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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