Council of EU: EU countries discussed cross-border healthcare plans
On the basis of a Presidency progress report (10026/09) and questions suggested by the Presidency (10345/09), the Council held a public debate on the EU Commission's draft directive concerning the application of patients' rights in cross-border healthcare.
Driven by the intention to find the right balance between the freedom of patients, the sustainability of the public health systems and the right of the member states to organize their own health system, ministers in general welcomed the direction the discussions are taking under the Czech Presidency. Points of discussion included the restructuring of the text, the clarification of the responsibilities of the member states and the prior authorisation.
With reference to the national competences of member states to organize their health system, on a large number of delegations wishes, Commissioner for Health Androulla Vassiliou accepted to include article 152 of the EC-Treaty as legal basis of the proposal. On numerous requests, Ms Vassiliou also accepted to exclude long-term care from the scope of the directive.
Concerning the scope of the draft directive, views differ on whether the scope should be limited only to healthcare providers contracted to public health insurance or otherwise recognized by the public system or extended also to private healthcare providers not thus recognized. Ministers agreed that cooperation in the field of healthcare is needed. However, a large number of delegations opposed to the use of comitology procedures for such a co-operation. Ms Vassiliou suggested however further discussions on the prior authorisation and the possible exclusion of some healthcare providers.
The Presidency concluded the debate by stressing the need for prior authorisation under certain conditions, as long as the relevant case-law of the European Court of Justice is respected. With regard to the scope of the draft directive, the Presidency suggested that quality and safety standards may be used as criteria to decide which healthcare providers are covered.
The work on this file will continue under the incoming Swedish Presidency.
The compromise proposal of the Czech Presidency attempts to solve questions such as “inflow of patients”, “gatekeeping”, adjustments of Chapter IV on healthcare cooperation in relation to comitology etc. Initial reactions to this compromise proposal in the responsible working group were overall positive (e.g. the new structure of the text, the clarifications of responsibilities of the Member States and consistent use of definitions). The new orientations helped also to find some convergent ground with regard to other parts of the proposal, e.g. the extent of the codification of the European Court of Justice case-law, the exclusion of certain types of care from the scope of the directive, the mutual recognition of prescriptions and the cooperation on healthcare.
Despite this tangible progress a number of substantive issues still need further discussion, including the actual content of key terms, the scope of the directive and the exclusion of certain types of care, the reasons for refusal to grant a prior authorisation, the reimbursement of prescriptions, the provisions on cooperation on healthcare and the legal basis.
The Commission submitted this legislative initiative as part of the social agenda package of 2 July 2008, focusing on a triple objective: to guarantee that all patients have care that is safe and of good quality, to support patients in the exercise of their rights to cross-border healthcare (with the aim to codify the case law of the Court of Justice relating to the reimbursement of cross-border healthcare) ; and to promote cooperation between health systems.
Source: Council of the European Union, http://www.consilium.europa.eu/App/newsroom/loadbook.aspx?BID=79&LANG=1&cmsid=351