The ability to receive medical treatment in a European country other than your own could take a step forward Wednesday (27 October). The European Parliament's public health committee could back the proposed directive on patients' rights on cross-border healthcare. This will strengthen your right to be treated in another country and hopefully iron out some of the administration hurdles that have at present hindered its wider use.
However, some EU countries are concerned about the cost - and whether you should pay-up front or be refunded later. Ahead of the vote in the committee (where it has reached its second reading stage) we put some questions to French MEP Françoise Grossetête (European Peoples Party) who has acted as Parliament's rapporteur on this directive. The European Court of Justice have already given its opinion, confirming patients' rights as regards freedom of movement in the EU.
What is the current situation in Europe regarding cross-border healthcare?
At present if a European citizen wants to get treatment in another country they do not know if they if will be refunded and how that may happen. One must anticipate the cost without knowing whether they will get a refund. So far there have been difficulties that citizens have brought before the European Court of Justice. Therefore, the European Parliament has said it must legislate to solve this problem.
This directive is designed to allow patient mobility. We already have mobility of workers and students. It's part of the fundamental rights of European citizens. This does not however encourage medical tourism. We simply want to allow a wider range of public health for patients. It is very important - especially in border regions.
For patients across Europe, what will change if the Directive is approved?
Patients have a choice about the place where they seek treatment and the possibility of having the best possible care. There will be centres with national contacts to access information relating to health care in other countries.
If someone needs permission to go and receive care in another EU country, the payment will be paid directly by the country of the patient to the country where the medical care is received.
Many EU countries have resisted this proposal as they fear an "invasion" of patients and an increase in healthcare costs. Is there such a risk?
Cross-border medical care is only a very small portion of public spending on health. In most cases patients can be reimbursed for treatment in another country only if this treatment is covered by their national system, and the level covered in their State. For example, if in Germany patients are not entitled to dental care reimbursement and they go for treatment in France, Germany will not have to repay them. There will be no way for a patient to obtain a financial benefit related to reimbursement.
This report has reached its second legislative reading stage -on which points do you and the European Parliament differ with European governments?
There are three main differences: prepayment, prior authorisation and rare diseases.
We believe the major political groups of the European Parliament are united on this issue - that to avoid discrimination towards people who have less, the home country shall pay the hospital directly or the country where the care is carried out (payment in advance), without the citizen being obliged to pay the money upfront. If this is not possible, then the patient can expect to be repaid in the shortest time.
Regarding prior authorisation, even though Parliament is against it, we can accept it on condition that the criteria for possible rejection are accurate, objective and limited.
Another very important point for us is that Europeans affected by rare diseases have the opportunity to receive treatment in another State. There are 25 million Europeans affected by rare diseases and they need access to better care. The Council of Ministers (of EU governments) ignored this point and for us this is a key point missed.
Are you confident agreement will be reached?
I hope there will be an agreement at the second reading in the interest of patients.
July 2008: European Commission proposal
April 2009: European Parliament first reading
June 2010: Council's of EU ministers reach their position
27 October 2010: Report scheduled for adoption in EP committee, 2nd reading
18 January 2011: EP plenary sitting, 2nd reading (indicative date)
1% (around 10 billion) of public health budgets spent per year on cross-border healthcare
30% of EU citizens are not aware of the possibility to receive healthcare outside their country
25 millions of European citizens suffer from rare diseases