Influencing European Union and national policy on patient mobility in Europe

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.