High-quality health services are a priority issue for European citizens¹. Rights to healthcare are also recognised in the Charter of Fundamental Rights of the EU. Health systems and health policies across the EU² are becoming more interconnected than ever in the past. This is due to many factors, including movement of patients and professionals (facilitated by rulings of the European Court of Justice), common public expectations across Europe, dissemination of new medical technologies and techniques through information technology, and the forthcoming enlargement of the Union. This increased interconnection raises many health policy issues, including quality and access in cross-border care; information requirements for patients, health professionals and policy-makers; the scope for cooperation on health matters; and how to reconcile national policies with European obligations in general.

In order to provide a means of addressing these issues, the Commission invited ministers from the Member States and representatives of civil society to take part in a high-level process of reflection on patient mobility and health care developments in the European Union. The report agreed by the reflection process at its final meeting on 8 December 2003 represented a political milestone by recognising the potential value of European cooperation in helping Member States to achieve their health objectives. In response to the High-level reflection process the Commission adopted a Communication on patient mobility and healthcare developments in the EU (COM (2004) 301 of 20 April 2004) and established a mechanism for taking forward the work set out in the Communication: a High Level Group on health services and medical care. This High Level Group started work in July 2004 and it brings together experts from all the Member States to work on practical aspects of collaboration between national health systems in the EU.

Besides this practical co-operation, however, there is still lack of clarity over what Community law means in practice for health services. The Commission’s proposal for a directive on services in the internal market³at the start of 2004 included provisions codifying the rulings of the Court of Justice in applying free movement principles to health services. This approach, however, was not considered appropriate by Parliament and Council, which invited the Commission to develop specific proposals in this area.

The Commission therefore undertook in its 2007 Annual Policy Strategy to develop a Community framework for safe, high quality and efficient health services, by reinforcing cooperation between Member States and providing certainty over the application of Community law to health services and healthcare⁴.

Access to cross-border health care in the EU: clarification needed!
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¹ See Eurobarometer 63 at http://ec.europa.eu/public_opinion/archives/eb/eb63/eb63_en.htm.
² See Article 35 on health care.
³ COM(2004)2,13.1.2004.
⁴ COM(2006)122 of 14 March 2006.