The 2011/24/EU directive on cross-border health care has been in force for exactly three years. It has produced limited effects. This is the conclusion drawn by the participants at a conference organised at the Committee of the Regions and the European Commission in its implementation report on Monday 24 October
The directive stipulates that European patients who have chosen to receive health care in a member state other than their own can be reimbursed for the planned health care by the country in which they are affiliated, to the tune of what is provided for in their respective national health system. The directive does, however, allow member states to limit the application of reimbursement rules when reasons pertaining to the general interest justify this. Moreover, a preliminary authorisation system could be introduced with regard to hospital treatment, treatment that requires the use of infrastructure, or care containing risks when managing possible patient outflows.
During the Committee of the Regions conference, the majority of contact points recognised that health care planned in other member states remained very limited. Health Commissioner Vytenis Andriukaitis regretted the lack of information for citizens, which could lead to limited take-up of the provisions in the directive. According to a Eurobarometer survey, one third of patients would be willing to be treated abroad.
The implementation report, published the same day, states that cross-border health care is indeed very limited in Europe. The document is based on the responses provided by 23 member states. Austria, Finland, France, Iceland, Latvia, Lithuania and Portugal did not provide any replies. The report demonstrates that six member states have implemented mechanisms for limiting operations planned abroad. A total of 18 member states apply preliminary authorisation systems and received fewer than 100 requests for 2015, with an average acceptance rate of 50%. The countries that do not apply the preliminary authorisation system are the Czech Republic, Estonia, Netherlands, Norway and Sweden. The number of reimbursement requests for health care not submitted for preliminary authorisation was low, with a few exceptions. Belgium and Denmark both received more than 30,000 requests for reimbursement.
In his opening speech to the Committee of the Regions, the commissioner said that "national contact points must act as gateways for cross-border health care and not as gatekeepers that block access". He took advantage of the occasion to announce the next stages of the directive’s implementation and the creation of an initial European reference network (that will link health specialists in different member states), which will be up and running by 2017. He also said that "the first appeal we launched this year was very well received, with almost 900 specialists interested". Andriukaitis added that the first electronic exchanges of patient and e-prescription files, currently involving the Commission and 16 members states, will begin in 2018. The report can be consulted at: http://ec.europa.eu/health/cross_border_care/docs/2015_msdata_en.pdf . (Original version in French by Sophie Petitjean)