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Directive Patient mobility
Brigitte van der ZandenTaskforce Health AEBR
12 November 2009Brussels - AER
Content
• History• Objectives• Content• Coherence with other policies• Reaction of Stakeholders• Implications for (border)regions• Conclusion
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
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 -> ………
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
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
Content
• Duty of cooperation• Recognition of prescriptions• European reference networks and health
technology assessment• E-health• Data collection• Implementing committee
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
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
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
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
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
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
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
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
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?
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
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
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)
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
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
Information:Brigitte van der [email protected]
Thank you for your attention!!
Thank you for your attention!!
