Healthcare across EU borders: a safe framework - European Union Committee Contents


The right of patients from EU Member States to travel to another Member State to receive healthcare is a principle that has been confirmed on a number of occasions over the last ten years by the European Court of Justice, but uncertainty remains over how that right should function in practice. In an attempt to provide some clarity, the Commission published its proposal for a Directive on the application of patients' rights in cross-border healthcare.

Our report examines the proposal and considers that it is a justified and necessary attempt to codify ten years of European Court of Justice case law. Until now, patients' rights in cross-border healthcare have evolved through courts rather than considered legislation, and we do not consider that to be sustainable.

The Council of Ministers recognised the need for a legal framework in 2006, and the European Parliament has been similarly supportive. In our report we have emphasised the need for a proportionate response that does not go beyond what is necessary to provide clarity over patients' rights and fully respects the constitutional arrangements of each Member State, such as the UK's system of devolved governance.

The right to access cross-border healthcare presents patients with choice, an opportunity which we welcome, particularly if it has a positive effect on the efficient delivery of health services locally. Along with choice, we have recognised too that equity must underpin the drafting and implementation of this legislation. This means equitable access to cross-border healthcare for all, regardless of financial means, but avoiding any distortion of national health services. We are confident that Member States' right to organise and deliver their own health services and medical care may be protected under this draft Directive.

The demand for cross-border healthcare is, at best, unclear and it is likely to differ significantly across the European Union with demand greater in countries that share land borders or, for reasons of size, lack certain specialities. The precise mechanisms required to deliver it are equally unclear. Our report identifies some of the challenges to be met that are unresolved in the Directive as drafted, such as: delivering a smooth pathway of care for patients; ensuring that patients and practitioners are able to communicate with one another; and collating and disseminating information on cross-border healthcare.

We understand and accept the need for the legislation but we consider the impact to be so hard to predict, and potentially very significant for patients and practitioners alike, that the implementation of the Directive must be submitted to early, rigorous and regular review.

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