Directive on Services in the Internal Market Issues related to health services.
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Transcript of Directive on Services in the Internal Market Issues related to health services.
Directive on Services in the Internal Market
Issues related to health services
Background and ScopeCovers both the right of establishment and the right to free
movement of services
Covers all economic services that are not already covered by Internal Market legislation and specifically exempt
Financial services Electronic communication services
(2002 regulatory package) Transport services
Services of general economic interest
Health services and the Internal Market
it follows from settled case-law that Community law does not detract from the power of the Member States to organise their social security systems (…) Therefore, in the absence of harmonisation at Community level, it is for the legislation of each Member State to determine the conditions on which social security benefits are granted (…) However, it is nevertheless the case that the Member States must comply with Community law when exercising that power.”
Muller- Faure C385/99 Paragraph 100
The Services Directive and Member States’ competence
The directive is fully consistent with the case law. It does not:• Detract from Member States’ competence to
organise their health service and the way they finance it.
• Require deregulation or privatisation of health services.
• Provide for any harmonisation of health services.
It only clarifies how the right of establishment and free movement of services applies to health services.
Patient mobility- Summary of the case law
Defining restrictions (Kohll)
Justifying restrictions - Prior authorisation schemes
Hospital care (Smiths and Peerbooms)
Non-hospital care (Müller-Faure)
Level of assumption (Vanbraekel)
Article 23 on patient mobility• Costs of non- hospital care must be
reimbursed. • Authorisations to receive hospital care must
be granted when the care cannot be given within a medically justifiable timeframe.
• The level off assumption must be at least at the level provided in the patient’s Member State of affiliation.
• Clarification of the distinction between hospital and non-hospital care.
Establishment- Mutual evaluation
Authorisation schemes must be:• Justified by overriding reasons in the
general interest,• Proportionate and • Non- discriminatory
Prohibited requirements and requirements to be evaluated
Free provision of services
The country of origin principle
Applies to cross border provision of services, not establishment.
Applies to all regulations falling within the coordinated field.
Exceptions relevant to health services
1. All issues regulated by the Directive on regulated professions, article 17 (8).
2. Justified prohibitions, article 17 (16).3. Requirement linked to specific characteristics of
the place where the service is provided, article 17 (17).
4. The authorisation system applicable to the reimbursement of hospital care, article 17 (18)
5. Consumer contracts, article 17 (21).6. Case by case derogations, article 19.
Further information
http://europa.eu.int/comm/internal_market/services/services-dir/index_en.htm