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
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
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.