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1 December 2008
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Commission to open internal market for health care[fr

Published: Monday 1 October 2007   

The European Commission is drafting a Directive ensuring the protection of basic rights for patients travelling to other EU member states in receiving medical treatment, in what could prove to be a far-reaching reform. 

Background:

When travellers fall ill in another EU country, their costs are covered by the EU health insurance card. Their domestic health insurance may also be able to pay for treatment abroad when a patient has obtained prior authorisation. The same is not true, however, when patients do not obtain such authorisation or when, acting in good faith, they fail to ask for it. 

The European Court of Justice ruled, in a number of landmark cases, on the following matters:

  • Patients with chronic pain for whom waiting time for treatment in another EU country can be much longer than in their home country (Yvonne Watts case - C-372/04external )
  • Patients who buy refundable medical aids, such as spectacles, in another EU member state where they are cheaper (Nicolas Decker case - C-120/95external ).

In both cases, the Court ruled in favour of free choice for patients.

The matter is also of extreme urgency for patients with rare diseases, where sometimes only a few specialists within the EU are able to apply treatment. Such treatment tends to be costly and unique, for which reason health insurance schemes are often reluctant to pay for it. 

Ministers at the Health Council on 1 June 2006 adopted a "Statement of common values and principles in EU health systems", which underlined the importance of "protecting the values and principles that underpin health systems in the EU" and called in particular for an initiative on health services "ensuring clarity for European citizens about their rights and entitlements when they move from one EU member state to another and enshrining these values and principles in a legal framework in order to ensure legal certainty".

In 2006, the Commission launched a public consultation with a view to Community action on health servicesPdf external . The outcomePdf external was that there was a clear need for better information, more legal clarity and liability rules for patients crossing borders to obtain health care. This confirmed the Commission and the Council's view that there is a need for action at EU level on health services provided to mobile patients. 

More on this topic:

Other related news:

Following the public consultation, the Commission started drafting a directive on "safe, high-quality and efficient cross-border healthcare", which has now reached the stage of inter-service consultation. 

The directive concerns chiefly EU citizens "travelling to another member state with the purpose of receiving health care there." The key principles of the directive are: 

  • Healthcare provision: Mobile patients should at least receive health care similar to what they would have been entitled to in their home country. Member states are in charge of ensuring the quality and safety standards thereof.
  • Costs: Patients' home countries should carry the cost for health care abroad up to at least the price they would have been charged had the patient been treated at home.
  • Authorisation: Patients will still need to obtain authorisation prior to looking for medical treatment abroad, but they cannot be denied treatment if it is deemed "appropriate". 
  • Information: Member states should provide all the relevant information "to enable informed choices by patients" concerning availability, prices and outcomes of the health care they provide. This concerns in particular the question of liability and procedures to be followed in the event of medical malpractice.  
  • Co-operation: Member states should work together, using, among other things, telemedicine services, in order to assure cross-border exchange of patient data, while respecting privacy rights. 

As a result of the draft directive, member states would have to establish rules concerning the EU-wide definition of treatment methods, including hospitalisation, and on the cross-border recognition of prescriptions. 

Next steps:

  • The directive could be adopted by the College of Commissioners before the end of 2007
  • After approval in the college, it will then be transmitted to Parliament and the Council, whose approval is required under the co-decision procedure. 

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