10 European health insurance card
| (24316)
6924/03
COM(03) 73
| Commission Communication on the introduction of a European health insurance card
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| Legal base | — |
| Department | Health |
| Basis of consideration | Minister's letter of 19 April 2004
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| Previous Committee Report | HC 63-xxxi (2002-03), para 5 (10 September 2003)
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| To be discussed in Council | No date set
|
| Committee's assessment | Politically important
|
| Committee's decision | Cleared
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Background
10.1 In March 2002, the Barcelona meeting of the European Council
decided that, as part of the overall aim of removing obstacles
to geographical mobility by 2005, a European health insurance
card should be created.[17]
It would replace the paper forms currently needed for an individual
to receive health treatment in another Member State, thereby simplifying
procedures, but without changing existing rights and obligations.
The Commission set out in this Communication ways in which this
objective might be achieved.
10.2 The Commission suggested the introduction, by
1 June 2004, of a single, personalised card to replace form E111,
which covers those temporarily visiting another Member State on
holiday or business.
10.3 In his Explanatory Memorandum of 17 March 2003,
the Minister of State at the Department of Health (Mr John Hutton)
told us that the proposal had a number of important policy implications
so far as the UK is concerned. He added that, while the Government
was generally supportive of proposals to simplify bureaucracy,
detailed consideration would need to be given to how such a card
should be produced in the UK, and that it would be important to
ensure that the financial and administrative burdens of producing
it, particularly in the case of a smart card, did not exceed the
benefits. A full Regulatory Impact Assessment would be provided
as soon as possible. We decided to defer our consideration of
the document until it was available.
10.4 By 10 September 2003, we had not received the
Regulatory Impact Assessment or the other information from the
Government and so we decided to report on the Communication.[18]
In the conclusion to the Report, we said that the proposal appeared
to be of direct and tangible benefit to individuals. We noted
the practical concerns raised by the Minister and that he would
be providing further information on the likely costs involved.
Accordingly, we held the document under scrutiny pending the receipt
of the information from the Minister.
10.5 In the meantime, the Commission had proposed
a Regulation to give effect to the proposal. We cleared it from
scrutiny on 17 September.[19]
The Minister's letter
10.6 In his letter of 19 April 2004, the Minister
notes that the current form E111 is produced through the Post
Office. People fill in an application form and can take it to
any Post Office to have it stamped and signed. The Minister says
that it is now clear that this decentralised system could not
be used for the new health insurance cards and that he is minded
to move to a centralised system.
10.7 The new system he envisages would involve postal,
telephone or internet applications to a central point for the
issue of the card. The system would;
- include a central database
of issued cards to enable checks to be made of cost reimbursement
claims from other Member States;
- issue a plastic card with information unique
to each holder; and
- enable checks to be made on the holder's entitlements.
10.8 The Minister says that the Prescription Pricing
Authority (PPA) would be capable of providing the system for England
and willing to do so. It currently produces some plastic cards
related to prescriptions. Scotland, Wales and Northern Ireland
have been asked if they wish to join with England in operating
a system through the PPA.
10.9 The Government will shortly be issuing a consultation
document on the details of the proposed system.
10.10 A Regulatory Impact Assessment (RIA) is attached
to the Minister's letter. It says that Member States which do
not already have a card may apply to defer until the end of 2005
the date by which they issue cards. The UK has applied for and
been granted the extension.
10.11 The RIA identifies and comments on five options:
- leave things as they are now;
- incorporate the card into the UK passport;
- combine the card with any future national ID
card;
- retain a decentralised system for issuing a cardboard
card, without a central database; and
- a centralised system of the kind the Minister
has in mind.
10.12 The RIA dismisses some of the options and says
that the last of them would produce the greatest benefits to individuals
(convenience and simplicity) and the taxpayer (reduction of fraud
and improved checking of eligibility). It provides estimates
of the additional cost of a centralised system compared with the
present system: £7.9 million in the first year, £5.6
million in the second year and £3.4 million a year thereafter,
with set-up costs of £3.7 million. The RIA concludes that
the decentralised system appears to be the best of the options.
Conclusion
10.13 We are grateful to the Minister for his
letter and the Regulatory Impact Assessment. He has now provided
the information for which we asked and there are no more questions
we need put to him about the Communication. Accordingly, we clear
the document from scrutiny.
17 Conclusion 34, Presidency Conclusions, 15 and 16
March 2002. Back
18
See headnote. Back
19
See (24703) 11057/03: HC 63-xxxii (2002-03), page 99 (17 September
2003). Back
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