EU Policies & Directives

Cross Border Healthcare

On 19 January 2011, the European Parliament voted in favour of the EU Directive on cross-border healthcare, a move hailed on that same day by European Commissioner for Health and Consumer Policy, John Dalli, as an important step forward for all patients in European countries.

The Directive 2011/24/EU, clarifies that EU patients seeking healthcare outside their country may do so as long as the type of treatment would have been normally provided at home. Payment must occur upfront in accordance to home country costs and the amount reimbursed from national authorities to the patient at a later date. Prior authorization for treatments that require overnight hospital stays, specialized healthcare, or treatment of a questionable quality and/or safety may be necessary in certain cases. Furthermore, each country is expected to establish a contact point for providing information to patients who come from abroad seeking treatment. However, national authorities may refuse authorization for treatment to non-domestic patients, if the treatment in question may pose a risk to the patient or if appropriate care can be provided in the patient’s home country in good time.

This Directive would mostly benefit patients on long waiting lists or those unable to find specialist attention at home. Particular provisions have been made for patients with rare diseases. People living near national borders and those who work in one country but want to get treatment near family members in another country will also be greatly benefited. However, as it is a Directive, Member States have a discretion on how to implement the legislation. Therefore, a cross-border healthcare committee has been set up at a European level to assist with the harmonization of national legislation to the articles of the Directive.

Concerns have been voiced that inequalities among EU patients may be accentuated, since according to the Directive, patients must pay upfront, and home authorities may wait a ‘reasonable’ but undefined period of time before reimbursement is issued. Furthermore, certain MEPs and health organisations worry that the Directive may encourage health tourism, that it does not tackle inequalities among EU health systems, and that cooperation is voluntary and standards not as high as they ought to be.

However, the general feeling is positive, and the Directive is seen as striking the right balance in facilitating patient cross-border movement and treatment, whilst also safeguarding the quality of health services at the national level.

All member countries of the EU are required to integrate the measures of the Directive into their national legislation by 2013.

Useful links:

Directive 2011/24/EU European Commission – Cross Border Healthcare Eurordis Q&A on Cross Border Healthcare
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