At first glance, the intention of giving patients the opportunity of getting treatment in other Member States seems by all means positive. A more detailed analysis of the Directive proposal, however, reveals that the text includes a number of pitfalls and threats to the health sector. This week MEPs voted on the proposal by the responsible Committee on the Environment and Public Health.
The Directive proposal provides that each patient has the right to receive hospital treatment in another Member State. The costs for this treatment would be reimbursed by the relevant social security scheme. The Committee on Health of the European Parliament supports this request, has, however, also drawn up an additional text to the effect that patient are not required to advance the costs.

A very problematic result for the social security schemes: hospital treatments such as a hip operation for example are calculated differently from region to region and from member state to member state. The costs incurred depend on which appliances (modern or older) are used, which capacities the hospital has and on the pay scale of the hospital staff, etc. In Austria, one has also to consider that not only social security authorities are responsible for financing hospitals but that the federal states are also contributing to the costs. The danger, however, that the social security schemes would incur an additional burden by patients being treated abroad could, however, be mitigated: it has now been proposed that it will be possible to introduce a prior approval in exceptional cases if the financial balance of the social security systems or the planning of the capacities in hospitals could seriously be undermined. In this case, patients would only be reimbursed with those costs if they were given prior approval by their social security authority. In contrast to all other fractions, the Social Democrats voted for a stricter regulation in accordance with the social security schemes. They were, however, not successful in pushing these through.

Another problem is the practical question of the support that patients are getting from their relatives. Who pays for their stay in the country of treatment? The language barrier when a patient is treated in another Member State must also be taken into account. We are therefore confronted with the danger that – as is already happening – only wealthy patients will seek treatment abroad. The Directive would basically be an advantage for residents of border areas, where for example the hospital in the neighbouring country is nearer than the next domestic clinic. In many cases, however, such agreements do already exist between the affected countries, which regulate cross-border treatments.

The proposal by the Commission concerning the mobility of healthcare professionals in all Member States has been firmly rejected by the Committees of the European Parliament.

The Directive proposal was rejected by the European United Left MEPs. Social Democrats and Greens abstained - on the one hand because of the above mentioned vote on prior approval and because of the fact that Article 152 of the EG Agreement had not been included as a basis for the Directive on the other. This Article regulates the health system and emphasizes that Regulations of the European Union support and improve Member State policy.

The Plenar vote in the European Parliament has been scheduled for 22nd/23rd April. However, because of the short time that the Plenum has available for preliminary work, this date has not yet been confirmed. Postponing the vote to the plenary assembly in May (4th -7th May) seems to be possible.