Congress report - European Health Forum Gastein

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European Health Forum Gastein 2001
In the light of the regional priorities thus defined, the local partners (public and private
institutions, associations etc.) have the same autonomy in preparing joint cross-border
projects27 .
The most significant results and progress achieved as regards cross-border accessibility to
health care have been under the Interreg programme. The most relevant question relates to
the assessment of the deliberate mobility of patients when the prior authorisation procedure
is lifted. This assessment should make it possible to evaluate the scale of care flows even if
it initially gives little information on the cost of such liberalisation or on the behaviour of the
providers.
On the basis of the results involved, we shall be able to identify the motives for this mobility
and determine whether the Euregions can, within a geographical area, constitute a suitable
response to the needs and expectations of citizens. Thus, is a patient seeking local care as a
matter of priority? Are the language barriers an obstacle? Are medical services available and
if so for what types of care and with what technologies? Do external factors such as waiting
lists encourage people to resort to care abroad? And so on.
Apart from the European and national legal and institutional frameworks, these
complementarity projects have given rise to:
• an easing in the administrative procedures for the authorisation of care abroad;
• partnerships between care establishments;
• bilateral agreements between neighbouring social security schemes;
• exchanges of knowledge and know-how.
This kind of cross-order accessibility implicitly ensures de facto mutual recognition of medical
and hospital practices in the Member States concerned.
4. Cross-border experiments28 Many healthcare projects have arisen within the framework of the Euregions, these projects
have allowed the way in which European citizens can obtain better access to health services
to be analysed29 . So, generally speaking, we can note two types of approach, one in relation
to contractual practices and the other to citizens’ cross-border mobility linked to an
administrative simplification.
4.1 Contractual practices
The agreement may relate either to a request for collaboration or a reciprocity convention
between individual service providers or hospital institutions and/or the insuring bodies in
order to supplement a range of care services which is insufficient on one side of the border
and/or plentiful on the other side or to reduce problems in accessibility for certain patients,
mainly connected to the distances to be travelled.
The development of these partnerships is built on the notion of complementarity and on the
search for medical cooperation. In practice this always requires a derogation to the principle
27 Coheur Alain, Final report of the cross-border project in the Meuse-Rhine Euregion "for the purpose
of guaranteeing greater access to health care in the cross-border region".
28 There are many experiments in progress in the border areas for instance the Gronau, Rhein Waal,
Ems Dollart, SaarLorLuxRhein, Bodensee and Inn Salzach Euregions. The cases mentioned here are
not exhaustive but we do not currently have any assessments or results obtained.
29 There are many experiments in progress in the border areas for instance the Gronau, Rhein Waal,
Ems Dollart, SaarLorLuxRhein, Bodensee and Inn Salzach Euregions. The cases mentioned here are
not exhaustive but we do not currently have any assessments or results obtained.
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