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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.
talk to us
Simon Tait
0115 976 6559/0121 237 3913
Partner and Head of Health
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