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OPENING THE DOOR TO BETTER HEALTHCARE ACROSS EUROPE Proposal for a Directive on

OPENING THE DOOR TO BETTER HEALTHCARE ACROSS EUROPE Proposal for a Directive on Patients’ rights in cross-border healthcare Royal College of Physicians London 16 October 2008 B. Merkel, Head of Unit DG SANCO C5. Aims of Initiative.

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OPENING THE DOOR TO BETTER HEALTHCARE ACROSS EUROPE Proposal for a Directive on

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  1. OPENING THE DOOR TO BETTER HEALTHCARE ACROSS EUROPE Proposal for a Directive on Patients’ rights in cross-border healthcare Royal College of Physicians London 16 October 2008 B. Merkel, Head of Unit DG SANCO C5

  2. Aims of Initiative • Help patients to exercise their right to reimbursement for health treatment in any EU country (‘cross-border healthcare’) • Provide assurance about safety and quality of cross-border healthcare 3. Foster cooperation between health systems to improve healthcare for all

  3. Patients prefer to be treated as close to home as possible Sometimes healthcare patients need is better provided abroad closer to home (in border regions) lack of capacity specialised care, rare diseases Why cross borders for healthcare?

  4. Size of Cross border mobility This doesn’t count the situations when the citizen decides to pay for healthcare himself – many people do not know they have a right to be reimbursed • Patient mobility is limited (currently 1% of public health spending) • but larger in certain frontier regions 4

  5. Background • ECJ rulings on patient mobility (since 1998…) under free movement • Removal of healthcare from Services Directive (2006) • EP and Council called for a specific health legal instrument • Council conclusions on Common values and principles in EU health systems (2006) • Public consultation (2006-2007) Impact Assessment (2007)

  6. Key Starting points for EU action • Values • Common values and principles of EU health systems: universality, solidarity, access to good quality care and equity • Patients • Free movement rights for patients established by the ECJ • Subsidiarity • Respect for Member States’ responsibilities for organisation and delivery of healthcare • No harmonisation • Social Security Regulation (1971) Urgent care in another MS – with European Health Insurance Card Plannedcare: prior authorisation granted where there is undue delay

  7. 1. Helping patients to access cross-border healthcare • For non – hospital care: right to seek healthcare in another MS without prior authorisation and be reimbursed( eg dental care, medical consultations) • For hospital care:MS may choose to introduce a system of prior authorisation if system faces risks • Clear rules on reimbursement: up front payment with reimbursement at home up to the level for the same or similar treatment in the home system • Procedural guarantees, i.e. fair and quick procedures and right to ask for a review of any administrative decision, • Informationavailable to patients to make informed decisions - national contact points.

  8. 2. Ensuring Safer and Better Quality Cross-border care by clarifyingresponsibilities • MS where treatment takes place is responsible for assuring: • quality and safety of care • information and assistance to patients • redress and compensation for harm • protection of privacy and personal data • equitable treatment of patients from home country and from other Member States including protection against discrimination. Arrangements should be transparent ; monitoring systems in place

  9. SAFEGUARDS TO ENSURE A FAIR AND EQUITABLE SYSTEM For Patients All patients will have: • Clarity about what they can get reimbursed and how • Information about healthcare in other countries • Assurances about quality and safety of care • Assurances about getting help and compensation, if needed

  10. SAFEGUARDS TO ENSURE A FAIR AND EQUITABLE SYSTEM For Health Authorities • They pay out no more than they would have for treatment at home • They pay out only for treatment they would pay for an home • The rules of the home system apply for people going abroad eg gp gatekeeper • They set the rules for care in their country • If there is a risk to their system they can introduce prior authorisation for hospital care

  11. Easier recognition of prescriptions issued in other MS Information on cross-border flows – for planning 3. Fostering cooperation between healthcare systems to improve healthcare for all • Efficient use of resources • strengthening eHealth and improving interoperability • EuropeanReferencenetworks (to share expertise and innovation on specialised care) • Sharing efforts on Health • Technology Assessment

  12. SO WHAT WILL THE IMPACT BE? Patient-mobility remains limited but impact for individual patients is high No significant impact on national budgets Quality and safety of cross-border care improves More clarity for all about rules for reimbursement of care Patients have new options to access the care they need So What will be the impact?

  13. Next steps • Proposal adopted by the Commission on 2 July 2008 as part of a « Renewed Social Agenda Package » - available in all languages - in co-decision procedure. • Implementing measures to be adopted by a new comitology committee

  14. Thank you!

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