De Europese raad voor Werkgelegenheid, Sociaal Beleid, Volksgezondheid en Consumentenzaken besprak op 8 en 9 juni haar standpunt bij de ontwerp-richtljin 'grensoverschrjidende gezondheidszorg' en dit nadat het Europees parlement op 24 april haar formele standpunt bepaalde (medebeslissingsprocedure). Zoals verwacht kan de raad zich niet vinden in de zeer brede interpretatie van het EP. Belangrijke visieverschillen gaan over langdurige zorg, zorg die niet gedekt wordt door sociale zekerheidssysstemen en het bekomen van voorafgaande toestemming.
Er is dus nog lang geen overeenstemming tussen het Europees parlement en de Eurepese raad over dit thema.
Uit de persmededeling:
EPSCO Council On the 8th and 9th June, on the basis of a Presidency progress report and questions suggested by the Presidency, the Council held a public debate on a draft directive concerning the applicationof patients' rights in cross-border healthcare
Motivated by a desire to find the right balance between patient freedom, the sustainability of publichealth systems and the right of the member states to organize their own health systems, ministers ingeneral welcomed the direction the discussions are taking under the Czech Presidency, in particular withregard to the restructuring of the text, the clarification of the responsibilities of the member states andprior authorisation. With reference to the national competences of member states to organize their healthsystem, a large number of delegations wished to add Article 152 of the EC Treaty as a legal basis for the proposal. Many ministers wished to exclude long-term care from the scope of the draft directive.
European Parlaiment
Following 2 years of reflection and broad consultation, the Commission adopted a proposal for a directive on the application of patients rights in cross border healthcare on 2 July 2008. The European Parliament voted its first reading on the 24 April, after several months of intense debates in 7 parliamentary committees. The European Parliament confirmed the need for a legislative framework which clarifies the rights and conditions under which patients seek, and are reimbursed, for healthcare in another Member State. Many of the amendments sought to strengthen patients' rights through greater emphasis on providing public information on the quality and safety of healthcare. Overall, the Commission welcomes the Parliament's supportive stance on fostering further European co-operation on health. The controversial report was backed by MEPs by 297 votes to 120, amid 152 abstentions, and has been the subject of criticism from political groups and the Committee of the Regions (CoR), which represents local government at EU level
Lack of consensus on the directive's scope
As regards the scope of the draft directive, views differ on whether the scope should be limited only to healthcare providers contracted to public health insurance or otherwise recognized by the public system, or also extended to private healthcare providers not thus recognized. Ministers agreed that cooperation in the field of healthcare is needed. However, a large number of delegations opposed the use of comitology procedures for such cooperation
Commissioner for Health Androulla Vassiliou agreed to include Article 152 in the legal basis and to exclude long-term care from the scope of the directive. She suggested further discussions however on prior authorisation and the possible exclusion of some healthcare providers. The Presidency concluded the debate by stressing the need for prior authorisation under certain conditions, as long as the relevant case-law of the European Court of Justice is respected. With regard to the scope of the draft directive, the Presidency suggested that quality and safety standards might be used as criteria to decide which healthcare providers are covered. The Czech Presidency's compromise proposal attempts to solve questions such as "inflow of patients", "gate keeping", adjustments of Chapter IV on healthcare cooperation in relation to comitology etc
Initial reactions to this compromise proposal in the responsible working group were overall positive (e.g the new structure of the text, the clarification of the responsibilities of the Member States and consistent use of definitions). The new orientations also helped to create some common ground with regard to other parts of the proposal, e.g. the extent of the codification of European Court of Justice case-law, the exclusion of certain types of care from the scope of the directive, mutual recognition of prescriptions and cooperation on healthcare
Despite this tangible progress, a number of substantive issues still need further discussion, including the actual content of key terms, the scope of the directive and the exclusion of certain types of care, thereasons for refusal to grant prior authorisation, the reimbursement of prescriptions, the provisions on cooperation on healthcare and the legal basis
