Politicians must choose between EU Health Directive and the NHS
03 July 2008
Responding to the publication of the EU's Health Directive today, Open Europe said that politicians now had to choose between the proposed EU Directive and the NHS model of funding.
Key points:
Under the planned law, patients in the EU will be allowed to receive non-hospital treatment outside their home country without pre-approval from their doctor or health authority. The patient's home healthcare service will have to pay the bill - but only up to the amount the treatment would cost in the home state. When the cost of treatment is larger, the patient will have to top up the difference.
For this reason critics are indeed right to point out that the Directive is similar to the "patients passport" which the Conservatives proposed in the past, and there are good reasons why the Conservatives have now moved away from that model with their current proposals on patient choice.
Two particular features of the Directive are problematic and would potentially favour higher income groups. Firstly, that people would spend money on treatments abroad, and then be reimbursed later, and secondly, that the system would operate on a top-up basis - patients could get a certain proportion of the cost of a treatment reimbursed by the NHS, but make up the difference themselves. Both these features would tend to lead to the diversion of resources towards higher income groups.
Put simply, if the well-off use up the NHS budget buying services abroad, there will be less money left for those who cannot afford to top up the difference.
Ironically, both main parties have been resisting moves towards allowing such "top up" payments in the UK. However, Health Minister Alan Johnson was forced to announce a review of the policy last month after a series of high profile cases where patients wanted to top up.
Nigel Edwards, Policy Director of the NHS Confederation, has said that, "the issue here is that people who are able to travel can go and get their procedure and because we have a fixed pot of money, that effectively means they can get first call on the NHS resources; one of the concerns that a number of people have - and not just in this country - is the impact that this has on trying to run an equitable system... there could be an effect here where those who are able to travel and pay upfront can to some extent push to the front of the queue... it has a potential differential effect that favours the young, mobile and relatively affluent." (Today Programme, 19 December 2007)
The Directive was first proposed in December last year, but withdrawn after widespread controversy. A full briefing can be found here:
http://www.openeurope.org.uk/research/health.pdf
Neil O'Brien, Director of Open Europe, said:
"Both main political parties are in danger of contradicting themselves. They don't want to allow top up payments at home, but will welcome their introduction at the European level."
"There are good arguments for introducing markets into healthcare. However, there are some big problems with this Directive which could lead to unfair queue-jumping by the well-off."
"The Directive also allows the EU to start regulating many other aspects of the way we run healthcare in Britain, from medical standards to prescriptions. It is no exaggeration to say that in a few years time we might end up with a European Health Service rather than a National Health Service."
"The Government is pretending this Directive is no big deal, but it will mark the end of the way we have run healthcare in Britain since the Second World War. Some will see the beginning of the end of the NHS as a good thing, and others will disagree, but either way it is a hugely significant moment."
Notes for Editors
For more information please call Neil O'Brien on 0207 197 2333 or 07973 142775.