EU opens borders for health treatment

Britons won the right yesterday to seek medical treatment in another EU country and to bill the NHS if waiting lists are too long.

The landmark deal struck by ministers in Brussels will have a huge impact on patients' power to shop around EU countries for the fastest treatment.

The decision was also hailed as a political milestone. "It is the first time that the EU is deciding about patients' rights," said one European official.

"We are entering the heart of national sovereignty and it is an important step as it establishes citizens' rights at EU level."

About 1,100 Britons each year go abroad for health care at the UK taxpayers' expense after little-publicised European Court judgments.

But the demand for cross-border medical care is expected to increase dramatically after EU ministers agreed a formal declaration enshrining the right to be treated anywhere in the Union. The ministers said residents of one member state could seek medical care in another, if their own country cannot provide it "within a time limit which is medically justifiable".

Patients will be able to travel to other EU countries for treatment if local hospitals cannot provide urgent care within a reasonable period of time. Health authorities will be obliged to cover the cost of the treatment.

How each individual case will be adjudicated has yet to be finalised among the 15 nations. However, officials say that decisions will be based on doctors' advice and that health service administrators will have the right to seek a second medical opinion.

Nor is it yet clear whether patients will have to pay up front, then reclaim the money from the NHS, or whether hospitals in France, Belgium or Germany would be able to bill the health authorities in the UK directly.

Details on the rules that will underpin yesterday's decision will be thrashed out by early 2004. In any event, national health authorities will have to sanction the treatment before it takes place but will not be able to refuse valid cases.

European Commission experts argue that yesterday's decision might, for example, boost the number of Britons who have hip or heart valve replacement operations abroad.

Anna Diamantopoulou, the European commissioner for social affairs, said: "Patients will still have to ask for permission from their health service but if their medical condition is so serious that they can't join the waiting list, then their member states will be required to let them go abroad to another EU country."

The decision, endorsed by the Secretary of State for Work and Pensions, Andrew Smith, is part of a wider overhaul of the EU's 30-year-old social security regulations. The new rules will come into force in 2004-05 and will have to be approved by the European Parliament.

The social, employment and health ministers also agreed that non-EU citizens who have accumulated social security rights in an EU state should be able to keep these rights if they move to another country in the EU.

The decision on health care follows a ruling from the European Court of Justice in 1998 when a Luxembourg lawyer, Nicolas Decker, brought a case over a £100 pair of glasses purchased in Belgium. His national health insurance in Luxembourg refused to pay because he had bought them abroad.

In another case, judges found in favour of Luxembourger Raymond Kohll, who wanted his insurance to pay for his daughter's dental care over the border in Germany. Finally, in July 2001, the Smits-Peerbooms judgment in the European Court decided that health care must be subjected to the same EU laws as other services, even when funding came directly from the public purse.