European citizens move across the continent with greater ease than ever before as European integration has broadened.
The increase in budget travel as well as cross-border working and retirement all have implications for individual countries’ health systems.
The School’s researchers, led by Martin McKee, professor of European public health, and research fellows Helena Legido-Quigley and Cecile Knai, have been involved in three large-scale projects looking at the impact of an increasingly integrated Europe on patients, providers and health care systems.
Researchers looked at two levels: Europe-wide initiatives and in-depth case studies of national and cross-border policies. Findings clarified various aspects of cross-border care, including: legal aspects at both European and country level; patterns of patient mobility; contracting arrangements; communication between professionals; arrangements for cross-border collaboration; and care of long-term residents.
After a comprehensive review of cross-border care in 2005, McKee and colleagues concluded that public authorities needed to put a legal and institutional framework for cross-border health care in place.
A 2008 study, commissioned by the European Parliament, used McKee’s findings on the slow emergence of cross-border movement of patients on the European health policy agenda and on controversial court rulings. McKee’s research on cross-border care in Slovenia, Austria and Italy also informed a European Commission document. A consultation paper from the EU Commission quotes McKee’s research on problems in cross-border care due to incompatible rules between the countries concerned.
Between 2008 and 2013 McKee advised individual governments on cross-border movement of patients and in the UK his research informed the response of various organisations to the proposed directive.
In 2011 the European Parliament and Council of Ministers passed a directive on patients’ rights in cross-border healthcare. The directive, which came into force in 2013, is based on the fundamental principle that a patient is entitled to buy healthcare in another European Union country and be reimbursed for it by their home healthcare system.
McKee has advised the European Union of Medical Specialists, a professional organisation of EU doctors. Alongside Legido-Quigley, he also advised the General Medical Council on patient mobility, helping the council respond to concerns about the movement of medical professionals.
A 2012 study by the research team found that the needs of people retiring to other European countries were not being met, concluding that a compromise was needed to ensure access to care without damaging the sustainability and integrity of national health systems.