EUREGIO II: Legal challenges in cross-border health care:

Legal challenges in cross-border health care

In June 2010 the Council agreed on a new proposal Directive for patients' rights in cross-border healthcare. The agreement came after a Council meeting in which a compromise proposal of the Spanish presidency (9948/10 +9948/10 COR 1) was presented. This Directive has a long history, one of the topics of discussion being liability rights. These rights have a close relation to health related cross-border activities in border regions (e.g. emergency and hospital services). In this discussion in both the border regions and on a Directive (EU) level it was claimed that legal challenges hindered cross-border cooperation. On the other hand arguments were put forward that these challenges were overcome by practical solutions and by bilateral agreements; or even that experiences in these border regions could be used to inform EU policy making. The new proposal by Spain will probably lead to a further discussion about what is thought to be necessary for border regions and cross-border health care in relation to liability and other legal challenges.

As is proven regions learn from each other by exchanging experiences; but in what way are regions and the EU pushing each other and which solutions are useful to make cross-border cooperation more adjusted to the (legal) challenges it‘s faced with? These questions can be linked to experiences from border regions, where many different cooperation forms exist that provide the citizens with health care services.

Over the years Europe has provided border regions with the legal capacity to initiate cross-border projects. Legal capacity or not this does not mean that within border regions there is a will or the financial capacity to start cooperation. Regions choose from the wide spectrum of possibilities for cross-border cooperation to suit their local needs. Sometimes this entails more practical solutions, other times cooperation’s choose for a suitable legal framework (e.g. bilateral agreement or legal entity based on EGTC).

Going back to the Directive, over the past years the demand for more legal clarity and solutions for legal challenges was heard clearly. This raised the question of what the exact challenges are that regions and local authorities are faced with. Even though legally there are a lot of possibilities for setting up a cross-border cooperation local authorities still find themselves faced with ‘complex legal structures’ and this leaves them to come up with other solutions for their local demands.

Statement: Do you think that the border regions use legal challenges as an excuse in order not to cooperate or agree on certain pertaining issues – e.g. liability? Your comments and/or experiences are welcome on our blog.

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