Cross-border health plan set to pass despite opposition

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A controversial directive on cross-border healthcare is expected to pass through the European Parliament at the end of this month, despite continued divisions between political groups and disagreement among member states.

The proposals was adopted yesterday (21 March) by the Parliament’s environment, public health and food safety committee (ENVI) without the support of the Socialist group or the Greens. It will be submitted to the full house for a vote on 21-24 April. 

The Socialists, led by shadow rapporteur Dagmar Roth-Behrendt, called a hastily-convened five-minute recess and decided to abstain from the final vote, despite being broadly favourable to the proposal. 

The last-minute withdrawal of support arose amid concerns that the report did not underline the potential impact of the directive on the health sector. Socialists preferred to abstain rather than vote against the plan, because the group is broadly in favour of the report, tabled by UK Conservative MEP John Bowis (EPP-ED). 

The PES is understood to have preferred an amendment on the prior authorisation of treatment tabled by the Parliament’s employment committee, which would have given more powers to member states. 

The Socialists are expected to spend the coming weeks attempting to drum up support for their amendments, and would be willing to vote in favour of the report at plenary if the changes can be incorporated. 

Green MEPs are likely to continue to oppose the plan, which they say treats healthcare as a service to be freely traded across Europe. 

The ALDE and EPP blocs both favour the report, meaning it is likely to pass through plenary regardless of how much support can be garnered from the left. 

However, divisions remain at Council level, where national health ministers are concerned that the move could lead to an erosion of sovereignty and could play havoc with how health services are planned, funded and delivered across Europe. 

UK Conservative MEP John Bowis (EPP-ED), rapporteur on the cross-border healthcare file in the ENVI committee, said the changes to the health system would see patients treated on the basis of needs rather than means. 

"Patients will have a right to seek treatment across the European Union if their national health provider has let them down with a poor or delayed service. The current system has too often caused people unnecessary confusion at a particularly vulnerable time in their lives, and it is essential that we provide greater clarity and legal certainty." 

Motions tabled by the GUE/NGL to reject the proposal in its entirety were not adopted at the ENVI committee, leading the group's MEPs to vote against the report. The group believes the report attaches more importance to Europe's economic interests than the rights of patients. 

"This proposal is therefore void of solidarity and will lead to situations in which only the rich are able to cross borders for healthcare," said Cypriot MEP Adamos AdamouGUE/NGL shadow rapporteur on the report. 

He also insisted the report would disadvantage citizens in poorer member states and said the EU has no authority to interfere with national health services.

"This directive will lead to the deconstruction of the national healthcare systems and will incite patients to go abroad for healthcare. Healthcare is and should remain the responsibility of the member states," Adamou said. 

Dutch liberal MEP Jules Maaten (ALDE) criticised the Greens, Socialists and communities who did not support the report. 

"It is incredible that none of the groups on the left supported this, when finally we get European legislation that benefits the European citizen in a concrete way. These groups put national health bureaucracies before patients' rights. This is not about liberalisation, but about free movement of patients. The directive will not interfere in the way national healthcare systems are organised. I am surprised that other parties are playing political games on the back of European patients," he said. 

A series of rulings by the European Court of Justice, beginning in 1998, have stated that healthcare can be sought in any member state, with patients entitled to have their costs covered by their own health systems.

This prompted the European Commission to adopt a communication in 2006, which began a consultation process on cross-border access to healthcare. This culminated in the publication of a proposal for a directive in July 2008 (EURACTIV 18/07/08).

The proposal would allow citizens to seek treatment anywhere in the EU and claim reimbursement from their home countries under certain circumstances. Patients can seek non-hospital care, such as dental treatment and medical consultations, without prior authorisation. 

However, prior authorisation is required for in-patient procedures such as surgery. The final report, presented by UK Conservative MEP John Bowis (EPP-ED), excludes organ transplantation and long-term care from the scope of the directive. 

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