Sweeping away obstacles to cross-border healthcare

The European Parliament has approved plans to give Europeans the right to seek healthcare abroad more easily and be reimbursed for the costs.

The general aim of the draft directive on cross-border healthcare is to ensure that there are no obstacles to patients who seek treatment in an EU Member State other than their own. It also clarifies the right for patients to be reimbursed after treatment in another Member State. These rights have been confirmed in European Court of Justice judgements but are not yet included in EU legislation. The directive also aims to ensure high-quality, safe and efficient healthcare and to establish healthcare co-operation mechanisms among Member States.

The directive does not change the right of Member States to define the benefits that they choose to provide. If a Member State does not include a particular treatment as part of the entitlement of their citizens at home, this directive does not create any new entitlement for patients to have such treatment abroad and be reimbursed.

Under the draft directive, patients will have the right to seek healthcare abroad but Member States may introduce a system requiring prior authorisation for the reimbursement of hospital costs. The prior authorisation requirement must not create an obstacle to the freedom of movement of patients.

Patients are to be reimbursed up to the level they would have received in their home country. Member States may individually decide to cover other related costs, such as therapeutic treatment and accommodation and travel costs.

The proposed rules would, in practice, mean that patients need to pay in advance and get reimbursed only later. Member States may offer their patients a system of voluntary prior notification. In return, reimbursement would be made directly by the Member State to the hospital of treatment. Member States must ensure that patients who have received prior authorisation will only be required to make direct payments to the extent that this would be required at home.

Parliament has added special rules for patients with rare diseases and disabilities that might need special treatment. Patients affected by rare diseases should have the right to reimbursement even if the treatment in question is not provided for by the legislation of their Member State and this shall not be subject to prior authorisation.

Parliament voted to exclude long-term care and organ transplants from the directive.

To improve patients' confidence in cross-border healthcare, they must receive appropriate information on all major aspects of such care, such as the level of reimbursement or the right of redress in the event of any harm arising from healthcare. National contact points should be established.

This was the European Parliament's first-reading position. This dossier is expected to require two readings and is unlikely to be concluded until the end of this year or possibly early 2010.

The UK government, which has consistently opposed this legislation and made it plain it will place obstacles in the way of patients seeking cross-border care, has not yet commented.

It is almost certain that the EU will pass this proposal, but even if the EU give a deadline for member countries to implement the rules in national law, this does not guarantee the UK government will meet that deadline. Earlier this year, on a key area of EU agreement on the environment, it eventually passed new laws - two years after the final EU deadline date. So if you need health care, you will have a few years to wait before you can go overseas and expect the NHS to pay for treatment.


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Sweeping away obstacles to cross-border healthcare
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