Despite some progress, EU health ministers meeting yesterday (16 December) in Brussels remained divided over a draft directive regarding the application of patients’ rights to treatment in other member states.
Taking stock of a progress report and a series of guidelines tabled by the French EU Presidency on the draft Cross-border Healthcare Directive, some ministers reaffirmed their fears about loss of national sovereignty over healthcare, while others expressed a wide range of views on the scope and implementation of the directive.
If it becomes law, the proposal, adopted by the Commission last July (EURACTIV 03/07/08) as part of its renewed social agenda, would help to remove unjustified obstacles to mobility and help to provide safe and high-quality health care with clear and transparent reimbursement procedures across borders. It aims to do so by improving cooperation between member states and by providing legal certainty over patients’ right to seek healthcare in another member state (see EURACTIV Links Dossier).
Although the vast majority of patients receive health care in their own countries, on occasions treatment is best provided elsewhere in the EU, for example if highly-specialised procedures are required, or in border areas where the nearest appropriate facility is in another member state.
Ministers focused their discussion on the first three chapters of the draft directive. They reached general consensus on improving legal recourse for cross-border patients by codifying all the European Court of Justice’s (ECJ) case law on the subject and linking it to a Regulation on the coordination of social security systems. Several ECJ rulings confirm that the EU Treaty gives individual patients the right to seek healthcare in other member states and be reimbursed for it at home, but uncertainty remains over how to apply the principles of that jurisprudence more generally.
A few stumbling blocks remained, notably concerning the definition of ‘hospital’ and ‘non-hospital’ care and ‘specialised’ care, as well as over securing the principle of prior authorisation for care reimbursement.
Plans to ensure that patients are provided with adequate information was also discussed, with member states expressing their preference for a provision allowing “informed choices” and enhanced cooperation between countries.
Small member states, like Cyprus, reiterated that the directive would put some health systems under strain, especially for long-term care.
The draft directive will be likely discussed by ministers at the Employment, Social Affairs, Health and Consumer Affairs Council of 8-9 June 2009, under the incoming Czech EU Presidency, after the European Parliament has issued its own opinion in spring 2009.