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Cross-border healthcare in EU not living up to high ambitions: report

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Cross-border healthcare in EU not living up to high ambitions: report


(LUXEMBOURG) - Better management is needed if the EU wants to deliver on the ambitions of its cross-border healthcare directive, aimed at ensuring safe, high-quality medical care across borders in the EU, says a report.

The report from the European Court of Auditors, published Tuesday, says EU patients still face challenges in benefiting from the actions envisaged by the EU directive on cross-border healthcare.

Only a minority of potential patients are aware of their rights to seek medical care abroad, it says. At the same time, the auditors also found problems and delays in exchanging patient health data electronically between Member States. Moreover, actions to facilitate access to healthcare for rare disease patients need to be improved.

The 2011 EU cross-border healthcare directive is aimed at ensuring safe and high-quality medical care across borders in the EU, as well as providing for reimbursement abroad under the same conditions as at home. EU patients who seek healthcare in another Member State - for example, undergoing planned hospital treatment or purchasing medicines - are therefore entitled to relevant information on standards of treatment, reimbursement rules and the best legal route.

For their report, the auditors examined whether the European Commission has monitored the implementation of the EU cross-border healthcare directive and supported Member States in informing patients of their rights. They assessed the results achieved on exchanges of health data across borders and checked key actions on rare diseases.

"EU citizens still don't benefit enough from the ambitious actions set out in the Cross-Border Healthcare Directive" said Janusz Wojciechowski, the Member of the European Court of Auditors responsible for the report. "EU action includes the right to cross-border treatment, facilitating the exchange of patients' health data across borders, and initiatives for rare diseases. But better management is needed to deliver on these ambitions."

The auditors found the Commission had monitored the transposition of the directive into national law and its implementation by the Member States well. It also supported the Member States in improving information on patients' rights to cross-border healthcare, but there were still some gaps.

The Commission underestimated the difficulties involved in deploying EU-wide eHealth infrastructure. By the time of the audit – November 2018 – Member States were only just about to start exchanging patient health data electronically, so the benefits for cross-border patients could not be demonstrated. Furthermore, the Commission did not properly assess either the potential use or the cost-effectiveness of exchanging cross-border health data.

Finally, the European Reference Networks for rare diseases are an ambitious innovation and are widely supported by doctors, healthcare providers and patients, say the auditors. Despite the fact that a total of between 27 and 36 million people suffer from rare diseases in the EU, the networks face significant challenges to ensure they are financially sustainable and able to operate effectively across national healthcare systems.

The auditors recommend the Commission should:

  • provide more support for national contact points to improve information on patients' rights to cross-border healthcare;
  • better prepare for cross-border exchanges of health data;
  • improve support for and management of European Reference Networks to facilitate rare disease patients' access to healthcare.

EU funding for cross-border healthcare comes primarily from the EU's Health Programmes, which provide around €64 million a year for health-related issues. Expenditure for the reimbursement of medical care abroad under the directive is estimated at 0.004 % of the EU-wide annual healthcare budget.

ECA special report 07/2019 "EU actions for cross-border healthcare: significant ambitions but improved management required"

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