in article
134, point 1, letter "c" of the Constitution and article 49, point 1, of law no. 8577/2000, which
recognize the right to start the abstract control of the constitutionality of the law, in the sense of
Article 131, point 1, letter "a", of the Constitution. The court has emphasized that the public interest of these
public officials is presumed, since their request sets in motion an
abstract and objective control of the normative act and the interest that is sought to be protected is related to the respect of
constitutional principles and the regular functioning of the state of of the right. The protection of the
normative system and state-forming principles, among others, such as constitutionalism, the rule of law,
democracy, human dignity, social equality, revealed in the Constitution, is not
conditioned by a concrete subjective interest. In this sense, the Court affirms that the purpose of
checking the constitutionality of laws is simultaneously also the prevention of negative consequences
that may come from their implementation (see decisions no. 35, dated 15.06.2023; no. 18, dated
07.07.2022; No. 55, dated 27.07.2016 of the Constitutional Court).
20. In view of the above, the Court notes that the petitioner, a group of 30
deputies of the Assembly, in the capacity of the constitutional subject of not less than one fifth of the deputies,
as an unconditional subject does not need to prove his interest in directly for setting in
motion the abstract control of compliance with the Constitution of the provisions of law no. 60/2023,
object of this request, therefore it is legitimized ratione personae.
B.1.2. For the legitimization of the student group
21. The group of students of the Faculty of Medicine, at UMT has submitted that it is legitimized
ratione personae, as it is the bearer of constitutional rights and has a direct interest in
opposing the provisions that are the object of the request, as the latter violate in a real way
their rights and guarantees protected by the Constitution. Regarding legitimization ratione
personae, the interested subjects have not submitted any arguments.
22. According to articles 131, point 1, letter "f" and 134, points 1, letters "i" and 2, of the
Constitution, as well as article 71 of law no. 8577/2000, any individual, natural or legal person, subject to
the Decision of the Constitutional Court
Requesting: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of Medicine of the Tirana University of
Medicine
private and public law, can set in motion the Court for the final adjudication of
appeals against any act of public power or judicial decision that infringes the fundamental rights and freedoms
guaranteed in the Constitution. The individual constitutional appeal, in any case, must
meet the criteria of Article 71/a of Law no. 8577/2000, related to the exhaustion of
effective legal remedies, the deadline for submitting the request, the negative consequences suffered in a direct and
real way, as well as the possibility of restoring the violated right. In the case under review, the request
addressed to the Court was signed individually by 37 applicants who are students of the
integrated study program of the second cycle "General Medicine" at UMT, according to the
relevant certifications issued by the dean of the Faculty of Medicine at UMT in connection with the request.
23. According to the Court, based on articles 49, point 3, letter "e" and 71, point 2, of law no.
8577/2000, the object of the individual constitutional appeal may be the law or normative act. In
these cases, the petitioner is legitimized if the following criteria are met together: (i) legitimization ratione
personae, in the sense that the individual proves that he is the bearer of the alleged violated constitutional right
, as well as proves the interest in the case, i.e. the direct violation and real
constitutional law;
(ii) exhaustion of effective legal remedies for the protection of the alleged violated constitutional right or the individual proves that the contested act is directly
applicable; (iii) legitimization ratione temporis, in the sense that the individual has filed a complaint within
the 4-month legal term from the finding of infringement; (iv) legitimization ratione materiae, in the sense that
the individual proves that the claims raised are such that they are part of the constitutional jurisdiction,
that is, the fundamental rights and freedoms, which are claimed to have been violated, are guaranteed in
the Constitution, as well as the constitutional review of case may restore the
violated constitutional right (see decisions no. 38, dated 12.07.2023; no. 4, dated 21.02.2022; no. 31, dated 04.10.2021
of the Constitutional Court).
24. In the present case, the Court, based on the documents attached to the request, notes that the students
of the Faculty of Medicine at UMT are not organized in the form of an organization in the sense of
Article 134, point 1, letter "h", of the Constitution, but they have addressed the Court as a group
of individuals. Consequently, for the purposes of legitimizing this petitioner in the sense of articles 131,
point 1, letter "f" and 134, point 1, letter "i" of the Constitution, in the case of claims of
incompatibility of the law with the Constitution, the group of students must prove that he is a victim of
the violation and that the implementation of the provisions of the contested law violates his interests, bringing
direct and real consequences.
25. According to the ECHR, applicants can claim to be victims of a violation if
they are members of a group at risk or directly affected by the legislation. The applicant can
Decision of the Constitutional Court
Applicant: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of the University of Medicine Tirana
claim that a law violates his/her rights and therefore he is a "victim" within the meaning of
Article 34 if he is required to modify his behavior or risks being prosecuted for
non-compliance with the law (see Burden v. the United Kingdom (DhM), no. 13378/05, § 34,
ECHR 2008; SAS v. France (DhM), no. 43835/11, dated 01.07.2014, § 57).
26. The court finds that the contested provisions of law no. 60/2023 define
the criteria for benefiting from special treatment if the students of the Faculty of Medicine at UMT
agree to sign the agreement with the consequence of the official transfer of the relevant
higher education diploma from the public institution of higher education, where the student completed his studies, to the
institution health care where he is employed until "repayment of employment obligations" according to the
established deadline. The students of the Faculty of Medicine, who have addressed the Court with a
constitutional appeal, are subjects of the alleged violated constitutional rights as long as
are included in those categories that are directly affected by the contested provisions.
At the beginning of the academic year, they are faced with the choice between signing the agreement
and benefiting from special treatment or paying the full value of the cost of studies.
The provisions of the contested provisions force students to modify their behavior in
the situation they are in, facing a new choice, which affects their interests
, especially for those students who do not have economic opportunities, being forced to accept
the conditions established for passing the diploma until the end of the mandatory term for employment.
For the above, the Court assesses that as long as these legal provisions are directly
and realistically applied to them, they can claim to be victims of the violation, therefore
the group of students is legitimized ratione personae, in the sense of articles 131, point 1,
letter "f" and 134, points 1, letter "i" and 2, of the Constitution, as it proves the
direct interest in the matter presented.
27. Regarding the criterion of exhaustion of effective legal remedies, in its jurisprudence
the Court has emphasized that in cases of claims of incompatibility of laws with the Constitution,
the applicant must have used all available legal remedies for the protection of the constitutional right
that violates the contested law not only formally, but also in a substantial sense.
As a rule, the law is implemented through acts of public bodies or judicial decisions, therefore
the individual must, first, challenge them before the competent courts, exhausting all
legal remedies provided by our legal system. This is also important to prove that the applicant
has been personally, directly and genuinely affected. However, the law also provides for cases
where the fulfillment of this criterion is impossible (the legislation does not provide for legal remedies or
they are ineffective). Since the legal remedy may be different, depending on the type of Appeal
Decision of the Constitutional Court
: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of the Tirana University of
Medicine , its effectiveness is assessed not simply by the fact that it is provided by law, but also by
its applicability. The characteristic of the direct application of the law is related to the ability of the
disputed law to directly infringe the fundamental individual right
and, therefore, it is a question of those cases where the law does not provide for the issuance of by-laws
necessary for its implementation. This means that the law causes its consequences for individual constitutional rights
without the need to detail additional rules in the form of
by-laws (see decisions no. 4, dated 21.02.2022; no. 31, dated 04.10.2021 of the
Constitutional Court ).
28. The applicant, the group of students, claimed that any kind of judicial opposition to
the provisions of law no. 60/2023 would be ineffective, since even if it invests
the courts of ordinary jurisdiction to request the suspension of law no. 60/2023 and sending
it for an incidental trial to the Constitutional Court, this would result in a waste of time,
a waste of judicial resources, while the acceptance of the request for incidental control would not
be certain. Likewise, the trial at all three levels of the ordinary judiciary, even with
an accelerated procedure, would be objectively impossible to complete within this
academic year, which would have consequences for the final year students of the Faculty of Medicine at UMT .
On the other hand, courts of ordinary jurisdiction cannot suspend laws and
normative acts, since such a prerogative belongs only to the Constitutional Court.
29. The interested entity, the Council of Ministers, has rejected that the group of students of
the Faculty of Medicine at UMT is not legitimized, as it has not exhausted the available effective legal remedies
, in the sense of Article 131, point 1, letter "f", of Constitution and Law no. 8577/2000.
It should raise claims at all levels of ordinary jurisdiction, allowing the
ordinary courts to assess whether the contested provisions present
constitutional problems, then referring the case to the Court through
incidental adjudication.
30. The court appreciates emphasizing, first, that the submission of the request for the initiation of the
incidental control of the rate does not constitute a necessary element from the point of view of fulfilling the
criterion of exhaustion of effective legal remedies, however, as a non-direct form of
access to constitutional trial, the parties to the judicial process, if they have initiated one,
may choose to ask the ordinary court to invest the Constitutional Court (see
decision no. 4, dated 21.02.2022 of the Constitutional Court).
31. In view of the above, the Court notes that the contested legal provisions
of Law no. 60/2023 do not provide for the issuance of by-laws necessary for the implementation of
the Decision of the Constitutional Court
Petitioner: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of Tirana University of Medicine
, but they are directly applicable to the petitioner, as students of the Faculty of Medicine
at UMT , from the moment the academic year begins, where they are faced with the choice of
signing the agreement, in order to benefit from special treatment, or paying the
full value of the cost of studies. These provisions are directly enforceable by
the petitioner, the group of students, bringing the constitutionally objectionable consequences. In these
conditions, in relation to the legal provisions that are the object of this trial, the applicant has no other means available
to exhaust other than setting in motion the control of their compliance with the Constitution, i.e. submitting an individual constitutional appeal for the restoration of constitutional
rights
allegedly violated.
B.2. For legitimation ratione temporis
B.2.1. For the legitimation ratione temporis of the applicant, a group of deputies
32. According to article 50, point 1, of the law no. 8577/2000, the deadline for submitting the request for
checking the compliance of the law or other normative acts with the Constitution is 2 years
from the entry into force of the act. Law no. 60/2023 was published in the Official Gazette no. 123, dated
16.08.2023 and entered into force 15 days after its publication, namely on 31.08.2023, while
the request was submitted to the Court manually on 19.10.2023, i.e. within the legal deadline.
B.2.2. For the legitimation ratione temporis of the petitioner, a group of students
33. According to the petitioner, the violation of the students' constitutional rights materialized at
the time of entry into force of law no. 60/2023, i.e. on 31.08.2023, or according to a
broader interpretation in view of Article 4 of the law, with the beginning of the academic year 2023-2024,
i.e. on 02.10.2023.
34. Regarding the legal deadline for submitting an individual constitutional appeal, based on
Article 50, point 4, of Law no. 8577/2000, it must be presented within 4 months from the finding of
the violation. The court has assessed that in the case of this type of appeal, the finding of infringement as a rule does not
coincide with the entry into force of the law or normative act. In these cases, the legal term is calculated
from the moment when the act begins to produce effects for the applicant or, in other words, when
the law or normative act is applied to him (see decision no. 31, dated 04.10.2021 of the Constitutional Court).
35. The court notes that law no. 60/2023 was published in the Official Gazette no. 123, date
16.08.2023 and entered into force on 31.08.2023, i.e. before the start of the academic year 2023-2024
, which according to the order of the Minister of Education and Sport is on 02.10.2023, and after the compulsory
admission test for the students of the year first, which, referring to the acts of this judgment, is
the Decision of the Constitutional Court
: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of the University of Medicine Tirana
developed in period 14-23.08.2023. Consequently, even though the students affected by this law
are categorized into two groups: students in the first year of studies and; intermediate students,
the disputed law has started to bring effects for everyone with the beginning of the academic year 2023-2024,
which coincides with the moment when, as the Court stated in the analysis of legitimation ratione
personae, they were faced with the choice between signing the agreement and the benefit of
special treatment or the payment of the full value of the cost of studies. Evaluating this as
the moment from which the 4-month deadline for the submission of an individual constitutional appeal has started,
the Court assesses that the criterion of legitimation ratione temporis has been met.
B.3. Regarding legitimation ratione materiae
36. The court notes that the petitioners have claimed the violation of several constitutional principles and rights
, more specifically the principle of legal certainty, guaranteed in Article 4 of the Constitution,
the right to work and the right to education, guaranteed by articles 49 and 57 of the Constitution,
contrary to the restriction criteria provided for in article 17 of the Constitution, of the right
not to be subjected to forced labor, guaranteed by article 26 of the Constitution, as well as the principle of
equality before the law and non-discrimination, guaranteed by Article 18 of the Constitution.
37. The court notes that the applicant based his claim on the violation of the principle of equality before the law and
non-discrimination, guaranteed in Article 18 of the Constitution, on the differences, due
to the economic situation, that, according to him, are created between different categories of students:
(i) among students studying at the Faculty of Medicine at UMT, related to
the payment of the full value of the cost of studies in case of non-signing of the agreement
defined in Article 4 of Law no. 60/2023 with the students who sign the agreement, as well as
(ii) between students studying at the Faculty of Medicine at UMT and students
studying at non-public institutions of higher education, because the latter do not
burdens the obligation to sign the agreement. Although the petitioner has claimed that this principle
is violated by the legal provisions object of the request, basically he has linked the claim to the value of the
financial cost of studies that must be borne by students who refuse to sign
the agreement with public health institutions. The court notes that the methodology for
determining the costs of studies and its value are not determined by law no. 60/2023, but
were approved by by-laws of the bodies of the UMT, which came out in implementation of this law, but
which are not the subject of this constitutional judgment and, moreover, may be subject to the control of
ordinary judicial jurisdiction . Consequently, the claim for violation of Article 18 of
the Constitution cannot be considered in this constitutional trial.
Decision of the Constitutional Court
Requesting: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of the University of Medicine in Tirana
38. Referring to the content of the other claims presented in the request, the Court
notes that those related to the right to education, according to Article 57 of the Constitution, are based
on the violation of the acquired rights and legitimate expectations of students due to the
change in the legal framework that was in force at the time they started their studies in
the Faculty of Medicine (law no. 80/2015 "On higher education and scientific research in
institutions of higher education in the Republic of Albania", amended (law no. 80/2015)) for
intermediate students, and when they have decided to compete to become part of that faculty,
for first-year students. Consequently, these claims will be analyzed below in terms of
the principle of legal certainty. Whereas the claims related to the violation of the right to
earn a living through legal work of one's own choosing or acceptance and not to be
subjected to forced labor, due to the way in which they are presented, will are examined
below in terms of the content of Article 49, point 1, of the Constitution.
C. On the foundation of claims
C.1. Regarding the violation of the principle of legal certainty
39. According to the petitioners, the students who follow the integrated program of the second cycle at
the Faculty of Medicine at UMT are violated as a result of the obligations provided for in the
disputed provisions of law no. 60/2023, since the signing of the agreement requires the
official transfer of the relevant diploma from the public institution of higher education to the institution
health where graduated students are employed until the payment of employment obligations
according to the relevant deadlines. Those students who do not agree to sign the agreement have the obligation to
pay the full cost of their studies. According to the petitioners, the disputed provisions have led to a
serious deterioration of the legal situation of students who wish to maintain the status quo, especially
those who follow the intermediate years, who have made the calculations on the basis of the
full cost of studies, as and their economic ability to afford the payment of the
corresponding fee each year, before starting their studies. According to them, the deterioration of the economic and
legal situation of students who do not wish to enter into an agreement does not serve the public interest, nor
does limiting the withdrawal of diplomas.
40. The interested entity, the Assembly, has argued that the aim of the legislator was to ensure
a fair relationship between the imposed restriction and the public interest, and the alternatives of the law are
related to the right of the student to choose whether he wants to benefit from the facilities that
are created by signing the agreement. According to him, since this is a proportional measure, the
right to education and work itself is not violated, since the state guarantees the education of students in the field of
Decision of the Constitutional Court
Applicant: A group of deputies of the Assembly (not less than 1/5 of the deputies ) and a group of students of the Faculty of
Medicine of the University of Medicine Tirana
medicine according to legal provisions, covering a part of the relevant costs. In
the evaluation of this subject, the right acquired by the intermediate students, who follow the
integrated program of the second cycle at the Faculty of Medicine at UMT is not violated, since the legal changes
are applied for the future, without infringing the rights acquired with the start of academic year for
each category affected by them.
41. The interested entity, the Council of Ministers, has stated that every student has the right to
choose whether they want to benefit from the facilities created by signing the agreement or
otherwise respond to the obligations that arise for the payment of study fees. According to him,
there is no violation of the right acquired by the intermediate students who follow the studies in this
study program, since the legal provisions do not have retroactive effects, while they aim at
the fastest possible employment of the students of the Faculty of Medicine. According to this subject, in case of
non-compliance with this obligation within one year from the moment of birth of the right to employment,
it is considered fulfilled and the graduated student, even though he is not equipped with the diploma and
its supplement, with the completion of the procedures, he has the right to employment in the
Albanian health system.
42. According to Article 57, point 1, of the Constitution, everyone has the right to education, while according to
point 4, higher education can only be conditioned by ability criteria. Even according to article 2, point
1, of the Additional Protocol of the ECHR, no one can be denied the right to education (article 2,
point 1). In this regard, the ECHR has emphasized that this right, by its very nature, requires
regulation by the state, regulation which can change in time and place, depending on the needs of the
community and individuals. It is self-evident that such regulation should never violate
the essence of the right to education, nor conflict with other rights provided for in the
Convention (see "Regarding some aspects of the laws on the use of languages ​​in education in
Belgium" v. Belgium No. 1474/62; 1677/62; 1691/62; 1769/63; 1994/63; 2126/64, dated
23.07.1968, § 5 (part "Law"); Leyla Şahin v. Turkey (DhM ), dated 10.11.2005, § 154).
43. For the above, the Court assesses that the right to education is a right that
is oriented by the state towards the creation, development, transmission and protection of knowledge through
teaching and scientific research, contributing to increasing the standards of democracy in
the country, as and economic, social and cultural development, etc. The legal limits of the regulation of this
right can be determined, case by case, also depending on the needs and
general public interests, but maintaining the balance that the interference in this right is to the extent
that it does not decrease in a way sensitive and essential its exercise.
Decision of the
Inquiring Constitutional Court: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of the University of Medicine in Tirana
44. Regarding the principle of legal certainty, the Court has emphasized that this principle, as well as
the protection of acquired rights and legitimate expectations, constitute elements of the
principle of the rule of law, sanctioned in Article 4 of the Constitution. The principle of legal certainty
includes, in addition to the clarity, comprehensibility and stability of the normative system,
the trustworthiness of citizens to the state and the immutability of the law for
regulated relations. Credibility is about the individual's conviction that he does not have to
constantly worry or live in fear of the variability and negative consequences of legal acts,
which may affect his private or professional life and worsen a situation established
by previous acts (see decisions no. 1, dated 16.01.2017; no. 15, dated 10.03.2016;
no. 25, dated 28.04. 2014 of the Constitutional Court). However, the principle of legal certainty does not
guarantee any kind of expectation of non-change of a favorable legal situation and it cannot
prevail in every case. This means that if it is the case that a
different legal regulation of a relationship is directly affected by an important public interest, with all
its essential elements, this interest may take precedence over the principle of
legal certainty. In this view, it should be seen in each case to what extent and to what extent the confidence that
the citizen has in the favorable legal situation is important to protect and what are
the reasons for such protection (see decisions no. 1, date 16.01.2017; No. 37, dated 13.06.2012 of
the Constitutional Court).
45. The court notes that in terms of the constitutional right to education, article 57, point 4, of the
Constitution has provided that its exercise in relation to higher education is conditioned only on
ability criteria. The obligations established at the constitutional level have been detailed by the legislator, in
accordance with the legal reserve, which has provided the rules and criteria for admission to higher education
, in order to materialize and exercise this right. In this regard, law no. 80/2015,
which also defined the main objectives of higher education and scientific research and which aims
to guarantee equal opportunities, based on merit, for all individuals who want to pursue
higher education studies (Article 2), has also determined that at the end of the study program,
according to its article 91, the student is provided with the relevant diploma or certificate. The constituent elements,
the form of the diploma and the registration procedures are determined by the ministry responsible for
education.
46. ​​Consequently, at the time when they started their higher studies at the Faculty of Medicine, as well as
when the students who are subject to law no. 60/2023, the admission criteria
and the rule for obtaining a diploma at the end of the study program were
Decision of the Constitutional Court
Requesting: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of the Tirana University of Medicine
determined by law no. 80/2015, with which they are familiar and have accepted as such, as
well as the study fees determined by the relevant institution of higher education.
47. With the law no. 60/2023 the legislator has defined some special rules for the treatment of
students who follow the integrated study program of the second cycle "General Medicine"
in public institutions of higher education, aiming to provide human resources for
the performance of health services public in health institutions in the Republic of
Albania (articles 1 and 2). This law foresees the concept of "special treatment" of
medical students, which is not found in law no. 80/2015, and which includes the
priority employment of the student following the integrated program at the Faculty of Medicine at UMT, as well as
the benefit from social housing programs. This special treatment applies both to students who
are continuing their studies at the Faculty of Medicine (specifically students from the
second to the fourth year and those from the fifth or sixth year), as well as to those who are
admitted to the first year of the integrated study program of the second cycle "
General Medicine" in public institutions of higher education if they sign the agreement
between them and the ministry responsible for education and health and the institution of
public higher education, through to which they agree to work in the profession of a doctor after
completing their studies for no less than, respectively, three, two and five years, which is accompanied by the
official transfer of the diploma from the institution where they completed their studies to the health institution
where they are employed until "repayment of employment obligations", which can be withdrawn
after fulfilling this obligation according to the relevant deadlines. According to Article 5 of Law no. 60/2023, in
case of not signing this agreement, the student pays the full value of the cost of the
relevant studies, according to the measure that has been approved by the by-laws of the UMT bodies, which
turns out to have increased compared to the fee that they have paid before the entry into force of
this law.
48. Based on the above, the Court notes that, contrary to the provisions of law no.
80/2015, the contested provisions of law no. 60/2023 have changed the legal situation of
medical students in terms of these elements: (i) deciding before choosing to
sign an employment agreement; (ii) in case of signing the agreement, the student
is not provided with a diploma after completing his studies, but it is kept by the
health institution where he is employed, according to the deadline set by these provisions and is issued only after
"repayment of employment obligations"; (iii) in case of non-signing of the agreement is paid
full cost of studies approved by by-laws of the UMT bodies.
Decision of the
Inquiring Constitutional Court: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of the University of Medicine Tirana
49. These changes, in the assessment of the Court, constitute a worsening of the situation legal requirements
of medical students, both intermediate ones and students who are newly entering
the Faculty of Medicine at UMT, who were not familiar with this situation and did not
accept it at the time they decided to compete at that faculty . In terms of the
right to education, as mentioned above, law no. 80/2015 has provided, in addition to the criteria,
procedures and rules for the development of the educational program, also the right to receive
a diploma at the end of this program, according to each cycle of studies. Having said that, the
disputed legal provisions that provide that students, in case of signing the agreement, do not
have the right to be awarded a diploma, but the latter is officially transferred from the institution of
higher education to the health institution where the student will be employed and issued to him only by
"paying off the obligations for employment", have brought negative consequences to their acquired rights,
according to the legal provisions adopted in the understanding and implementation of the right to education.
The deterioration of the legal situation of the students, by foreseeing new obligations and rules, which
they did not know and did not accept before, does not comply with the principle of
legal certainty, therefore the claim of the applicants in this regard is based .
50. In the Court's assessment, these legal changes apparently affect the right provided
by Article 49, point 1, of the Constitution, according to which everyone has the right to earn a living
by work that they have chosen or accepted, as and to choose his own workplace (right
to work). Therefore, in the following, it will stop at the evaluation of whether this constitutional right of
students has been limited and if it reaches a positive answer in this regard, it will evaluate
whether this limitation meets the criteria of Article 17 of the Constitution.
C.2. Regarding the violation of the right to work
51. According to the petitioners, this right has been limited contrary to the criteria of Article 17 of
the Constitution, as it does not respond to the public interest or the objectives of the law no. 60/2023,
the measures used are harsher than necessary to achieve the required objective and the limitation
it is not proportionate to the situation that dictated it, violating the principle of
proportionality. According to them, the provision of Article 5 of the law does not respond to
its main objective, which is about providing medical staff in the long term, and the economic sanction imposed
by this provision forces students in difficult economic conditions to agree to
conclude the agreement or punishes students who refuse to sign it by exponentially raising
tuition. In the assessment of the petitioners, there is no
emergency situation, since there is no decrease in the number of doctors in relation to the population and the means used
Decision of the Constitutional Court
Petitioner: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of the Tirana University of Medicine
are not necessary, which means that the goal could be achieved with other means and
other economic or social incentives, as well as the intervention is not suitable for the realization of the
intended goal . According to the petitioners, the measures are not reasonably related to
the objective, are arbitrary, unfair and based on illogical assessments, while even
the measure of keeping the diploma to enable the implementation of the law is unjustifiable, since
the state has all legal means to guarantee the implementation of the agreement signed with
the students.
52. The interested entity, the Assembly, failed to meet the criteria of Article 17 of
the Constitution, because the right to health care aims to protect the right to life, therefore
the state has a public interest to intervene in this aspect, as there is a need high enough
to guarantee the complementation of public health services with human resources. According to him,
the public interest in guaranteeing the medical service for the population prevails over the expectation
of the students. The alternatives presented by the law are related to the student's right to choose
whether he wants to benefit from the facilities that are created by signing the agreement to work in the
medical profession, after completing his studies, in health institutions in the country and
are drafted in accordance with the needs dictated in the country. According to this subject, the law guarantees
the employment of graduated doctors and there is no violation of the essence of the right to work, therefore
there is no exceeding of the limitations provided for in the ECHR.
53. The interested entity, the Council of Ministers, has submitted that the criteria provided
for in Article 17 of the Constitution have been respected and that the public interest in guaranteeing the service
medical care for the population prevails over the expectation of the applicants, which cannot be
prioritized. According to him, the law helps to keep local talent in the Albanian health system,
preventing their departure abroad and through the contested provisions,
the fastest possible employment of medical students is aimed at, forcing the employing institutions to
comply with this legal provision, which, in case of non-compliance within one year from
the birth of the right to employment for students, is considered fulfilled. According to this
subject, the law has a temporary effect and regardless of the implemented policies, there is an immediate need
to comprehensively address the phenomenon of doctors leaving the system and the country.
According to him, the legal provisions give students the right to choose the conditions for
special treatment and the obligation of employment after completing their studies in a way that respects
the freedom and will of the individual.
54. In terms of Article 49, point 1, of the Constitution, in the constitutional jurisprudence it has been
emphasized that this right includes the choice of profession, place of work, as well as the system of
the Decision of the Constitutional Court
Applicant: A group of deputies of the Assembly (no longer less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of the University of Medicine Tirana
professional qualification, in order to ensure the means of living legally.
The choice of profession, as provided by the constitutional provision, is a right of the individual,
in the sense that he dedicates himself to an activity to secure the means of livelihood. This right
to benefit from legal work also gains importance from a social point of view, since work as a
profession is a value for the contribution it brings to society as a whole (see decisions no.
17, dated 23.03.2023; no. 9, dated 23.03.2010; No. 20, dated 11.07.2006 of the Constitutional Court).
55. The court appreciates to emphasize that even the right to earn the means of living by work chosen
and accepted by oneself and to choose the place of work, guaranteed by article 49, point 1, of the
Constitution is not absolute and it can be object of restrictions in accordance with the criteria
of Article 17 of the Constitution, which allows the limitation of fundamental rights and freedoms only by law,
for public interest or the protection of the rights of others. In the sense of this provision,
the restriction must be proportionate to the situation that dictated it, must not violate the essence of
freedoms and rights, and must not exceed the limitations provided by the ECHR.
56. The court notes, as it was emphasized above during the treatment of the principle of legal certainty, that with
the approval of law no. 60/2023 the legislator aimed to provide human resources for
the performance of public health services in health institutions in the Republic of
Albania by defining the rules for the special treatment of students who follow
the integrated study program of the second cycle "Medicine and general" in
public institutions of higher education (Article 2). The concept of "special treatment", according to this law, includes the
priority employment of the student following the integrated program at the Faculty of Medicine at
UMT, as well as the benefit from social housing programs, and it applies to students who are
continuing their studies in the Faculty of Medicine, as well as for those who register in
the first year of the study program, on the condition of signing the agreement with the ministry
responsible for education, the ministry responsible for health and the institution of
public higher education (Article 4, point 1 , letter "c", point 2, letter "b" and point 3, letter "b", of Law
No. 60/2023) through which the student agrees to work in the medical profession after completing his
studies for no less than five, three and two years, the period during which the diploma stays with
the health institution where it is employed until "repayment of employment obligations" according to these
terms. In case of not signing this agreement, Article 5 of the law stipulates that the student
pays the full value of the cost of the relevant studies, which is approved by by-laws.
57. Consequently, the Court assesses that the contested legal provisions have affected the rights
of students of the Faculty of Medicine at UMT, both intermediate students who have started
and continued their studies in accordance with another legal framework, as well as students who have
Decision of the Constitutional Court
Inquiring: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of the University of Medicine Tirana
newly entered the Faculty of Medicine, whom they did not know and accepted the new
legal regulations at the moment they decided to choose this profession, that is, to compete at that
faculty. The provision of new legal instruments that allows the execution of the employment entry scheme
interferes with the constitutional right to accept and choose the place of
work, in the sense of Article 49 of the Constitution, as long as it places the students before the choice of
signing the agreement or, on the contrary, paying the full value of the cost of studies.
In the Court's assessment, the basis of the constitutional right to work is the will of
the individual to provide the means of living with work chosen or accepted by him, a will that in
this case turns out to be dependent due to the formula selected by legislators to implement
the new employment scheme for medical students after graduation. This
intervention of the legislator constitutes a limitation of the free exercise of the right of students to
choose, in accordance with their professional qualification, the workplace
where they wish to exercise their profession in the manner and form they decide themselves after completing their studies. Consequently
, the obligation of the students
to work, during this period, at the health institution where
the diploma from the public higher education institution is awarded until the "repayment of employment obligations" is concluded, in the event of a two-, three- and five-year contract.
constitutes a limitation of Article 49, point 1, of the Constitution.
58. Having said the above, the Court will assess in the following whether this restriction has respected
the criteria of Article 17 of the Constitution, i.e. whether it was made by law, in the public interest and whether
the criterion of proportionality between the intervention and the situation that dictated it has been respected that.
59. Regarding the first restriction criterion "only by law", its purpose is to provide
the most complete guarantees in the case of restrictions and for this reason only
one body should be competent, namely the highest legislative body ( see decisions No. 21, dated 18.04.2023; No. 4,
dated 21.02.2022; No. 11, dated 09.03.2021 of the Constitutional Court). The court notes that this criterion
has been respected, since the intervention was made with the law no. 60/2023, which was approved by
the Assembly, according to the procedures provided for this purpose.
60. Regarding the second restriction criterion, for public interest, the Court has emphasized that
it is difficult to list exhaustively the issues that constitute public interest or of
public reason that lead to the restriction of a fundamental right, since the public interest should be understood in
a relative sense, depending on the different situations that arise. They can only be ranked
negatively, that is, in terms of limiting each specific case. In constitutional practice, it has
already been accepted that the legislator, in principle, is free to act within his normative space,
Decision of the Constitutional Court
Inquiring: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty THE
Medicine of the Tirana University of Medicine,
clearly defining the goals it seeks to achieve on a case-by-case basis (see decisions no. 20, dated
20.04.2021; no. 16, dated 01.03.2017; no. 1, dated 16.01.2017 of the Constitutional Court ).
61. The court assesses that, referring to the interested subjects, the Assembly and the Council of
Ministers, the public interest evidenced in the concrete case is directly related to
the proper functioning of the health care scheme and the guarantee of meeting the needs for
human resources in the performance of health services public in health institutions, which
turns out to be high, therefore the law was drafted in accordance with the needs dictated in the country.
The court notes that according to Article 55 of the Constitution, citizens equally enjoy the right
to health care and health insurance from the state, which has the obligation to intervene in order to
ensure it for all citizens through the provision of health care in
health institutions public. However, according to Article 59, point 1, letter "c", of the Constitution, the state,
within the constitutional powers and means at its disposal, also aims for the highest
possible health standard. Referring to Article 2 of Law no. 60/2023, it aims to provide
human resources for the performance of public health services in health institutions in
the Republic of Albania by defining the rules for the special treatment of students
who follow the integrated study program of the second cycle "General Medicine" in
public institutions of higher education. Consequently, the Court assesses that in the present case there is a
public interest that has justified the intervention in the students' right to employment, as long as
the disputed legal regulations aim to guarantee the provision of health services, in the
sense of Article 55, point 1 , of the Constitution, as well as the guarantee of public health standards,
according to Article 59, point 1, letter "c", of the Constitution.
62. In the conditions where the above two limitation criteria have been met, the Court assesses
to analyze the other criterion, that of the proportionality of the intervention, at the core of which lies
the fair balancing of interests, the objective assessment, as well as the avoidance of conflict through
the selection of appropriate means for their realization (see decisions no. 30, dated 05.07.2021;
no. 20, dated 20.04.2021; no. 16, dated 01.03.2017 of the Constitutional Court). For the assessment of
the proportionality of the intervention, the balance between the harm caused to the individual is considered
and the general good of society, the measure of protection from arbitrariness provided by
legal procedures, as well as the possibility of the state to use other ways or means to achieve
the goal. The state should, as far as possible, limit the intervention to a minimum, seeking
alternative solutions and, generally, trying to achieve the goals in the least
harmful way from the point of view of human rights (see decision no. 17, dated 23.04.2010 of
the Constitutional Court). The measures can be diverse, but what is important in this case is
the decision of the Constitutional Court
: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of the University of Medicine in Tirana
is that the essence of this activity of the individual is not violated to the extent that it becomes impossible to
exercise it (see decisions no. 37, dated 01.12.2022; no. 52, dated 05.12.2012; no. 18,
dated 14.05 .2003 of the Constitutional Court).
63. The principle of proportionality imposes the evidence of the real need to interfere with
individual rights in a concrete situation (see decisions no. 20, dated 20.04.2021; no. 1, dated
16.01.2017 of the Constitutional Court). In addition, the use of these means must be
necessary, which means that the goal cannot be achieved by other means. Necessity
is also related to the use of the least harmful means for subjects whose rights
and freedoms are violated. Regarding the sub-criterion of necessity, in the Court's assessment the restriction is
unconstitutional if it is proven that there are other means available that would be clearly
effective in achieving the goal, but, at the same time, even less restrictive. fundamental rights and
freedoms. In the same way, the intervention to limit a right or freedom should be done with
appropriate means that respond to the goal that is intended to be achieved. With regard to the sub-criterion of
suitability, the measure taken as limiting the right must bring the appropriate effect and achieve
the purpose for which it was selected (see decisions no. 70, dated 27.12.2023; no. 30,
dated 05.07. 2021; No. 16, dated 01.03.2017 of the Constitutional Court).
64. The court emphasizes that it does not have the competence to analyze whether the measure of intervention is
the most fair and appropriate for achieving the intended goal, but its duty is to assess
whether the legislator has respected the constitutional limits of his evaluation space. According to its jurisprudential standards
, the Court considers the presumption of compliance of the act
normative with the Constitution, until the parties prove the opposite (see decisions no. 30, dated
02.11.2022; no. 5, dated 27.01.2017; no. 52, dated 26.07.2016 of the Constitutional Court).
65. In terms of the sub-criterion of need, which requires a reasonable connection between the restriction and
the situation that requires intervention, the Court notes that, as it has emphasized above in terms of the
public interest of intervention, the purpose of the adoption of law no. 60/2023 is the guarantee by the state, for
its citizens, of the equal enjoyment of the rights stemming from Article 55 of
the Constitution. The factual situation evidenced at the time of the adoption of this law, also proven during
this trial and related to the problems in terms of the ratio of the number of doctors and
the population, is a circumstance that makes clear the existence of the need to act on the part of
the legislator in the approval of law no. 60/2023, which justifies the limitation of the right
to work guaranteed by Article 49, point 1, of the Constitution.
66. Regarding the sub-criterion of necessity, the Court notes that the priority employment
of newly graduated doctors according to Article 4 of Law no. 60/2023, it is conditioned: first, by
the Decision of the Constitutional Court
Requesting: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of the University of Medicine of Tirana
the employment in the health institutions within country and, secondly, with fixed-term employment for
a period of two, three or five years, which is determined by the academic year in which
the student who agrees to enter into the agreement with the health institution is studying. According to the first sentence
of Article 6 of this law, the student who completes the integrated study program of the second cycle
"General Medicine" in public institutions of higher education and has signed
an agreement according to the provisions of this law is employed with priority in
health institutions from the moment of birth of the right to employment.
67. During the trial, it was found that the total number of doctors providing services in the
health system is 5400, which in relation to the population is 1.93 doctors for every
1000 inhabitants. The number of vacant positions for doctors is 482, the number of doctors at
retirement age is 213 and the number of doctors who leave the country every year is about 200. Based
on the above data, as stated in the session by the interested entity,
the Council of Ministers, it turns out that there are 1000 vacancies for doctors and currently the places
vacancies for general practitioners in the health system are 4% of the total number of
medical personnel in primary care. In this sense, the Court assesses that the legal provision that regulates
the employment scheme of young graduating students, in order for them to be employed and
serve in the public health service to ensure the needs of the population throughout
the country, so that citizens equally enjoy the right to
health care, is a measure that is considered necessary to achieve the goal of the legislator.
The new employment scheme for medical students after completing their studies turns out
to have been the way to solve the situation facing the health system in the country
and to guarantee the implementation of Article 55 of the Constitution. The court has emphasized that regarding the
alleged unconstitutionality, the arguments presented must be convincing, to enable
it to assess whether the applied solutions violate constitutional norms and values ​​(see
decisions no. 30, dated 02.11.2022; no. 5 , dated 27.01.2017; No. 52, dated 26.07.2016 of the
Constitutional Court). In this sense, even from the petitioners themselves, in relation to the real possibilities to
adopt another employment scheme, no other measure or scheme that
could be used in this direction, which could bring the same desired effect and which it would
be efficient for the fulfillment of the intended purpose and, on the other hand, less or not at all
restrictive of the students' rights. Under these conditions, the Court assesses that the contested measure
also meets the requirement of being necessary.
68. Regarding the sub-criterion of the measure's suitability, the Court assesses to analyze
whether the duration of the forced employment measure meets this criterion, i.e. if it is expected to bring
Decision of the Constitutional Court
Applicant: A group of members of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of the University of Medicine of Tirana
to have the right effect and achieve the goal for which it was selected.
According to the contested legal provisions , specifically Article 4 of Law no. 60/2023, the obligation extends from the
first year students of the Faculty of Medicine for a period of five years, which is expected to be implemented no
sooner than the year 2029, when they complete the cycle of studies according to the curriculum and end
no later later than 2034, when they repay the obligation according to the agreement signed
with the public service institution. For fifth or sixth year students who accept
sign the priority employment agreement, the implementation of this scheme is expected to start
no sooner than 2024, while for other intermediate students, second to
fourth year, it is expected to be implemented no sooner than 2026 The court notes that despite the fact that the law has
a temporary effect, as according to the transitional provision (Article 9) it extends the effects to the period from the
academic year 2023-2024 to the academic year 2027-2028, taking into account this formula of
the implementation of this scheme , it turns out that the measure provided by the legislator currently affects five generations
of students in full or in part, based on the year of studies they
are currently in and for a long period of time, which, in the Court's assessment,
is not appropriate in relation to the urgency of the legislative intervention in terms of
its expected effects. Moreover, the duration of the employment measure under this scheme for the
five-year period is almost equal to the full duration of the study cycle for the
six-year integrated program.
69. The court assesses that the interested parties, even though they had the burden of proof in this
regard, failed to prove that this measure is appropriate, linking it to the
actual expected effects that have brought about the need for the intervention and its consequences in time, in terms of
the expected effects for the future, that is, the term of the duration of this measure, determined depending on
the years of study in which intermediate students or those who have acquired the right
to start studies before entering in force of the contested legal changes, it is
the most appropriate tool to ensure the health care needs of the population. The court
above found the ratio of the number of doctors in relation to the population, this ratio was estimated
to create difficulties in providing the health care scheme and guaranteeing the rights of
citizens to benefit from this care from the state equally. During this trial
, it also emerged that there has been a gradual increase in the number of quotas opened for each year for the
"General Medicine" study program at UMT, reaching around 500 within
the year 2024. Even according to decision no. 17, dated 10.03.2023 of the academic senate of UMT, the number of
admission quotas for the academic year 2023-2024 in the "General Medicine" faculty,
"Master of Science" program, is 464. Referring to the facts obtained during this trial ,
Decision of the Constitutional Court
Applicants: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of the University of Medicine of Tirana,
the flow from the UMT for graduated doctors year after year, in the period that the effects of of this
law, are greater than the current needs to hire general practitioners in the
vacant positions, which can be filled by graduated students approximately within two to three years.
Despite these measures that are being taken and that aim to ensure the goal of
the legislator noted above, the interested entities have not managed to justify in
what way the conclusion of agreements and the retention of the diploma until "repayment of
employment obligations". according to the legal deadlines, for students who complete their studies at the Faculty of Medicine,
it will bring the desired effect, while the number of vacant positions in the health system
is 1000, while the number of quotas for students at the Faculty of Medicine is about 500 per year.
70. Likewise, the Court notes that the practice of hiring doctors within the country for
its needs has been implemented for temporary periods, in similar ways, in other countries, such as
Sweden, Spain, Denmark, Kazakhstan or South Africa, but contrary to the provisions of
Article 4 of Law no. 60/2023, the deadline does not exceed half of the duration of
the studies. In contrast to these similar cases, the ratio in the case of Albania turns out to
be, referring to the five-year period of employment in relation to the six years of study, to
the extent of 83%.
71. For the above, the Court assesses that the contested provisions, specifically
the provisions of Article 4 of Law no. 60/2023, in the part that foresees the deadlines for employment after
the end of studies, restricts the constitutional right of students to choose
the place of work, guaranteed by article 49, point 1, of the Constitution. In terms of the
proportionality test, the chosen scheme is harsher than was necessary to achieve the
intended goal in relation to the circumstances that dictated it. Forcing students to
choose between signing or not signing the agreement, with the consequence that in case of signing, the diploma
is officially transferred to the health institution where they are employed until "payment of
employment obligations" has led to a complete denial of the right to choose the place of work, according to the conditions
and criteria that the students were familiar with and accepted at the moment they started
their studies or competed for this purpose.
72. Based on the premise that the deadlines set by Article 4 of Law no. 60/2023
are not proportional, as well as taking into account that the five-year period provided for in point 1,
letters "b" and "c" of this article is almost the same as the duration of the studies itself, as well
as taking into consideration the experiences of similar to those of other countries, the Court considers revising
this term up to a limit no longer than three years. In the same way, the legislator should
review in order to guarantee the principle of proportionality of the intervention and the other deadlines
Decision of the Constitutional Court
Requesting: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of the University of Medicine Tirana
three and two years defined respectively in point 2, letters "a" and "b" and point 3,
letters "a" and "b" of article 4 of law no. 60/2023.
73. According to Article 48 of Law no. 8577/2000, when there is a connection between the object of the request and
other normative acts, the Court decides on a case-by-case basis. In terms of this provision, the Court
assesses that, within the proportionality test, the violation of the constitutional rights guaranteed
by Articles 49, point 1, and 57 of the Constitution is also due to the lack of
legal provisions in Article 6 of Law no. . 60/2023, in terms of: (i) objective criteria for
priority employment, (ii) financial treatment in the context of providing the necessary means of living, according to
Article 49, point 1, of the Constitution, (iii) payment calculation of the waiting period in
the duration of the employment obligation, if the state does not provide a job to the students, because
during the first year of waiting they have no other employment opportunities, since they do not yet have
the diploma and, therefore, are harmed by the foreseen measure .
74. The Court has emphasized the necessity for the functioning of the state of
law to avoid the legal gap, but also its function as a negative legislator to guarantee
constitutionality, which, in compliance with the principle of separation and balancing of powers, cannot
interfere in the powers of the lawmaker to regulate the fair regulation of
legal provisions (see decisions no. 4, dated 15.02.2021; no. 31, dated 19.11.2003 of the Constitutional Court).
Pursuant to Article 76, point 5, of Law no. 8577/2000, since the lack of the
above provisions constitutes a legal gap, as a result of which there have been negative consequences on the fundamental rights
of the students of the Faculty of Medicine, the Court estimates that they must be filled
by the legislator in accordance with the reasoning of this decision, defining the issues and
principles that must be applied in this case, within a term that is considered to be set three months
from the entry into force of the decision.
75. Consequently, until the approval of new legal regulations by the legislator, the signing of
the agreement provided for in Article 4, point 1, letter "c", point 2, letter "b" and point 3,
letter "b", of Law no. . 60/2023 cannot be implemented until the entry into force of the
new legal deadlines, which must respect the criteria of Article 17 of the Constitution.
76. In conclusion, the Court assesses that the claims of the petitioners regarding the violation of the right
to education, guaranteed by Article 57 of the Constitution related to the principle of legal certainty, as well as
the violation of the right to choose the place of work, guaranteed by Article 49, point 1,
of the Constitution, are partially based, according to the above reasoning of this decision, so
the request is partially accepted.
Decision of the
Inquiring Constitutional Court: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of the University of Medicine in Tirana
FOR THESE REASONS,
the Constitutional Court of the Republic of Albania, in support of articles 131, point 1,
letter "a" and 134, points 1, letters "c" and "i" and 2, of the Constitution, as well as articles 72 and
76, point 5, of law no. 8577, dated 10.02.2000 "On the organization and functioning of the
Constitutional Court of the Republic of Albania", amended, by majority vote,
DECIDED:
1. Partial acceptance of the request.
2. Repeal of the words "5 (five) years" in article 4, point 1, letter "b", "5-year" in article
4, point 1, letter "c", "3 (three) years" in article 4, point 2, letter "a", "3-year" in article
4, point 2, letter "b", "2 (two) years" in article 4, point 3, letter "a", "2-year ” in
article 4, point 3, letter “b”, of law no. 60/2023 "On the special treatment of students
who follow the integrated study program of the second cycle "General Medicine" in
public institutions of higher education".
3. Finding the legal omission in Article 6 of Law no. 60/2023 "On the special treatment of
students who follow the integrated study program of the second cycle "
General Medicine" in public institutions of higher education", related to the lack of
objective criteria for priority employment, the financial treatment within of providing the
necessary means of living, as well as the calculation of the payment of the waiting period in
the duration of the employment obligation.
4. Obliging the Assembly of the Republic of Albania to approve the necessary
legal changes within 3 (three) months from the entry into force of this decision.
5. Removal of the measure of suspension of the implementation of law no. 60/2023 "On the special treatment of
students who follow the integrated study program of the second cycle "
General Medicine" in public institutions of higher education".
This decision is final and enters into force on the day of its publication in the Official Gazette.
Received on 25.01.2024
Announced on 26.02.2024
Decision of the Constitutional Court
Requesting: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of the University of Medicine Tirana
Partial opinion against
1. In the constitutional trial set in motion by the petitioners, 30 deputies of the Assembly (not
less than 1/5 of the deputies) and 37 students of the Faculty of Medicine of the University of
Medicine of Tirana (UMT), with the object of repealing some provisions of law no. 60/2023 "On
the special treatment of students who follow the integrated study program of the second cycle
"General Medicine" in public institutions of higher education", I am partially against
the position of the majority, as I believe that the request should have been accepted completely. In support of
Article 132, point 3, of the Constitution and Article 72, point 8, of Law no. 8577/2000, which provide for
the publication of the minority opinion together with the final decision of the Court, I present below
the arguments that support my position.
2. Law no. 60/2023 aims to ensure human resources, professionals in
health service institutions in the country by defining the rules for the
special treatment of students who follow the integrated study program of the second cycle "General Medicine
" in public educational institutions high (Article 2), but also the increase of
their interest to work in the public health sector as part of the increase in investments in health.
In function of this goal, it offers these students special treatment, in terms of
priority employment after completing their studies and benefiting from social
housing programs (Article 3, point 1).
3. The applicants objected to article 4, points 1, letter "c", 2, letter "b", 3,
letter "b", as well as article 5, first sentence, of law no. 60/2023. Article 4 provides that special treatment
benefits: (i) the candidate who is accepted in the integrated study program of the second cycle
"General medicine" in public institutions of higher education (item 1, letter "c"); (ii)
second year to fourth academic year student (point 2, letter "b");
(iii) the fifth or sixth year student in this program (point 3, letter "b"), when they accept the official transfer of
the relevant higher education diploma from the public institution of higher education, where he completed
his studies, to the institution of health where he is employed, until the payment of employment obligations,
according to the terms, respectively 5-year, 3-year and 2-year, with the right that after the fulfillment of the
employment obligation, the candidate can withdraw the university diploma. While article 5 provides that
the student who does not agree to sign the agreement to work in a health institution
in the country, public or private, from the date of birth of the right to employment with the ministry responsible
for education, the ministry responsible for health and the educational institution of public high court,
Decision of the Constitutional Court
Inquiring: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of the University of Medicine in Tirana
according to the definitions of points 2 and 3 of article 4 of this the law, pays the full value of the cost of
studies (first sentence).
4. At the end of the trial, the majority has decided to abolish only the terms of five,
three and two years of the obligation for employment, provided respectively in article 4, points 1,
letters "b" and "c", 2, letters "a ” and “b”, as well as 3, letters “a” and “b”, of law no.
60/2023, on the grounds that they limit the right of students to choose and accept
the workplace, guaranteed by Article 49, point 1, of the Constitution. According to the majority, although
the intervention is established by law and is in the public interest, it is not proportionate, since the scheme
chosen is harsher than was necessary to achieve the intended goal in relation to
the circumstances that dictated it (see paragraphs 57 , 59, 61 and 71 of the decision).
5. I do not agree with this position of the majority, since it basically admits that the
chosen legal scheme of priority employment is in accordance with the Constitution, but
only the duration of the obligation for employment should be modified, shortening it (see paragraph 72
and 76 of the decision). Despite this position, I estimate that, as a whole, the legal mechanism of
priority employment of the student who follows the integrated study program of the second cycle for medicine in
public institutions, does not respect the principle of proportionality of the intervention he makes in it
the basic rights to choose or accept the workplace and for education, guaranteed
by articles 49, point 1 and 57, of the Constitution.
6. Regarding the assessment of the principle of proportionality in interventions that limit
fundamental rights and freedoms, the Court has developed several criteria: (i) if the legislator's objective is
sufficiently important to justify the limitation of the right; (ii) if the measures taken
are reasonably related to the objective, they cannot be arbitrary, unfair
or based on illogical assessments; (iii) if the means used are not harsher than
necessary to achieve the desired objective – the greater the harmful effects of the chosen measure
, the more important the objective to be achieved must be, in so that the measure
is justified as necessary. The proportionality of a restriction is assessed case by case, bearing in
mind that the above criteria are not analyzed separately, but intertwined with each other (see decisions no. 21, dated 18.04.2023; no. 20, dated 20.04.2021; no. 33, dated 08.06.2016
of the Constitutional Court).
7. During the constitutional trial of the case, it was found that the law no. 60/2023 was approved
to guarantee the provision of health care. The latter constitutes not only a social objective
provided by Article 59, point 1, letter "c" of the Constitution, but also a fundamental right guaranteed
by Article 55 thereof. The interested entities, the Assembly and the Council of Ministers, have
Decision of the Constitutional Court
Requesting: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of the University of Medicine Tirana
submitted that the law was responds to the needs dictated in the country regarding the lack of
human resources, the challenges to maintain the existing resources in the health centers, as well as to
motivate the health professionals to continue working in Albania, in order to guarantee the
medical service for the population. The Council of Ministers, in the plenary session of 21.12.2023,
has stated that for the next 4 years it is expected that there will be about 1000 vacant positions in the
health sector.
8. In these circumstances and based on the criteria developed by constitutional jurisprudence,
the issue that was presented for resolution before the Court was the careful analysis of the situation to
identify the extent of the need for young doctors who should practice the profession in Albania,
the logic and honesty of the legal mechanism "agreement before admission to the program."
study to practice the profession in Albania and in case of non-acceptance, with the sanction of payment of the
full cost of studies in public education", as well as the severity of this mechanism.
9. First of all, it should be noted that, as noted in the accompanying report, the initiative for
the adoption of the law was undertaken by the Council of Ministers without being part of the annual
analytical program of draft acts for 2023, approved by the decision of 27.12.2022. The annual program
of draft acts is one of the instruments provided by the legislation in force (see
Article 27 of Law No. 9000, dated 30.01.2003 "On the organization and functioning of the Council of
Ministers" and points 2, letter "ç", 7, 8 , 9 and 10 of the regulation approved by decision No.
584, dated 28.08.2003, amended), based on the constitutional role of the Council of Ministers to
determine the general directions of state policy (Article 100 of the Constitution). On the
other hand, in the accompanying report of the draft law, it is noted that the initiative is in accordance with
the political program of the Council of Ministers approved by decision no. 68/2021, dated
17.09.2021 of the Assembly, as well as with several national strategies, such as that for development and integration
(2022-2030), education (2021-2026), and health (2021-2030). However, in none
of these programmatic and strategic documents does it appear that
such a legal initiative has been foreseen, but they only contain general commitments for the improvement of
human resources in order to provide quality services.
10. Following this, the Council of Ministers, based on Article 83, point 2, of the Constitution has
proposed to the Assembly that the review and approval of the draft law be done with an accelerated procedure
, due to the urgent need it presents for approval and entry into force ,
before the start of the procedures for the application and registration of candidates for students in
the field of medicine for the academic year 2023-2024 (see page 11 of the accompanying report of the
Decision of the Constitutional Court
Requesting: A group of deputies of the Assembly (not less than 1/5 of deputies) and a group of students of the Faculty of
Medicine of the Tirana University of Medicine
draft law). On the basis of this proposal, the Assembly approved the law no. 60/2023 with
accelerated parliamentary procedure in the plenary session of 21.07.2023.
11. For the above, this initiative was included in the calendar without planning, and it was
drafted and approved urgently. This means that there has been a lack of logical assessment and
adequate analysis of the actual need – the magnitude of the departure of medical professionals
abroad, including the impact that the number of doctors graduating
from private educational institutions operating in the country may have on this need, as well as the possibility of using
other less restrictive alternatives to respond to the actual need.
12. Law no. 60/2023 extends its effects to the period from the academic year 2023-2024 to the
academic year 2027-2028 (Article 9), so through it 10 generations of students are affected, who
are forced to practice their profession in Albania after completing their studies. It is about 5
full generations of students with 6 years each, as far as the full duration of the study cycle
for the integrated study program "General Medicine", while 5 generations of students
are partially affected according to the year they are currently in until at the end of the program (see
the second paragraph of point 5 of the written response given by the Council of Ministers with
the letter dated 05.01.2024). In the context of the content and purpose of the law, it is clear that
the category of affected individuals includes students and young doctors who are in the profession up to 5
years after graduation.
13. During the constitutional trial, it was found that
5,400 doctors provide services in the health system, which means 1.93 doctors for every 1,000 inhabitants (see page 6, third paragraph, of the
accompanying report of the draft law). Currently, the health system has 4% vacant positions
(482) doctors, 213 doctors are at retirement age, while every year about 200 doctors leave the country
(see point 1 of the written answer given by the Council of Ministers with the letter
dated 05.01. 2024). Regarding the age of the doctors who leave the country and the type of
education they attended (public or private), no data was presented in the trial. On the
other hand, to respond to the situation of the departure of doctors, at the University of Medicine in Tirana there has
been a gradual increase in the number of quotas opened for each year for the "
General Medicine" study program, reaching 464 such within of 2024 (see decision no. 17, dated
10.03.2023 of the UMT Academic Senate).
14. From the analysis of these data, it is easily established that the state of
human resources in the health system cannot be described as an emergency need, as
the interested parties have submitted. It should be noted that the phenomenon of young people leaving the country
Decision of the Constitutional Court
Inquiring: A group of deputies of the Assembly (not less than 1/5 of the deputies) and a group of students of the Faculty of
Medicine of the Tirana University of Medicine
well-educated and qualified, also known as brain drain, is very
worrying, but it seems to exist in the entire Balkan region.1 However, this
local and regional phenomenon cannot be simplified by addressing it as an issue related only
to the medical sector or only to doctors studying and graduating from
public education programs. Even the interested subject, the Assembly affirmed in the judgment that the trend and spirit that
prevails among young Albanians, without excluding medical students, is that of leaving
the country. Likewise, the departure of newly graduated doctors abroad is not a situation
that was created suddenly, to find the policy-making and
decision-making authorities in Albania unprepared.
15. In view of the above and taking into consideration that Albania is
a developing country, which has been affected by the demographic movements of the population, including
the free movement abroad of young people and professionals, I estimate that in the trial it was not proven
that the need for new doctors is of such an urgent magnitude as to justify the adoption of
such a harsh legal mechanism. On the other hand, admissions to study programs from UMT year after year are increasing and seem to be higher than the number of doctors leaving (see
paragraph 13 above). Furthermore, it seems that the situation in question does not include the indicators
generated by private medical universities, which have planned annual quotas
and significant numbers of young doctors who graduate year after year.
16. Under this lens, I appreciate that the interested subjects failed to explain in a
reasonable and convincing manner in the judgment why this situation was assessed by them as an emergency to the
extent that it dictated the drafting of an "emergency" law, outside the legislative program and with
an accelerated procedure. Likewise, it does not seem that the assessment for undertaking such an initiative
was logical and fair, as it forces students, including those with
limited family and personal financial means, to sign an agreement with
financial consequences for them. In this sense, the tuition fee in public education has multiplied
by equaling the costs of the study. Specifically, the cost/fee of the study is currently calculated
at 248,975 ALL per student (see paragraph 4 of the decision) from 45,000 ALL. This value
is very high and returns the agreement before admission to the study program for him
practicing the profession in Albania" in itself an economic sanction, as it forces students to
agree to sign it or punishes those who refuse to sign it, depriving
them of the opportunity to choose.

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1 https://www.gmfus.org/news/reversing-brain-drain-western-balkans
Vendim i Gjykatës Kushtetuese
Kërkues: Një grup deputetësh të Kuvendit (jo më pak se 1/5 e deputetëve) dhe një grup studentësh të Fakultetit të
Mjekësisë të Universitetit të Mjekësisë Tiranë
17. Nga ana tjetër, pretendimi i subjekteve të interesuara se ky mekanizëm është analog
me atë të Shkollës së Magjistraturës është i pabazuar, pasi ky i fundit i ofron kandidatit që gjatë
periudhës së ndjekjes së programit të formimit fillestar të përfitojë një bursë shkollimi, e cila
përllogaritet me përqindje mbi pagën bruto fillestare të tij, të cilën ai është i detyruar ta kthejë
tërësisht ose 50%, në rastet e parashikuara shprehimisht në ligj (shih nenin 19 të ligjit nr.
96/2016, datë 06.10.2016 “Për statusin e gjyqtarëve dhe prokurorëve në Republikën e
Shqipërisë”, të ndryshuar dhe nenin 267 të ligjit nr. 115/2016, datë 03.11.2016 “Për organet e
qeverisjes së sistemit të drejtësisë”, të ndryshuar). Kjo do të thotë se kandidatët për magjistratë
përfitojnë bursë shkollimi dhe detyrohen të kthejnë eventualisht vetëm bursën e përfituar,
përkundër detyrimit të studentëve të mjekësisë për t’u sanksionuar me kostot e studimit.
18. Nën këtë analizë, rezulton se detyrimi në fjalë aplikohet vetëm ndaj studentëve të
mjekësisë në institucionet e arsimit publik dhe në një masë të tillë që nuk është në raport të drejtë
me nivelin e jetesës. Kjo barrë bëhet akoma edhe më e ndjeshme, nëse mbahet në konsideratë se
ligjvënësi për të bërë të zbatueshëm ligjin ka vendosur edhe ndalimin e tërheqjes së diplomës. Në
këtë kontekst, çmoj se mekanizmi ligjor, në tërësi, nuk është rrjedhojë e një vlerësimi logjik dhe
e bën raportin midis tij dhe nevojës të shpërpjesëtuar dhe në atë masë që e shndërron atë në
arbitrar dhe të padrejtë.
19. Për rrjedhojë, mbështetur në argumentet e mësipërme, vlerësoj se Gjykata duhej të
kishte pranuar kërkesën e kërkuesve dhe të vendoste shfuqizimin e dispozitave ligjore, sipas
objektit.
Anëtare: Marsida Xhaferllari
Vendim i Gjykatës Kushtetuese
Kërkues: Një grup deputetësh të Kuvendit (jo më pak se 1/5 e deputetëve) dhe një grup studentësh të Fakultetit të
Mjekësisë të Universitetit të Mjekësisë Tiranë
Mendim pjesërisht kundër
1. Në çështjen objekt gjykimi kam votuar për pranimin e kërkesës sipas objektit, ndaj dhe
në vijim do të paraqes argumentet mbi të cilat mbështetet ky qëndrim.
2. Shumica ka arritur në konkluzionin e shfuqizimit vetëm të fjalëve që parashikojnë
afatet ligjore për punësim pas përfundimit të studimeve, në dispozitat objekt kundërshtimi, për
shkak të mosrespektimit të parimit të proporcionalitetit, në drejtim të nëntestit të
përshtatshmërisë. Sipas saj, afatet e përcaktuara nga neni 4 i ligjit nr. 60/2023 nuk janë
proporcionale, si dhe duke pasuar parasysh se afati pesë vjeçar, i parashikuar në pikën 1,
shkronjat “b” dhe “c” të këtij neni, është gati i njëjtë me vetë kohëzgjatjen e studimeve, dhe duke
marrë në konsideratë eksperiencat e ngjashme të vendeve të tjera, ajo vlerëson që të rishikohet
ky afat deri në një kufi jo më të gjatë sesa tre vjet. Po kështu ligjvënësi duhet të rishikojë me
qëllim që të garantojë parimin e proporcionalitetit të ndërhyrjes edhe afatet e tjera tre dhe dy
vjeçare të përcaktuara në pikën 2, shkronjat “a” dhe “b” dhe pikën 3, shkronjat “a” dhe “b” të
nenit 4 të ligjit nr. 60/2023 (shih paragrafin 72 të vendimit). Ndërsa në vlerësimin tim, në vetvete
masa ndërhyrëse legjislative, pra punësimi me detyrim në sistemin mjekësor publik pas
diplomimit të studentëve të mjekësisë dhe pagesa e kostove të studimit në rast mospranimi të
nënshkrimit të kontratës për punësim, nuk plotëson kriterin kushtetues të proporcionalitetit, në
drejtim të secilit prej nënkritereve të testit të proporcionalitetit, përkatësisht nevojës,
domosdoshmërisë dhe përshtatshmërisë, të analizuara së bashku ose veç e veç.
3. Në parim, në gjykimin tim, zbatimi i ligjit objekt shqyrtimi imponon një barrë të
tepruar mbi studentët dhe në këtë mënyrë dështon në arritjen e një ekuilibri të drejtë midis
interesit publik për mbrojtjen e shëndetit publik dhe ofrimit të kujdesit mjekësor, nga njëra anë,
dhe interesit të studentëve për arsim publik dhe së drejtës për punë të ligjshme e që duhet ta
zgjedhin vetë, nga ana tjetër.
4. Referuar çështjes konkrete, rezulton se Kuvendi, në bazë të propozimit të Këshillit të
Ministrave dhe në zbatim të procedurës së përshpejtuar parlamentare, ka miratuar ligjin nr.
60/2023. Ky ligj ka parashikuar një mekanizëm përmes së cilit studentëve që ndjekin programin
e integruar të studimit të ciklit të dytë “Mjekësi e përgjithshme” në institucionet publike të
arsimit të lartë u ofrohet një trajtim e veçantë, i cili, në kuptim të nenit 3, pika 1, të ligjit, përfshin
punësimin me prioritet të tyre pas përfundimit të studimeve, si dhe të drejtën për të përfituar nga
programet sociale të strehimit. Ky trajtim përfitohet si nga kandidati që pranohet rishtazi në
programin e integruar të studimit të ciklit të dytë “Mjekësi e përgjithshme” në institucionet
Vendim i Gjykatës Kushtetuese
Kërkues: Një grup deputetësh të Kuvendit (jo më pak se 1/5 e deputetëve) dhe një grup studentësh të Fakultetit të
Mjekësisë të Universitetit të Mjekësisë Tiranë
publike të arsimit të lartë, ashtu edhe nga studenti i vitit të dytë deri në vitin e katërt akademik
dhe nga studenti i vitit të pestë ose të gjashtë (student i ndërmjetëm) në këtë program, kur pranon
të nënshkruajë marrëveshje me ministrinë përgjegjëse për arsimin, ministrinë përgjegjëse për
shëndetësinë dhe institucionin e arsimit të lartë publik. Sipas marrëveshjes, studenti duhet të
punojë në profesionin e mjekut pas përfundimit të studimeve për, respektivisht, jo më pak se
pesë vjet, tre vjet dhe dy vjet, në institucionet shëndetësore në Republikën e Shqipërisë, si dhe
pranon kalimin zyrtarisht të diplomës përkatëse të arsimit të lartë nga institucioni publik i arsimit
të lartë, ku ka përfunduar studimet, në institucionin shëndetësor ku punësohet deri në shlyerjen e
detyrimeve për punësim sipas afatit, përkatësit, 5-vjeçar, 3-vjeçar dhe 2-vjeçar, me të drejtën që
pas përmbushjes së detyrimit të punësimit të tërheqë diplomën universitare (neni 4, pika 1,
shkronja “c”, pika 2, shkronja “b”, pika 3, shkronja ‘b”, i ligjit nr. 60/2023). Ndërkohë studenti
që nuk pranon të nënshkruajë marrëveshjen sipas përcaktimeve të pikave 2 dhe 3 të nenit 4,
paguan vlerën e plotë të kostos së studimeve (neni 5 i ligjit nr. 60/2023).
5. Kërkuesit në lidhje me këto parashikime ligjore, të cilat i kundërshtojnë si në cenim të
së drejtës për arsim dhe së drejtës për punësim, kanë pretenduar se për ndërhyrjen nuk ekziston
një situatë emergjente, që të ketë ulje të numrit të mjekëve në raport me popullsinë. Mjetet e
përdorura nuk janë të domosdoshme, që do të thotë se synimi mund të arrihej me mjete të tjera.
Garantimi i shërbimit mjekësor nuk ka asnjë lidhje me pagimin e vlerës së plotë të kostos së
studimeve, ndërhyrja nuk është e përshtatshme për realizimin e këtij qëllimi, si dhe nuk e
influencon atë. Objektivi i ligjvënësit nuk është mjaftueshmërisht i rëndësishëm për të justifikuar
kufizimin e së drejtës (shih paragrafin 9.2. të vendimit).
6. Po në këtë drejtim, Kuvendi ka prapësuar se kriteret për vendosjen e kufizimit sipas
nenit 17 të Kushtetutës janë plotësuar. E drejta për kujdes shëndetësor synon mbrojtjen e së
drejtës së jetës, për rrjedhojë shteti ka interes publik që të ndërhyjë në këtë aspekt. Qëllimi i
ligjvënësit gjatë hartimit dhe miratimit të ligjit nr. 60/2023 ka qenë sigurimi i një raporti të drejtë
midis kufizimit të vendosur dhe interesit publik. Për sa i përket kriterit të proporcionalitetit,
interesi publik në garantimin e shërbimit mjekësor për popullsinë mbizotëron ndaj pritshmërisë
së studentëve, që janë në ndjekje e sipër të programit të studimit në mjekësi, për të vijuar edhe
kohën e mbetur të studimit me të njëjtin trajtim dhe kushte që kanë pasur deri më sot (shih
paragrafët 10.2.1. dhe 10.2.2. të vendimit). Edhe subjekti i interesuar, KM-ja, ka prapësuar se
pandemia botërore COVID-19 ka gjeneruar efekte negative, ndaj politikat për rimëkëmbje duhet
të rimodelohen. Ligji objekt shqyrtimi është hartuar në përputhje me strategjitë kryesore në vend,
Vendim i Gjykatës Kushtetuese
Kërkues: Një grup deputetësh të Kuvendit (jo më pak se 1/5 e deputetëve) dhe një grup studentësh të Fakultetit të
Mjekësisë të Universitetit të Mjekësisë Tiranë
e konkretisht me qëllimet e politikave në fushat e arsimit, shëndetësisë dhe punësimit (shih
paragrafin 11.2. të vendimit).
7. Lidhur me kufizimet e të drejtave themelore kushtetuese, Gjykata ka një jurisprudencë
të konsoliduar, sipas së cilës për vlerësimin e proporcionalitetit të ndërhyrjes merret në shqyrtim
balanca ndërmjet dëmit të shkaktuar individit dhe së mirës së përgjithshme të shoqërisë, masa e
mbrojtjes nga arbitrariteti që ofrojnë procedurat ligjore, si dhe mundësia e shtetit për të përdorur
mënyra a mjete të tjera për të arritur qëllimin. Shteti, brenda mundësive, duhet të kufizojë
ndërhyrjen në minimum, duke kërkuar zgjidhje alternative dhe, përgjithësisht, duke u përpjekur
t’i arrijë qëllimet në mënyrë sa më pak të dëmshme nga pikëpamja e të drejtave të njeriut (shih
vendimin nr. 17, datë 23.04.2010 të Gjykatës Kushtetuese). Përdorimi i këtyre mjeteve duhet të
jetë i domosdoshëm, çka do të thotë se synimi nuk mund të arrihet me mjete të tjera.
Domosdoshmëria lidhet edhe me përdorimin e mjeteve më pak të dëmshme për subjektet që u
cenohen të drejtat dhe liritë. Po kështu, ndërhyrja për kufizimin e një të drejte ose lirie të bëhet
me mjete të përshtatshme që i përgjigjen drejt qëllimit që synohet të arrihet (shih vendimet nr.
30, datë 05.07.2021; nr. 20, datë 20.04.2021; nr. 16, datë 01.03.2017 të Gjykatës Kushtetuese).
8. Po sipas Gjykatës, për vlerësimin e proporcionalitetit duhen mbajtur në konsideratë
disa nënkritere: (i) nëse objektivi i ligjvënësit është mjaftueshmërisht i rëndësishëm për të
justifikuar kufizimin e së drejtës; (ii) nëse masat e marra janë të lidhura në mënyrë të arsyeshme
me objektivin, ato nuk mund të jenë arbitrare, të padrejta ose të bazuara mbi vlerësime alogjike;
(iii) nëse mjetet e përdorura nuk janë më të ashpra se sa duhet për të arritur objektivin e kërkuar,
sa më të mëdha efektet e dëmshme të masës së përzgjedhur, aq më tepër duhet të jetë i
rëndësishëm objektivi për t’u arritur, në mënyrë që masa të justifikohet si e nevojshme (shih
vendimet nr. 20, datë 20.04.2021; nr. 11, datë 09.03.2021; nr. 33, datë 08.06.2016 të Gjykatës
Kushtetuese).
9. Përveç sa më lart, kjo Gjykatë mban në konsideratë prezumimin e pajtueshmërisë së
aktit normativ me Kushtetutën, derisa palët t’i provojnë asaj të kundërtën. Kjo do të thotë se
lidhur me jokushtetutshmërinë e pretenduar argumentet e parashtruara duhet të jenë bindëse, për
t’i dhënë mundësi kësaj Gjykate të vlerësojë nëse zgjidhjet e aplikuara shkelin normat dhe vlerat
kushtetuese (shih vendimet nr. 30, datë 02.11.2022; nr. 5, datë 27.01.2017; nr. 52, datë
26.07.2016 të Gjykatës Kushtetuese). Ndërsa, në vështrim të kontrollit kushtetues të respektimit
të parimit të proporcionalitetit është thelbësore të theksohet se nuk i takon Gjykatës të përcaktojë
nëse mjeti i përzgjedhur është mënyra më e përshtatshme, më e arsyeshme ose e duhura, por roli
i saj është të kontrollojë nëse përmbajtja e vetë dispozitës normative është e pajtueshme me të
Vendim i Gjykatës Kushtetuese
Kërkues: Një grup deputetësh të Kuvendit (jo më pak se 1/5 e deputetëve) dhe një grup studentësh të Fakultetit të
Mjekësisë të Universitetit të Mjekësisë Tiranë
drejtat, liritë dhe parimet themelore kushtetuese (shih vendimin nr. 55 datë 21.07.2015 të
Gjykatës Kushtetuese).
10. Në vështrim të standardeve të sipërpërmendura, në rastin konkret duhet analizuar
nëse kërkuesit arritën ta përmbysin prezumimin e kushtetutshmërisë së normave ligjore të
kundërshtuara në raport me tri nënkriteret e ndërhyrjes: (i) nevojës; (ii) domosdoshmërisë, (iii)
përshtatshmërisë. Në këtë drejtim, pyetjet që duhej të merrnin përgjigje në këtë gjykim ishin: A
ishte e nevojshme në momentin e marrjes së nismës ligjore dhe miratimit të ligjit ndërhyrja
përmes detyrimit për punësim të studentëve të mjekësisë pas diplomimit? A ishte ky mjet
ndërhyrës më pak i ashpri referuar jo vetëm afateve detyruese të punësimit nga 2, 3 dhe deri në 5
vjet, por edhe detyrimit për pagimin e kostos së studimit të 5 brezave studentorë, në rast se ata
nuk pranojnë të nënshkruajnë marrëveshjen përkatëse? A kishte mjete të tjera për të arritur
objektivin e synuar, dhe a u shqyrtuan alternativat e tjera nga ligjvënësi? A do të sjellë rezultate
konkrete ky mjet për realizimin e objektivit të synuar?
11. Duke iu referuar dokumenteve të administruara në gjykim, kërkuesit paraqitën
shkresën nr. 3697/1 të datës 17.10.2023 të Ministrisë së Shëndetësisë dhe Mbrojtjes Sociale, me
të cilën i kthehet përgjigje organizatës “Qëndresa Qytetare” dhe deklarohet se “aktualisht, vendet
vakante për mjekë të përgjithshëm në sistemin shëndetësor janë 4% e numrit total të personelit
mjekësor në kujdes parësor. Plotësimi i 4% të vendeve vakante në sistem shëndetësor është një
proces dinamik dhe nuk ka krijuar mungesë të ofrimit të shërbimit shëndetësor të aksesueshëm
dhe pranë vendbanimit për qytetarët”. Ndërsa, sipas parashtrimeve të subjekteve të interesuara
në seancë plenare rezultoi se numri i përgjithshëm i mjekëve që ofrojnë shërbim në sistemin
parësor shëndetësor është 5400.
12. Po kështu, referuar shkresës nr. 5288/10 të datës 05.01.2024 të Këshillit të
Ministrave, numri i pozicioneve vakante për mjekë është 482, numri i mjekëve në moshë
pensioni është 213 dhe numri i mjekëve që largohen çdo vit jashtë vendit është rreth 200, pasi
kërkojnë të pajisen me certifikatë të sjelljes së mirë, tipike për ata që kërkojnë të largohen nga
vendi, pra rreth 895 vende vakante. Ndërkohë, po sipas këtij subjekti të interesuar, ka pasur rritje
graduale të numrit të kuotave të çelura për çdo vit për programin e studimit “Mjekësi e
përgjithshme” në UMT, duke arritur rreth 500 të tilla brenda vitit 2024.
13. Për sa më lart, në çështjen në gjykim, nga kërkuesit, përmes shkresës së sipërcituar,
u përmbys prezumimi i nevojës aktuale për ndërhyrjen legjislative përkatëse, pasi nga Ministria e
Shëndetësisë dhe Mbrojtjes Sociale pranohet se plotësimi i 4% të vendeve vakante për mjekë të
Vendim i Gjykatës Kushtetuese
Kërkues: Një grup deputetësh të Kuvendit (jo më pak se 1/5 e deputetëve) dhe një grup studentësh të Fakultetit të
Mjekësisë të Universitetit të Mjekësisë Tiranë
përgjithshëm në sistem shëndetësor është një proces dinamik dhe nuk ka krijuar mungesë të
ofrimit të shërbimit shëndetësor të aksesueshëm dhe pranë vendbanimit për qytetarët.
14. Po në drejtim të nevojës, 4% vende vakante nga numri total i 5400 mjekëve në
kujdes parësor (në terma konkretë 216 vende vakante), nuk justifikon nevojën reale të marrjes së
masës kufizuese objekt kundërshtimi në një kategori të zgjeruar prej 5 brezash, kur edhe prurjet
nga UMT-ja për mjekë të diplomuar vit pas viti, në periudhën që shtrihen efektet e këtij ligji,
janë më të mëdha se nevojat aktuale për të punësuar mjekë të përgjithshëm në vendet vakante.
Konkretisht, ndërhyrja legjislative prek një kategori studentësh që i përkasin vitit të parë deri në
vitin e gjashtë të studimeve. Po ashtu, ndërhyrja legjislative prek studentët e vitit të parë që do të
pranohen në sistemin universitar çdo vit, duke filluar nga viti akademik 2023-2024 deri në vitin
akademik 2027 -2028, pra 5 breza studentësh, që në varësi të numrit të kuotave të pranimit ndër
vite mund të arrijnë, rreth 2500 studentë gjithsej, nëse pranimet do të jenë rreth 500 kuota në vit,
sikundër pranimet për vitin akademik 2023-2024, referuar vendimit nr.17/2023 të senatit
akademik të UMT-së. Në këto kushte, vlerësoj se subjekti i interesuar nuk ka dhënë argumente
se situata faktike e evidentuar në kohën e miratimit të ligjit objekt kundërshtimi për ekzistencën e
nevojës, mbështetet në vlerësime të mjaftueshme për zbatim të kufizimit në të gjithë kategorinë e
zgjeruar të studentëve të mjekësisë, (5 breza të plotë studentësh me nga 6 vjet shkollim dhe 5
breza studentësh që preken pjesërisht, sipas vitit të studimit ku ndodhen deri në përfundim të
programit). Në këtë drejtim, nuk pajtohem me argumentet e shumicës, se situata faktike e
evidentuar në kohën e miratimit të këtij ligji, e provuar edhe gjatë këtij gjykimi dhe që lidhet me
problematikat në drejtim të raportit të numrit të mjekëve dhe popullsisë, është rrethanë që bën të
qartë ekzistencën e nevojës për të vepruar nga ana e ligjvënësit në miratimin e ligjit nr. 60/2023,
e cila është e tillë që justifikon kufizimin në të drejtën për punë, të garantuar nga neni 49, pika 1,
i Kushtetutës, (shih paragrafin 65 të vendimit). Kjo pasi në vlerësimin tim, problematikat e
evidentuara në gjykim në drejtim të raportit të numrit të mjekëve dhe popullsisë, lidhen me një
nevojë të përhershme për përmirësimin e kujdesit shëndetësor dhe cilësisë së shërbimit
shëndetësor, si e drejtë kushtetuese me natyrë progresive dhe nuk janë rrethana të tilla që mund
të argumentonin nevojën aktuale dhe reale për plotësim të vendeve vakante ekzistuese për mjekë
të përgjithshëm në sistemin shëndetësor, përmes masës kufizuese legjislative objekt
kundërshtimi.
15. Po ashtu, duke argumentuar më lart se nuk ka ekzistuar nevoja aktuale si kusht
paraprak për ndërhyrjen legjislative, në vlerësimin tim nuk plotësohet as domosdoshmëria.
Megjithatë, edhe në drejtim të domosdoshmërisë nuk u provua se kjo ishte masa më pak e
Vendim i Gjykatës Kushtetuese
Kërkues: Një grup deputetësh të Kuvendit (jo më pak se 1/5 e deputetëve) dhe një grup studentësh të Fakultetit të
Mjekësisë të Universitetit të Mjekësisë Tiranë
ashpër, në kuptimin që edhe nëse ndërhyrja detyruese për vitet e punësimit të ishte i vetmi mjet
për arritjen e objektivit, ai lidhet në mënyrë të paarsyeshme me detyrimin për pagimin e kostove
për ata studentë të mjekësisë që nuk e pranojnë, duke e kthyer masën në tërësi të ashpër. Në këtë
drejtim, nga subjektet e interesuara nuk u provua se përse nuk u analizua paraprakisht jo
detyrimi për pagimin e kostove për shkollim për ata studentë mjekësie që nuk e pranojnë atë
detyrim, por edhe mjete të tjera alternative si p.sh. nxitja dhe mbështetja përmes pagimit të
shpenzimeve personale të shkollimit nga ana e shtetit për ata studentë të mjekësisë që do të
pranonin punësimin me detyrim. Sa studentë të prekur nga ky ligj, potencialisht mund të
pranonin detyrimin përkatës lidhur me punësimin me detyrim, nëse shteti do u merrte përsipër
shpenzimet personale të jetesës? Sa mundësi financiare kishte shteti në këtë aspekt? Kjo, pasi në
vlerësimin tim, punësimi me detyrim sipas viteve përkatëse, duke mos e kombinuar me pagesën
e kostos së studimit në rast mospranimi të nënshkrimit të kontratës, mund të rezultonte si një
masë më pak të ashpër sa i përket ekuilibrit të interesave publike për ofrimin e kujdesit mjekësor,
nga njëra anë, dhe interesit të studentëve për arsim publik dhe së drejtës për punë të ligjshme e
që duhet ta zgjedhin vetë, nga ana tjetër. Ndaj, në këtë drejtim, nuk pajtohem me shumicën, sipas
së cilës, edhe nga vetë kërkuesit, në lidhje me mundësitë reale për të miratuar ndonjë skemë
tjetër të punësimit, nuk u evidentua ndonjë masë ose skemë tjetër që mund të përdorej në këtë
drejtim, e cila mund të sillte të njëjtin efekt të dëshiruar dhe që do të ishte eficiente për
përmbushjen e qëllimit të synuar dhe, nga ana tjetër, më pak ose aspak kufizuese e të drejtave të
studentëve. Në këto kushte, ajo vlerëson se masa e kundërshtuar plotëson edhe kërkesën e të
qenit e domosdoshme. (shih paragrafin 67 të vendimit).
16. Për më tepër, në drejtim të përshtatshmërisë nuk rezulton dokumentacion paraprak
dhe analizë mbështetëse e mjaftueshme që masa mund të sjellë rezultat, pra të jetë efektive. Në
vlerësimin tim, qëllimi thelbësor i ndërhyrjes në të drejtat themelore me ligj, për t’i kufizuar ato
për shkak të një nevoje publike, është arritja e objektivave të synuar, ndaj edhe efektiviteti merr
rëndësi kryesore në kuadër të kontrollit kushtetues të parimit të proporcionalitetit. Në këtë
aspekt, raporti që shoqëronte projektligjin në Komisionin e Punës, Çështjeve Sociale dhe
Shëndetësisë nisej nga premisa të pabazuara dhe jo të mbështetura në fakte konkrete. Sipas këtij
raporti, parashikohej se “…50% e studentëve do të pranojnë të nënshkruajnë marrëveshjen”. Po
sipas raportit, “…në rast se të gjithë studentët nuk do ta pranojnë marrëveshjen dhe do të
paguajnë koston e plotë të studimeve, efekti financiar do të jetë…, por sipas këtij skenari që
asnjë student nuk do të pranojë të nënshkruajë marrëveshjen për qëndrim 2-5 vjeçar në Shqipëri
është skenar jo realist”.
Vendim i Gjykatës Kushtetuese
Kërkues: Një grup deputetësh të Kuvendit (jo më pak se 1/5 e deputetëve) dhe një grup studentësh të Fakultetit të
Mjekësisë të Universitetit të Mjekësisë Tiranë
17. Për sa më lart, nuk rezultoi e mbështetur me të dhëna dhe analiza paraprake se si
është vlerësuar se 50% e studentëve do ta pranojnë marrëveshjen dhe në hipotezën që të gjithë të
paguajnë koston e studimit dhe mos ta nënshkruajnë atë, që mund të mos jetë dhe aq situatë
jorealiste, cila do të ishte një masë tjetër sipas Këshillit të Ministrave për plotësimin e mungesave
për mjekë në sistemin shëndetësor. Edhe në seancë gjyqësore, pyetjes nëse të gjithë studentët e
prekur nuk do të pranonin të nënshkruanin kontratën, çfarë alternative do të kishte për plotësimin
e vendeve vakante, Këshilli i Ministrave, si subjekt i interesuar, iu përgjigj se do të merreshin
masa të tjera, duke mos i konkretizuar se cilat janë ose cilat do të ishin (shih procesverbalet e
seancës gjyqësore). Në kuptim të testit të përshtatshmërisë, sipas të cilit masa që ka kufizuar të
drejtën duhet të sjellë efektin e duhur dhe të realizojë synimin për të cilin është përzgjedhur, nuk
u provua se kjo masë është bazuar mbi vlerësime logjike, që mund të realizonte objektivin e
synuar me kufizim më pak të ashpër, ndaj edhe në këtë drejtim kjo ndërhyrje nuk plotëson
standardet e efektivitetit dhe të racionalitetit.
18. Në përfundim, vlerësoj se dispozitat ligjore objekt kundërshtimi nuk respektojnë të
drejtën për arsim dhe të drejtën për punësim të studentëve të mjekësisë, si rezultat i ndërhyrjes
joproporcionale të ligjvënësit, referuar nenit 17 të Kushtetutës dhe jurisprudencës së konsoliduar
të kësaj Gjykate, ndaj dhe kërkesa duhej pranuar në tërësi.
Anëtare: Elsa Toska
Vendim i Gjykatës Kushtetuese
Kërkues: Një grup deputetësh të Kuvendit (jo më pak se 1/5 e deputetëve) dhe një grup studentësh të Fakultetit të
Mjekësisë të Universitetit të Mjekësisë Tiranë
Mendim pjesërisht kundër
1. Në gjykimin kushtetues të çështjes nr. 1 (Nj) 2023 të Regjistrit Themeltar, që i përket
kërkesës së një grupi deputetësh të Kuvendit (jo më pak se një e pesta e deputetëve) dhe një
grupi studentësh, me objekt: “Shfuqizimin e nenit 4, pikat 1, shkronja “c”, 2, shkronja “b”, 3,
shkronja “b” dhe nenit 5, fjalia e parë të ligjit nr. 60/2023 “Për trajtimin e veçantë të studentëve
që ndjekin programin e integruar të studimit të ciklit të dytë “Mjekësi e përgjithshme” në
institucionet publike të arsimit të lartë”, si dhe pezullimin e tij deri në hyrjen në fuqi të vendimit
përfundimtar të Gjykatës”, ndaj qëndrim pjesërisht të ndryshëm nga shumica për sa i përket
zgjidhjes së kësaj çështjeje, pasi vlerësoj se duhej të ishte vendosur pranimi i plotë i kërkesës,
duke parashtruar argumentet si më poshtë vijojnë.
2. Në datën 21.07.2023 Kuvendi, në bazë të propozimit të Këshillit të Ministrave dhe në
zbatimit të procedurës së përshpejtuar parlamentare, ka miratuar ligjin nr. 60/2023, i cili është
botuar në Fletoren Zyrtare nr. 123, datë 16.08.2023 dhe ka hyrë në fuqi 15 ditë pas botimit të tij.
Ky ligj ka parashikuar një mekanizëm përmes së cilit studentëve që ndjekin programin e
integruar të studimit të ciklit të dytë “Mjekësi e përgjithshme” në institucionet publike të arsimit
të lartë u ofrohet një trajtim e veçantë, i cili, në kuptim të nenit 3, pika 1, të ligjit, përfshin
punësimin me prioritet të tyre pas përfundimit të studimeve, si dhe të drejtën për të përfituar nga
programet sociale të strehimit.
3. Ky trajtim përfitohet si nga kandidati që pranohet rishtazi në programin e integruar të
studimit të ciklit të dytë “Mjekësi e përgjithshme” në institucionet publike të arsimit të lartë,
ashtu edhe nga studenti i vitit të dytë deri në vitin e katërt akademik dhe nga studenti i vitit të
pestë ose të gjashtë (student i ndërmjetëm) në këtë program, kur pranon të nënshkruajë
marrëveshje me ministrinë përgjegjëse për arsimin, ministrinë përgjegjëse për shëndetësinë dhe
institucionin e arsimit të lartë publik. Sipas marrëveshjes, studenti duhet të punojë në profesionin
e mjekut pas përfundimit të studimeve për, respektivisht, jo më pak se pesë vjet, tre vjet dhe dy
vjet, në institucionet shëndetësore në Republikën e Shqipërisë, si dhe pranon kalimin zyrtarisht të
diplomës përkatëse të arsimit të lartë nga institucioni publik i arsimit të lartë, ku ka përfunduar
studimet, në institucionin shëndetësor ku punësohet deri në shlyerjen e detyrimeve për punësim
sipas afatit, përkatësisht, 5-vjeçar, 3-vjeçar dhe 2-vjeçar, me të drejtën që pas përmbushjes së
detyrimit të punësimit të tërheqë diplomën universitare (neni 4, pika 1, shkronja “c”, pika 2,
shkronja “b”, pika 3, shkronja ‘b”, i ligjit nr. 60/2023). Ndërkohë studenti që nuk pranon të
Vendim i Gjykatës Kushtetuese
Kërkues: Një grup deputetësh të Kuvendit (jo më pak se 1/5 e deputetëve) dhe një grup studentësh të Fakultetit të
Mjekësisë të Universitetit të Mjekësisë Tiranë
nënshkruajë marrëveshjen, sipas përcaktimeve të pikave 2 dhe 3 të nenit 4, paguan vlerën e plotë
të kostos së studimeve (neni 5 i ligjit nr. 60/2023).
4. Kërkuesit kanë pretenduar se dispozitat e kundërshtuara të ligjit nr. 60/2023 kanë
cenuar disa parime dhe të drejta kushtetuese, më konkretisht parimin e sigurisë juridike, të
garantuar në nenin 4 të Kushtetutës, të drejtën për punë dhe të drejtën për arsimim, të garantuara
nga nenet 49 dhe 57 të Kushtetutës, në kundërshtim me kriteret e kufizimit të parashikuara në
nenin 17 të Kushtetutës, të drejtën për të mos iu nënshtruar punës së detyruar, të garantuar nga
neni 26 i Kushtetutës, si edhe parimin e barazisë para ligjit, të garantuar nga neni 18 i
Kushtetutës. Në lidhje me parimin e barazisë përpara ligjit jam dakord me qëndrimin e shumicës
se ky pretendim është i lidhur me vlerën e kostos financiare të studimeve që duhet të përballojnë
studentët që nuk pranojnë të nënshkruajnë marrëveshjen me institucionet shëndetësore publike,
metodologjia dhe vlera e të cilës nuk përcaktohen nga ligji nr. 60/2023, por janë miratuar me
akte nënligjore të organeve të UMT-së që nuk janë objekt i këtij gjykimi kushtetues (shih
paragrafin 37 të vendimit).
5. Në lidhje me pretendimet e tjera të kërkesës, që lidhen me të drejtën për arsimim, sipas
nenit 57 të Kushtetutës, shumica ka vlerësuar se janë mbështetur në cenimin e të drejtave të
fituara dhe pritshmërive të ligjshme të studentëve për shkak të ndryshimit të kornizës ligjore që
ka qenë në fuqi në kohën kur ata kanë filluar studimet në Fakultetin e Mjekësisë (ligji nr.
80/2015), për studentët e ndërmjetëm, dhe kur kanë vendosur të konkurrojnë për t`u bërë pjesë e
atij fakulteti, për studentët e vitit të parë. Për rrjedhojë, ajo ka vlerësuar t`i analizojë këto
pretendime në vijim në drejtim të parimit të sigurisë juridike. Kurse pretendimet që kanë të bëjnë
me cenimin e së drejtës për të fituar mjetet e jetesës me punë të ligjshme të zgjedhur ose pranuar
vetë dhe asaj për të mos iu nënshtruar punës së detyruar, për shkak të mënyrës se si janë
parashtruar ato, shumica ka vlerësuar t`i shqyrtojë në kuptim të përmbajtjes së nenit 49, pika 1, të
Kushtetutës (shih paragrafin 38 të vendimit).
6. Në vijim, pasi ka gjetur shkelje të parimit të sigurisë juridike, për shkak se dispozitat e
kundërshtuara kanë sjellë pasoja negative të të drejtave të fituara të studentëve, sipas
parashikimeve ligjore të miratuara në kuptim dhe zbatim të së drejtës për arsimim, shumica ka
vlerësuar se këto ndryshime ligjore prekin në dukje të drejtën për punë të parashikuar nga neni
49 i Kushtetutës, ndaj në vijim është ndalur në vlerësimin nëse kjo e drejtë kushtetuese e
studentëve është kufizuar dhe nëse janë respektuar kriteret e nenit 17 të Kushtetutës (shih
paragrafin 50 të vendimit). Edhe në këtë pjesë të vendimit bashkohem me qëndrimin e shumicës,
ashtu si bashkohem edhe me qëndrimin se në rastin konkret ndërhyrja e ligjvënësit nuk ka
Vendim i Gjykatës Kushtetuese
Kërkues: Një grup deputetësh të Kuvendit (jo më pak se 1/5 e deputetëve) dhe një grup studentësh të Fakultetit të
Mjekësisë të Universitetit të Mjekësisë Tiranë
respektuar kriteret kushtetuese të kufizimit. Ajo që më ndan nga arsyetimi i shumicës është
shkaku për të cilin ajo ka vendosur të shfuqizojë dispozitat e kundërshtuara nga kërkuesit.
7. Shumica e ka vlerësuar të drejtën për punë në bazë të kritereve të nenit 17 të
Kushtetutës, e më konkretisht duke ia nënshtruar atë testit kushtetues për të parë nëse: (i)
ndërhyrja është bërë vetëm me ligj; (ii) ekziston interesi publik; (iii) është respektuar parimi i
proporcionalitetit midis ndërhyrjes dhe gjendjes që e ka diktuar atë.
8. Në lidhje me kriterin e parë të kufizimit, në rastin konkret nuk vihet në diskutim
respektimi i tij për sa kohë ndërhyrja është bërë me ligjin nr. 60/2023, i cili është miratuar nga
Kuvendi, sipas procedurave të parashikuara për këtë qëllim (shih paragrafin 59 të vendimit).
9. Më tej, në analizë të kriterit të dytë të kufizimit, atij për interes publik, qasja ime
ndryshon nga ajo e shumicës. Gjykata ka theksuar se është e vështirë të radhiten në mënyrë
shteruese çështjet që përbëjnë interes publik ose të arsyes publike që çojnë në kufizimin e një të
drejte themelore, pasi interesi publik duhet kuptuar në sensin relativ, në varësi të situatave të
ndryshme që krijohen. Ato mund të renditen vetëm negativisht, pra në aspektin e kufizimit të çdo
rasti konkret. Në praktikën kushtetuese është pranuar tashmë se ligjvënësi, parimisht, është i lirë
të veprojë brenda hapësirës së tij normuese, duke përcaktuar qartë dhe rast pas rasti qëllimet që
kërkon të arrijë (shih vendimet nr. 20, datë 20.04.2021; nr. 16, datë 01.03.2017; nr. 1, datë
16.01.2017 të Gjykatës Kushtetuese).
10. Sipas shumicës, referuar subjekteve të interesuara, Kuvendit dhe Këshillit të
Ministrave, interesi publik i evidentuar në çështjen konkrete është i lidhur drejtpërdrejt me
mirëfunksionimin e skemës së kujdesit shëndetësor dhe garantimin e plotësimit të nevojave për
burime njerëzore në kryerjen e shërbimeve të shëndetit publik në institucionet shëndetësore, i cili
rezulton të jetë i lartë, prandaj ligji është hartuar në përputhje me nevojat e diktuara në vend.
Shumica ka vlerësuar se sipas nenit 55 të Kushtetutës shtetasit gëzojnë në mënyrë të barabartë të
drejtën për kujdes shëndetësor dhe sigurim shëndetësor nga shteti, i cili ka detyrimin për të
ndërhyrë me qëllim sigurimin e saj për të gjithë qytetarët përmes ofrimit të kujdesit shëndetësor
në institucionet e shëndetit publik. Kurse sipas nenit 59, pika 1, shkronja “c”, të Kushtetutës,
shteti, brenda kompetencave kushtetuese dhe mjeteve që disponon, synon edhe standardin më të
lartë shëndetësor të mundshëm. Referuar nenit 2 të ligjit nr. 60/2023, ai synon sigurimin e
burimeve njerëzore për kryerjen e shërbimeve të shëndetit publik në institucionet shëndetësore
në Republikën e Shqipërisë nëpërmjet përcaktimit të rregullave për trajtimin e veçantë të
studentëve që ndjekin programin e integruar të studimit të ciklit të dytë “Mjekësi e përgjithshme”
në institucionet publike të arsimit të lartë. Për rrjedhojë, shumica ka vlerësuar se në rastin
Vendim i Gjykatës Kushtetuese
Kërkues: Një grup deputetësh të Kuvendit (jo më pak se 1/5 e deputetëve) dhe një grup studentësh të Fakultetit të
Mjekësisë të Universitetit të Mjekësisë Tiranë
konkret ka një interes publik që ka justifikuar ndërhyrjen në të drejtën e studentëve për punësim,
për sa kohë që me rregullimet ligjore të kundërshtuara synohet të garantohet ofrimi i shërbimit
shëndetësor, në kuptim të nenit 55, pika 1, të Kushtetutës, si dhe garantimi i standardeve të
shëndetit publik, sipas nenit 59, pika 1, shkronja “c”, të Kushtetutës (shih paragrafin 61 të
vendimit).
11. Sipas kërkuesve, ligjvënësi ka rritur tarifën e studimeve deri në koston e plotë të tyre
pa një qëllim legjitim. Detyrimi për të paguar vlerën e plotë të kostos së studimeve për studentët
që preferojnë të ruajnë status quo-në nuk i përgjigjet objektivit kryesor të tij, që ka të bëjë me
sigurimin e stafit mjekësor në periudhë afatgjatë. Edhe kufizimi i marrjes së diplomës nuk i
shërben interesit publik dhe e drejta e studentëve për të përfituar diplomën është një e drejtë
themelore që nuk mund të lidhet me suksesin e marrëveshjes. Në vlerësimin tim ky pretendim i
kërkuesve është i bazuar dhe në rastin konkret, në ndryshim nga përfundimi i arritur nga
shumica, interesi publik nuk është i justifikuar pasi masat e përdorura janë më të ashpra se sa
duhet për të arritur objektivin e kërkuar, duke cenuar kështu të drejtën kushtetuese të studentëve
për arsim.
12. Referuar parashtrimeve me shkrim dhe atyre të paraqitura në seancë plenare publike
nga subjektet e interesuara, rezulton se numri i përgjithshëm i mjekëve që ofrojnë shërbim në
sistemin shëndetësor është 5400, që në raport me numrin e popullsisë i takon 1.93 mjekë për çdo
1000 banorë. Numri i pozicioneve vakante për mjekë është 482, numri i mjekëve në moshë
pensioni është 213 dhe numri i mjekëve që largohen çdo vit jashtë vendit është rreth 200. Bazuar
në të dhënat e mësipërme, sikurse është deklaruar në seancë edhe nga subjekti i interesuar,
Këshilli i Ministrave, rezultojnë 1000 vende vakante për mjekë. Aktualisht, vendet vakante për
mjekë të përgjithshëm në sistemin shëndetësor përbëjnë vetëm 4% te numrit total të personelit
mjekësor në kujdes parësor. Ndërkohë që ka pasur rritje graduale të numrit të kuotave të çelura
për çdo vit për programin e studimit “Mjekësi e përgjithshme” në UMT, duke arritur rreth 500 të
tilla brenda vitit 2024. Këto të dhëna janë referuar edhe nga vetë shumica në vendimin e saj,
bazuar në sa kanë parashtruar subjektet e interesuara (shih paragrafin 69 të vendimit).
13. Në analizë të këtyre të dhënave, duke mbajtur në konsideratë përqindjen e ulët të
vendeve vakante për mjekë (vetëm 4%), si dhe numrin e lartë të studentëve që studiojnë në këtë
fushë të shëndetit publik, vlerësoj se bazuar vetëm në këto statistika situata aktuale nuk paraqitet
e tillë, pra që të ketë qenë në atë masë emergjente që të përkthehet në një interes publik të shtuar
posaçërisht, gjë që do ta bënte të nevojshme një ndërhyrje të tillë dhe do të justifikonte masa me
natyrë ligjore dhe miratimin e skemave të tilla për të plotësuar nevojat e popullatës në kuptim të
Vendim i Gjykatës Kushtetuese
Kërkues: Një grup deputetësh të Kuvendit (jo më pak se 1/5 e deputetëve) dhe një grup studentësh të Fakultetit të
Mjekësisë të Universitetit të Mjekësisë Tiranë
nenit 55 të Kushtetutës. Detyrimi kushtetues që i ngarkohet shtetit për të garantuar shërbimin e
shëndetit publik të shtetasve, të cilin ata duhet ta gëzojnë në mënyrë të barabartë, mbetet i tillë në
çdo moment, me përjashtim të rasteve kur ngrihet në një nivel emergjence siç ishte situata e
pandemisë globale COVID 19 apo në raste të situatave të jashtëzakonshme, të cilat do të
justifikonin në kuadër të një interesi publik akoma me akut edhe ndërhyrjen me masa kufizuese
të kësaj natyre.
14. Po kështu, çmoj se shteti mund të merrte masa të tjera efektive për të siguruar
shërbimin shëndetësor në vend dhe për të evituar largimin e mjekëve jashtë vendit, duke e bërë
më tërheqëse ofertën e punës, sipas mundësive të vetë ekzekutivit në këto drejtime punësimi.
Mundësia për marrjen e masave të tjera efektive është pranuar në seancë plenare publike edhe
by the representative of the Council of Ministers, when it was asked how the
health service would be provided in the country if all the students of the Faculty of Medicine at UMT would not agree
to conclude the agreements, but would accept the payment of the full value of the cost of studies . Therefore,
I think that in such a situation, where, referring to what was brought to the Court's attention by this
interested entity, we are faced with a low percentage of vacancies in the health system
compared to the needs of the public service, and moreover, we are not ahead pandemic-global or extraordinary situations
, which would require such
immediate interventions in the restrictions, I estimate that the legislator had all the opportunities to analyze
alternative and milder interventions in this direction.
15. In conclusion, based on the above analysis, I estimate that in the situation that the criterion
provided by Article 17 of the Constitution, i.e. that of intervention in the public interest, has not been met
in the present case, the request of the petitioners should have been accepted only for this cause as long as
the absence of this criterion made unnecessary the analysis of the following criteria provided for by this
constitutional norm, which are related to the proportionality of the intervention.
Member: Sonila Bejtja

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