Wednesday, December 22, 2010

Cross-border health care

Just today I have been told again by somebody who thought he was very superior and sarcastic in his comments (for arguments they cannot be called) that the EU was not the enemy (true, it is the political class) and, really, what is all the fuss about. Has the House of Commons really voted away more powers recently, he asked with a smirk, and told me that his comments would probably leave me very angry. Actually, I said, determined ignorance leaves me full of contempt rather than anger.

When people genuinely do not know but ready to find out I am equally ready to explain. I am also very sympathetic to those who say they have enough trouble making their living and bringing up their family to have any time for rooting around in those boring EU documents. But when I hear somebody who is convinced he (or she, there are no gender differences in this) knows so much better than hopeless rubes like all those eurosceptics about politics and sneers in a superior fashion while refusing to find out the most basic facts, contempt becomes the most appropriate reaction.

On the subject of powers moving away: EurActiv reports
Despite opposition behind the scenes, plans to let Europeans seek medical treatment in other countries in the 27-country bloc surged forward Tuesday (21 December) when EU countries gave their stamp of approval.

The deal, reached at ambassador level (Coreper), paves the way for a vote in Parliament on 19 January and increases the chances the cross-border healthcare directive could be in force as early as 2013.
Coreper is the Committee of Permanent Representatives, possibly the most powerful body in the EU.

On the whole 2013 sounds a bit optimistic to me. There will be many hurdles to get over and even if the Directive is in place it will have to be implemented in the Member States and who knows what the situation will be by then.

As it happens, I think we shall do quite well out of this as a number of European countries have better hospital care and are ahead of the NHS in various treatments. For all of that, this will not be an example of a bilateral or, even, multilateral agreement between various countries. This will mean control over healthcare moving over to the EU. I am quite sure that the House of Commons will, if it comes up, vote the necessary legislation through and I am equally sure that I shall still get sneering comments about my obsession with power seeping over to the EU.


  1. "As it happens, I think we shall do quite well out of this as a number of European countries have better hospital care and are ahead of the NHS in various treatments"

    What of those without the financial means or physical ability to channel hop for care? The NHS budget will be claimed by the well-heeled, who can afford to travel and who can afford to wait for reimbursement for the care they paid for abroad. The poor and the bedbound, however, will find themselves queue-jumped again and again as health budgets leak away to overseas hospitals (unless the Health Services Directive has been substantially amended since the last time it failed in the Council). I cover this in my book (quoting that sage of our age, Frank Dobson).

    I agree with you on one point: it "will mean control over healthcare moving over to the EU". Even if this directive were welcome, any benefit would be negated by the Commission's (further) control of healthcare.

    Yours with very best wishes for Christmas.

  2. I am sorry, Clarence, you can't be serious about quoting Frank Dobson. Just a Christmas joke, I take it.

  3. To a certain extent this already exists in practise, at least for small treatments. When I go to France you pay for your treatment they give you the receipt and you claim back at home. You need an E111 to make it happen I believe. But we've never failed yet to get the money back. I guess this directive is talking about pre-planned major treatments which are a different kettle of fish.

  4. Ian, you're right about emergencies but the E111 has been superseded:
    you now need to register with

  5. Yes, Helen, it's a particularly poor joke from a cracker. But you and I can - when he's talking about the EU at least - find ourselves agreeing often enough with even Tony Benn. On this matter, I agree with Dobbo.

    Here he is discussing the Health Services Directive just after it first surfaced:

    Shortly before that, Nigel Edwards, policy director of the NHS Confederation, told the Today programme:

    “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 get first call on NHS resources. One of the concerns that a number of people – not just in this country – have is the impact that this [Health Services Directive] 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.” (BBC Today programme, 19 December 2007)

    This policy fails the poor (one could say the same about the NHS as it is but that's a separate argument). But even if the HSD were an undiluted boon for the poor, the rich, the lame and the halt, we eurosceptics must still resist *any* measure that bolsters the Commission's power over us - however much fun it would be to marginalise Mr Lansley - because the EU eventually destroys everything that it manages.

    Shameless plug: much of the above is from pp280-2 of:

  6. What is also depressing is that people who used to say (so often) that they really cared about freedom and British independence stay in the present government - they do not resign.

    Not just William Hague (who always seemed a bit of a phony), but also Ian Duncan-Smith - who (to me at least) seemed sincere.

    I fear this country is finished.

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