The Directive on the application of patient’s rights in cross brother healthcare was adopted in 2011 and the Member States have till 2013 to transpose it into national law. There are concerns that the directive will have a negative impact on Member State’s ability to organise their respective national health systems or on the safety and security of patients. The rights of patients who seek/receive cross-border healthcare should be protected but one could wonder if the directive would protect those rights whilst ensuring the Member State’s responsibility for the organisation and delivery of health services and medical care. In fact, one could say that such measures wont work.
The Directive creates further bureaucratic and administrative burdens for the UK health commissioning bodies. There would be further costs in administering mechanisms for reimbursing costs. It seems there will be a huge administrative burden to keep a system to just a few. In the other hand, if there is a wave of ´health tourism´ and the number of foreign patients increases this would have a negative impact on NHS.
The Directive, for the purpose of reimbursing cross-border healthcare, not only covers situations where the patient receives healthcare provided in another Member State but also health goods, including prescriptions. The obligation to reimburse cross-border healthcare is limited to the healthcare that is among the benefits to which the patient is entitled within its Member State of affiliation. The Member State of affiliation shall, therefore, reimburse the costs of cross-border healthcare up to the level of costs that would have been assumed by it, had this healthcare been provided in its territory without exceeding the actual costs of healthcare received.
The Member State of affiliation is not allowed to make the reimbursement of costs of cross-border healthcare subject to prior authorisation except in the cases foreseen in the Directive. However, it “may limit the application of the rules on reimbursement for cross-border healthcare” if this can be justified by overriding reasons of general interest. But, such restriction on the reimbursement of costs shall be limited to what is necessary and proportionate and cannot constitute arbitrary discrimination.
Member States have been allowed to make the reimbursement of costs of cross-border healthcare subject to prior authorisation, if the treatment requires at least one night stay in a hospital, requires the use of highly specialised and cost-intensive medical infrastructure or medical equipment, or raises “serious and concrete concerns related with the quality or safety of the care.”
Member States are, therefore, required to put in place a mechanism for calculation of costs that are to be reimbursed for healthcare provided in another Member State, which shall be based on objective, non-discriminatory criteria, and it shall be known in advance.
According to the Daily Telegraph, “Britain has paid out more than £900 million to EU countries to cover the costs of British patients who fell ill abroad – and received just £49 million back for NHS treatment of overseas visitors”. It notes that “The Government data shows that for every £18 paid out to EU countries, the UK receives £1 back for caring for their patients.” It then stressed, “The “balance of payments deficit” means that every week, NHS budgets lose £16 million a week to fund treatment of those who come here from abroad.”
