Select Committee on European Union Eighth Report

Cross Border Health Services in the European Union

1.  This Report refers to issues raised by the EU Commission's Communication "Consultation regarding Community Action in Health Services"—SEC (2006) 1195/4. The Commission's document addresses the present unclear situation, in which Community law provides patients with rights to cross-border health care, but there is need for a clear, practical framework in which greater individual choice can be reconciled with the sustainability of health systems overall. Some of the practical issues raised are the need to clarify: the terms and conditions under which cross-border healthcare must be authorised and paid for; whose rules apply; and what happens when things go wrong.

2.  We recognised that the issues raised in the context of cross-border health care are difficult and sensitive, and that both practical issues and issues of principle are involved. We therefore invited the Minister of State for Health Services Minister—Ms Rosie Winterton MP—to speak to us about the subject. In this Report, we make available for the information of the House, the oral evidence she gave to us.

3.  An opening statement made by Ms Winterton as part of her evidence covered the following key issues (Q 1):

  • the problems with the current legal position that might usefully be addressed by Commission proposals;
  • the UK Government's views of how the Commission's proposals might best be framed to address these problems;
  • any concerns about possible legislative proposals that the UK Government would not find acceptable; and,
  • whether a framework for non-regulatory co-operation between Member States could help to support the legal framework and, if so, the sort of issues it could most usefully cover.

4.  In answering questions from the Sub-Committee, the Minister's evidence went on to cover the following topics:

  • the position of other Member States and the Commission in relation to the UK Government's views (QQ 2-3);
  • the extent to which future progress in clarifying the issues of patient mobility depends upon political or legal decisions (Q 4);
  • the impact of patient mobility on the provision of health services in the UK (QQ 5-6);
  • practical issues relating to patient mobility (QQ 7-11);
  • the confidentiality of patient information (Q 12);
  • mobility of doctors and quality of care for patients (QQ 13-15);
  • different definitions of healthcare across the EU (QQ 16- 20); and,
  • liability for negligence (QQ 21-22).

5.  The meeting with the Minister helped to improve our understanding of the significant and sensitive issues, of both a legal and political nature, that need to be resolved in order to find an acceptable way forward in this case. In particular, we recognised the point she made that there is a need to get the framework for European Health Services right so that it can provide a fair and transparent system for people seeking health care and, at the same time, ensure that it does not undermine the UK health service.

6.  We look forward to seeing the responses of the Government, of other Member States and of other stakeholders to the Commission's consultation; and we will look further at these issues when the Commission publish firm proposals.

7.  Copies of our correspondence with the Minister, before and after our meeting on 25 January 2007, can be found in the Appendix. In our letter to the Minister of 8 February 2007, we release the Commission's consultation document from scrutiny.

8.  The full transcript of the Minister's oral evidence is printed from pp 1-8.

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