I'll attempt to answer some of the questions that people are asking about this new Directive and its impact.
Why do we need a Directive on cross border healthcare?
The Directive has come about from a desire to create a European market in healthcare, and to some extent as a result of European Court judgements which have upheld the rights of patients to gain reimbursement for treatment in other countries where they have been subject to "undue delay" in their own country.
What does it cover?
The Directive proposes a number of developments in cross border healthcare, including reimbursement of medical tourists, patient safety and quality issues, European cooperation on healthcare, assessment of new medical technology and standards for e-health and transfer of patient information between member states.
How will it affect UK NHS patients?
In April this year, NHS patient choice in the UK was extended, giving patients the right to opt for treatment anywhere in the UK. The Directive, in effect, extends this patient choice to anywhere in the EU, provided that the treatment is available at a cost which is the same or lower than the NHS cost.
Under the Directive, the NHS will be requested to establish a direct payment or reimbursement system. This means that patients will not have to fund the treatment and then claim the cost back from the NHS. They will have to fund their travel and accommodation costs. No prior approval is required from the NHS or the patient's primary care trust.
It doesn't mean that patients in the UK or elsewhere in the EU can opt for treatments overseas that are not covered by the NHS. So, if a new drug or a new procedure is available in another country, the patient cannot obtain payment for this.
How many patients will opt for treatment abroad?
Who knows? Patients may decide to travel abroad because:
- Surgeons and hospitals with better results for their treatment may be available elsewhere in Europe.
- Hospital infection rates may be lower in other European countries.
- Faster treatment may be available elsewhere.
It is worth noting that:
- There is no requirement for the patient to be suffering "undue delay" in treatment.
- The patient will need a referal from a GP.
- Patients cannot jump the waiting list in other countries..... which is one reason why why we will not see large numbers of patients travelling to the UK for treatment. They will join the end of the queue of existing UK patients.
- And since the UK is one of the most expensive healthcare providers in Europe, this will also discourage an inflow of patients from lower cost countries.
How will it affect the NHS?
It depends on how many UK patients opt for treatment abroad. If the NHS can prove that the number could be so large that it would affect the planning and funding of healthcare facilities in the UK, then it can make an application to set up a "Prior Approval" system which means that a patient would have to apply for treatment abroad. This is unlikely, I believe. It would be an admission of failure by the Government that the NHS cannot compete in a competitive European marketplace.
Overall the Directive has to be a good thing for both the NHS and UK patients. It could reduce the burden on NHS waiting lists, and offer cost savings where cheaper treatment is available elsewhere in the EU. It would also mean that NHS hospitals would face increased competition and would have to improve their performance relative to other European healthcare providers.
What else is covered by the Directive?
In addition to clarifying the position regarding medical tourism within the EU, the Directive also embraces:
- The establishment of common principles in terms of guaranteeing patient safety and ensuring quality and continuity of care.
- Stimulating greater European cooperation on healthcare including the establishment of “European Reference Networks” which would create a concentration of expertise, training and resources for specific diseases and health issues.
- Establishment of a European network for the assessment of new medical technology.
- Establishment of standards for e-health, in particular the transfer of patient information and treatment records between member states.
When will it take effect?
It's a draft directive, so it has to go through the EU mechanisms to be officially adopted as policy. But it's a part of a consultation process that's been going on for three years, so it's likely to become reality.
Good news or bad news for the medical tourism industry?
Undoubtedly, good news! It will add to the credibility of medical tourism, and will mean that people become more familiar with and confident about travelling for treatment. It will also reinforce the need for an improvement in standards and business practices in the industry. (See the Treatment Abroad Code of Practice for Medical Tourism).
Ultimately, it will result in greater patient choice and more people will choose to travel for treatment abroad.