WRITTEN QUESTION E-2350/02

by Alexandros Alavanos (GUE/NGL) to the Commission

(30 July 2002)

Subject: Children with multiple disabilities

A report from the Ministry of Education in Greece states that, for one category of children with multiple disabilities (simultaneously suffering from psychomotor deficiencies, blindness and lack of self-sufficiency in terms of their basic needs), there is no specific, specialised infrastructure for the rehabilitation of their injuries and their care, so that their living conditions depend on their close relatives.

Article 13 of the Treaty establishing the European Community stipulates that the Council may take appropriate action to combat discrimination based on sex (), disability, age or sexual orientation. In its resolution on equal opportunities for people with disabilities (20/12/96, 97/C 12/01), the Council expressed its commitment to the principle of equality of opportunity in the development of comprehensive policies in the field of disability and substantial funding has already been allocated to measures in favour of individuals with special needs. In view of this:

1. Does the Commission intend to contribute to the establishment of a protection and care framework in Greece which will give these individuals the opportunity to lead lives which are as dignified as possible? What arrangements are made in the other Member States for people with disabilities of this type?

2. Within the context of the free movement of people, is it possible for these children to be admitted to centres or institutions established in other Member States under the applicable rules, provided that their guardians wish them to do so and they cannot be catered for in Greece?

3. 2003 has been designated European Year of Disabled People; with this in mind, does the Commission intend to take any additional initiatives to improve the lives of children in this category?

Answer given by Mrs Diamantopoulou on behalf of the Commission

(16 September 2002)

The arrangements for treatment of individual citizens in institutions within a Member State does not fall within the competence of the Commission and it is therefore unable to intervene in individual instances. However, since 1984, under the Community Support Framework (CSF), financial assistance has been made available in order to support

reforms in the psychiatric care sector. Under the CSF2, projects in Greece have contributed to tackling the issues raised by the Honourable Member. The CSF3 agreed in 2000 (for the period 2000-2006) to provide financial assistance for actions to tackle these issues. In particular, under the Operational Programme for Health and Welfare, just over EUR 513 million is available under five priority axes, including health, mental health and welfare measures. A number of actions have already begun which specifically target improvements in the situation of children with disabilities.

In the context of the right to free movement for persons in the Union, the Commission would refer in the first place to Regulation (EEC) No 1408/71(1) which co-ordinates the national social security schemes. As far as the care for disabled children could be considered as health care, there is the possibility of invoking the provisions of Article 22 of this Regulation concerning persons who deliberately go to another Member State to receive medical care. In this case, Article 22 of Regulation (EEC) No 1408/71 stipulates that this person must obtain prior authorisation from the sickness insurance institution where he is insured. This prior authorisation may not be refused when the medical care provided for under the legislation of the Member State of residence cannot be provided within the time normally necessary for obtaining the treatment in question, taking account of the person's state of health and the probable course of the disease. In all other instances, the sickness institution enjoys a large margin of discretion in deciding whether to grant its authorisation or not.

Nevertheless, in the decisions Kohll (C-155/96), Decker (C-120/95), Smits and Peerbooms (C-157/99) and Vanbraekel (C-368/98), the Court of Justice stated that when exercising their powers, Member States must comply with Community Law. In these decisions the Court indicated that Regulation (EEC) No 1408/71 is not designed to regulate the reimbursement by Member States as such and hence does not in any way prevent Member States from reimbursing costs at the tariffs in force in the competent Member State, which incurred in connection with treatment provided in another Member State, even without prior authorisation. According to the Court, tourists, persons receiving medical treatment and persons travelling for the purpose of education or business are all to be regarded as recipients of services, so that they benefit from the freedom to provide services as mentioned in Article 49 of the EC Treaty, even without having been authorised. Furthermore, in the Kohll judgement the Court confirmed that a Member State should provide for the reimbursement of the costs of medical treatment obtained in another Member State in so far as the treatment obtained in the other Member State is part of the medical services paid for by the social insurance system of the Member State of insurance and the tariffs of the Member State of insurance applied. However, it depends on the specific circumstances, especially on the desired kind of treatment, whether the national legislation can be considered as justified.

Regarding the European Year of People with Disabilities, within the establishing Council Decision(2), each Member State must establish or designate a national co-ordinating body which is responsible for the implementation of the European Year within its territory. One of the roles of this body will be to establish a strategy and key priorities for the Member State in question. It is therefore the national co-ordinating body in Greece which must decide whether there should be particular focus on disabled children in Greece during the Year.

(1) Regulation (EEC) No 1408/71 of the Council of 14 June 1971 on the application of social security schemes to employed persons and their families moving within the Community OJ L 82, 27.3.1980.

(2) 2001/903/EC: Council Decision of 3 December 2001 on the European Year of People with Disabilities 2003 OJ L 335, 19.12.2001.