Brussels, 30/11/2009 (Agence Europe) - The EU Member States' health ministers will be trying to reach agreement on Tuesday 1 December 2009 in their first reading of a draft EU directive on patients' rights to healthcare overseas.
Although progress has been made in recent months on this 'martyr' legislation, there are two sticking points, one with how to define the Member State where patients are registered (the Member State where the patient resides or the Member States where the patient has health insurance?) and one with healthcare provided by healthcare professionals who are not members of insurance fund schemes. Member States like Spain, Portugal, Ireland and Poland have problems with at least one of these two issues, particularly Spain, which fears that that the large numbers of British pensioners living in Spain (but covered by social security in the UK) will request refunds from Spain for the cost of healthcare they receive in France. Spain's healthcare system is based on contracts with healthcare providers and this makes it awkward to cater for healthcare provided by other healthcare providers abroad not covered by a contract in Spain. The most recent draft compromise drafted by the Swedish Presidency of the Council of the EU has the backing of 18 Member States, but this is fewer than the number required for the legislation to be voted through using qualified majority voting (qmv). Devised with the aim of protecting the economic interests of Member States as far as possible (by requiring prior authorisation, ruling out long-term healthcare, etc), the direction the Council is moving towards with its draft compromise is markedly different from the direction reached in the first reading at the European Parliament (see EUROPE 9888). In the vote on the Bowis Report, the EP called for a strengthening of patients' rights (introducing a direct settlement system whereby the patient does not have to pay in advance for healthcare and request repayment at a later date, exempting patients suffering from rare diseases from the prior authorisation requirement, introducing an open cost calculation system and reimbursement system, and recognising prescriptions). Although the EP's version stated that Member States have the option of introducing a system whereby patients will not have to pay for healthcare in advance, the Council's current draft compromise restricts the amount that can be reimbursed to the amount that is authorised in the country where the patient originates from, and this raises serious problems in the light of the segmentation of the pharmaceutical market in the EU. The Council agrees with the EP, however, that patients need better access to their medical records and information about healthcare provision.
The Council is expected to adopt a conclusions document on antibiotics, which will note an increase in resistance to antibiotics and the need for joined-up strategies for reducing resistance and combatting infections contracted while undergoing healthcare (hospital bugs and the like). New antibiotics are urgently required and the Commission will be urged to develop an overreaching action plan over the next two years to encourage the development of the new antibiotics and ensure antibiotics are used appropriately. The conclusions document notes that the Commission might work on the basis of experience gained in the field of drugs for rare diseases and medicines for children.
The Council will also adopt conclusions documents urging Member States to improve and expand the use of online healthcare. The document says that Member States and the European Commission should introduce an EU governance mechanism with the necessary resources to coordinate work in this connection. Another conclusions document looks at work needed to combat alcohol abuse and improve the protection of embryos, children, teenagers and young people from the dangers of alcohol.
The Swedish Presidency will brief the ministers on progress on the pharmaceutical package, where progress has been made on pharmacovigilance and tackling fake medicines, two areas where the ministers agree in principle.. As already reported, the question of patient information has been put on the back-burner due to its controversial nature in many Member States. The European Parliament is unlikely to hold its first reading on the package until the spring of next year.
The ministers will also examine developments in the swine flu epidemic (A(H1N1) and the upcoming Spanish Presidency will outline its work programme for January to June 2010 inclusive, namely the quality and safety of organ transplants, cross-border healthcare, the pharmaceutical package, flu and public health innovations). (O.J. trans fl)