Patients already have the right, under European law, to receive medical treatment anywhere in the European Union and, subject to certain conditions, the costs, or a proportion of them, must be reimbursed by their home country. The draft proposals, put forward by the European Commission in July 2008, aim to clarify the rules around these existing rights.
State of play in Europe
Members of the European Parliament and Health Ministers have been discussing the proposals and the NHS European Office prepared a briefing, based on your responses to our consultation, setting out NHS views on some key aspects of the proposals. We have also drawn on your views to contribute an article to the journal Eurohealth on the implications of the EU proposals for the NHS.
Some key NHS concerns were addressed by amendments to the draft legislation voted through by MEPs in their report on the proposals at first reading. Health ministers of the European countries reached agreement on their own amended draft of the legislation when they met at the Health Council in June. This text also represents a positive step forward from an NHS perspective.
However, there are several major differences between the Parliament and Council texts, and a number of EU countries have concerns that have not yet been resolved. Negotiations and compromises will therefore be necessary in order for a common agreement to be reached and for the draft Directive to become law.
Next steps
Efforts to reach an agreement will continue over the coming months. In the meantime, there may be further developments in the European Court. The NHS European Office will continue to monitor the situation and engage with EU decision-makers to advance NHS views. Further information will be available as developments occur.
Updated guidance for the NHS
Whilst EU discussions continue, the existing rules on cross-border healthcare, established in a number of European Court cases, remain in force and it is important that NHS organisations are aware of these.
Alongside engaging in the negotiations at EU level, the Department of Health (DH) has been reviewing how the existing UK framework fits with the rules that have emerged from EU case law, as well as looking ahead to prepare for implementation of the new rules if the draft directive is agreed in the future.
As part of this work, DH has published regulations (which entered into force on 1 June 2010), directions and guidance on the establishment of prior authorisation and reimbursement arrangements for NHS patients seeking treatment under the cross-border rules. This guidance sets out important additional advice which will help local commissioners deal with requests for treatment in another European country.
NHS organisations should be aware of their obligations relating to patient's rights in cross-border healthcare and prepared for managing such requests, otherwise they leave themselves open to the threat of legal action.
Our healthcare for EU travellers page gives more information for NHS organisations about the EHIC system, which gives travellers access to emergency and urgent treatment whilst in another EEA country.