As pointed out in the Directive 2011/24/EU of the European Parliament and of the Council on the application of patients’ rights in cross-border healthcare and stressed also in the COM(2017) 534 “Boosting growth and cohesion in EU border regions”, “encouraging  cooperation between the Member States to improve complementarity of their health services in border regions is a priority for the EU”.

Thanks to the initiative b-solutions, some of the legal obstacles that keep affecting the cross-border cooperation in the field of health and the provision of helthcare and emergency services, have been identified and selected in order to receive consultancy.

Check the list below to learn which borders are involved and in which sectors and structures the obstacles have been found:

Ambulances without Borders: towards sustainable cooperation between emergency services

Municipality of Woensdrecht

(BE-NL)

Obstacles related to reimbursement issues, discrepancies concerning lights and sirens and differences in education of the personnel employed, prevent the cross-border cooperation in emergency services management. Although the nearest available ambulance is just a few kilometers away – on Belgian soil – inhabitants of the Dutch town Putte have to wait for the Dutch ambulance services coming from an hospital which is almost 20 kilometers away.

Cross-border health care between twin cities Valga (Estonia) and Valka (Latvia) to ensure the survival of Valga Hospital

Valga Municipality

(EE-LV)

At the moment medical services are not financed across Estonian-Latvian border, so patients from Latvia cannot be treated in an Estonian hospital.
Differences between national healthcare systems (i.e. restrictive or inadequate domestic legislation, different organisation of insurance systems and of cost reimbursement) hamper the access of persons not being cross-border workers to health care services on the other side of the border.
 

Speedy mutual recognition of qualifications for heathcare professional exercise (Franco-Spanish border)

AECT-Hospital de Cerdanya

(SP-PT)

The Cerdanya Hospital is the only bi-national, public hospital existing in Europe, meaning that its mission is to provide specialised healthcare for both French and Spanish people thanks to bi-national teams of professionals. However, the absence of a standardised method of mutual recognition of qualifications prevents the creation of stable cross-border teams, limiting the effectivness of the services provided.

Development of trans-border water supply network

Kalvarija Municipality Administration

(LT-PL)

Current Lithuanian and Polish laws don’t describe how to get permission to build and finance a cross-border water supply network. Furthermore, according to the law practice of both Countries, local government should act following the principle: “what is not allowed is forbidden”. Therefore, it seems that it is not possible to create such a network, despite the municipalities located on the cross-border area would widely benefit of this kind of service.

Cross-border Emergency Medical Services (EMS) and its financial dimension within the scope of the French-Belgian Convention (2007)

French Regional Health Agency (Grand-Est & Hauts-de-France)

Federal Public Health Service of Belgium

(FR-BE)

The France-Belgium Convention on Cross-border emergency medical services (EMS) was signed in 2007. Despite an operational level that works very well, some regulatory obstacles keep hindering the cooperation between the two countries. In particular: it is not possible for some Belgian ambulances (112-authorized) to cross the border in order to refer patients to a healthcare facility. Furthermore, depending on the type of vehicle used for patients transportation, financial compensation cannot always be provided to the patients and is limited to the interventions of the French SMURs (Service Mobile d'Urgence et de Réanimation), meaning that the financial burden occurring would weigh directly on the patients.

Cross-border health care

Euroregion Nisa

(CZ-DE)

In Šluknov tip (the most northern edge of the Czech Republic), surrounded by Germany on 3 sides, does exist only one hospital which has big financial problems and faces a potential shut down. However, despite there are two hospitals very close to border on the German side, these facilities cannot be used by Czech patients due to legislative obstacles concerning the health insurances management and the medical emergencies rescue services.