Conclusions of the Council and of the Representatives of the Member States meeting in the Council of 19 July 2002 on patient mobility and health care developments in the European Union

(2002/C 183/01)

1. The Council and the Representatives of the Member States meeting in the Council recognise that the health care systems in the European Union share common principles of solidarity, equity and universality, despite their diversity. They also recognise the emerging interaction between health systems within the European Union particularly as a result of the free movement of citizens, and their desire to have access to high-quality health services.

2. The Council recalls that according to Article 152 of the Treaty, Community action in the field of public health must fully respect the responsibilities of the Member States for the organisation and delivery of health services and medical care. However, it recognises that other developments, such as those relating to the single market, have an impact on health systems. The Council is concerned that these should be consistent with the Member States' health policy objectives, and the common principles outlined above. It therefore considers that there is added value in examining certain health issues from a perspective that goes beyond national borders. In this context it welcomes the debate at the seminar of health ministers held in Malage in February 2002 which set out a number of priority issues for further cooperation and takes note of the expert discussions on this subject.

3. The Council takes note of the ongoing work in the future of health care and care for the elderly being carried out by the Social Protection Committee and the Economic Policy Committee on the basis of the conclusions of successive European Councils. It als notes the work being undertaken on the reform and modernisation of Regulation (EEC) No 1408/71 which should provide a simplified framework to support, inter alia, patient mobility. It underlines the necessity to take health concerns and patients' interests fully into account in this process in which the delivery of care shall be another main concern together with the administrative issues. The relevant instances of the Community and its Member States should be fully involved regarding the implications of this process. In particular, the Ministers of Health should be fully involved in this process.

4. With regard to developing cross-border cooperation, the Council and Member States' representatives recognise that bilateral or regional arrangements, which respect the competence of Member States to organise their health care systems and which are in accordance with relevant Community legislation, can play an important role, and they underline the importance of sharing information about such initiatives. They emphasise that patient mobility, especially concerned with tourism or long-term residence abroad, presents particular challenges in terms of the need to exchange clinical and other information, in order to ensure proper follow-up and continuity of care. They recognise the importance of cooperation, inter alia, to examine the benefit of reference centres, in order to facilitate the most effective treatment for those diseases requiring specialist interventions.

5. The Council recognises that the new programme of Community action in the field of public health together with, inter alia, the new research and telematics programmes provide a framework to pursue a number of issues in relation to mobility of patients, in particular aspects relating to information and exchanges of experience.

6. In the light of these considerations, the Council and Member States' representatives consider that there is a need to strengthen cooperation in order to promote the greatest opportunities for access to health care of high quality while maintaining the financial sustainability of health care systems in the European Union. The imminent enlargement of the Euopean Union makes this even more imperative.

7. To this end the Council and the Representatives of the Member States meeting in the Council:

- recognise that there would be value in the Commission pursuing in close cooperation with the Council and all the Member States - particularly health ministers and other key stakeholders - a high level process of reflection. This process should be closely coordinated with relevant work ongoing in different fora, including action already initiated in the context of the Lisbon process. This high-level process of reflection, about which they wish to be kept regularly informed, should aim at developing timely conclusions for possible further action.

- welcome the Commission's intention to take forward work in this field, inter alia, by including relevant actions in its work plan for the programme of Community action in the field of public health.

8. The Council and Member States' rerpresentatives will return to this issue at the next meeting of the Health Council, taking into account the developments of the reflection process mentioned above.