Activities of Elisabeth SCHROEDTER related to 2008/0142(COD)
Plenary speeches (1)
Patients' rights in cross-border healthcare (debate)
Amendments (18)
Amendment 35 #
Proposal for a directive
Recital 8
Recital 8
(8) This directive aims to establish a general framework for provision ofprovide rules for the access to safe, and high -quality and efficient cross-border healthcare in the Community and to ensure patients mobility and freedom to provide healthcare and high level of protection of health, whilshealthcare in another Member State and establish cooperation mechanisms on healthcare between Member States, in full respect of national competence in organising and delivering healthcare, in accordance with the principles of universal access, solidarity, affordability, equal territorial accessibility and democratic control. It fully respectings the responsibilities of the Member States for healthcare according to the treaty including the definition of social security benefits related to health and the organisation and delivery of healthcare and medical care and social security benefits in particular for sickness.
Amendment 37 #
Proposal for a directive
Recital 10
Recital 10
Amendment 38 #
Proposal for a directive
Recital 11
Recital 11
(11) As recognised by the Member States in the Council Conclusions on Common values and principles in European Union Health Systems there is a set of operating principles that are shared by health systems throughout the Community. These operating principles include quality, safety, care that is based on evidence and ethics, patient involvement, redress, the fundamental right to privacy with respect to the processing of personal data, and confidentiality. Patients, professionals and authorities responsible for health systems must be able to rely on these shared principles being respected and structures provided for their implementation throughout the Community. It is therefore appropriate to require that it is the authorities of the Member State on whose territory the healthcare is provided, who are responsible for ensuring compliance with those operating principles. This is necessary to ensure the confidence of patients in cross-border healthcare which is itself necessary for achieving patients' mobility and free movement of provision of healthcare in the internal market as well as a high level of health protection.
Amendment 48 #
Proposal for a directive
Recital 26
Recital 26
(26) This Directive does not provide either for transfer of social security entitlements between Member States or other coordination of social security schemes. The sole objective of the provisions regarding prior authorisation and reimbursement of healthcare provided in another Member State is to enable freedom to provide healthcare for both patients and healthcare providers and to remove unjustified obstacles to that fundamental freedom within the patient's Member State of affiliation. Consequently the Directive fully respects the differences of national health-care systems and the Member States' responsibilities for organisation and delivery of health services and medical care.
Amendment 51 #
Proposal for a directive
Recital 31
Recital 31
(31) The evidence available indicates that the application of free movement principles regarding use of healthcare in another Member State within the limits of the cover guaranteed by the statutory sickness insurance scheme of the Member State of affiliation will not undermine the health systems of the Member States or financial sustainability of their social security systems. However, the Court of Justice has recognised that it cannot be excluded that the possibleCourt of Justice has recognised that there is a risk of seriously undermining a social security system's financial balance or the objective of maintaining a balanced medical and hospital service open to all may constitute overriding reasons in the general interest capable of justifying a barrier to the principle of freedom to provide services. The Court of Justice has also recognised that the number of hospitals, their geographical distribution, the way in which they are organised and the facilities with which they are provided, and even the nature of the medical services which they are able to offer, are all matters for which planning must be possible. This Directive should provide for a system of prior authorisation for assumption of costs for hospitalealth care received in another Member State, where the following conditions are met: had the treatment been provided on its territory, it would have been assumed by its social security system and the consequent outflow of patients due to the implementation of the directive seriously undermines or is likely to seriously undermine the financial balance of the social security system and/or this outflow of patients seriously undermines, or is likely to seriously undermine the planning and rationalisation carried out in the hospital sector to avoid hospital overcapacity, imbalance in the supply of hospital care and logistical and financial wastage, the maintenance of a balanced medical and hospital service open to all, or the maintenance of treatment capacity or medical competence on the territory of the concerned Member. As the assessment of the precise impact of an expected outflow of patients requires complex assumptions and calculations, the Directive allows for a system of prior authorisation if there is sufficient reason to expect that the social security system will be seriously undermined. This should also cover cases of already existing systems of prior authorisation which are in conformity with conditions laid down in Article 8. Prior authorisation is essential for all hospital and specialised care as it provides guarantee for patients that they will be treated and that the treatment will be covered by their social security system.
Amendment 56 #
Proposal for a directive
Recital 45
Recital 45
(45) In particular, power should be conferred on the CommissionMember States’ competent authorities to adopt the following measures: a list of treatments, other than those requiring overnight accommodation, to be subject to the same regime as hospital care; accompanying measures to exclude specific categories of medicinal products or substances from the recognition of prescriptions issued in another Member State provided for in this Directive; a list of specific criteria and conditions that European reference networks must fulfil; the procedure for establishing European reference networks. Since those measures are of general scope and are designed to amend non-essential elements of this Directive, or to supplement this Directive by the addition of new non-essential elements, they should be adopted in accordance with the regulatory procedure with scrutiny provided for in Article 5a of Decision 1999/468/EC.
Amendment 60 #
Proposal for a directive
Article 1
Article 1
This Directive establishes a general framework for the provision of safe, high quality and efficient cross-border healthcareprovides rules for the access to safe and high-quality healthcare in another Member State and establishes cooperation mechanisms on healthcare between Member States, in full respect of national competences in organising and delivering healthcare, in accordance with the principles of universal access, solidarity, affordability, equal territorial accessibility and democratic control.
Amendment 73 #
Proposal for a directive
Article 3 – paragraph 2
Article 3 – paragraph 2
2. When the circumstances under which an authorisation to go to another Member State in order to receive appropriate treatment under Article 22 of Regulation (EC) No 1408/71 must be granted are met, the provisions of that Regulation shall apply and the provisions of Articles 6, 7, 8 and 9 of this Directive shall not apply. Conversely, when an insured person seeks healthcareThis Directive does not address the assumption of costs of healthcare which become necessary on medical grounds during a temporary stay of insured persons in another Member State. Nor does this Directive affect patients' rights to be granted an authorisation for a treatment in another Member State in owhere ther circumstances, Articles 6, 7, 8 and 9 of this Directive apply andonditions provided for by the regulations on coordination of social security schemes, in particular Article 22 of Council Regulation (EEC) No 1408/71 shall not apply. However, whenever the conditions for granting an authorisation set out inof the Council of 14 June 1971 on the application of social security schemes to employed persons and their families moving within the Community and Article 22(2)0 of Regulation (EC) No 1408/71 are fulfilled, the authorisation shall be accorded and the benefits provided in accordance with that Regulation. In that case Articles 6, 7, 8 and 9 of883/2004 of the European Parliament and of the Council of 29 April 2004 on the coordination of social security systems are met. To the extent that this Directive covers situations that are also covered by Regulation (EEC) No 1408/71 and Regulation (EC) No 883/2004, those regulations shall apply and this Directive shall not apply.
Amendment 76 #
Proposal for a directive
Article 4 – point a)
Article 4 – point a)
(a) "healthcare" means a health service provided by or under the supervision of a health professional in exercise of his profession, and regardless of the ways in which it is organised, delivered and financed at national level or whether it is public or privateto patients in order to assess, maintain or restore their state of health. For the purpose of Articles 6, 7, 8, 9, 10 and 11, healthcare means treatments that are among the healthcare benefits provided for by the legislation of the Member State of affiliation;
Amendment 79 #
Proposal for a directive
Article 4 – point f
Article 4 – point f
(f) for the purposes of this Directive "patient" means any natural person who receives or wishes tointends to travel to another Member State with the purpose of receiveing healthcare in a Member Statthere;
Amendment 122 #
Proposal for a directive
Article 8 – paragraph 1 – introductory part
Article 8 – paragraph 1 – introductory part
1. For the purposes of reimbursement of healthcare provided in another Member State in accordance with this Directive, hospital care shall meanand specialised care shall include at least:
Amendment 130 #
Proposal for a directive
Article 8 – paragraph 1 – point b
Article 8 – paragraph 1 – point b
(b) healthcare, included in a specific list, that does not require overnight accommodation of the patient for at least one night. This list shall be limited to: - healthcare that requires use of highly specialised and cost-intensive medical infrastructure or medical equipment; or - healthcare involving treatments presenting a particular risk for the patient or the population.
Amendment 133 #
Article 8 – paragraph 1 – points b a (new)
(ba) Healthcare for which planning is necessary in order to maintain universal access, affordability and equal territorial accessibility, to control costs and to prevent any significant wastage of financial, technical and human resources.
Amendment 138 #
Proposal for a directive
Article 8 – paragraph 2
Article 8 – paragraph 2
2. This list shall be set up and may be regularly updated by the Commission. Those measures, designed to amend non- essential elements of this Directive by supplementing it, shall be adopted in accordance with the regulatory procedure with scrue competent authorities of the Member State of affiliation shall set up a list of treatments considered as hospital or specialised care and notinfy referred to in Article 19(3)it to the Commission.
Amendment 146 #
Proposal for a directive
Article 8 – paragraph 3 – point b
Article 8 – paragraph 3 – point b
(b) the purpose of the system is to address the consequent outflow ofsignificant patient flows due to the implementation of the present Article and to prevent it from seriously undermining, or being likely to seriously undermine:
Amendment 147 #
Article 8 – paragraph 3 – point b − subpoint ii
(ii) the planning and rationalisation carried out in the hospitalealthcare sector to avoid hospital overcapacity, imbalance in the supply of hospital ealthcare and logistical and financial wastage, the maintenance of a balanced medical and hospital service open to all, or the maintenance of treatment capacity or medical competence on the territory of the concerned Member State.
Amendment 148 #
Proposal for a directive
Article 8 – paragraph 3 – point b a (new)
Article 8 – paragraph 3 – point b a (new)
(ba) The competent authorities of the Member State of affiliation shall establish criteria in order to be able to identify when the financial balance of the Member State's social security system, or the planning and rationalisation carried out in its healthcare sector is undermined or is likely to be undermined.
Amendment 150 #
Proposal for a directive
Article 8 – paragraph 4
Article 8 – paragraph 4
4. The prior authorisation system shall be limited to what is necessary and proportionate to avoid such impactenable the Member State to organise and deliver safe high quality healthcare within its territory in accordance with the principles of universal access, solidarity, affordability, equal territorial accessibility and democratic control, and shall not constitute a means of arbitrary discrimination.