1. Directive on the application of patients’ rights in cross-border healthcare Recent developments Jooske Vos European Partnership for Supervisory Organisations in health services and social care a co-operation between supervisory bodies in EUROPE

2. Directive on patients 'rights in cross-border healthcare Recent developments Presentation by : Jooske Vos Head of the EPSO Secretariat and director of EURinSPECT

3. Main ‘Aims’ of Directive 2011/24/EU The main aims of the Directive: Clarify the rights of patients seeking healthcare in another EU country, while being reimbursed by their national system. Help patients exercise their rights of access to cross border care Assure safety and quality cross-border Make national health systems co-operate to achieve economics of scale

4. ‘Main points’ of Directive 2011/24/EU as published April 4 th 2011  Patients allowed to receive care in other MS than State of affiliation;  Reimbursement may be limited by MS;  Outgoing flow maybe ‘managed’ (by prior authorisation for certain types of healthcare and by ‘gate keeping’ principle (GP);  Inflow maybe limited justified by ‘overriding reasons’ ;  Information on safety and quality standards obliged ;  Co-operation between MS necessary;  Prescriptions between MS made possible.

5. ‘Short History’ of Directive 2011/24/EU Towards a European policy of cross-border patients’ rights and cross-border healthcare:  1998 - EU Court of Justice starts cases Kohl/ Decker;  1998 -2011 Subsequent Court decisions;  2 July 2008 First draft directive by Commission to MS;  23 April 2009 European Parliament- first opinion;  June 2010 Draft Directive (Agreement in Luxembourg;  Final text adopted by EU in January 2011;  Published 4 April 2011 in official Journal ;

6. The Future of the Directive 2011/24/EU before 25 October 2013 (a lot of work to do)  Member States have to adopt the necessary laws and regulations and administrative provisions  Including for MST ( Member State of Treatment ) :  Provisions to ensure access to good quality cross- border health care (art 4) standards and guidelines / information.  Including for MSA ( Member States of Affiliation ):  Prior authorisation ( in limited cases);  Reimbursement procedures.

7. The Future of the Directive 2011/24/EU Including :  National contact point(s) per MS (art 6 ) ( information)  Promotion of Co-operation in healthcare between MST  Standards and guidelines on quality and safety laid down by the MST(art 4,1b );  Relevant Information including provisions on supervision and assessment of healthcare providers (art 4,2a);  Relevant information to help individual patients make an informed choice (art 4, 2b);  Transparent procedures in case of harm (art 4, 2c);  Non discrimination to foreign patients (art 4, 3).

8. What is interesting for supervisory bodies ? Main point The directive calls for: Relevant information on the standards and guidelines on quality and safety laid down by the MS of treatment, including provisions on supervision and assessment of healthcare providers;

9. What is interesting for supervisory bodies ? The Directive implies the need for: Efficient communication channels - also between supervisory bodies; Network building on quality and safety ; Relevant information on standards and guidelines on quality and safety laid down by the MS of treatment; Provisions on supervision and assessment of healthcare providers;

10. All European countries have to enhance their cooperation. How does EPSO fit in this process? Can we add our joint expertise?

11. Questions or Answers on the questions of this presentation?