6 Cross-border healthcare
| (29786) 11307/08 COM(08) 414 + ADDs 1-2
+ ADD 3
| Draft Directive on the application of patients' rights in cross-border healthcare
Commission staff working documents: impact assessment and summary of impact assessment Commission staff working document: Towards a renewed social agenda for Europe — citizens' well-being in the Information Society
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| Legal base | Article 95 EC; QMV; co-decision
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| Department | Health |
| Basis of consideration | Minister's letter of 16 June 2009
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| Previous Committee Report | HC 16-xxviii (2007-08), chapter 2 (22 July 2008); HC 16-xxx (2007-08), chapter 7 (8 October 2008); and HC 19-xix (2008-09), chapter 12 (10 June 2009)
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| Discussed in Council | 9 June 2009
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| Committee's assessment | Politically important
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| Committee's decision | Cleared (decision reported on 21 October 2008). Further information awaited
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Previous scrutiny of the document
6.1 In July 2008, when we first considered this draft Directive,[27]
we noted that the European Court of Justice has consistently ruled
that patients who go to another Member State for healthcare are
entitled to reimbursement of the cost by their home Member State
if they would have been entitled to the treatment in the home
State. The Court's judgments have, however, left a good deal of
uncertainty. So the Commission proposes this draft Directive to
clarify the rights and duties of patients, Member States and health
providers.
6.2 We agreed with the Government and the Commission
about the desirability of EC legislation to clarify the law on
patient mobility. Because of its importance, we recommended the
draft Directive for debate in European Committee C. The debate
was held on 21 October 2008.
6.3 Subsequently, the then Minister of State at the
Department of Health (Dawn Primarolo) sent us further information
and progress reports on the negotiations.[28]
In particular, she provided the text of the amendments proposed
by the European Parliament when it gave the draft Directive a
first reading on 23 April 2009. She told us that the Government
welcomed most of the amendments but had not reached a view about
a few of them, such as the European Parliament's proposal that
organ transplantation should be excluded from the scope of the
Directive and the proposal for the establishment of a European
Patents' Ombudsman to consider and, if appropriate, mediate on
patients' complaints about prior authorisation, reimbursement
or harm .
6.4 In the Conclusion to our report of 10 June 2009,
we said that we shared the Government's view that many of the
European Parliament's amendments are welcome. We explained why
we are sceptical, however, about the European Parliament's proposal
for legislation to establish a European Patient's Ombudsman. It
seemed to us that, in principle, any "European" Ombudsman
should be concerned solely with the actions of European institutions
and should not have power to investigate the actions of national
or regional governments. Moreover, the European Parliament proposes
that complainants should not have access to the European Patients'
Ombudsman until "all the complaint options within the relevant
Member State have been exhausted".[29]
In effect, therefore, the European Ombudsman would be a court
of appeal against the findings and conclusions of the national
ombudsmen for health services; this, too, appeared to us to be
objectionable in principle. We asked for the Minister's comments
on these points and to know if she had consulted the UK's Health
Services Ombudsmen about the proposal. We also asked her for further
progress reports on the negotiations and to tell us the Government's
conclusion on the European Parliament's proposal for the exclusion
of organ transplantation from the scope of the Directive.
The Minister's letter of 16 June 2009
6.5 We congratulate Gillian Merron on her appointment
as Minister of State at the Department of Health and thank her
for her letter of 16 June responding to the questions we put to
her predecessor.
6.6 The Minister tells us that, when the Health
Council discussed the draft Directive on 9 June, most Member States
(including the UK) were agreed that good progress has been made
in the negotiations so far. There are, however, two important
questions on which opinions are divided:
- whether some types of healthcare
provider (such as private providers not contracted to the State
system) should be excluded from the scope of the Directive; and
- whether to delete the provisions in Chapter 4
of the draft Directive on healthcare cooperation between Member
States and the provisions on the use of comitology to specify
the details of such cooperation.
6.7 The Minister says that she believes our concerns
about the European Parliament's proposal for a European Patients'
Ombudsman are valid. She will seek clarification of the proposal
and will consult the UK Health Services Ombudsman before the amendment
is discussed by the Council.
6.8 The Health Commissioner (Androulla Vasilliou)
told the Council on 9 June that it might not be possible to exclude
organ transplantation from the scope of the Directive because
transplantation comes within the definition of healthcare used
by the European Court of Justice. But the Commissioner has asked
Commission officials to consider the question in more detail and
the Government looks forward to hearing the conclusions of that
work.
6.9 Finally, the Minister says that she will provide
us with further progress reports on the negotiations.
Conclusion
6.10 We are grateful to the Minister for her helpful
letter. We look forward to receiving further progress reports.
In particular, we ask to be kept fully informed about the consideration
and discussion of:
- the proposal for a European
Patients' Ombudsman;
- the cooperation and comitology provisions;
and
- whether organ transplantation and some types
of healthcare provider should be excluded from the scope of the
Directive.
27 See HC 16-xxviii (200-08), chapter 2 (22 July 2008). Back
28
See HC 19-xix (2008-09), chapter 12 (10 June 2009). Back
29
European Parliament amendment 92. Back
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