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Health Care, the United Kingdom and the Draft Patients’ Rights Directive: One Small Step for Patient Mobility but a Huge Leap for a Reformed NHS?

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Health Care and EU Law

Part of the book series: Legal Issues of Services of General Interest ((LEGAL))

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Abstract

Interestingly the trigger for re-evaluating patients’ health care rights in the EU has come not from the Charter but rather from the evolving jurisprudence regarding free movement and medical treatment. The EU has now gone further and proposed a draft Patients’ Rights Directive. This chapter explores first, the background to the Directive, the evolution of the free movement cases and how these came to impact upon the delivery of NHS patient care. It questions how radical the impact of cases in this area upon the NHS has been to date. Secondly, the chapter explores the draft Directive proposals concerning patient mobility and what their impact could be upon the NHS. It examines the implications of recent developments in the form of the NHS Act 2006 which introduce new provisions concerning patient reimbursement for treatment. Thirdly, it explores some of the broader ramifications of proposals in the draft Directive for the UK in relation to issues such as standards of patient care. It suggests that while the rise in patient mobility by itself does not seem, in the short-term at least, to have radically undermined resource allocation decision making in the NHS some of the other proposals in the Directive could prove more influential in relation to evolving standards of patient safety and quality of care in the future.

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Notes

  1. 1.

    See, for example, McHale (2010).

  2. 2.

    Evans v. UK [2007] 43 EHRR 21 and Dickson v. UK [2006] 46 EHRR 437.

  3. 3.

    Pretty v. UK (2002) 35 EHRR 1.

  4. 4.

    See, for example, Montgomery (2005).

  5. 5.

    Protocol No. 7 Treaty of Lisbon 2009.

  6. 6.

    See generally Hervey (2003).

  7. 7.

    Fredman (2006), p. 41 at p. 57.

  8. 8.

    Article 57 TFEU (ex Article 50 EC) further provides that:

    ‘Services shall be considered to be ‘services’ within the meaning of the Treaties where they are normally provided for remuneration…

    ‘Services’ shall in particular include… (d) activities of the professions.’

  9. 9.

    See further ECJ, Joined Cases 286/82 Luisi and Carbone v. Ministero del Tesoro [1984] ECR 377 and ECJ, Case C-158/96 Kohll [1998] ECR I-1935.

  10. 10.

    ECJ, Case C-158/96 Kohll [1998] ECR I-1935.

  11. 11.

    ECJ, Case C-157/99 Geraets-Smits v. Stchting Ziekenfonds VGZ and Peerbooms v. Stichting CZ Groep Zorgverzekerigen [2001] ECR I-5473, and ECJ, Case C-368/98 Abdon Vanbraekel and others v. Alliance nationale des mutualities chretiennes [2001] ECR I-5363.

  12. 12.

    ECJ, Case C-385/99 Müller-Fauré and van Riet [2003] ECR I-4509.

  13. 13.

    ECJ, Case C-56/01 Inizan v. Caisse primarie d’ Assurance Maladie des Hauts de Seine [2003] ECR I-12403.

  14. 14.

    For discussion regarding the development of the case law in this area for example, Hervey and McHale (2004), Chap. 4; Cabral (2004), p. 673; Koutrakos (2005); Palm and Glinos (2010).

  15. 15.

    See further McHale and Bell (2002), p. 39.

  16. 16.

    Supra n. 4.

  17. 17.

    Sections 1 and 3 NHS Act 2006.

  18. 18.

    Re J (a minor) [1992] 4 All ER.614, though see R v. Portsmouth Hospitals NHS Trust ex parte Glass [1999] Lloyd’s Rep Med 367, per Lord Woolf.

  19. 19.

    R v. Secretary of State for Social Services, ex p Hincks. ([1980] 1 BMLR 93); R v. Central Birmingham HA, ex p Walker (1987) 3 BMLR 32; R v. Central Birmingham Health Authority, ex p Collier. (Unreported, Court of Appeal 6 January 1988. LEXIS transcript); R v. Cambridge DHA, ex p B [1995] 1 WLR 898; R v. North Derbyshire HA ex parte Fisher [1997] 8 Med LR 327; R v. Secretary of State for Health ex parte Pfizer Ltd ([1999] Lloyds Rep Med 289); Cf., R (on the application of Rogers) v. Swindon NHS Primary Care Trust and another [2006] EWCA Civ 392. See further Brazier (2003); Newdick (2004); McHale (1999); Newdick (2007), p. 236.

  20. 20.

    National Health Service Act 2006 s.18.

  21. 21.

    National Institute for Clinical Excellence (Establishment and Constitution) Order 1999, SI 1999, No 220 and SI 1999, No 2219. For challenges in relation to the operation of NICE see Eisai Ltd v. NICE [2007] EWHC 1941. See further Syrett (2007), p. 127.

  22. 22.

    See further Rawlins (2005), p. 904.

  23. 23.

    Department of Health, Chose and Book- Patient’s Choice of Hospital and Booked Appointments, London, Department of Health, 2004.

  24. 24.

    Health and Consumer Protection Directorate General European Commission Summary Report of the responses to the consultation regarding community action on health services, SEC 2006, 1195/4 of 7 September 2006.

  25. 25.

    ECJ, Case C-372/04 R (on the application of Watts) v. Bedford Primary Care Trust, Secretary of State for Health [2006] ECR I-4325 and see further on this case Bois-Pedain, du [2007], p. 66; Davies, (2007a), pp. 160, 162; McHale [2007a], p. 99.

  26. 26.

    R v. Bedford PCT v. the Secretary of State for Health ex parte Watts,EWHC 2228. See further the discussion of the judgement of Munby J in McHale (2006), p. 169.

  27. 27.

    Supra n. 26, para 123.

  28. 28.

    Ibid., para 60.

  29. 29.

    Ibid., para 75.

  30. 30.

    Ibid., para 76.

  31. 31.

    See Davies (2007), p. 162 and Newdick (2006), p. 1661 at p. 1646 and further discussion in McHale (1999), p. 273.

  32. 32.

    Supra n. 26, para 116.

  33. 33.

    See further Newdick (2006).

  34. 34.

    Newdick (2005), p. 244. See also his chapter in this book.

  35. 35.

    See further Davies (2007).

  36. 36.

    Department of Health, ‘Going to Another European Country to Get Treatment’, http://www.dh.gov.uk/en/PolicyandGuidance/Healthadvicefortravellers/Gettingtreatmentaroundtheworld/EEAandSwitzerland/DH_4114804 (Department of Health, May 2007) and Department of Health Patient Mobility: Advice to Local Health Care Commissioners on Handling Requests for Hospital Care in other European Countries following the ECJ judgement in the Watts case. Gateway reference 8010, Department of Health, April 2007.

  37. 37.

    See further discussion in McHale (2007b), p. 263.

  38. 38.

    Report on Patient Mobility and Health care Developments in the EU (2005).

  39. 39.

    Council Conclusions of Common Values and Principles in EU Health Systems 2733rd Employment, Social Policy, Health and Consumer Affairs Council Meeting, Luxembourg 1–2 June 2006.

  40. 40.

    Directive 2006/123 [2006] OJ L 373/36. See the discussion in the chapter by Szyszczak.

  41. 41.

    Communication from the Commission, Consultation Regarding Community action on Health Services, Commission of the European Communities, Brussels, SEC (2006) 1195 of 26 September 2006.

  42. 42.

    House of Lords, EU Committee 8th Report of Session 2006–7, Cross-Border Health Services in the European Union Report with evidence, HL Paper 48.

  43. 43.

    Health and Consumer Protection Directorate-General, European Commission Summary Report of the responses to the consultation regarding Community action on health services (SEC 2006, 1195/4 of September 2006), 23–24.

  44. 44.

    Watson (2007), p. 974.

  45. 45.

    Proposal for a Directive of the European Parliament and of the Council on the application of patients’ rights in cross-border health care COM(2008) 414 final. See the discussion in the chapter by Szyszczak.

  46. 46.

    Commission Press Release IP/08/1080 and MEMO/08/473, 2 July 2008.

  47. 47.

    SI 2010, National Health Service (Reimbursement of the Cost of EEA Treatment) (England) Directions 2010.

  48. 48.

    Department of Health, Cross-border healthcare and patient mobility; revised advice on handling requests from patients for treatment in countries of the European Economic Area-Guidance to the NHS London, Department of Health (2010), para 3.9.

  49. 49.

    Supra n. 48, para 3.5.

  50. 50.

    Ibid., para 5.4.

  51. 51.

    Ibid., para 5.7.

  52. 52.

    Ibid., para 5.7.

  53. 53.

    Ibid., para 6.3.

  54. 54.

    Ibid., para 7.3.

  55. 55.

    Ibid., para 7.4.

  56. 56.

    Ibid., para 7.4.

  57. 57.

    Ibid., para 7.5.

  58. 58.

    Ibid., para 7.8.

  59. 59.

    Ibid., para 7.9.

  60. 60.

    Ibid., para 8.5.

  61. 61.

    Ibid., para 8.5.

  62. 62.

    Ibid., para 8.11.

  63. 63.

    Ibid., para 9.3.

  64. 64.

    Ibid., para 9.3.

  65. 65.

    Ibid., para 9.3.

  66. 66.

    Ibid., para 4.7.

  67. 67.

    Ibid., para 11.4.

  68. 68.

    Ibid., para 11.2.

  69. 69.

    See further Bowden (2009), p. 18.

  70. 70.

    Ibid.

  71. 71.

    Bowden (2009), p. 19.

  72. 72.

    See Palm and Glinos (2010), p. 551.

  73. 73.

    Supra n. 45, para 2.3.1.

  74. 74.

    Ibid., para 2.32.

  75. 75.

    Ibid., para 2.3.2.

  76. 76.

    Ibid., para 8.4.

  77. 77.

    Bowden (2009), p. 19.

  78. 78.

    House of Lords European Union Committee, Healthcare across EU borders; a safe framework, CM 7580 April 2009, para 124.

  79. 79.

    Ibid., para 124.

  80. 80.

    Ibid., para 125.

  81. 81.

    Ibid., para 134.

  82. 82.

    S.1 Health and Social Care Act 2008. See further discussion in McHale (2010).

  83. 83.

    McHale and Bell (2002), p. 39.

  84. 84.

    Article 5(d) and supra n. 45, para 8.6(16).

  85. 85.

    House of Lords European Union Committee, supra n. 78.

  86. 86.

    Ibid., para 144.

  87. 87.

    Ibid., para 145.

  88. 88.

    Ibid., para 145.

  89. 89.

    Nys (2001), p. 317.

  90. 90.

    Supra n. 45, para 8.1.

  91. 91.

    Ibid., para 7.5.

  92. 92.

    Ibid., para 4(a).

  93. 93.

    Commission Recommendation C (2008) 3282 of 2 July 2008 on cross-border interoperability of electronic health record systems.

  94. 94.

    Supra n. 78, para135.

  95. 95.

    BBC News, ‘Calls to halt England NHS patient database development’, http://news.bbc.co.uk/1/hi/health/8559045.stm.

  96. 96.

    Supra n. 78, para 177.

  97. 97.

    Ibid., para 167.

  98. 98.

    Ibid., para 178.

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Authors and Affiliations

  1. School of Law, University of Birmingham, Birmingham, UK

    Jean McHale

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  1. Jean McHale
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Correspondence to Jean McHale .

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Editors and Affiliations

  1. , Faculty of Law, Radboud University, Comeniuslaan 4, Nijmegen, 6525 HP, The Netherlands

    Johan Willem van de Gronden

  2. , School of Law, University of Leicester, University Road, Leicester, LE1 7RH, United Kingdom

    Erika Szyszczak

  3. , Faculty of Law, University of Copenhagen, Studiestræde 6, Copenhagen K, 1455, Denmark

    Ulla Neergaard

  4. , Fachbereich Rechtswissenschaft, Universität Erlangen-Nürnberg, Schillerstraße 1, Erlangen, 91054, Germany

    Markus Krajewski

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McHale, J. (2011). Health Care, the United Kingdom and the Draft Patients’ Rights Directive: One Small Step for Patient Mobility but a Huge Leap for a Reformed NHS?. In: van de Gronden, J., Szyszczak, E., Neergaard, U., Krajewski, M. (eds) Health Care and EU Law. Legal Issues of Services of General Interest. T.M.C. Asser Press, The Hague. https://doi.org/10.1007/978-90-6704-728-9_10

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