Commission plans cross-border healthcare law

The European Commission will attempt next month to make it easier for patients to get a refund on the cost of healthcare received outside their home country.

A proposal for a framework directive on cross-border healthcare, to be published on 28 November, will set out the Commission’s thinking on balancing patients’ rights and freedoms with the sustainability of national healthcare services.

The proposal follows a series of European Court of Justice (ECJ) judgements in favour of patients wanting to be treated abroad.

The Commission has long warned that unless there is specific EU legislation, policy on cross-border healthcare will be decided by ECJ case law.

"It is important to address these issues in a specific community legal instrument in order to achieve greater legal certainty and clarity," says the draft, seen by European Voice.

The Commission has previously attempted to achieve legal clarity, by mentioning healthcare in the ill-fated proposal for an EU-wide law on the liberalisation of services. At the time of last year’s agreement on a reworked services directive, which dropped any mention of healthcare, it was agreed that the Commission should come forward with a sector-specific proposal.

According to the draft of the directive, the ECJ judgements make it clear that the provision of health services has to be in line with "the freedoms of the internal market enabling goods, services, persons and capital to circulate freely".

The legal basis for the proposed framework directive will be the internal market. The Commission has limited power to legislate on health policy and member states have been reluctant to surrender control over what is a politically and financially sensitive area. The reform treaty approved by EU leaders on 19 October agreed only to "encourage co-operation between the member states to improve the complementarity of their health services in cross-border areas".

The Commission’s proposal stresses that member states remain "primarily responsible" for health services.

It states that patients are entitled to be reimbursed for hospital care received outside the country where they are insured, so long as treatment is authorised by the insurer country.

Authorisation should be given if treatment abroad "is appropriate to the patient’s condition and his state of health", and if the patient would face an "undue delay" at home, though these terms are not defined. The amount reimbursed cannot be more than patients would have been entitled to in their insurer country .

These criteria, if adopted, could give rise to further legal differences between member states. Medical prescriptions would have to be recognised across the EU. The Commission will propose measures to make this possible.

Member states would have to offer patients’ information on their cross-border healthcare rights, with the help of "easily accessible national contact points".

Lisette Tiddens-Engwirda, secretary-general of the CPME, the European doctors’ association, said that doctors hoped the framework would promote the free movement of both patients and professionals.

Nicola Bedlington, director of the European Patients’ Forum said that she hoped the framework law would be followed by a ‘patients’ charter’, making it more easily understandable for the general public.

The European Commission will attempt next month to make it easier for patients to get a refund on the cost of healthcare received outside their home country.