- Total revision of the Health Act for material and formal harmonization with federal law, closure of regulatory gaps and modernization.
- Obligation for electronic patient documentation with a transitional period of three years, unalterable storage and proof of data protection compliance.
- Specification of the duty of confidentiality, presumption of consent in joint practices and strengthened formal legal data protection principles.
The canton of Zurich is currently revising its Health Act (GesG). The consultation process will last until mid-November 2025:
- Current GesG
- Draft of the revised GesG (automatically prepared online at datenrecht)
- Media release on the opening of the consultation
- Consultation documents
- Government council resolution no. 577/2024 of May 29, 2025: Approval of the Government Council of the “Total Revision of the Health Act” standard concept and mandate to the Health Directorate (GD) to submit a draft revision
- Government council resolution no. 657/2025 of 18 June 2025: Authorization of the DG to carry out the consultation process
Revision targets
The aim of the revision is summarized by the GD in the Explanatory report as follows:
The current GesG has been in force since July 1, 2008 and has been revised several times to date. The objectives of a total revision of the GesG are a formal and material alignment with the applicable federal law, the closing of regulatory gaps, the necessary implementation of the principle of legality, a modernization and harmonization of terms as well as an increased readability and comprehensibility of the law. The Health Act fulfills important information functions for users of the law. The completely revised Health Act should take account of new developments in healthcare law and the digital transformation in the healthcare sector. It should be designed in such a way that, as far as possible, no further legislative amendments are necessary.
and:
The objectives of the total revision of the GesG are to formally and materially Alignment with applicable federal lawthe closing of Regulatory gapsthe necessary implementation of the Principle of legality, a Modernization and harmonization of terms as well as making the law easier to read and understand. By also taking account of new developments in healthcare law (namely Telemedicine or digitalization), it is designed as a sustainable decree.
The regulatory density of cantonal healthcare legislation should only be increased where this is absolutely necessary. This is particularly the case in the area of data protection. The Data protection requirements lead to a comparatively extensive regulation on a formal legal basis. Otherwise, new provisions are only introduced where there are regulatory gaps and standardization at the legislative level is required due to the material concept of law enshrined in Art. 38 para. 1 of the cantonal constitution. Provisions of a subordinate and technical nature are regulated at ordinance level. In addition, federal or intercantonal provisions should not be repeated in cantonal law unless this is necessary for reasons of comprehensibility or context.
Where appropriate, related regulatory areas should be standardized in the totally revised Health Act. Since the entry into force of the Cancer Registration Act (KRG) […], cancer registration has been regulated at federal level. The cantons are responsible for the organization, financing and supervision as well as the regulation of data retrieval from the population registers. Against this background, the cantonal Cancer Registry Act […] has largely become obsolete. Individual provisions […] are to be transferred to the completely revised GesG. Otherwise, the cantonal Cancer Registry Act is to be repealed. Furthermore, in connection with the regulation of Patient documentation in the new GesG, provisions in the Patients Act (PatG) of April 5, 2004 (LS 813.13) will be repealed.
Obligation for electronic patient documentation
Section 22 of the draft provides for an obligation for electronic patient documentation for human medicine:
§ 22 Patient documentation b. Management
1 Patient documentation is kept electronically.
2 The date and authorship of the entries must be immediately apparent. The entries must be stored unalterably and be retrievable at any time. Corrections are made by adding to the entries.
3 Patients may request that an entry in the patient documentation be supplemented with their opinion if they have an interest worthy of protection.
4 Compliance with federal and cantonal data protection regulations must be demonstrated.
However, this should only apply to future entries; digitization of existing documentation is not required (although it may be a matter of diligence to digitize ongoing, i.e. incomplete, patient documentation as well). There is also a transitional period of three years.
It is obvious that this will result in costs for the permit holders, but the government council believes that it will pay off:
The obligation to keep electronic patient documentation is also associated with costs. In particular, investment costs are incurred, which can vary depending on the system, offer and service. In view of the desired gains in quality and efficiency, such as better readability, access during home visits or from the home office, less storage space, i.e. conversely a gain in space, streamlining and simplification of processes, it can be assumed that the costs can be offset within a reasonable period of time.
Duty of confidentiality
The new GesG is intended to specify the duty of confidentiality of healthcare professionals, in particular with regard to exemption. § Section 25 should read as follows, in each case with the explanatory report:
1 Persons exercising a healthcare profession and their auxiliaries shall maintain confidentiality with regard to secrets that have been entrusted to them as a result of their profession or that they have perceived in the exercise of their profession.
Para. 1: The Federal law provides for the medical, health and psychology professions within the meaning of the PsyG in Art. 40 lit. f MedBG, Art. 16 lit. f. GesBG and Art. 27 lit. e PsyG. GesBG and Art. 27 lit. e PsyG that professional secrecy must be maintained in accordance with the relevant provisions. Federal law therefore refers to other statutory provisions that serve to protect the patient’s personal rights, in particular Art. 321 StGB, but also Art. 30 (violations of personality rights) and 62 DSG as well as Art. 28 ZGB (protection of personality rights). If one of these obligations under private or criminal law is breached, this also constitutes a breach of professional duties under the MedBG or PsyG or GesBG, which may also result in disciplinary action. Art. 321 StGB covers a closed circle of medical professionals (doctors, dentists, chiropractors, pharmacists, midwives, psychologists, nurses, physiotherapists, occupational therapists, nutritionists, optometrists, osteopaths and their assistants). The Cantonally regulated professions – subject to their qualification as auxiliary persons within the meaning of the criminal provision – are not included. For these, the duty of confidentiality is therefore expressly enshrined in the cantonal GesG. Disciplinary measures can therefore also be imposed on healthcare professionals under cantonal law in the event of a breach of the duty of confidentiality. This does not affect criminal liability under Art. 62 FADP.
2 The patient and, upon request, the management may exempt a confidential informant and their assistants from the applicable Exemption from the duty of confidentiality.
Para. 2: The possible framework for official exemptions from the duty of confidentiality and disclosure obligations is largely determined by the Federal law specified. Within the framework of the regulatory competence remaining with the canton, the current provision of Section 15 para. 1 GesG will be continued with substantive clarifications.
3 Consent to the disclosure of patient data is presumed within group practices and healthcare facilitiesinsofar as the persons working there complement or represent each other.
Para. 3: In medical practices and healthcare facilities, the patient’s consent shall be presumed if the persons working there complement or represent each other.
4 Consent to exemption is deemed to have been given by the patient if this is necessary to safeguard the legitimate interests of the healthcare professional within the scope of the Defense against a report made against them to supervisory or criminal prosecution authorities or one directed against them Demand is required on the part of the patient. This also applies if (liability) insurance policies would cover any claim.
Para. 4: These are cases of obviously tacit consent in accordance with Art. 321 para. 2 StGB. The provision is based on the fact that, on the one hand, the patient himself or herself makes it known to the outside world that he or she has undergone certain treatment and thus waives confidentiality. The healthcare professional must be able to defend themselves against claims. They may therefore disclose the content of the treatment to the (supervisory) authorities and courts conducting the proceedings or make unredacted treatment documents available. They may also send the complete and unredacted medical records to the expert commissioned by them to prepare an expert opinion and forward these to their lawyer and/or liability insurance without the patient’s consent. The provision does not apply to cases in which a healthcare professional makes a claim against a patient.
5 Persons pursuant to para. 1 are also entitled without exemption,
a. to report observations to the competent child protection authorities if the physical, psychological or sexual integrity of a child appears to be at risk and reporting is in the child’s best interests,
b. to assist the investigating authorities in the identification of corpses,
c. to provide information to the competent authorities as part of investigations into unusual deaths.Para. 5: The reporting rights listed enumeratively are based on Art. 321 para. 3 SCC in conjunction with Art. 314c SCC, according to which persons bound by professional secrecy within the meaning of the SCC may also report to the child protection authority if the physical, psychological or sexual integrity of a child appears to be at risk and reporting is in the child’s best interests. It should be noted that this right to report in accordance with Art. 314 para. 2 sentence 2 of the Swiss Civil Code does not apply to auxiliaries bound by professional secrecy under the Swiss Criminal Code.
6 Notwithstanding the duty of confidentiality, persons in accordance with paragraph 1 shall immediately report to the police Extraordinary deathsespecially those with signs of a criminal offense and suicide.
Para. 6: According to Art. 253 para. 4 of the Code of Criminal Procedure, the cantons determine which medical personnel are obliged to report unusual deaths, and any exceptions to the duty of confidentiality in connection with communicable diseases are governed by the Federal Epidemics Act and the associated ordinances. Other exceptions arise from other federal laws
What is particularly interesting is the presumption of consent within joint practices and healthcare facilities. This is hardly a question of consent, but rather a lack of will to secrecy, which is not given up but never formed in such constellations. Moreover, the presumption is potentially somewhat narrow. “Complement” must probably be understood as a synonym for any meaningful collaboration.
The presumed consent to disclosure for the defense against complaints and claims is also remarkable. Here, too, there is hardly any consent in reality, as the disclosure does not generally serve the interests of the patient. Rather, it is a matter of a lack of interest in secrecy, i.e. a form of prohibition of abuse of rights. What is missing here is an exemption to Enforcement of own claims, e.g. debt collection measures. It is therefore still necessary to work with the patient’s consent or an exemption (the GD provides a form for this purposebut unfortunately only on a case-by-case basis and not as a general authorization).
Digitization
The new GesG authorizes the GD, Standards for data exchange between healthcare professionals, healthcare facilities and payers to be defined. This is intended to facilitate the digitalization of the healthcare system, or more precisely the networking of healthcare facilities and healthcare professionals, so that information can be exchanged electronically along the treatment chain and data that has been recorded once can be used multiple times. In doing so, the DG is to support ongoing activities, e.g. in the project DigiSanté (package 1).
Privacy
In particular, the formal legal basis for the processing of particularly sensitive personal data will be strengthened:
The GesG currently in force does not adequately meet the current requirements for modern data protection. The data processing by the directorate, the district council, the municipalities and other bodies entrusted with public duties provided for the implementation of the present Act must be regulated in the Act itself according to the current legal situation, insofar as they do not already arise from other laws, in particular from federal law. Should Special personal data processed (for example, when inspecting patient data in the context of inspections and supervisory procedures against healthcare professionals or healthcare facilities or when examining requests for release from professional secrecy), a Sufficiently specific regulation required. This also applies to the processing of Authorization, supervision and sanction data of healthcare professionals and healthcare facilities: These data regularly contain information on health and the criminal or administrative measures and sanctions imposed on these persons. Taken as a whole, they also allow an assessment of key aspects of personality.