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I&EHL: Mobility of Health Professionals in the EU

I&EHL: Mobility of Health Professionals in the EU. André den Exter Andre.denExter@ua.ac.be. Outline. What is Professional mobility? Data History Legal framework Case law Concerns Recent developments Conclusions. What is professional mobility?.

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I&EHL: Mobility of Health Professionals in the EU

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  1. I&EHL: Mobility of Health Professionals in the EU André den Exter Andre.denExter@ua.ac.be

  2. Outline • What is Professional mobility? • Data • History • Legal framework • Case law • Concerns • Recent developments • Conclusions

  3. What is professional mobility? • "any intentional change of country after graduation with the purpose and effect of delivering health-related services, including during training periods" (PromeTheus2009)

  4. Data PromeTHeus 2008

  5. Prometheus2008

  6. Prometheus 2008

  7. History • Occasion • Risks and challenges • Call for regulation

  8. Legal framework: old and new • Art. 53 FTEU: need for coordination • Old approach: sectoral and general directives • Harmonisation minimum standards • Principle: mutual recognitions (automatic or conditional) • Effect

  9. Shortcomings • Quality safeguards • Decker and Kohll-ruling • Practice: variety curricula and competencies, new disciplines • Language skills and tests • Information exchange: ‘ problemdoctors’

  10. New: Professional Qualifications (PQ) Directive 2005/36 • Objective • Scope • ‘regulated professions’ • automatic recognition: art 21 (para)medical professions • establishment vs provision of services • min. standards (art 24(5) • 3rd country diplomas (HAIM I/ Hocsman) • ‘General system’: compensation measures (art 14(5)) • Common platforms • Administrative cooperation (art 56)

  11. Dr Ubani case • Daniel Ubani, a German locum (Nigerian-qualified) who came to the UK to provide out-of-hours services as a GP and accidentally killed a patient with an overdose of diamorphine. • The repercussions of the case have been considerable prompting the Health Committee to launch an inquiry which resulted in the report “The use of overseas doctors in providing out-of-hours services”.

  12. Shortcomings • Permanent education; diversity, lack of coherence • Free establishment (Hartlauer C-169/07 (dentists); Blanco Perez C-570/07 (pharmacists) and art 49, 52, 168(1) FTEU • Exchange of information (disciplinary rulings) • art 56 (administrative cooperation) • European professional card • Free movement students: numerus clausus Bertini and Bisignani (C-98/85), Bressol (C-73/08) • Admission exam • Quota (75:20:5) • Telemedicine

  13. Recent developments • Green paper PQ Directive 2005/36 • Modernization • Internal Market Information System (IMI) • Link with PM Directive 2011/24 and Services Directive 2006/123/EC

  14. Conclusions • Facilitate professional mobility while protecting consumer and public health • Towards a European curriculum? • Quality assessment via permanent review • Proactive automatic alarming instead on request • Language test a potential barrier

  15. Discussion • What are the policy and regulatory options for addressing health professional mobility issues at MS and EU-level?

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