With the opportunity of addressing the large majority of European citizens
EPHA expressed its concern about 4 main issues affected by this proposed Directive:
- impact on the patient: The proposal clearly states that it will secure the same access, equity and solidarity for all patients in the EU Member States. EPHA is concerned about the real practice of this directive, taking into account the existing differences concerning access to and quality of healthcare, both in and between Member States. With regards to healthcare tourism, it is already a reality for those who can afford it and all this directive will do is save this tiny percentage of the population some money.
- impact on the health professional: At first glance this proposal for a directive appears not to involve health professionals too heavily as it is aimed primarily at citizens and health services. However there are obvious effects on health professionals as any directive on health services would be bound to have. The ’Centres of Excellence’ proposed by the Commission could lead to pocketing of experts across Europe. The proposal for the increased use of so called ’e-health’ could be very useful to health professionals but details of the implementation need to be worked on.
- impact on Health Systems in Member States EPHA fears that with this proposal, the European Commission can not ensure the common values and principles in health systems agreed by member states in 2006. EPHA therefore stresses the need to respect the principles of the universality of health services, access to good quality care, equality and solidarity. EPHA is concerned that more people will now look for treatment in another Member State, especially if their national health service does not provide the same quality treatment, as in a neighboring EU country. EPHA believes that the European Union should first focus on facilitating the same level of quality care throughout Member States.
- impact on socially excluded citizens’ The Alliance is concerned that this proposal would not support Member States in addressing existing inequalities within countries but even creating a bigger gap between and within the Member States. EU citizens coming from higher income groups would have greater access to healthcare services and could be favoured by this directive and leads to more health tourism for wealthy EU citizens.
To end with a positive note on this proposal citizens living close by EU border Regions and patients with rare diseases could find some more clarity and EPHA hopes that this Directive will, at least, initiate discussions at the highest political level on the access to and quality provided by, health care systems in Europe. Quality standards are left to each country and this could possibly raise discussions about different quality standards.
Could this be the beginning of a European benchmark for health care standards? EPHA believes there are plenty of questions still to be answered...
For further information
Please visit the Commission website, DG Sanco:
Background
Health systems are primarily the responsibility of the Member States, but in some cases, as confirmed by several European Court of Justice (ECJ) rulings, EU citizens can seek healthcare in other member states with the cost being covered by their own health systems.
Health services were excluded from the Directive on services in internal market in Spring 2006, but the many ECJ rulings show that they are to be considered as an economic activity and that Community law applies to them.
Issues
The Commission stated that this Directive is necessary to clarify the role of the Member States as a result from the rulings established by the European Court of Justice (Watts Case, May 2006).
It is essential for the Member States to be clear what rules and limits are in order to meet their common objectives of universal access to high-quality healthcare on a financially sustainable basis. But the Commission acknowledges that this Directive aims to fill a ’hole’ made in the Services Directive and therefore the proposed legal basis is under the internal market article (article 95) of the Treaty.
For non-hospital treatments EU citizens can get treated and be reimbursed up to the cost of their national health service. Member States cannot insist that people get prior authorisation before going abroad.
For hospital treatment people need to apply to a national contact point and according to the Directive, patients should have a decision regarding the cross border healthcare within two weeks. For urgent cases, prior authorisation will not be needed.
