Under a new proposed European directive (the snappily titled 2008/0142 Proposal for a directive of the European Parliament and of the council on the application of patients’ rights in cross-border healthcare) patients will be able to access NHS-funded treatment for hospital, outpatient or dental treatment in any EU country.

The proposed directive appears to be a consequence of a number of court cases brought by patients seeking reimbursement for their overseas treatment. However, it is not a case of the patient having total freedom of choice. The proposed directive would allow member states to insist that patients obtain prior authorisation from their healthcare providers for hospital treatment abroad, subject to certain conditions.

However, the prior authorisation system is to be limited to what is necessary and proportionate and member states must make all relevant information (such as costs and waiting times) on the prior authorisation system publicly available.

Furthermore, in order to facilitate the implementation of the proposed directive, member states will be required to collaborate on matters such as patient prescriptions, the assessment of new medical technology and standards for “e-health” – information and communication technology systems in the healthcare field. The NHS would also be requested to establish a direct payment or reimbursement system with other member state healthcare systems.

Under the proposals, NHS patients who receive treatment abroad are likely to retain their full status as NHS patients, thus allowing them to keep their place in queues in their home state for follow-up services to the treatment. But it should be noted that NHS patients will not be able to opt for treatment abroad not covered by the NHS. Furthermore, patients will have to pay for their own travel and accommodation expenses, as well as any premium if the overseas treatment is more expensive.

The Department of Health has said that it does not think the NHS will be burdened by an invasion of “health tourists” on the grounds that, if a particular service is being overloaded, the Government could apply for it to be omitted from the scope of the directive. Furthermore, the NHS would want to demand payment for treatment upfront from any patient travelling to the UK for treatment.

The proposal for the directive must now be examined by the European Parliament and the European Council of Ministers before becoming EU law. The proposed directive, if adopted, is expected to be in force by 2011. The UK would then have to introduce new legislation to implement the directive.

The full text of the proposal for the directive can be accessed at http://ec.europa.eu/health/ph_overview/co_operation/healthcare/docs/COM_en.pdf