The move comes after Spain, which holds the rotating EU presidency, pushed for political agreement on an issue which has divided governments since it was proposed by the European Commission in July 2008.
It means patients will now be entitled to seek treatment in any member state and apply for reimbursement from the Ministry of Health in their home country.
However, a series of clauses had been inserted into the directive to reassure governments that their national health systems will not be destabilised. The right to travel can be blocked if it requires an overnight stay, the use of expensive high-tech medicines, or where the quality and safety of services cannot be guaranteed.
Spain had led a small group of countries which sank Swedish hopes of a deal late last year, but since pledged to seek a solution to the long-standing legal uncertainty which stems from European Court of Justice (ECJ) rulings on patient mobility.
As ministers meet in Luxembourg this morning (8 June), officials believe compromises have been reached in key areas which will see the controversial plan passed.
Conditions attached to mobility
Patients will have to seek "prior authorisation" before travelling for treatment and member states will only have to reimburse costs based on the price of the operation in their own health services.
In effect, this means a Polish citizen who has a hip replacement in Germany will be able to recoup what the operation would cost in Poland. The prior authorisation clause means health authorities will have the last word when it comes to granting permission to travel – ending speculation that widespread "medical tourism" would arise from the directive.
It is also expected that general practitioners (GPs) will act as "gatekeepers" who decide whether their patients should be considered for treatment overseas.
Public and private hospitals could be covered equally by the new arrangement, provided that they meet strict quality standards, allowing patients on public waiting lists to request treatment in private hospitals outside their home member state.
Consensus sought on overseas pensioners
The status of pensioners living outside their country of origin remains a source of considerable controversy. The example of a French pensioner who moves to Spain during their retirement years but seeks medical treatment in France is seen as a typical test case.
Some health ministers want costs to be paid by the country of residence, while others believe the burden should be borne by the country where the patient has paid social security contributions during their working life.
The Spanish Presidency also wants the final deal to include references to e-health and the European Commission's coordinating role in this area.
Officials say the compromises give legal certainty to an area which has been the subject of controversial ECJ rulings. The deal takes patient mobility out of the hands of the Courts and gives control back to member states, according to one source, who acknowledged that agreement has been difficult due to fundamental opposition in some quarters to the case law emanating from the ECJ.
Although the precise impact of the directive will not be clear until it comes into force, there is growing expectation that patient mobility will be much lower than originally envisaged before the Council added a range of new clauses.
