[Ip-health] EU countries to discuss cross-border health plans

[Sangeeta]

8 June 2009
Breaking News:

EU countries to discuss cross-border health plans
Published: Friday 5 June 2009

Fundamental divisions on a proposed directive allowing patients to seek
treatment in any EU country will dominate a meeting of European health
ministers on Monday (8 June), with a small bloc of countries firmly
opposed to the basic principle of the plan.
Background:

A series of rulings by the European Court of Justice , beginning in
1998, have stated that healthcare can be sought in any member state,
with patients entitled to have their costs covered by their own health
systems.

This prompted the European Commission to adopt a communicationPdf
external in 2006, which began a consultation process on cross-border
access to healthcare. That culminated in the publication of a proposal
for a directivePdf external in July 2008 (EurActiv 18/07/08).

The Commission proposal would allow citizens to seek treatment anywhere
in the EU and claim reimbursement from their home countries under
certain circumstances. Patients can seek non-hospital care, such as
dental treatment and medical consultations, without prior authorisation.

An amended version of the text passed through the European Parliament at
the end of April (EurActiv 24/4/09). This document included a clause
requiring prior authorisation for in-patient procedures such as surgery.
It also excludes organ transplantation and long-term care from the scope
of the directive.

Spain and Portugal are firmly opposed to the principle of the directive,
which could have an impact on how services are planned and funded,
EurActiv has learned.

In addition, Hungary, Poland and Italy also have reservations about what
is proposed and may seek to impose limitations on the kinds of treatment
that will be reimbursed under the new system.

Among the ideas currently being floated is exempting private hospitals
and clinics from the directive in certain cases. But several member
states are concerned that this runs contrary to the case law upon which
the new legislation is built.

Despite this, a lot of progress has been made on the issue, with the UK,
France and Germany believed to be reaching broad agreement on what the
final text could look like, according to diplomatic sources.

The major obstacle will be the circumstances under which countries can
refuse to pay for treatment for citizens who have suffered from "undue
delays". The definition of this term and the question of who will decide
whether a patient has waited too long are yet to be thrashed out.

Some smaller member states have consistently expressed concerns that the
directive could have a negative impact on their health systems if there
is a large outflow of patients or medical specialists to other countries.

Behind-the-scenes discussions on this subject have centred on finding
ways to limit the potential negative impacts on health systems, and may
lead to additional protection for border regions.

A debate on whether member states can refuse to reimburse specialist
procedures on the grounds that they affect the integrity of the national
health system is also likely.

Information to patients

Ministers will also discuss the European Commission's pharmaceutical
package, which contains three major directives: on pharmacovigilance,
counterfeit medicines and information patients. The Information to
Patients Directive is expected to be blocked, as previously reported,
while the other two are seen as less problematic (EurActiv 25/5/09).

The technical details of the legislation on counterfeit drugs and drug
safety will be worked through, but there are no major stumbling blocks
to their adoption.

The issue of allowing pharmaceutical companies to provide controlled
information to patients caused controversy when ministers met in
December, and attitudes have hardened further since then.

A large group is fundamentally opposed to the plan, launched last year
by Commission Vice-President G=FCnter Verheugen, while a smaller number of
member states will suggest discussing access to quality information on
medicines in another setting, possibly the successor to the
pharmaceutical forum.

H1N1 influenza

A discussion on the H1N1 influenza outbreak =AD commonly referred to as
'swine flu' =AD is scheduled for lunchtime, but is unlikely to be a source
of major controversy.

The EU's health security committee has been meeting daily since the
World Health Organisation raised the pandemic threat level to stage five
of a six-point scale, and health ministers are broadly happy with
coordination to date.

However, speculation has grown that the WHO is close to declaring swine
flu a global pandemic as the number of cases mounts.

Information and disease surveillance measures are in place, say sources
close to next week's talks, and the issue of managing vaccine stockpiles
is a national competence.
Next steps:

* June 2010: A first reading of the directives on pharmacovigilence and
counterfeit drugs in the European Parliament is anticipated.

Links
European Union

* European Commission: Results of consultation with member states on
community action on health servicesexternal (31 Jan. 2007)
* European Commission: Communication regarding community action on
health servicesPdf external (26 Sept. 2006) [FR]Pdf external [DE]Pdf
external
* European Commission: Proposal for directive on patients' rights in
cross-border healthcarePdf external (2 Jul. 2008)

Industry federations and trade unions

* CPME (Standing Committee of European Doctors): Doctors congratulate
European Parliament on positive outcome of vote on cross-border
healthcareexternal (23 Apr. 2009)
* European Public Health Alliance: Response to parliamentary backing of
patient mobility directiveexternal (24 Apr. 2009)

EurActiv.com - EU countries to discuss cross-border health plans | EU -
European Information on Health & Lifestyle (8 June 2009)

http://www.euractiv.com/en/health/eu-countries-discuss-cross-border-health-=
p
lans/article-182897?_print