Memo

Medical treatment in other EU countries

Medical treatment in other EU countries

Summary On 1 January 2014, the EU directive on patients’ rights in cross-border healthcare came into force in Denmark. The directive gives Danish citizens the right to treatment in another EU country at the Danish government’s expense. However, a survey of the five Danish regions shows that these rights can only be exercised to a very limited extent. One explanation is that there has been no information campaign or public debate on the directive and what it means in practice.
 
On the other hand, the directive is intended to give the public a clearer picture of their rights, which is why a duty to provide information is a principle element of upholding the rights outlined in the directive. But neither the domestic politicians nor the Danish authorities have done a lot to make citizens more aware of their rights.
 
Patients’ rights across EU borders are characterised by a dilemma between citizens’ rights on the one hand, and the member states’ desires’ for autonomous healthcare systems on the other. A number of decisions made by the Court of Justice of the European Union over recent years have emphasised patients’ rights, but in the meantime the Court has ajusted its course and has proven itself receptive to the political scepticism over the issue.
 
This is reflected in the new directive on patients’ rights, in which the EU countries’ battles for autonomy have emerged in two distinct areas. Firstly, it has introduced a so-called “emergency brake”, which ensures that the member states can control the number of patients they accept from other EU countries. Secondly, the countries can demand that the treatment of their patients in other EU countries is “pre-approved” before it takes place. This makes it possible to control the number of patients who travel abroad to undergo treatment.
 
The directive shows that the Court of Justice of the European Union’s decisions are influenced by the politically elected, and that the Court is willing to address their concerns and desires. The directive gives citizens better opportunities to receive the best treatment with less waiting time. It can also allow Danish health specialists to hone their expertise and attract patients from other EU countries. However, it will be difficult to realise these opportunities as long as Danish decision-makers and authorities retract from the debate and neglect to inform citizens about the directive.

Main conclusion
  • Since the beginning of 2014, a new directive on patients’ rights has given all EU citizens better opportunities to receive treatment in other EU countries.
  • However, Danes only exercise their rights to treatment abroad to a very limited extent. Less than 1000 referrals for treatment in other EU countries have been registered in the Danish regions since the start of the year.
  • Insufficient information provided by the Danish authorities on the newly awarded rights could be one reason behind the low demand for treatment abroad.
  • Politicians are trapped in a dilemma, as, on the one hand, free movement reinforces EU citizens’ rights to healthcare, but, on the other hand, the member states want health policies to remain as a national responsibility.
  • The new directive has guaranteed two new provisions for the member states – the so-called “emergency brake” and the “right to pre-approval” – which ensures that the patients’ free movement will not put individual countries’ medical systems under undue pressure.
  • The EU Court, which has previously followed a liberal line in relation to medical treatment across EU borders, has shown greater sensitivity towards the new political trend which is expressed in the directive. The Court has responded to the member states’ desires for more autonomy and has addressed their specific challenges in the context of the right to free movement.
  • Denmark can win big from the new directive, as Danish patients can receive faster treatment abroad and Danish doctors can enhance their specialisation by treating foreign patients.
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