A directive intended to help people get healthcare treatment wherever they are in the EU moved a step closer to becoming law today (8 June) as health ministers struck a crucial deal on the draft proposal.

Just six months ago, the proposal seemed beyond rescue after being blocked by Spain and several other member states. In a surprise move, Spain, the current holder of the rotating presidency of the Council of Ministers, came up with a compromise, which today won the backing of other health ministers.

“This is an important step that allows us to move forward on this,” said John Dalli, the European commissioner for health and consumer policy.

Trinidad Jiménez, Spain’s health minister, spoke of “a great day for European healthcare”.

The cross-border healthcare proposal was unveiled in July 2008 with the aim of clarifying patients’ rights to treatment in other EU countries. More than a decade of court rulings from the European Court of Justice had established that patients did have the right to get healthcare in other EU countries, but the European Commission wanted more legal certainty, so people did not have to go to court every time they went abroad for an operation or medical procedure.

Discussions on the law collapsed last year because Spain feared being saddled with the costs of healthcare for thousands of northern European pensioners living in retirement on the Spanish coasts. The text endorsed by ministers today contains a compromise on who bears these costs.

The country of residence usually pays the healthcare costs for resident non-citizens. But today’s compromise departs from this principle, by requiring the citizen’s country of origin to pay the costs. So if a German pensioner living in Spain returned to Germany for healthcare, Germany would pay the bill.

The ministers’ agreement falls short of what the Commission had wanted. Under the ministers’ version of the law, patients would be required to seek prior authorisation from healthcare authorities if their treatment involves a hospital stay of more than one night, hi-tech equipment or raises safety and quality concerns.

National governments say these safeguards will allow them to manage health budgets, but the Commission believes that they frustrate the original intention of the law to help patients assert their rights.

Dalli also said today that the Commission would have preferred clearer language in the draft. Some EU officials are concerned that the ministers’ version of the law risks creating more confusion for patients.

Today’s agreement clears the way for the Commission, the Council and the European Parliament to begin negotiations on a final version of the law in the autumn.

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