Bloggers for health tourism?

On 2 July 2008, the European Commission released its long awaited proposal for a directive on cross-border healthcare. The proposal, whose full title is “directive on the application of patient’s right in cross-border healthcare” is designed to clarify the right of EU citizens to obtain healthcare outside their Member State of residence and be reimbursed for that treatment. Clearly a proposal of great interest to the general public (we all use healthcare services don’t we?).

Almost immediately after it was published, some actors and the media were referring to it as a proposal on “health tourism”, although the proposal doesn’t actually create any new rights, it merely clarifies those that already exist (through European Court of Justice rulings). Publication of the proposal was originally planned for December 2007, but was postponed at the 11th hour (after journalists had received embargoed press materials). The Brussels rumour mill reports that the delay was due to certain Member States requesting changes to the text due to concern about the cost of increased cross-border provision of health to their healthcare systems. For an overview of the new directive and its likely implications, please see the FH Brussels briefing on the proposal.

So what does the blogosphere say on the proposal?

Quite a lot in fact and the tone is generally very positive:

  • Andrew Craig on public involvement sees the proposal as an EU development that no-one in their right mind would say no to. In particular he applauds the potential of the directive to help patients with rare or complex conditions.
  • A post on UK blog site Having fun after cancer positions the directive as being for “all those who want drugs unavailable in the UK, treatment for side effects and no long waits for treatment”.
  • Keith Pollard of Treatment Abroad a popular UK website providing information for people seeking healthcare abroad thinks that the directive will “provide a boost for medical tourism”.
  • A debate on the BBC website showed a wide range of views including those convinced the NHS would be overrun with patients from other EU countries and those who believed that other European countries had better healthcare systems, so the proposal would be more valuable for UK residents.
  • Germany’s GesundheitsNachrichten gives an overview of the proposal and quotes Carl-Heinz Mueller, President of the Association of statutory health insurance doctors saying that “healthcare received abroad must meet the high quality standards of German healthcare”
  • The blog of German Green MP Manuel Sarrazin mentions the proposal as part of the social package, which he welcomes as “strengthening Social Europe”.

When it comes to Brussels based health policy actors, the web is quite busy:

  • The European Public Health Alliance welcomes the proposal, but expresses a number of concerns including the apparent lack of involvement of health professionals in the plans and whether the directive will help efforts to reduce health inequalities.
  • ALDE health spokesperson and long established MEP blogger Jules Maaten mentions the proposal in the 2nd July entry of his blog saying that “patients rights are more important than the bureaucracy of healthcare systems and medical establishments”.
  • The Standing Committee of European Doctors welcomes the proposal, while stressing that most people prefer to be treated at home, but if they go abroad their quality of care must be guaranteed.
  • Healthblogger on supports the proposal and points out that most people are not “medical tourists”; they only seek treatment abroad when they are dissatisfied with treatment at home have to wait too long.
  • In a press release welcoming the proposal, BEUC the European consumers association raises concern about prior authorisation for hospital care fearing that it may increase health inequalities.

Member States are however for the most part silent or at least reticent in expressing their views on the proposal. Our research has however revealed that:

  • In a press statement, the UK department of health has said that the NHS is committed to “retaining the ability of the NHS to decide what care it will fund” and “will not fund health tourism”, which was cited by PharmaTimes and the BBC.
  • The Irish Health Ministry is conducting a consultation on the proposal.
  • The Times reports that more than 50 Labour MPs have signed a petition protesting that only the wealthy will be able to benefit from the directive because of the need to pay up front.
  • LaCroix says that Spain “fought” to keep the right to prior authorisation where healthcare systems are negatively impacted.
  • The Europe portal of the Luxembourg government reports on the proposal, stressing that it doesn’t means harmonisation of healthcare systems.

Perhaps politicians face the dilemma of choosing between the likely popularity of such a directive with voters (if bloggers are anything to go by…) and the (perceived) negative impact it could have on healthcare systems.

It is interesting to see that media reports on the proposal have shown up all over the globe including:


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