Local view for "http://purl.org/linkedpolitics/eu/plenary/2008-09-25-Speech-4-009"
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"en.20080925.4.4-009"2
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Mr President, Commissioner Vassiliou, Mr Bowis, co-rapporteurs, draftsmen of the opinion, ladies and gentlemen, I thank the European Parliament for agreeing to defer our working meeting originally scheduled for the beginning of this month.
At a time of serious budgetary constraints – ageing, technical progress – Member States must be able to be fully in charge of the care they provide in this respect, in particular hospital planning. As the Court itself recognised, one purpose of that planning is to ensure adequate and permanent access to a balanced range of quality hospital treatment throughout a national territory. It also forms part of the effort to control costs and to avoid, where possible, any waste of human, financial or technical resources.
I also want to point out that the requirement of prior authorisation ensures that cross-border care can be provided as soon as it is medically justified. In fact, the regulation on the coordination of social security systems already recognises this: authorisation may not be refused in the event that the same treatment is not available within a reasonable time. Nor must we forget that prior authorisation is also a protective measure for patients, since it ensures that any care provided in another Member State will be reimbursed.
Lastly, even if we keep to what we regard as the correct interpretation of the Court’s case law, the directive would still offer great added value by clarifying the rights of patients, providing them with the necessary information and ensuring that this case law is interpreted in a uniform manner and is therefore applied universally and consistently in all the Member States of the European Union.
Thank you for your attention. I will be taking the floor again at the end of the debate to answer your questions.
As you know, the French Presidency attaches great importance to consultation and dialogue on legislation. I felt it was essential to hold an initial exchange of views with my ministerial colleagues at the informal Angers Council on 8 and 9 September before coming before you to set out not, of course, the French position, but the position of the Council of 27 health ministers.
That first exchange of views, like the initial work done in the Council’s working group on health, will not enable me to answer all your questions on this highly complex and varied subject but I am certain our sitting today will give the Commissioner responsible for health a chance to explain the European Commission’s major decisions and allow me to share the Council’s first impressions with you.
The Council supports the adoption of a directive on cross-border healthcare and patients’ rights. It would be inconceivable to leave the decisions in this area solely in the hands of the Court of Justice of the European Communities. In my view, which I share with my colleagues, that should not be taken as a criticism of the Court or even of the content of its judgments, which often bring about major advances for patients. Nonetheless, it would be advisable for health policy in Europe to be developed by the two co-legislators, i.e. you and us, as the outcome of a political dialogue and a democratic process. It must be our common objective to build up a legislative framework that can contribute toward legal certainty.
Second point: in Angers, the delegations from the 27 countries all praised the quality of the work done over these past months and agreed that they had been listened to during the recent consultations. Commissioner Vassiliou was warmly thanked for that at the informal Council meeting. Indeed, the Slovenian Presidency will no doubt have informed you that the Council was very hesitant about the initial version of the text, the broad lines of which had been presented to the EPSCO Council of 19 December 2007. Only a small minority of states had supported that version. In fact, there was similarly great opposition to it in your Parliament, as MEPs confirmed to me during my preparatory consultations with the French Presidency in Strasbourg, Brussels and Paris. There is no doubt that the political dialogue Commissioner Vassiliou started as soon as she took office helped establish a sound basis for negotiation and the Council welcomes that.
Third point: with regard to the timetable, this proposal that the college of Commissioners adopted on 2 July came too late for us to be able to envisage a first reading during our Presidency, but we will press on with negotiations in the Council as far as we can, while entering into a political dialogue with the European Parliament. In that vein, the public health working group has already considered the directive on several occasions. It will be meeting again tomorrow to continue examining the text article by article. In this area as with our other political priorities, France will play its part in the presidential trio by working closely with the Czech Republic and Sweden. For the record, let me remind you that the subject of European health in the service of the patients has been a priority of our common 18-month programme.
Fourth point: regarding the scope of the draft directive, I know from talking to MEPs on the Committee on the Internal Market and Consumer Protection when they were in Paris last May that many of you regret the decision to confine this text solely to patient mobility and not to address the question of the mobility of health professionals. Given that I myself was an MEP at the time of the vote on the report by Evelyne Gebhardt and left Parliament just a few days before the debate on Bernadette Vergnaud’s report, I well understand the reasons for that regret. Excluding health services from the directive on services in the internal market leaves a grey area that is not entirely covered by the current proposal for a directive, which only addresses patient mobility. One could even say that the proposal for a directive has more to do with the wish to incorporate and adapt Court of Justice case law than with excluding health services from the services directive and therefore with the demands by some MEPs for a specific sectoral instrument covering health services. There was no debate on that subject by the health ministers. Yet, in that regard, it is all a question of timetables and the European Commission’s decision can be explained by the need to respond as rapidly as possible to the challenges that exist in the area of patient mobility, which already covers a very wide field. It is certain that a more broadly-based directive that included the mobility of health professionals would have had no chance of being adopted before the elections next June.
Fifth point: regarding the content of the text, we have not yet addressed all the proposed provisions. Nevertheless, the Presidency can say at this stage that in the Council’s view prior authorisation for hospital care is a key question for EU Member States. It could even be described as the fundamental concern of health ministers. During the working lunch on the subject organised in Angers on 9 September, ministers who spoke were in favour of moving towards a better balance between the individual rights of patients to mobility and maintaining national regulatory and planning powers for the benefit of all.
The text reflects that improved balance, in particular by restoring the need for prior authorisation for hospital care. It is not a question of calling into question the case law of the Court of Justice, which specified how the principles of free movement set out in the Treaty applied to the health field, but of the need to incorporate in positive legislation the balance that the Court has already established in its case law between the principle of free movement and Member States’ regulatory capacity. In fact, it distinguished between outpatient care, where the affiliation system cannot require prior authorisation, and hospital treatment, where the requirement of prior authorisation appears to be a necessary and reasonable measure."@en1
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