WRITTEN QUESTION P-1151/04 by Elizabeth Lynne (ELDR) to the Commission. Commissioning medical treatment abroad.
Date: 2004-04-06
Institutions: European Parliament, Provisional data
Subjects: hospital expenses, judgment of the Court (EU), medical diagnosis, right to health, social-security harmonisation

C 84 E/952

Official Journal of the European Union

EN

3.4.2004

(2004/C 84 E/1051)

WRITTEN QUESTION E-1136/04

by Erik Meijer (GUE/NGL) to the Commission

(15 April 2004)

Subject: Restrictions on the right to vote in European elections in Northern Ireland that have so far
disenfranchised 16,5 % of the population because of a complicated system of annual individual
voter registration

Is the Commission aware that rules in the United States under which people who are entitled to vote
1.
cannot do so unless they register to vote on various occasions have effectively disenfranchised a large
number of people, primarily those who are on low incomes, less well-educated, or who have a disability or
are less familiar with administrative formalities?

Does the Commission know that the electoral law in Northern Ireland was changed in May 2002 so
2.
that, unlike the rules in other parts of the United Kingdom and the Irish Republic, individual voters are
required to re-register before each election, submitting photographs and national insurance documents,
and that this has resulted in the numbers on the electoral roll dwindling every year?

Does the Commission realise that it is now evident that unless the rules are soon changed soon
3.
211 000 people who are entitled to vote, or 16,5 % of the population of Northern Ireland, will not be able
to take part in the forthcoming European Parliament elections?

Does the Commission not agree that if the new restrictions are aimed at combating fraud this aim
4.
can best be achieved by means of accurate population registers, accurate registration of anyone who is
temporarily deprived of the right to vote as a result of a court judgment, with speedy updating of electoral
registers and an effective system of checks at polling stations, so that anyone who is entitled to vote can
decide whether or not to go to the polls up until the day of the election?

5.
Does the Commission have any means, under the agreements between EU Member States concerning
elections to the European Parliament which have been in force since 1979 or on any other grounds, of
ensuring that restrictions on the right to vote in Northern Ireland will in any case not apply to the next
European elections in June? Is it prepared to use the means at its disposal?

Answer given by Mr Vitorino on behalf of the Commission

(30 April 2004)

Electoral registration is part of electoral procedures, the regulation of which falls under the responsibility
of the Member States. Electoral procedures for national or local elections are thus covered by national
legislation. This is also confirmed regarding elections to the Parliament in Article 8 of the 1976 Act (1) as
amended by Council Decision 2002/772/EC (2) which provides that electoral procedure shall be governed
in each Member State by its national provisions. In conclusion, electoral procedures are not harmonised by
Community law, and the Member States are not obliged to inform the Commission about changes in their
electoral laws.

(1) Act of 20 September 1976 concerning the election of the representatives of the European Parliament by direct

universal suffrage, annexed to Decision 76/787/ECSC, OJ L 278, 8.10.1976.

(2) Council Decision 2002/772/EC, Euratom of 25 June and 23 September 2002 amending the Act concerning the
election of the representatives of the European Parliament by direct universal suffrage, OJ L 283, 21.10.2002.

(2004/C 84 E/1052)

WRITTEN QUESTION P-1151/04

by Elizabeth Lynne (ELDR) to the Commission

Subject: Commissioning medical treatment abroad

(6 April 2004)

Does the Commission regard medical practitioners’ assessments of a patient’s clinical need (and thus the
determination of reasonable waiting time before a patient can seek treatment abroad) to be potentially
compromised by their position in health institutions with limited resources and competing demands on
those resources?

3.4.2004

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Official Journal of the European Union

C 84 E/953

According to the ruling by the European Court of Justice in the case of Geraets-Smits v. Stichting
Ziekenfonds (Case C-157/99), a patient can be denied medical treatment abroad only if ‘the patient can
receive the same or equally effective treatment without undue delay from an establishment with which his
sickness insurance has contractual arrangements.’

Considering that ‘undue delay’ is determined by a patient’s clinical need, what steps has the Commission
taken to ensure that the assessment of a patient’s need is not compromised by the financial considerations
of the competent institutions?

Answer given by Mr Bolkestein on behalf of the Commission

(30 April 2004)

In some Member States, patients are facing sometimes long waiting periods before getting medical
treatment which may prejudice their state of health.

The Court in its judgement in Smits and Peerboom (1) and in Muller-Fauré-van Riet (2) indicated that
authorisation to receive treatment in another Member State may be refused only if treatment which is the
same or equally effective for the patient can be obtained without undue delay in the Member State of
registration of the patient. The Court put the patient’s medical situation first in indicating that in
‘the national authorities are required to have regard to all
considering the condition of undue delay,
circumstances of each specific case and take due account not only of the patient’s medical condition at the
time when authorisation is sought and where appropriate, of the degree of pain and the nature of the
patient’s disability which might, for example, make it impossible or extremely difficult for him to carry out
a professional activity, but also of his medical history’ (Müller-Fauré/van Riet, C-385/99, paragraph 90).
the
Member States are therefore required to make an assessment on a case-by-case basis of all
circumstances surrounding the medical situation of the patient concerned and cannot simply refer to pre-
defined waiting times to refuse an authorisation for hospital treatment abroad.

The Commission would wish to inform the Honourable Member that in order to improve legal certainty
for the sake of patients who benefit as recipients from the free movement of services, and for health
professionals and managers of social security systems, it has recently adopted a proposal for a Directive on
Services in the Internal Market (3) that clarifies the conditions under which Member States shall ensure that
authorisation by their social security system is given for the assumption of the costs of hospital care
provided in another Member State. In particular, it specifies that such authorisation cannot be refused
where the treatment in question is among the benefits provided for by the legislation of the Member State
of affiliation and where such treatment cannot be given to the patient within a time frame which is
medically acceptable in the light of the patient’s current state of health and the probable course of the
illness.

This will allow medical practitioners to ensure that, where medically necessary, their patients can benefit
from the principles of the Internal Market. It will also assist Member States to make more efficient use of
existing health care infrastructures within the Union.

(1) Smits and Peerbooms judgement, Case C-157/99 of 12.07.01, ECR 2001 p. I-05473.
(2) Müller-Fauré and van Riet judgement, Case C-385/99 of 13.05 003, ECR 2003 p. I-04509.
(3) COM(2004) 2 final.

(2004/C 84 E/1053)

WRITTEN QUESTION P-1167/04

by José Ribeiro e Castro (UEN) to the Commission

(7 April 2004)

Subject: Regulation No 1954/2003: fishing activity in the Azores EEZ

The Commission stated in its answer to my written question P-0455/04 (1) of 11 March 2004 on
Regulation No 1954/2003 (2) and fishing by Spanish vessels between the 100-mile and 200-mile limits of