1. Directive Patient mobility Brigitte van der Zanden Taskforce Health AEBR 12 November 2009 Brussels - AER

2. Content History Objectives Content Coherence with other policies Reaction of Stakeholders Implications for (border)regions Conclusion

3. History 1996: Jurisprudence of the Court of Justice 2003: Healthcare ministers asked the EC to investigate the legal certainty concerning medical treatment in another MS 2004: Directive on services in the internal market 2005:The EP adopted a report concerning patient mobility and healthcare developments

4. History 2007: the EP adopted a resolution on Community actions on the provision of cross border healthcare 2007: the EP adopted a report on the impact and consequences of the exclusion of healthcare services from the Directive on services in the internal market. 2007 -> ………

5. Objectives The directive should provide sufficient clarity about rights to be reimbursed for healthcare provided in other MS The directive should ensure that the necessary requirements for high-quality, safe and efficient healthcare are ensured for cross- border care

6. Content Healthcare provided in another MS Non-hospital care and hospital care Procedural guarantees: administrative and reimbursement procedures, quality standards and standards to ensure the safety of patients Information and national contact points Rules for healthcare services

7. Content Duty of cooperation Recognition of prescriptions European reference networks and health technology assessment E-health Data collection Implementing committee

8. Coherence with other policies Regulations for coordination of social security schemes Framework for mutual recognition of professional qualifications Community framework for protection of personal data E-health Racial equality

9. Reaction of Stakeholders Pros: The directive contributes to the free movement of services It makes it for the patient easier to use the healthcare system in an other MS, when wished for; it is focussing more on the needs and wishes of patients (Border) regions will get more competences to act

10. Reaction of Stakeholders Pros: It supports the cross border and European work that is already done by (border) regions or the work that they are planning Citizens need more clarification and juristical certainty about there rights The healthcare systems can be improved taking the demographical developments into account

11. Reaction of Stakeholders Opinion AEBR: Patient needs a central position Recognition of professional qualifications is a necessity The EU should give transparent criteria Border regions and Patient organisations should be involved in the contact points

12. Reaction of Stakeholders Opinion AEBR: Patient should have the right of reimbursement (corresponding the reimbursement in their own country) Healthcare tourism is not jeopardizing a reliable demand-planning system in the MS

13. Reaction of Stakeholders Opinion EPECS: Patients or their representatives should be seen as an official third stakeholder Patients need relevant, transparent and clear information concerning the possibilities of patient mobility Patient organisations should be involved in the contact points as the independent representatives of patients

14. Reaction of Stakeholders Opinion of Province of Limburg and Euregion Maas- Rhine: Appoint Pilot Regions Contact points in border regions Patients should be involved in the implementation of the directive Patients should get the guarantee of minimum standards concerning quality and safety Healthcare services should be included in the directive

15. Reaction of Stakeholders Cons: The directive interferes to much in the national healthcare system It will result in more problems than it solves More competition: the directive is only in the interest of healthcare services It will lead to two class medicine: because of prefinancing

16. Reaction of Stakeholders Cons: The directive does not give the minimum standards concerning for example quality and safety How to monitor the implementation of the directive in the MS?

17. Implications for regions Added value for cross border regions The need to get familiar with the healthcare system of your neighbouring country and the health care services over there Border regions could develop into a significant economic sector with regard to healthcare services

18. Implications for regions Could more easily lead to mutual recognition of procedures and values, mutual healthcare planning, information- and communication systems, continuity in healthcare and so on. Development of transparent and objective procedures

19. Changes in healthcare system The impact of patient mobility will be small Contact points must be installed Clear and public information concerning the possibilities of patient mobility – When to go (waiting lists, specific specializations) – What are the conditions (for example reimbursement)

20. Changes in healthcare system There must be developed a clear safety and quality framework There must be clear objective criteria described for administration and reimbursement Collection of patient mobility related data Support neighbouring MS when this is necessary for the implementation of the directive

21. Conclusion Patient mobility is a reality and it is irreversible There are still some challenges implementing the directive The most important benefit should be the patient

22. Information: Brigitte van der Zanden info@bzconsultancy.com Thank you for your attention!!