EDI - European Association of Dental Implantologists

46
EDI
EDI News
European Commission to strengthen patients’ rights
Are we Threatened by
a New Wave of Regulations?
Peter Knüpper, solicitor, Munich/Germany
The European Court of Justice (ECJ) has passed an
extensive body of legal decisions on this topic since
1998. In summary, the court has stated that healthcare
services are covered by the freedom to render
services, which is one of the four European fundamental
freedoms. The free movement of goods, persons,
capital and, not least, services have long been
taken for granted by most of us. Nevertheless, only
30 percent of all EU citizens know that they can
choose to obtain health services in other EU countries,
where the social security system in the patient’s
home country – whether run directly by the state or
in the form of an insurance system – has to reimburse
the patient if those services would have been
offered or reimbursed for in the home country.
No prior authorization required
for outpatient services
This is exactly what the draft Directive codifies, with
the result that EU citizens will no longer have to
approach the ECJ in Luxembourg in order to obtain
reimbursement but can confront their national
administrations or health insurance institutions
directly with the new Directive on patients’ rights. It
states, in unison with ECJ decisions, that outpatient
services do not require prior authorization. The same
is true of inpatient health services that require a
patient to be admitted overnight or that are included
on a list of specific diseases – unless “the financial
balance of the Social Security system” were threat-
The European Commission finally presented its proposal for a Directive to facilitate the application
of European patients' rights in relation to cross-border healthcare on 2 July 2008, as part of its
Renewed Social Agenda. The proposal is intended to respond to rapid changes in the social and eco-
nomic fields. It intends to promote citizens’ “social well-being” through a mixture of measures and
instruments while at the same time harmonizing and modernizing the existing political armamen-
tarium. The proposed Directive covers cross-border health services that patients may obtain outside
their home country – such as the hip joint surgery that a British patient had had performed in
France, bypassing the long waiting lists of the British National Health Service.
ened or the planning and rationalization carried out
in the hospital sector were “seriously undermined”
(Article 8 (3) of the draft guideline). The prior authorization
system must be limited to what is necessary
and proportionate to avoid such an impact and must
not constitute a means of arbitrary discrimination.
The Member States must act to improve the flow of
information concerning potential healthcare services
in other EU Member States.
The European Commission continues to uphold
the sole responsibility of the Member States for the
organization and delivery of health services and
medical care. The Directive also demands of the
Member States to respect the principles of universality,
access to quality care, equity and solidarity and
define observe clear standards for quality and safety
and health care. They also have to ensure that “mechanisms
are in place for ensuring that healthcare
providers are able to meet such standards, taking
into account international medical science and generally
recognized good medical practices”. In addition,
EU Member States are tasked to ensure that the
application of such standards in practice is regularly
monitored.
National contact points
Healthcare providers will have to “provide all relevant
information to enable patients to make an informed
choice, in particular on availability, prices and outcomes
of the healthcare provided”. This also includes