Aachen, 20/04/2007 (Agence Europe) - At an informal meeting chaired by German Federal Health Minister Ulla Schmidt in Aachen on Friday 20 April, European Commissioner Markos Kyprianou presented the results of the consultation exercise on health care to European Union health ministers. Ms Schmidt told press she hoped that the discussions in Aachen would open the way for measures to be prepared by the European Commission. “Europe has to be able to ensure access for all to healthcare, quality health provision independent of the individual's finances and high quality care for all patients,” she said, without hiding the fact that there are different opinions among member states on how to get to this point. Many member states remain concerned for the long term balance of their health systems. UK Minister Rosie Winterton argued for clear rules to be put in place, and expressed some concern over the development of the dental care market in Europe.
Mr Kyprianou told press that he aimed to bring forward a package of measures to better organise access to healthcare in the context of patient mobility before the end of year, under Portuguese presidency. Ms Schmidt noted that healthcare had been excluded from the services directive because “in health, competition must be used only to increase the quality” of care. She acknowledged that the principle, whereby reimbursement of care received in the supplier's state cannot be more than the cost of similar care in the state of origin, could penalise nationals of the EU's poorest countries. “This is one of the most difficult problems to resolve,” said her Slovenian counterpart Andrej Brucan, who also said that combating cancer would be the highest priority for the Slovenian presidency in the first half of 2008. The issue of inequality of treatment for patients from less well-off countries was also raised by Italy and Spain during the meeting. These two countries spoke of creating a European fund to make compensation for the difference in reimbursement of costs and to ensure better access to healthcare, but this idea is still far from being accepted by all. “The discussion will have to go on,” said Ms Schmidt, while her Portuguese counterpart Antonio Fernando Correia de Campos said that the theme of the Portuguese presidency, in the second half of 2007, would be health for all. Portugal will hold a conference on “health for migrants” in Lisbon in September.
The analysis of the 276 submissions, mainly from member states, health insurance bodies and health professionals confirmed that there is a broad consensus with regard to Community action to ensure legal security and to promote cooperation between health systems, the commissioner said. Although the consultation exercise might have highlighted the lack of data on cross-border healthcare, it would appear that patient mobility remains not very widespread (around 1% of health spending), but its impact is greater for border regions, smaller countries, rare illnesses and areas visited by a large number of foreign tourists.
Virtually everyone agreed that clinical oversight should be provided by the medical authority which was at the origin of the treatment. A similar consensus applied to the added value that European support for national authorities could bring on quality and safety of healthcare, through guidelines, indicators, exchanges of information, clarification of patients' rights etc. Whoever provides the treatment should be liable for harm caused to the patient, and for damages. This said, there remained differences of opinion between those who would like to see legal responsibility in cross-border healthcare strengthened, and those who felt that the current rules of international private law were sufficient. Practical solutions to improve the way the system worked were also put forward. To these were added a number of proposals: developing networks of European reference centres (an idea supported by Belgium, France and Luxembourg, in particular), the creation of a monitoring centre to produce comparable data and indicators, European assessment of health technology, improved exchange of information on healthcare, better use of structural funds for healthcare infrastructure. Most contributions favoured the development of a policy that used a variety of instruments (directive, and also recommendation, open method of coordination, etc.). As Dutch minister Ab Klink stressed during the meeting, agreement of objectives must come before instruments.
A summary of proceedings and the contributions made can be consulted at: http: //ec.europa.eu/health/ph_overview/co_operation/mobility/results_open_consultation_en.htm (oj)