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Patient mobility in Europe to cut waiting
lists
12 November 2007
The draft health services directive, due to be
published by the European Commission on 20 November, will consider
whether patients should be able to seek treatment abroad based not
on the present “waiting time” test but simply on clinical need.
The European Court of Justice has established
a number of principles governing the rights of patients to seek
treatment in another Member State and then to recoup the cost from
their own health service.
The Court has made it clear that:
- Health services provided for remuneration are
“services” and so the relevant provisions on free movement of
services apply
- Patients may seek non-hospital care they are
entitled to at home in another Member State and then seek
reimbursement. They do not need prior authorisation
- Patients may seek hospital care they are
entitled to at home and seek reimbursement providing they have
prior authorisation from their own system. Such authorisation must
not be withheld if their system cannot provide the required care
within a medically acceptable time
At present the European Commission estimates
that the level of patients seeking treatment in another Member
State is low, estimated at 1% of the overall public expenditure on
healthcare. However, the Commission believes that in principle at
least patients are interested in cross-border healthcare.
In June 2006 Ministers of Health of the 25
Member States adopted “Common Values and Principles” to guide EU
health systems. This agreement recognised the importance of free
and equal access to health care. The Ministers invited the
Commission to develop a community framework for health care.
The Commission has now drawn up a draft health
services directive which will, amongst other matters, clarify the
circumstances in which patients will be able to seek treatment
abroad and then look to their own system for reimbursement. The
detail is not yet available because other Commission departments
are reviewing the directive and propose amendments.
This could have a huge impact on the NHS both
in terms of delivering care to residents of other Member States
coming here for treatment but also in respect of reimbursing UK
residents seeking treatment abroad.
There will also be a host of practical issues
to be addressed such as how patients will be able to identify
suitable providers, how quality will be assessed and managed, how
adverse incidents will be managed and what system of redress will
be available.
Whilst the devil will inevitably be in the
detail it is likely that the main planks of the directive will grab
the morning headlines as patient-choice is (or appears to be)
extended across the European Union. Browne Jacobson will of course
continue to monitor the position and provide an update following
publication of the directive.
For more information or advice, please contact
Ian or
Simon
The content of this bulletin is provided for
the purposes of general interest and information. It contains only
brief summaries of aspects of the subject matter and does not
provide comprehensive statements of the law. It does not constitute
legal advice and does not provide a substitute for it.