Barroso faces battle over cross-border healthcare

MEPs and trade unions are stepping up pressure on the European Commission to increase legal protection for public services, threatening changes to its forthcoming proposals on cross-border healthcare.

The campaign follows the refusal this week (20 November) by José Manuel Barroso, the Commission president, to propose laws safeguarding public services from internal market and competition rules. Barroso’s critics fear that without overarching legal protection the Commission will leave the way open for liberalisation of public services, starting with next month’s proposal on healthcare.

"We will push the Commission to make changes. If the proposals are not adequate, then we will do as we did with the services directive and we will change them," said German Socialist MEP Evelyne Gebhardt, who drafted reports on the services directive in 2005 and 2006. She said that the healthcare proposals, to be released next month (5 December) by Markos Kyprianou, the commissioner for health, place too much emphasis on internal market principles.

The Commission failed in its earlier attempt to create legal certainty for healthcare by including it in the controversial services directive. Healthcare was specifically excluded from that legislation when a revised version was agreed last year, allowing companies to provide services across national borders while observing the rules of their home country. A draft version of the healthcare proposal does not state whether the rules of the country of destination or the country of origin should apply to healthcare services.

Vladimír Špidla, the commissioner for employment and social affairs, told European Voice that an existing regulation on the co-ordination of social security schemes made irrelevant the question of which rules should apply. The regulation allows citizens to seek refunds for healthcare treatment received abroad, subject to home country authorisation.

"Naturally, we must always accept the existence of regulation 1408, in other words co-operation between different member states. So, the question would not really arise if the country of origin or destination is...to be regulated," he said.

Gebhardt said: "There are quality-related aspects relating to health services which are much stronger than in other services. We will have much work to do if the proposals remain as they are."

Barroso’s decision not to propose over-arching legislation on public services irritated MEPs and unions. The Commission argued that the reform treaty, which is to be signed in Lisbon in December, introduces the notion of services of general interest into EU primary law through a specific protocol, helping to clarify the role of different authorities in organising public service provision.

But Martin Schulz, the leader of the socialists in the European Parliament, described Barroso’s statements as "a provocation". He added: "Legal uncertainties about our public services need to be cleared up. We have been calling for action for the last six years, as have EU ministers."

John Monks, general secretary of the European Trade Union Confederation (ETUC), conceded that the protocol would be a "powerful instrument" to protect public services, but said there was "incessant pressure" for outsourcing and for privatisation to allow private investment in public services. "The scope for increased public expenditure is limited. Governments are under pressure to look for value for money," he said.

On the healthcare directive, he said that the ETUC was "waiting for legal advice on whether it is in line with the reform treaty protocol".

Brian Synnott of the European Federation of Public Service Unions said that legal clarity should precede the drafting of the healthcare directive. "If the universal principles are properly defined and given legal personality, then there can be value in coming forward with a health directive that improves the effectiveness of healthcare systems," he said.

MEPs and trade unions are stepping up pressure on the European Commission to increase legal protection for public services, threatening changes to its forthcoming proposals on cross-border healthcare.