Latest News on the Directive on CB Healthcare and Patients' Rights:


This Draft Directive has entered quite a fast second reading process after its approval in first reading at the end of the Spanish Presidency of the Council (June 2010). The Belgian Presidency promoted a three-way meeting on 15 December, together with the European Parliament's rapporteur and the Commission. They achieved a compromise and waited for the Committee of Permanent Representatives (Coreper) to clear the Directive on 21 December.


Within this agreement, the main issue still was “prior authorization” for the following services: hospital care, specialised care, patients at particular risk and treatment that could raise serious concerns. This agreement also tried to clarify the cases justifying the refusal of that authorization.


Member States’ competences are a main issue when dealing with healthcare, but it is the time for the EU to go one step forward in order to strengthen the integration of all European territories. Still, national logic prevails and the focus on national competences hinders the opportunity to discuss a real European task: cross-border healthcare for citizens living in border regions.


Other topics addressed were quality and safety, rare diseases and e-health.


Then, on 19th January 2011, the European Parliament debated and voted (Plenary Session, Strasbourg) the “Recommendations for a second reading of the Directive on Patients' rights in Cross-border Healthcare”, proposed by the Committee on the Environment, Public Health and Food Safety. MEP Françoise Grossetête (EPP, FR) was the rapporteur on cross-border health care. As it was widely supported by various political groups, the voting developed very positively. Now, this Directive should be approved by the Council, probably in February or March, and then, Member States will have thirty months to adapt their legislation accordingly.



We would like to draw your attention on the following elements within these “Recommendations” which are particularly relevant for border and cross-border regions (bold means new text included during the Parliamentarian debate:


Introduction, new paragraph 39:

Patient flows between Member States are limited and expected to remain so as the vast majority of patients in the Union receive healthcare in their own country and prefer to do so. However, in certain circumstances patients may seek for some forms of healthcare to be provided abroad. Examples include highly specialised care or healthcare provided in frontier areas where the nearest appropriate facility is on the other side of the border. Furthermore, some patients wish to be treated abroad in order to be close to their family members who are residing in another Member State, in order to have access to a different method of treatment than that provided at home or because they believe that they will receive better quality healthcare in another Member State.


Introduction, new paragraph 49; it is already included that:

The existence of national contact points should not preclude Member States from establishing other linked contact points at regional or local level, reflecting the specific organisation of their healthcare system.


Introduction, new paragraph 50; it was already included that:

Member States should facilitate cooperation between providers, purchasers and regulators of different Member States at national, regional or local level in order to ensure safe, high-quality and efficient cross-border healthcare. This could be of particular importance in border regions, where cross-border provision of services may be the most efficient way of organising health services for the local population, but where achieving such cross-border provision on a sustained basis requires cooperation between the health systems of different Member States. Such cooperation may concern joint planning, mutual recognition or adaptation of procedures or standards, interoperability of respective national information and communication technology (hereinafter ‘ICT’) systems, practical mechanisms to ensure continuity of care or practical facilitating of cross-border provision of healthcare by health professionals on a temporary or occasional basis. Directive 2005/36/EC of the European Parliament and of the Council of 7 September 2005 on the recognition of professional qualifications(9) stipulates that free provision of services of a temporary or occasional nature, including services provided by health professionals, in another Member State is not, subject to specific provisions of Union law, to be restricted for any reason relating to professional qualifications. This Directive should be without prejudice to Directive 2005/36/EC.


Introduction, new paragraph 51; has been amended as follows:

The Commission should encourage cooperation between Member States in the areas set out in Chapter IV of this Directive and may, in accordance with Article 168(2) of the Treaty, take, in close contact with the Member States, any useful initiative to facilitate and promote such cooperation. In that context, the Commission should encourage cooperation in cross-border healthcare provision at regional and local level, particularly by identifying major obstacles to collaboration between healthcare providers in border regions, and by making recommendations and disseminating information and best practices on how to overcome such obstacles.


Article 10, paragraph 2, has been amended as follows:

Member States shall facilitate cooperation in cross-border healthcare provision at regional and local level as well as through information and communication technologies and other forms of cross-border cooperation.

...adding a new paragraph:

The Commission shall encourage Member States, particularly neighbouring countries, to conclude agreements among themselves and to develop joint action programmes. The Commission shall also encourage the Member States to cooperate to create areas in which patients will have improved access to health care, particularly in cross-border areas.


Article 12, paragraph 1, has been proposed to be amended as follows:

The Commission shall support Member States in the development of European reference networks between healthcare providers and centres of expertise in the Member States, in particular in the area of rare diseases, which shall draw on the health cooperation experience acquired within the European groupings of territorial cooperation (EGTCs). Those networks shall at all times be open to new healthcare providers which might wish to join them, provided that such healthcare providers fulfil all the required conditions and criteria.


Article 12, paragraph 2, a new bullet point on European reference networks:

(fa) to implement instruments which enable the best possible use to be made of existing healthcare resources in the event of serious accidents, particularly in cross-border areas.


There are also many references to the consultation of patients and patients' organizations. The amendments reinforce this and give some more dynamism to the proposed Directive. Wait and see!


You will find the Resolution and Consolidated Text here:


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