European and External Affairs Committee
Response to the report of the National Assembly European and External Affairs Committee's report on the Draft Directive on Patients’ Rights in Cross-border Healthcare
We welcome the findings in the report. This IS a complex issue in that as you will be aware, the initial draft Directive will be amended through a complicated process of negotiation involving the Commission, the 27 Member States and the European Parliament. That negotiation is on-going and whilst the Welsh Assembly Government is not directly involved in that process, my officials and I have been In constant communication with the Department of Health which is handling this non-devolved matter on behalf of the United Kingdom.
1. Recommendation
The Committee recommends that the Welsh government urges the UK Government to seek a further amendment to Article 20, paragraph 1 of the Directive, which would require the Commission to collect data on patient outflows and inflows at "regional" level. so that this takes account of impact within devolved health care systems in Member States, rather than just at a Member State level.
Partial acceptance
The principle of collecting data at regional level is accepted, but no action is needed to change the Directive as this matter is already being managed within the Commission, Eurostat, the Statistical Office of the European Communities, has already set in train arrangements for collecting cross-border healthcare data at regional level.
2 Recommendation
The Committee recommends that the Welsh government provides assurances that a full impact assessment of the Directive (including an equality impact assessment) is conducted which specifically takes account of the needs of Welsh patients and service provision in Wales and prevents those already disadvantaged in accessing healthcare from being at a double disadvantage.
Accepted
A partial impact assessment was undertaken by the United Kingdom government at an early stage in the discussions on the Directive. A fuller impact assessment will be undertaken in due course and the Welsh Assembly Government will need to clarify its engagement with that process In addition, the Welsh Assembly Government will undertake a full impact assessment when the time comes for implementation of the Directive.
3 Recommendation
The Committee recommends that the Welsh government closely monitors the issue of establishing national contact points and their role in providing information to patients on their rights to cross-border healthcare, to ensure that arrangements for Welsh patients are satisfactory but do not place an unnecessary administrative or financial burdens on Welsh health bodies.
Accepted
The final scope and role of the national contact points are still to be determined. The Welsh Assembly Government will monitor the negotiations and S!lares the objectives of the Committee on this point.
4 Recommendation
The Committee recommends that the Welsh government urges the UK Government to argue strongly in the discussions in Council for the draft Directive to be amended to give explicit recognition of the gatekeeper model that exists in the UK, and the importance of prior authorisation for patients seeking hospital care and certain costly non-hospital care.
Accepted
The Welsh Assembly Government and the other governments in the United Kingdom are united in support of this point.
5 Recommendation
The Committee would like to see further clarification in the draft Directive on the issue of patient redress, perhaps by amendments within Article 5(1) to ensure that patients are aware of what constitutes "harm" in the Member State of treatment and, if harm is caused, what remedies will be available and against whom. The Committee recommends that the Welsh government seeks a response from the UK Government as to whether it will be taking this matter forward in negotiations on the draft Directive.
Partial Acceptance
The Welsh Assembly Government supports strong safeguards for patients travelling abroad, and the Directive lays a clear responsibility in this area on the country of treatment and on the provider of the service. This has already been a matter of negotiation, with the United Kingdom government fully engaged. Securing a common definition of 'harm' has proved elusive because of the differences in understanding and practice across the 27 countries. It is likely that this will be deleted from the text.
6 Recommendation
The lack of recognition of pharmacist prescribers in the Directive is a UK-wide issue. The Committee recommends that the Welsh government seeks a response from the UK Government regarding the concern raised by the Royal Pharmaceutical Society of Great Britain in its evidence and whether it will be taking this matter forward in negotiations on the draft Directive.
Partial Acceptance
This is a difficult matter in that different countries have different practices.
The current position of the United Kingdom government is that only prescriptions from those with appropriate qualifications within the Mutual Recognition Directive should be dispensed but this is subject to continuing negotiations.
7 Recommendation
The Committee recommends that the Welsh government provides it with assurances that it will be in direct consultation with the UK Department of Health in the process of the future transposition of the Directive. to ensure that the implementation of the Directive will adequately address the issues raised in the Committee's report.
Accepted
The Welsh Assembly Government has worked closely with the UK government and other devolved administrations on negotiations and work has already started on preparing the way for the transposition process.
