BETA

21 Amendments of Eva-Britt SVENSSON related to 2008/0142(COD)

Eva-Britt SVENSSON

Proposal for a directive
Recital 13 a (new)

(13a) It is important to underline the need to put in place specific measures to ensure that women have equitable access to public health schemes. This applies both to access to care which is intended for women and men and to access to gynaecological and obstetric health care, including the protection of mothers and infants, in accordance with the definition of primary health care established by the World Health Organisation at its 56th World Health Assembly on 24 April 20031. Every Member State should respect women's rights to sexual and reproductive health in accordance with the International Covenant on Civil and Political Rights. ________________ 1 International Conference on Primary Health Care, Alma-Ata; twenty-fifth anniversary; report by the Secretariat (A56/21).

2009/01/22
Committee: FEMM

Søren Bo SØNDERGAARD, Eva-Britt SVENSSON

The Committee on the Internal Market and Consumer Protection calls on the Committee on the Environment, Public Health and Food Safety, as the committee responsible, to propose rejection of the Commission proposal.

2009/01/30
Committee: IMCO

Søren Bo SØNDERGAARD, Eva-Britt SVENSSON

Proposal for a directive
Citation 1

Having regard to the Treaty establishing the European Community, and in particular Article 95s 42, 152 and 308 thereof,

2009/01/30
Committee: IMCO

Søren Bo SØNDERGAARD, Eva-Britt SVENSSON

Proposal for a directive
Recital 6

(6) Some issues related to cross-border healthcare, in particular reimbursement of healthcare provided in a Member State other than that in which the recipient of the care is resident, have been already addressed by the Court of Justice. As healthcare was excluded from the scope of Directive 2006/123/EC of the European Parliament and of the Council of 12 December 2006 on services in the internal market it is important to address these issues in a specific Community legal instrument in order to achieve a more general and effective application of principles developed by the Court of Justice on a case by case basis.deleted

2009/01/30
Committee: IMCO

Søren Bo SØNDERGAARD, Eva-Britt SVENSSON

Proposal for a directive
Recital 8

(8) This directive aims to ~~establish a general framework for~~complement Regulation 1408/71 and its successor Regulation 883/2004 with regard to the provision of safe, high quality and efficient cross-border healthcare in the Community and to ensure ~~patients mobility and freedom to provide healthcare~~the application of patients' rights in the framework of patients mobility and a high level of protection of health, whilst fully respecting the responsibilities of the Member States for the definition of social security benefits related to health and the organisation and delivery of healthcare and medical care and social security benefits in particular for sickness.

2009/01/30
Committee: IMCO

Søren Bo SØNDERGAARD, Eva-Britt SVENSSON

Proposal for a directive
Recital 19

(19) In accordance with the principles established by the Court of Justice, and without endangering the financial balance of Member States' healthcare and social security systems, greater legal certainty as regards the reimbursement of healthcare costs should be provided for patients and for health professionals, healthcare providers and social security institutions.deleted

2009/01/30
Committee: IMCO

Søren Bo SØNDERGAARD, Eva-Britt SVENSSON

Proposal for a directive
Recital 21

(21) It is appropriate to require that also patients who go for healthcare to another Member State in other circumstances than those envisaged for coordination of social security schemes established by the Regulation (EC) No. 1408/71 should be able to benefit from the principles of free movement of services in accordance with the Treaty and the provisions of this Directive. Patients should be guaranteed assumption of the costs of that healthcare at least at the level provided for the same or similar healthcare had they been provided in the Member State of affiliation. This fully respects responsibility of the Member States to determine the extent of the sickness cover available to their citizens and prevents any significant effect on the financing of the national healthcare systems. Member States may nevertheless provide in their national legislation for reimbursement of the costs of the treatment at the tariffs in force in the Member State of treatment if this is more beneficial for the patient. This may be the case in particular for any treatment provided through European reference networks as mentioned in Article 15 of this Directive.deleted

2009/01/30
Committee: IMCO

Søren Bo SØNDERGAARD, Eva-Britt SVENSSON

Proposal for a directive
Recital 22

(22) For the patient, therefore, the two systems are coherent; either this directive applies or Regulation 1408/71. In any event, any insured person who requests an authorisation to receive a treatment appropriate to his/her condition in another Member State shall always be granted this authorisation under the conditions provided for in Regulation 1408/71 and 883/04 when the treatment in question cannot be given within the time medically justifiable, taking account his current state of health and the probable course of the disease. The patient should not be deprived of the more beneficial rights guaranteed by Regulation.1408/71 and 883/04 when the conditions are met.deleted

2009/01/30
Committee: IMCO

Søren Bo SØNDERGAARD, Eva-Britt SVENSSON

Proposal for a directive
Recital 23

(23) The patient may choose which mechanism they prefer, but in any case, where the application of Regulation 1408/71 is more beneficial for the patient, the patient should not be deprived of the rights guaranteed by that Regulation.deleted

2009/01/30
Committee: IMCO

Søren Bo SØNDERGAARD, Eva-Britt SVENSSON

Proposal for a directive
Recital 26

(26) This Directive does not provide either for transfer of social security entitlements between Member States or other coordination of social security schemes. The sole objective of the provisions regarding prior authorisation and reimbursement of healthcare provided in another Member State is to enable freedom to provide healthcare for both patients and healthcare providers and to remove unjustified obstacles to that fundamental freedom within the patient's Member State of affiliation. Consequently the Directive fully respects the differences of national health-care systems and the Member States' responsibilities for organisation and delivery of health services and medical care.deleted

2009/01/30
Committee: IMCO

Søren Bo SØNDERGAARD, Eva-Britt SVENSSON

Proposal for a directive
Recital 37

(37) ~~Realising the potential of the internal market for c~~Cross-border healthcare requires cooperation between providers, purchasers and regulators of different Member States at national, regional or local level in order to ensure safe, high quality and efficient care across borders. This is particularly the case for cooperation in border regions, where cross-border provision of services may be the most efficient way of organising health services for the local populations, but where achieving such cross-border provision on a sustained basis requires cooperation between the health systems of different Member States. Such cooperation may concern joint planning, mutual recognition or adaptation of procedures or standards, interoperability of respective national information and communication technology systems, practical mechanisms to ensure continuity of care or practical facilitating of cross- border provision of healthcare by health professionals on a temporary or occasional basis. Directive 2005/36/EC on the recognition of professional qualifications stipulates that free provision of services of a temporary or occasional nature, including services provided by health professionals, in another Member State should not, subject to specific provisions of Community law, be restricted for any reason relating to professional qualifications. This Directive sh~~ould~~all be without prejudice to those provisions of Directive 2005/36/EC.

2009/01/30
Committee: IMCO

Søren Bo SØNDERGAARD, Eva-Britt SVENSSON

Proposal for a directive
Article 1

This Directive ~~establishes a general framework for~~aims at complementing the existing framework on the coordination of social security systems (Regulation 1408/71/EC and its successor Regulation 883/2004/EC) with a view to the application of patients' rights in the context of the provision of safe, high quality and efficient cross-border healthcare.

2009/01/30
Committee: IMCO

Søren Bo SØNDERGAARD, Eva-Britt SVENSSON

Proposal for a directive
Article 3 – paragraph 2

2. When the circumstances under which an authorisation to go to another Member State in order to receive appropriate treatment under Article 22 of Regulation (EC) No 1408/71 must be granted are met, the provisions of that Regulation shall apply and the provisions of Articles 6, 7, 8 and 9 of this Directive shall not apply. Conversely, when an insured person seeks healthcare in another Member State in other circumstances, Articles 6, 7, 8 and 9 of this Directive apply and Article 22 of Council Regulation (EC) No 1408/71 shall not apply. However, whenever the conditions for granting an authorisation set out in Article 22(2) of Regulation (EC) No 1408/71 are fulfilled, the authorisation shall be accorded and the benefits provided in accordance with that Regulation. In that case Articles 6, 7, 8 and 9 of this Directive shall not apply.deleted

2009/01/30
Committee: IMCO

Søren Bo SØNDERGAARD, Eva-Britt SVENSSON

Proposal for a directive – amending act
Article 6 – paragraph 1

1. Subject to the provisions of this Directive, in particular Articles 76, 87 and 9, the Member State of affiliation shall ensure that insured persons travelling to another Member State with the purpose of receiving healthcare there or seeking to receive healthcare provided in another Member State, will not be prevented from receiving healthcare provided in another Member State where the treatment in question is among the benefits provided for by the legislation of the Member State of affiliation to which the insured person is entitled. The Member State of affiliation shall reimburse the costs to the insured person, which would have been paid for by its statutory social security system had the same or similar healthcare been provided in its territory. In any event, it is for the Member State of affiliation to determine the healthcare that is paid f, according to the same mechanisms as provided for by Regulation 1408/71/EC and its successor rReg~~ardless of where it is provided~~ulation 883/2004/EC.

2009/02/12
Committee: IMCO

Søren Bo SØNDERGAARD, Eva-Britt SVENSSON

Proposal for a directive – amending act
Article 6 – paragraph 2

2. ~~The costs of healthcare provided~~ Member States must ensure that physicians and service providers which are working anos contract partners of their Member State shall be reimbursed by the Member State of affiliation in accordance with the provisions of this Directive up to the level of costs that would have been assumed had the same or similar healthcare been provided in the Member State of affiliation, without exceeding the actual costs of healthcare receivedrespective national health systems or statutory social security systems are obliged to accept the European Health Insurance Card (EHIC), form E-112 etc. and treat patients showing their EHIC on the same conditions as stipulated by the Regulation on the coordination of social security systems. Member States must oblige service providers to post an EHIC symbol in the lobby of the service provider (e.g. in a similar way to credit cards in shops and restaurants) to indicate that the EHIC is accepted there in line with that Regulation.

2009/02/12
Committee: IMCO

Søren Bo SØNDERGAARD, Eva-Britt SVENSSON

Proposal for a directive – amending act
Article 6 – paragraph 3

3. ~~The~~ Member State of affiliation may impose on a patient seeking healthcare provided in another Member State, the same conditions, criteria of eligibility and regulatory and administrative formalities for receiving healthcare and reimbursement of healthcare costs as it would impose if the same s must ensure that physicians and service providers which are working as contract partners of their respective national health systems or statutory social security systems are prohibited to treat patients from another Member State on a private basis or demanding upfront cash payments from them, in such cases that the patient can prove her or his status as an insured person of the respective statutory s~~imilar healthcare was provided in its territory, in so far as they are neither discriminatory nor an obstacle to freedom of movement of persons~~ocial security system of the respective Member State of affiliation by the European Health Insurance Card, form E-112 etc..

2009/02/12
Committee: IMCO

Søren Bo SØNDERGAARD, Eva-Britt SVENSSON

Proposal for a directive – amending act
Article 6 – paragraph 4

4. Member States shall have a mechanism for calculation of costs that are to be reimbursed to the insured person by the statutory social security system for healthcare provided in another Member State. This mechanism shall be based on objective, nondiscriminatory criteria known in advance and the costs reimbursed according to this mechanism shall be not less than what would have been assumed had the same or similar healthcare been provided in the territory of the Member State of affiliation.deleted

2009/02/12
Committee: IMCO

Søren Bo SØNDERGAARD, Eva-Britt SVENSSON

Proposal for a directive – amending act
Article 6 – paragraph 5

5. Patients ~~travelling to another Member State with the purpose of receiving healthcare there~~receiving healthcare in another Member State than their Member State of affiliation or seeking to receive healthcare provided in another Member State shall be guaranteed access to their medical records, in conformity with national measures implementing Community provisions on the protection of personal data, in particular Directives 95/46/EC and 2002/58/EC.

2009/02/12
Committee: IMCO

Søren Bo SØNDERGAARD, Eva-Britt SVENSSON

Proposal for a directive
Article 8

1. For the purposes of reimbursement of healthcare provided in another Member State in accordance with this Directive, hospital care shall mean: (a) healthcare which requires overnight accommodation of the patient in question for at least one night. (b) healthcare, included in a specific list, that does not require overnight accommodation of the patient for at least one night. This list shall be limited to: - healthcare that requires use of highly specialised and cost-intensive medical infrastructure or medical equipment; or - healthcare involving treatments presenting a particular risk for the patient or the population. 2. This list shall be set up and may be regularly updated by the Commission. Those measures, designed to amend non- essential elements of this Directive by supplementing it, shall be adopted in accordance with the regulatory procedure with scrutiny referred to in Article 19(3). 3. The Member State of affiliation may provide for a system of prior authorisation for reimbursement by its social security system of the cost of hospital care provided in another Member State where the following conditions are met: (a) had the healthcare been provided in its territory, it would have been assumed by the Member State’s social security system; and (b) the purpose of the system is to address the consequent outflow of patients due to the implementation of the present Article and to prevent it from seriously undermining, or being likely to seriously undermine: (i) the financial balance of the Member State’s social security system; and/or (ii) the planning and rationalisation carried out in the hospital sector to avoid hospital overcapacity, imbalance in the supply of hospital care and logistical and financial wastage, the maintenance of a balanced medical and hospital service open to all, or the maintenance of treatment capacity or medical competence on the territory of the concerned Member State. 4. The prior authorisation system shall be limited to what is necessary and proportionate to avoid such impact, and shall not constitute a means of arbitrary discrimination. 5. The Member State shall make publicly available all relevant information on the prior authorisation systems introduced pursuant to the provisions of paragraph 3.Article 8 deleted Hospital and specialised care

2009/02/12
Committee: IMCO

Søren Bo SØNDERGAARD, Eva-Britt SVENSSON

Proposal for a directive – amending act
Article 9 – paragraph 1

1. The Member State of affiliation shall ensure that administrative procedures regarding the use of healthcare in another Member State related to any prior authorisation referred to in Art~~icle 8(3), reimbursement~~.22.1 c) and Art. 22.2 of Regulation 1408/71, coverage of costs of healthcare incurred in another Member State and other conditions and formalities referred to in Article 6(31), are based on objective, non- discriminatory criteria which are published in advance~~, and which are necessary and proportionate to the objective to be achieved~~. In any event, an insured person shall always be granted the authorisation pursuant to Regulations on coordination of social security referred to in Art. 3.1 f) whenever the conditions of Art.22.1 (c) and Art. 22.2 of Regulation 1408/71 are met.

2009/02/18
Committee: IMCO

Søren Bo SØNDERGAARD, Eva-Britt SVENSSON

Proposal for a directive – amending act
Article 9 – paragraph 3

3. Member States shall specify in advance and in a transparent way the criteria for refusal of the prior authorisation ~~referred to in Article 8(3)~~.

2009/02/18
Committee: IMCO