Local view for "http://purl.org/linkedpolitics/eu/plenary/2009-04-23-Speech-4-065"
| Predicate | Value (sorted: default) |
|---|---|
| rdf:type | |
| dcterms:Date | |
| dcterms:Is Part Of | |
| dcterms:Language | |
| lpv:document identification number |
"en.20090423.3.4-065"2
|
| lpv:hasSubsequent | |
| lpv:speaker | |
| lpv:spoken text |
"Mr President, as we have seen once again today, Parliament’s debates on this matter are both rich and passionate. Its discussions add a great deal to the Commission’s initiative, and the amendments on which it is to vote will also constitute a most valuable input on a number of key aspects.
Some of you have said that, if we adopt this proposed directive, only a few patients would profit from it, and that they would be the very few informed patients. On the contrary, I believe that under this directive we are giving the opportunity and the right to every single patient, before he or she leaves home, to be fully informed in order to be able to make an informed choice.
I understand the concerns raised regarding the difficulty of getting clear information on health professionals when seeking health care abroad. This is simply a question of patient safety. Here, we need to agree on practical solutions which also respect a number of key principles, such as the right to personal data protection and the presumption of innocence. I am sure that common ground can be found on the basis of your preliminary suggestions.
Reference was made to Amendment 67 on relaxation of the rule for affiliations to social security systems. Unfortunately, this cannot be accepted.
Regarding the legal basis for the proposed directive, many of you would like to add Article 152 to Article 95. I understand that this is an important issue for some of the political groups, but it is difficult to have definite views at this stage of the examination of the directive. It is important to assess this issue in the light of the evolution of the text, in order to decide what the appropriate legal basis is. Clearly, if the content of the final text justifies it, the addition of Article 152 to Article 95 could certainly be considered. I remain open to considering this at any future stage of the codecision process.
Some of you have again raised the issue of the possible excessive inflow of patients from other Member States, and of how the receiving health system would be protected. My reply is the same as the one I would give to those who fear excessive outflows in the absence of prior authorisation for hospital care, which is that the intention of this proposal is not to promote patient mobility. As I have said, mobility of patients is a limited phenomenon and we do not expect this to change. Therefore, it would be simply disproportionate to give carte blanche to Member States to take measures to refuse patients in order to control inflows. Member States have to ensure that patients from other Member States are not discriminated against. Any form of control of incoming patients would have to be assessed as to whether it would amount to an acceptable exception to the principle of non-discrimination on the basis of nationality set out in the EU Treaty.
Regarding patients suffering from rare diseases, I understand that you are looking for the best approach in order for them to benefit from the health care they need, but sometimes the best is the enemy of the good. Today, you will vote on Mr Trakatellis’ report, which concerns the recent strategy that the Commission has already set out on rare diseases, and includes the proposed Council recommendation. As you know, for these conditions, quick diagnosis and access to treatment are complex and not always possible or available at home. Therefore, in order to bring the benefits of European cooperation to patients with rare diseases, they really need to be included in this directive on patients’ rights in cross-border health care. I think that there is broad agreement on the need for European cooperation on centres of reference for rare diseases, for example. I would therefore urge you to keep rare diseases in the scope of the directive.
Regarding the proposed exclusion of organ transplantation, I simply cannot agree. Transplantation is a medical procedure and it is difficult to justify why patients should not have the right to benefit from it as cross-border health care, as ruled by the Court. However, the issue of organ allocation is a different matter. I have therefore asked experts in the Commission to look into this question to see how organ allocation could be dealt with in a different context.
Today, we can take an important step forward towards the adoption of this directive. Now that we are just a matter of weeks away from the next European elections, allow me to pay tribute to this Parliament and to its administration for all the efforts made to make this vote today possible, for which I thank you all. Let me also once again thank Mr Bowis and the shadow rapporteurs for their efforts and hard work and wish him a speedy recovery. We hope to see him back soon to take up his duties and a normal life.
On patients’ rights to quality and safe health care, many of you have confirmed the fundamental importance of securing clarity and assurances. I fully agree, and very much hope that this ambition will be confirmed.
On the question of assumption of the costs of treatment abroad, clear concerns have been expressed about the inability of a significant number of patients to afford cross-border health care. Indeed, this is an important and most valid point. Inequalities of revenue clearly exist throughout Europe, and this has serious consequences in relation to access to a number of fundamental services, including health care. This issue has to be addressed. However, reducing such inequalities is a difficult challenge, and even more difficult against the backdrop of the current economic crisis. It will require a significant and coordinated effort from the EU and the Member States at all levels.
Unfortunately, what we can do in the context of the draft directive is limited. The Commission proposal leaves the door open for Member States to offer direct assumption of the costs of cross-border treatment, for example with a system of written confirmation of the amount that will be paid. If Parliament wants this to be clear in the text, I can only welcome it. The proposed directive did not seek to prevent this, but is careful to respect Member States’ responsibilities in organising health care. That is why we were cautious to limit the financial impact of cross-border health care on national health systems and sickness insurance funds. However, the two objectives are not incompatible. It would be up to the Member States to reconcile them as far as possible to the benefit of the patients, in particular those with modest revenues.
Regarding the relationship of this directive with the social security regulation, we agree, I believe, on the need for clear articulation, which would mean that, once prior authorisation is requested by a patient, and if the conditions of the regulation are fulfilled – in other words, when there is undue delay – the regulation should apply. It has to be crystal clear that this means the tariffs of the regulation shall apply so that patients can benefit from the most advantageous system.
Regarding prior authorisation for hospital care, the proposed provisions are based on two kinds of consideration. Firstly, case-law: the Court has ruled that such a system could be justified under certain circumstances. We have codified this in Article 8(3). Secondly, it would not be appropriate to go beyond such provisions with a looser – or indeed unconditional – system of prior authorisation, legally or
generalised in all Member States. We all know that patient mobility will remain a very limited phenomenon. This means that its budgetary impact will also be limited. Therefore, there is no need to construct unnecessary barriers for patients. Prior authorisation for hospital treatment has to remain a safeguard mechanism, applicable when justified.
Against this background, systems of prior notification as proposed by the rapporteur could amount to indirect – and indeed unnecessary – control of patients, impeding rather than facilitating the process. I understand that the rationale behind this suggestion was not to achieve such an outcome, but believe that this would actually restrict patients’ rights as defined by the Court. Such administrative mechanisms run the risk of being both cumbersome and arbitrary.
I am concerned at the suggestion regarding the definition of hospital care. This definition is indeed a key point for patients’ rights as it sets the boundary for the prior authorisation system. We have proposed to define the concept of hospital care through a Community list based on the shared understanding of experts, who would take account of the development of technologies. This would allow for a reasonable and modern approach to the concept of hospital care.
Some of you are calling for national lists to be drawn up independently, and most Member States are calling for that as well. A definition based on national lists would actually lead to discrepancies as to what constitutes hospital care in each Member State, with a considerable risk of eroding patients’ rights. If we were to go down this road, we would need to have such lists based on clearly defined criteria and subjected to a review process. Otherwise, patients’ rights, as defined by the European judges, would be undermined."@en1
|
| lpv:unclassifiedMetadata | |
| lpv:videoURI |
Named graphs describing this resource:
The resource appears as object in 2 triples