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Brussels, 20 April 2007

Consultation backs EU action on health services

The majority of contributors to the Commission's recent consultation favour some form of Community action on health services, combining both legislative elements and practical support for cooperation between European health systems. EU Health Commissioner Markos Kyprianou presented the results of this consultation today to the Informal Health Council in Aachen, Germany. Contributors saw a need for better information to patients to enable informed choices about cross-border care and greater clarity about the procedures to follow, with a broad consensus that quality and safety of healthcare should be ensured by the country where treatment is provided.

Commissioner Kyprianou said: "These contributions provide a solid basis for proposals to clarify rules for cross-border care, to create important and positive synergies in the health sector from European cooperation and to help improve healthcare provision throughout the Union."

Key results from the responses to the consultation include:

  • The scale of cross-border healthcare is limited – many contributors agreed with the Commission's estimate that overall it represents about 1% of total healthcare expenses. But it is larger in some cases (for example in border regions, smaller Member States, for rare diseases and areas with high numbers of visitors from abroad) – and it is expected to grow;
  • Greater clarity was seen as needed over limits of cross-border healthcare under Community law, in particular when prior authorisation can be required or refused. Suggestions by contributors included clear information for patients; effective and transparent decision procedures; a patient-centred approach; evidence-based standards; the right to appeal against refusals; and easier procedures for border regions;
  • Many contributors saw value in European support to improve further the level of quality and safety in healthcare, such as through developing guidelines and indicators. Other suggestions included developing systems for exchanging patient data between countries, an EU standard discharge letter, Europe-wide prescriptions, and establishing arbitration or mediation systems regarding compensation for any harm arising from cross-border care;
  • Suggestions for practical European support to national health systems included European networks of centres of reference; an observatory for comparative data and indicators; better sharing of healthcare innovations; and support for health investment through the structural funds.

Many contributors felt that any Community action should be based on the common values (universality, access to good quality care, equity and solidarity) and principles (quality, safety, care that is based on evidence and ethics, patient involvement, redress, privacy and confidentiality) of EU health systems (as set out notably by the Council in June 2006). A majority of contributors also felt that a combination of supportive practical tools and legally binding measures would be best.

Regarding the nature of any legal instrument, opinions were divided, with the two main options being to include any changes within the existing regulations on the coordination of social security systems, while other contributors preferred a new specific directive on health services in order to tackle also issues pertaining to areas falling outside the scope of these regulations.

The background

Responding to the request by many healthcare stakeholders for greater clarity over what Community law means for health services, the Commission launched a public consultation process on 26 September 2006 regarding Community action on health services. Over 270 responses have been received from national governments, regional authorities, international and national umbrella organisations, social security institutions, universities, industry and individual citizens. The report released today represents the Commission’s summary of these responses, not the views of the Commission itself. The Commission intends to bring forward proposals for Community action on health services toward the end of 2007.

Further information

The summary report and all individual responses to the consultation regarding “Community action on health services” are available at:

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