International

Kartika Liotard is worried about the creeping liberalisation of health care via the back door of 'cross border patient mobility'.

This morning the European Parliament held a debate on cross-border health care. At last, I would add, because this debate was originally scheduled for June 2007. Why? The answer is simple: the rightward-leaning European Parliament has already decided it wants to move to liberalise health services. It wants to do this under the label of 'patient mobility'.

Services Directive
My proposed amendments were aimed, some time ago, at preventing health care from being included under the Services Directive. But from then on repeated attempts have been made to hand health care to the market via the back door. However, during negotiations on the European Constitution (or the Lisbon Treaty, as it is now known) even ultra-neoliberal former Commissioner Frits Balkenende let it be known that while health care must become a European concern, it should continue to be the responsibility of the member states. Patients were, nevertheless, the victims, because the pressure for liberalisation meant that things were left unclear. Now at last the revised proposal from the European Commission has arrived and some light can be thrown on this, as follows:

• The interests of the patient must be central and cross-border health care must be possible, without the bureaucratic barriers which still exist in the member states. This does not alter the fact that health care is and shall remain a responsibility of the member states. The proposal for cross-border health care in not aimed at harmonising the market for health care providers and this must remain the case.
• The European Court of Justice has already ruled that patients have the right to health care outside their own member state. This flows naturally from the right to free movement of persons. But not everyone knows this and most do not have the resources to enforce their right by going to law. This uncertainty regarding rights on the part of patients must be dispelled. They should be informed as to what rights they have.
• What is now, however, needed, is equal treatment for patients. Everyone must qualify for health care, whether rich or poor, and despite the demographic differences between different population groups in Europe. And if you need to go abroad for health care, you should have a right to be compensated in your home country, without having to wade through piles of paperwork.
• In addition, the level of quality of health care must be raised so that in all member states the same high quality of care can be given to all who need it.

Attacks in the offing
It is now the turn of the Members of the European Parliament to get back to work on this proposal and so we can once again expect attacks on health services. The rights of patients should indeed be protected. The patient must be able to choose freely and independently where he or she can best be treated. But the throwing of health care to the market must be prevented. Watch this space.