Directive Patient mobility

1. Directive Patient mobility Brigitte van derZanden Taskforce Health AEBR 12 November 2009 Brussels - AER

2. Content • History • Objectives • Content • Coherence with other policies • Reaction of Stakeholders • Implications for (border)regions • Conclusion

3. History • 1996: Jurisprudence of the Court of Justice • 2003: Healthcare ministers asked the EC to investigate the legal certainty concerning medical treatment in another MS • 2004: Directive on services in the internal market • 2005:The EP adopted a report concerning patient mobility and healthcare developments

4. History • 2007: the EP adopted a resolution on Community actions on the provision of cross border healthcare • 2007: the EP adopted a report on the impact and consequences of the exclusion of healthcare services from the Directive on services in the internal market. • 2007 -> ………

5. Objectives • The directive should provide sufficient clarity about rights to be reimbursed for healthcare provided in other MS • The directive should ensure that the necessary requirements for high-quality, safe and efficient healthcare are ensured for cross-border care

6. Content • Healthcare provided in another MS • Non-hospital care and hospital care • Procedural guarantees: administrative and reimbursement procedures, quality standards and standards to ensure the safety of patients • Information and national contact points • Rules for healthcare services

7. Content • Duty of cooperation • Recognition of prescriptions • European reference networks and health technology assessment • E-health • Data collection • Implementing committee

8. Coherence with other policies • Regulations for coordination of social security schemes • Framework for mutual recognition of professional qualifications • Community framework for protection of personal data • E-health • Racial equality

9. Reaction of Stakeholders Pros: • The directive contributes to the free movement of services • It makes it for the patient easier to use the healthcare system in an other MS, when wished for; it is focussing more on the needs and wishes of patients • (Border) regions will get more competences to act

10. Reaction of Stakeholders Pros: • It supports the cross border and European work that is already done by (border) regions or the work that they are planning • Citizens need more clarification and juristical certainty about there rights • The healthcare systems can be improved taking the demographical developments into account

11. Reaction of Stakeholders Opinion AEBR: • Patient needs a central position • Recognition of professional qualifications is a necessity • The EU should give transparent criteria • Border regions and Patient organisations should be involved in the contact points

12. Reaction of Stakeholders Opinion AEBR: • Patient should have the right of reimbursement (corresponding the reimbursement in their own country) • Healthcare tourism is not jeopardizing a reliable demand-planning system in the MS

13. Reaction of Stakeholders Opinion EPECS: • Patients or their representatives should be seen as an official third stakeholder • Patients need relevant, transparent and clear information concerning the possibilities of patient mobility • Patient organisations should be involved in the contact points as the independent representatives of patients

14. Reaction of Stakeholders Opinion of Province of Limburg and Euregion Maas-Rhine: • Appoint Pilot Regions • Contact points in border regions • Patients should be involved in the implementation of the directive • Patients should get the guarantee of minimum standards concerning quality and safety • Healthcare services should be included in the directive

15. Reaction of Stakeholders Cons: • The directive interferes to much in the national healthcare system • It will result in more problems than it solves • More competition: the directive is only in the interest of healthcare services • It will lead to two class medicine: because of prefinancing

16. Reaction of Stakeholders Cons: • The directive does not give the minimum standards concerning for example quality and safety • How to monitor the implementation of the directive in the MS?

17. Implications for regions • Added value for cross border regions • The need to get familiar with the healthcare system of your neighbouring country and the health care services over there • Border regions could develop into a significant economic sector with regard to healthcare services

18. Implications for regions • Could more easily lead to mutual recognition of procedures and values, mutual healthcare planning, information- and communication systems, continuity in healthcare and so on. • Development of transparent and objective procedures

19. Changes in healthcare system • The impact of patient mobility will be small • Contact points must be installed • Clear and public information concerning the possibilities of patient mobility • When to go (waiting lists, specific specializations) • What are the conditions (for example reimbursement)

20. Changes in healthcare system • There must be developed a clear safety and quality framework • There must be clear objective criteria described for administration and reimbursement • Collection of patient mobility related data • Support neighbouring MS when this is necessary for the implementation of the directive

21. Conclusion • Patient mobility is a reality and it is irreversible • There are still some challenges implementing the directive • The most important benefit should be the patient

22. Thank you for your attention!! Information: Brigitte van der Zanden info@bzconsultancy.com