Inhoudsopgave van deze pagina:
Delen
COUNCIL OF Brussels, 20 January 2011 THE EUROPEAN UNION 5672/11 PE 23 SAN 9 SOC 54 NOTE from: General Secretariat of the Council
to: Delegations Subject : Summary of the European Parliament Plenary meeting on 18 January 2011 Patients' rights in cross-border healthcare (debate)
Ms Grossetête (EPP, FR), rapporteur, recalled that the proposal for a directive clarified the rights of patients seeking medical care in other Member States. She emphasised the benefits for patients on long waiting lists or suffering from rare diseases and she underlined that the objective was not to encourage health tourism. She hoped that the agreement at second reading would be adopted[[note: 1]].
Ms Gyiri, on behalf of the Council, was confident that this compromise would create the right balance between patients' rights and the obligations of the Member States to organise and provide healthcare and medical services. She mentioned in particular prior authorisations, reimbursement of costs, patients with rare diseases, e-health systems, mutual acceptance of prescriptions and national contact points. She highlighted, as well the right to quality care, equity and solidarity, and competitiveness and efficiency in providing healthcare.
Mr Dalli, on behalf of the Commission, delivered the speech set out in Annex. [[note: 1]]The Council's position was adopted as amended on 19 January 2001.
For the political groups, the following speakers took the floor:
· Mr Liese (EPP, DE) considered that the current legal situation, confirmed by the ruling of the European Court of Justice, was unacceptable and he welcomed the important clarifications enshrined in the proposal.
· Ms Roth-Behrendt (S&D, DE) welcomed the progress achieved as regards patients with rare diseases and better information about patients' rights. She commented on the unwillingness of the Member States to invest in healthcare and criticised the introduction of prior authorisations, as well as the different quality of national healthcare systems.
· Ms Parvanova (ALDE, BG) welcomed the first clear legislative framework in this field.
However, she regretted that organisational concerns had prevailed over citizens' needs, resulting in a less ambitious text, and the lack of ambition in the field of e-health.
· Mr Lambert (Greens/EFA, UK) considered that the proposal was a reasonable compromise, including also on the issues of responsibility for follow-up treatment, quality of care and the question of redress. Nevertheless, he underlined the importance of proper care of patients in their own Member States.
· Mr Cabrnoch (ECR, CZ) shared the views of other Members on the agreement. However, he thought that the exemption of cross-border healthcare from the Services directive[[note: 2]] was a mistake, as instead of addressing the free movement of healthcare services, it only tackled the rights of patients.
· Ms Liotard (GUE/NGL, NL) was concerned about the commercialisation of healthcare resulting in health tourism and the disappearance of services from more expensive regions, leaving patients with no choice.
· Mr Rossi (EFD, IT) acknowledged all the achievements of the proposal. However, he regretted that it did not include the obligations of Member States to ensure a basic level of healthcare. He emphasised the need for better coordination between them, and also on other health-related proposals.
· Mr Szegedi (NI, HU) highlighted the big differences in healthcare standards and financial conditions between Member States. Accordingly, he considered it important to coordinate medical views on treatment of the same disease group. [[note: 2]]Directive 2006/123/EC of the European Parliament and the Council on services in the internal market.
Members welcomed the compromise agreement on the Directive, which provide legal clarification and certainty. They raised the following issues : health tourism (Mr Fjellner (EPP, SV),
Mr Schnellhardt (EPP, DE)), commercialisation (Mr Ferreira (GUE/NGL, PT), Ms Wils (GUE/NGL, DE), Ms Estrela (S&D, PT)) and delocalisation of healthcare (Ms Rosbach (EFD, DK)), Mr Pargneaux (S&D; FR), Ms Lepage (ALDE, FR), Mr Rurmes (Greens, LU)), prior
authorisations (Mr Fjellner, Mr Pargneaux, Ms Lepage, Mr Ferreira, Ms Ronzulli (EPP, IT));
reimbursement of costs (Mr Pargneaux, Ms Lepage, Ms Roithová (EPP, CZ)); rare diseases (Mr Pargneaux, Ms Ries (ALDE, BE), Ms Rosbach, Mr Schnellhardt, Ms Herczog (EPP, HU),
Ms Klass (EPP, DE)); better information (Ms Lepage) and national contact points (Mr Pargneaux, Ms Ronzulli); and early and proper implementation of the Directive (Ms Kadenbach (S&D, AT),
Mr Paska (EFD, SK)).
They also commented on some outstanding issues, such as disparities between Member States (Mr Pargneaux, Mr Cymaski (ECR, PL)), equal access to treatment (Ms Lepage, Ms Wils, Ms Klass), guaranteed quality of care (Mr Ferreira) and investment (Ms McGuinness (EPP, IE),
Mr Stolojan (EPP, RO)) and improvement of national health care systems (Mr Turmes, Ms Swinburne (ECR, UK), Ms Lukacijewska (EPP, PL), Mr Casa (EPP, MT)).
Mr Dalli disagreed that the Directive promoted health tourism and enabled health insurance companies to reduce costs. On the contrary, he saw it as an incentive for Member States to invest in their own health systems. On e-health, he saw it as a key factor for increasing equality in healthcare and improving its sustainability.
Ms Gyiri reiterated that the Directive set up a more transparent system of cross-border healthcare for the benefit of citizens, allowing access to better quality and timely services.
In her final remarks, the rapporteur did not share the concerns about health tourism, as the Directive provided for a safeguard clause enabling the Member States to control the planning of their healthcare and its infrastructure. She agreed that the Directive could be more ambitious, but saw it as a first step in a long process.
* * * * *
Annex Speech of Mr Dalli on the patients' rights in cross-border healthcare, Plenary session of the European Parliament, 18 January 2011
Mr President, let me congratulate Parliament on the major achievement of reaching an agreement on this directive. I am particularly grateful to the rapporteur, Ms Grossetête, and the shadow rapporteurs for their hard work and their commitment to patients' rights. I would also like to thank the previous two presidencies Spain and Belgium for the hard work they did to conclude this dossier.
I believe that the new directive will provide a coherent and uniform set of rules for patients all over Europe. It will also generate a new phase of cooperation between 27 national health systems. The path towards today's successful conclusion was far from easy. I remember last year, when I took up office, people told me that negotiations on the directive were at a dead end. The directive is a good example of the need for political leadership: it shows that, with courage and determination, decisions which are important for our citizens can be taken. I believe that legislators must not leave the European Court of Justice to decide in their place, nor leave citizens with no other means of having their rights recognised than by going to court. The Court recognised the right of patient mobility under the Treaty. It is the legislator's role to decide how to deliver such rights. Allow me now to share with you some views on the directive. Firstly, the directive makes clear that all Member States have a duty to invest at home, to provide their citizens with the healthcare they need without undue delay. The directive will thus contribute towards reducing inequalities in access to care by helping to minimise delays across the EU. Patients will be able to seek primary care with the provider of their choice across Europe. As regards hospital care, the directive provides that, when the delay I mean the waiting time for receiving treatment is too long, the patient will be able to choose a provider in another Member State and will be reimbursed. However, what precisely constitutes an acceptable waiting time will need to be carefully considered and defined.
The main progress achieved by this directive, as compared with existing legislation, is that patients will be able to choose their healthcare provider and will have access to information on the quality and safety of the care they will receive. I can assure you that the Commission will carefully monitor how Member States implement the directive in that respect. Secondly, the directive will give patients access to information on their rights and on cross-border healthcare information validated by national contact points and not left to private initiatives on the internet or other media. Thirdly, on quality of care, the directive offers transparency and accountability in relation to national standards. This should gradually lead to some convergence across Europe on the quality and safety of care.
Lastly, the directive lays the foundation for European collaboration on health. While the cooperation networks set up by the directive are voluntary, I am convinced that all Member States will see that they have much to gain by working together. This is a matter of solidarity in Europe. I am therefore counting on the Member States to launch cooperation initiatives in key areas such as e- health and health technology assessments. The directive also provides for European reference centres, which will facilitate the pooling of expertise and its dissemination across Europe. I believe such centres can lead to better healthcare for our citizens.
Mr President, Minister, honourable Members, the final compromise which is on the table today reflects the essential spirit and fundamental purpose of this directive: to enhance patients' rights to cross-border healthcare, while taking into account the sustainability of health systems. This is a good day for the building of a `Europe for health'.
I should like to conclude by making the following statement on an institutional aspect of the text: `The Commission has certain doubts that some of the future acts which the Commission has been given the power to adopt by the legislative act would be implementing acts. When exercising its implementing powers, the Commission will not adopt, on the basis of the powers granted, acts that it considers as being delegated acts within the meaning of Article 290 of the Treaty on the Functioning of the European Union.'
