Brussels, 26/10/2010 (Agence Europe) - Too many uncertainties persist with regard to health care access, reimbursements and responsibility for cross-border clinical health care follow-up. The “patients' rights in cross-border health care” directive should enable all patients, not just the best informed or most well-off, to benefit from a number of rights, which are already recognised by the European Court of Justice on health care, and conditions governing repayments in this area. Speaking on the eve of the vote on the report, Françoise Grossetête (EPP, France) explained that this issue was a big challenge. The vote takes place on Wednesday 27 October at the environment, public health and food safety committee at the European Parliament (EP). The vote is expected to go in favour of the report and Françoise Grossetête has already obtained the support of the political groups at the EP.
Grossetête pointed out that the EP had adopted a report in a first reading in April 2009. After lengthy negotiations, the Council obtained an agreement under the Spanish presidency of the EU Council of Ministers on this sensitive subject on 13 September 2009, with the support of 23 member states. Poland opposed the agreement, as did Slovakia and Portugal, whislt Romania abstained. The draft recommendation in the second reading will be voted on in the parliamentary committee this Wednesday.
The main objectives in this directive are: 1) clarifying the patient rights announced by the European Court of Justice and improving overall legal security for cross-border health care, 2) facilitating access and reimbursements for safe and quality cross-border health care; and 3) promoting cooperation in health care between member states.
In a note distributed to the press on Tuesday 26 October, Grosstête emphasised: “This is not about encouraging cross-border health care as it stands but making it accessible, safe and of good quality, when it is useful or necessary. The future European legal framework aims to provide European citizens with better information and more clarity about the substance of legal rules applicable to travelling to another member state”. She also explained that the proposal focused on patients and their mobility and not on the free movement of service providers. The MEP exclaimed: “Contrary to certain fears, there is no link between the present directive on cross-border health care and the services directive. Just as the Polish plumber had not really invaded France, there will be no hordes of patients coming to get treatment in our hospitals!”
What kind of health care can we benefit from abroad? How and on what criteria can this health care be reimbursed? How will responsibilities be shared between the member state responsible for healthcare affiliation and the member state providing the treatment? The patients and services to which they address themselves are equally unable to identify and compare different kinds of health care. Until now, the rapporteur noted that the European Court of Justice had explained the right “on a case-by-case basis” by way of its jurisprudence. She said that this situation was unsatisfactory to both patients and the competent national authorities. She also said that the poorest patients and the least well-informed did not have the means to envisage or use cross-border health care. Françoise Grossetête warned against “discrimination based on money”.
Concrete advantages for patients include: (1) if treatment is covered by the national health care system, patients will be able to receive treatment in another EU member state and be reimbursed without prior authorisation; (2) for hospital healthcare (surgery) or care involving high-technology materials, a member state will be able to decide, in certain circumstances, whether to introduce a system where patients will have to receive prior administrative authorisation before accessing the health care in question abroad; (3) patients will be guaranteed “fair and quick” procedures, particularly with regard to the effective reimbursement of costs incurred; (4) they will be able to benefit from cross-border health care information through a one-stop shop in each member state (national contact points); (5) by way of European co-operation in areas such as European reference networks (which have been developed, in particular, to treat rare diseases), patients will have access to highly specialised health care, which they would not have been able to benefit from otherwise.
Finally, Europe has a duty to use new technologies (telemedicine, e-health etc) in an effort to improve access to specialised health care in certain areas that suffer from a shortage of specialists or in zones where health care access is difficult. Last but not least Grossetête is one of the MEPs who is totally opposed to “medical tourism, a tourism that the directive must absolutely steer clear of”. (G. B./transl.fl)