International

This coming week is once again a Strasbourg week, and that means that we will again be voting. One of the items on the agenda is the so-called patients’ directive, ostensibly designed to make it easier for patients to look for and obtain health care outside their own member state. In reality this is an attempt by the European Commission to develop a European market for health care services. And it looks as if a majority in the European Parliament will vote in favour.

During the debate over the Bolkestein Directive, a measure which established freedom of movement and of establishment for services within the EU, we succeeded in excluding health care from the directive’s provisions. Health care is not a service that should be handed over to market forces. The Commission wasn’t happy, but was forced to make this concession in order to push the new law through.

The Commission, however, never knows when it’s beaten. As so often, after a little while they come back with a new proposal, ostensibly from a quite different perspective, but with the same result: in this case, that health care services within Europe must be subject to competition. That’s good for investors, and it suits the Dutch government, as was shown by their attempts to have hospitals record a profit, as if the patient were a customer, and as if health care were not a public service, to which everyone has a right, but a product to be traded. Everyone who works in health care agrees that the partial introduction of market principles into health care in the Netherlands has been a failure, but the Commission carries on regardless.

The patients’ directive gives citizens of any member state the right to seek treatment anywhere within the EU. Only in a limited number of cases will the prior consent of the assurer be necessary. That looks fine at first sight, but as a society we gain no added value from it. It will probably mean that health care will become more expensive, because not only must treatment received abroad be paid for according to Dutch standards, but travel and accommodation costs will have to be reimbursed. At the same time pressure to improve health care in one’s own country will be reduced. Waiting lists in the Netherlands? No problem, you can always go abroad. Certain specialisms underdeveloped here? Then just pop over the border.

Patients want to receive good care, and as near as possible to where they live. Of course if you live in a border region a hospital over the frontier might be closer than one in your own country. In addition, you want to be able to access health care while on holiday. This sort of thing, however, is already fully regulated. Giving insurers the right to send you to another European country, where you may not speak the language and where visits by family and friends may be extremely costly or even quite impossible, surely nobody asked for that?

The Dutch government’s task is to ensure the delivery of quality health care within the Netherlands itself. Get rid of bureaucracy and, above all, of ‘market principles’. That’s the message we in the SP have delivered to Prime Minister Rutte, and we are saying the same thing to the European Commission. That’s why I’ll be voting against this directive. Unfortunately, on this point there is no chance of a left bloc. As things now look, social democrats and greens will in the end vote in favour.