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Public Health

Health-EU newsletter 228 - Focus

Are EU citizens reaping the benefits of the Cross-border Healthcare Directive?

Andrzej Rys, Director responsible for health systems, medical products and innovation, Directorate-General for Health and Food Safety, European Commission, says that the Directive on Cross-border Healthcare has furthered cooperation between health systems and clarified the rights of patients when they receive healthcare in another European Union country. As legislation that clearly impacts EU citizens, it should be better known.

What are the lessons learned from this triennial Commission Report?

When speaking about the lessons learned, it is not a question of encouraging people to engage in 'medical tourism', but of allowing patients to benefit from their rights in accessing the greatest expertise and most appropriate treatment available, even if this is not available without undue delay in their own countries.

What has been the impact of the Directive thus far?

The Directive has improved legal certainty and clarity for cross-border as well as for domestic patients over their rights. This strengthened legal certainty has helped not only the patients themselves, but also the national authorities responsible for their management.

This Directive has also allowed Member States to join forces in voluntary cooperation and cohesion between border regions and in furthering cooperation in the field of eHealth and European Reference Networks for rare and complex diseases. The 24 European Reference Networks launched in Vilnius in March 2017 will allow for improvements in the diagnosis, treatment and management of rare diseases, while cooperation and the pooling of resources will pave the way for breakthroughs in research. Significant progress has been achieved, and I am delighted that the European Reference Networks are a very concrete example of EU added value and of the benefits that Europe can gain when we choose to join forces in thematic strands rather than work individually or in silos.

What are the next milestones?

Compliance and conformity checks and dialogues with Member States will continue over the next reporting period and more use will be made of mobility data. Proper implementation of the EU Acquis, particularly in health, is an ongoing process and there is much left to do. Citizens' awareness of their rights and of the Directive is still a challenge. National Contact Points have been set up to inform citizens, but citizens don’t always know about them.

Cross-border patient flows are showing a stable pattern, mostly driven by geographical or cultural proximity. Broadly speaking, patient mobility and its financial implications within the EU remain relatively low and the Cross-border Healthcare Directive has not proven to negatively impact the sustainability of health systems. In the future, I would like to place greater emphasis on the interconnection of our healthcare systems, under the auspices of the increasingly rapid development of e-health.

Activities at EU level

Cross-border healthcare

European Commission – Health and Food Safety


Cross-border healthcare Directive: proven to clarify and guarantee patients' rights

Since the Directive’s adoption, no further European court rulings have been needed to ensure cross-border healthcare rights, and patients are increasingly aware of these rights. Nevertheless, patient mobility and its financial dimensions within the EU remain relatively low.

Read the EU report on the application of patients' rights in cross-border healthcare

Cross-border patient mobility within the EU shows a slight increasing trend over the last three years since Directive 2011/24/EU was implemented. Read more about how the Directive has had an impact in this report, available in all EU languages.

Factsheet answer questions about the European Reference Networks model in relation to EU cross-border healthcare

The new factsheet, Application of the ERN model in European Cross-Border Healthcare cooperation, was published on 10 December 2018.

Study on cross-border health services shows patients have better access to info, but more work is needed

The study found that National Contact Point (NCP) websites had improved but that more data should be given on patients' rights, quality and safety standards and reimbursement of cross-border healthcare costs. The study also resulted in a toolbox and training material for NCPs.

Member State data on cross-border health care gives overview of patient mobility

This report gives an overview of data on patient mobility in the reporting year 2016, collected July - November 2017 and addressing treatment provided with Prior Authorisation from the Member State where the patient is insured, as well as treatment where prior-authorisation is not required.

The top ten mistakes patients make in cross-border healthcare - and how to avoid them!

Every EU/EEA citizen has the right to receive public or private health services in any other EU Member State, Iceland, Liechtenstein or Norway, and to be fully or partially reimbursed. But patients first need to know how to avoid making the mistakes outlined in this brochure!

Cross-border Healthcare Travel Notice between the EU and the UK

Notice on travelling between the EU and the United Kingdom following withdrawal of the United Kingdom from the EU.

Health Programme Projects

Paediatric Cancer European Reference Network

The mission of ERN-PAEDCAN is to improve outcomes of childhood cancer and malignant haematological diseases by reducing the current inequalities in different member states.

ERN-PAEDCAN PARTNER: Paediatric Rare Tumours Network - European Registry

National registries that collect epidemiological, clinical and treatment data of children and adolescents with very rare tumours exist in four European countries. This project aims to link these registries through a paediatric rare tumour European Registry and support the ERN PAEDCAN.

European Reference Network on Rare and Undiagnosed Skin Disorders - Framework Partnership Agreement

The ERN-Skin aims to enhance high-level patient management for rare complex and undiagnosed skin disorders, by improving the quality, safety and access to highly specialized healthcare. These diseases are frequently misdiagnosed and misunderstood.

Other interesting links