Health

Patient Mobility & EU Healthcare Developments

John Bowis was the European Parliament's Rapporteur on the Commission's Communication on Patient Mobility and Healthcare Developments in the European Union. The European Parliament is now awaiting a proposal from the European Commission to clarify in law the guidelines and procedures for patient mobility in the EU, building on the European Court of Justice's rulings.

Click here for John's Report (with Explanatory Statement).

Click here for the Report as adopted by the European Parliament Plenary (Resolution).

Click here for John's speech at the Plenary.

Press statement.

John Bowis held a Hearing in the European Parliament on Patient Mobility on 3rd March 2005. He is pictured here with Magdalene Rosenmoller, IESE Business School.

Patient Mobility (Background).

Most citizens are aware of the long-established E111, a certificate that can be taken when travelling, studying, being posted or seeking employment outside their own country in the EU. This allows access to medical care on the same basis as local people and entitles them to have any costs reimbursed by their home country. The E111 and other current paper forms are being replaced by the European health insurance card.

The implementation of rights of patients to healthcare across the EU holds the prospect of giving tangible benefits to European citizenship. If these emerging rights can be defined and articulated and the potential burdens properly managed, there is a real chance to show citizens concrete evidence of Europe working for them in their daily lives.

In recent years patients have sought medical treatment in other countries for non-emergencies. There have been a series of court rulings by the European Court of Justice on patients' rights to receive planned treatment in other Member States in situations where they cannot be treated in their home country within an acceptable time limit.

After representing the European Parliament in the EU High Level Ministerial Reflection Group on Patient Mobility, John Bowis welcomes the chance for the European decision-makers to draw up detailed guidelines to establish a coherent policy on patients' rights and national health systems' responsibilities.

The Commission has already included provisions in its recent proposal for a Directive on Services in the Internal Market about the reimbursement of health care costs, making a broad distinction between hospital and non-hospital care. The general principles set out are:

• Any non-hospital care to which you are entitled in your own Member State you may also seek in any other Member State without prior authorisation, and be reimbursed up to the level of reimbursement provided by your own system.
• Any hospital care to which you are entitled in your own Member State you may also seek in any other Member State provided you first have the authorisation of your own system. This authorisation must be given if your system cannot provide your care within a "medically justifiable" time limit considering your condition. Again, you will be reimbursed up to at least the level of reimbursement provided by your own system.
• If you wish to seek treatment abroad, your health authorities can provide you with information on how you can seek authorisation for care in another Member State, the reimbursement levels that will apply and how you can appeal against decisions if you wish to.

From these principles a clearer definition of patients' entitlements and health services' obligations will need to be spelt out in relation to all forms of health care (dental services, outpatient services, day surgery, hospital treatment, etc.) and different conditions (depending on acuteness, what constitutes "undue delay", etc.).

The emerging rights for patients in the European single market is good news for patients who have been facing unacceptably long waits for treatment in the UK. It is an indictment of the British Labour Government that so many British patients stand to gain from these provisions.

There is much work to be done by the European Commission and national governments to get the definitions and management of the system right, so that patients benefit and health service managers are able to plan their budgets and services effectively. That work itself must be completed without "undue delay".

EU Healthcare Developments.

Health systems across Europe face common challenges as they adapt to constant developments in medical science, the ageing of the European population, and rising public expectations. Although the delivery of national health systems are the responsibility of national governments, cooperation at European level has great potential to bring benefits both to individual patients and to health systems overall.

In addition to a better understanding of the rights and benefits of patients, European cooperation already facilitates mobility of health professionals and could help cross-border care and spare capacity to be shared between systems, as well as the identification of European centres of excellence and coordinated assessment of new health technologies to avoid duplication. The EU is also an invaluable vehicle for the spread of best practice, knowledge and education, for example, in the field of cancer screening or prevention of illness campaigns and anti-smoking campaigns.

Work is being carried out on an ‘open method of coordination’ to healthcare and long-term care to support national strategies to reform and develop health and long-term care, and on an “e-Health action plan” for using information and communication technologies to help improve access, quality and effectiveness for health services.

The task will be the bring together these strands of policy development so that the EU has a clear health strategy which will help ensure that resources are invested in the best possible way and which will help deliver better health for people - which will in turn improve economic growth and quality of life.