Case C-372/04: Judgment of the Court (Grand Chamber) of  16 May 2006  (reference for a preliminary ruling from the Court of Appeal (Civil Division) — United Kingdom) — The Queen, on the application of Yvonne Watts v Bedford Primary Care Trust, Secretary of State for Health (Social security — National health system funded by the State — Medical expenses incurred in another Member State — Articles 48 EC to 50 EC and 152(5) EC — Article 22 of Regulation (EEC) No 1408/71)
Date: 2006-07-15
Institutions: Court of Justice
Subjects: State health service, free movement of persons, freedom to provide services, health care, health expenditure, health service, interpretation of the law, social security

C 165/6

EN

Official Journal of the European Union

15.7.2006

Parties to the main proceedings

Parties to the main proceedings

Applicant: Land Oberösterreich

Defendant: ČEZ a.s.

Re:

Reference for a preliminary ruling — Oberster Gerichtshof
(Austria) — Interpretation of Article 16(1)(a) of the Brussels
Convention — Exclusive jurisdiction for ‘proceedings which
have as their object rights in rem in immovable property’ —
Action for cassation of a nuisance caused, or likely to be
caused to agricultural
land by a neighbouring nuclear plant
located on the territory of a non-contracting State

Operative part of the judgment

The Court:

Article 16(1)(a) of the Convention of 27 September 1968 on Juris-
diction and the Enforcement of Judgments in Civil and Commercial
Matters, as amended most
recently by the Convention of 29
November 1996 on the Accession of the Republic of Austria, the
Republic of Finland and the Kingdom of Sweden, must be interpreted
as meaning that an action which, like that brought under Paragraph
364(2) of the Allgemeines bürgerliches Gesetzbuch (Austrian Civil
Code) in the main proceedings, seeks to prevent a nuisance affecting
or likely to affect land belonging to the applicant, caused by ionising
radiation emanating from a nuclear power station situated on the
territory of a neighbouring State to that in which the land is situated,
does not fall within the scope of that provision.

(1) OJ C 251, 9.10.2004.

Judgment of the Court (Grand Chamber) of 16 May 2006
(reference for a preliminary ruling from the Court of
Appeal
(Civil Division) — United Kingdom) — The
Queen, on the application of Yvonne Watts v Bedford
Primary Care Trust, Secretary of State for Health

(Case C-372/04) (1)

(Social security — National health system funded by the
State — Medical expenses incurred in another Member State
— Articles 48 EC to 50 EC and 152(5) EC — Article 22 of
Regulation (EEC) No 1408/71)

(2006/C 165/11)

Language of the case: English

Referring court

Court of Appeal (Civil Division)

Applicants: The Queen, on the application of Yvonne Watts

Defendants: Bedford Primary Care Trust, Secretary of State for
Health

Re:

Reference for a preliminary ruling — Court of Appeal (Civil
Division) — Interpretation of Articles 48, 49, 50, 55 and
152(5) EC and Article 22 of Council Regulation (EEC) No
1408/71 on the application of social security schemes to
employed persons, to self-employed persons and to members
of their families moving within the Community, as amended
and updated by Council Regulation (EC) No 118/97 of
2 December 1996, and of Council Regulation (EEC) No 574/72
of 21 March 1972 fixing the procedure for implementing
Regulation No 1408/71, as amended and updated by Regu-
lation No 118/97 — Conditions for reimbursement of the costs
of hospital treatment incurred without prior authorisation in a
Member State other than that of the competent authority

Operative part of the judgment

1. The second subparagraph of Article 22(2) of Council Regulation
(EEC) No 1408/71 of 14 June 1971 on the application of social
security schemes to employed persons,
to self-employed persons
and to members of their families moving within the Community,
as amended and updated by Council Regulation (EC) No 118/97
of 2 December 1996, must be interpreted as meaning that, in
order to be entitled to refuse to grant the authorisation referred to
in Article 22(1)(c)(i) of that regulation on the ground that there is
a waiting time for hospital treatment, the competent institution is
required to establish that that time does not exceed the period
which is acceptable on the basis of an objective medical assessment
of the clinical needs of the person concerned in the light of all of
the factors characterising his medical condition at the time when
the request for authorisation is made or renewed, as the case may
be.

2. Article 49 EC applies where a person whose state of health neces-
sitates hospital treatment goes to another Member State and there
receives such treatment for consideration, there being no need to
determine whether the provision of hospital treatment within the
national health service with which that person is registered is in
itself a service within the meaning of the Treaty provisions on the
freedom to provide services.

Article 49 EC must be interpreted as meaning that it does not
preclude reimbursement of the cost of hospital treatment to be
provided in another Member State from being made subject to the
grant of prior authorisation by the competent institution.

A refusal to grant prior authorisation cannot be based merely on
the existence of waiting lists intended to enable the supply of
hospital care to be planned and managed on the basis of predeter-
mined general clinical priorities, without carrying out an objective
medical assessment of the patient's medical condition, the history
and probable course of his illness, the degree of pain he is in and/
or the nature of his disability at the time when the request for
authorisation was made or renewed.

15.7.2006

EN

Official Journal of the European Union

C 165/7

Where the delay arising from such waiting lists appears to exceed
an acceptable time having regard to an objective medical assess-
ment of the abovementioned circumstances, the competent institu-
tion may not refuse the authorisation sought on the grounds of
the existence of those waiting lists, an alleged distortion of the
normal order of priorities linked to the relative urgency of the cases
to be treated, the fact that the hospital treatment provided under
the national system in question is free of charge, the obligation to
make available specific funds to reimburse the cost of treatment to
be provided in another Member State and/or a comparison
between the cost of that treatment and that of equivalent treatment
in the competent Member State.

objective medical assessment of the condition and clinical require-
ments of the patient concerned does not contravene Article 152(5)
EC.

(1) OJ C 273, 6.11.2004.

treatment,

3. Article 49 EC must be interpreted as meaning that where the
legislation of the competent Member State provides that hospital
treatment provided under the national health service is to be free of
charge, and where the legislation of the Member State in which a
patient
registered with that service was or should have been
authorised to receive hospital treatment at the expense of that
service does not provide for the reimbursement in full of the cost of
that
institution must reimburse that
patient the difference (if any) between the cost, objectively quanti-
fied, of equivalent treatment in a hospital covered by the service in
the treatment
question up to the total amount
provided in the host Member State and the amount which the
institution of the latter Member State is required to reimburse
under Article 22(1)(c)(i) of Regulation No 1408/71, as amended
and updated by Regulation No 118/97, on behalf of the compe-
tent institution pursuant to the legislation of that Member State.

the competent

invoiced for

Article 22(1)(c)(i) of Regulation No 1408/71 must be interpreted
as meaning that the right which it confers on the patient concerned
relates exclusively to the expenditure connected with the healthcare
received by that patient in the host Member State, namely, in the
treatment, the cost of medical services strictly
case of hospital
defined and the inextricably linked costs relating to his stay in the
hospital.

Article 49 EC must be interpreted as meaning that a patient who
was authorised to go to another Member State to receive there
hospital treatment or who received a refusal to authorise subse-
quently held to be unfounded is entitled to seek from the competent
institution reimbursement of the ancillary costs associated with
that cross-border movement for medical purposes provided that the
the competent Member State imposes a corre-
legislation of
sponding obligation on the national system to reimburse in respect
of treatment provided in a local hospital covered by that system.

4. The obligation of the competent institution under both Article 22
of Regulation No 1408/71, as amended and updated by Regu-
lation No 118/97, and Article 49 EC to authorise a patient
registered with a national health service to obtain, at that institu-
tion's expense, hospital treatment in another Member State where
the waiting time exceeds an acceptable period having regard to an

Judgment of the Court (Third Chamber) of 11 May 2006
(reference for a preliminary ruling from the Court of
Appeal (Civil Division) — United Kingdom) — Commis-
sioners of Customs & Excise, Attorney General v Federa-
tion of Technological Industries and Others

(Case C-384/04) (1)

(Sixth VAT Directive — Articles 21(3) and 22(8) —
National measures to combat fraud — Joint and several liabi-
lity for the payment of VAT — Provision of security for VAT
payable by another trader)

(2006/C 165/12)

Language of the case: English

Referring court

Court of Appeal (Civil Division)

Parties to the main proceedings

Appellants: Commissioners of Customs & Excise, Attorney
General

Respondents: Federation of Technological Industries and Others

Re:

Reference for a preliminary ruling — Court of Appeal (Civil
Division) — Interpretation of
Sixth Council Directive
77/388/EEC of 17 May 1977 on the harmonisation of the laws
of the Member States relating to turnover taxes — Common
system of value added tax: uniform basis of assessment (OJ
1977 L 145, p. 1) — Scope of Article 21(3) whereby Member
States may provide that a person other than the taxpayer is
jointly and severally liable for payment of the tax — ‘Carousel’
type frauds

Operative part of the judgment

1. Article 21(3) of Sixth Council Directive 77/388/EEC of 17 May
1977 on the harmonisation of the laws of the Member States
relating to turnover taxes — Common system of value added tax:
uniform basis of assessment, as amended by Council Directives
2000/65/EC of 17 October 2000 and 2001/115/EC of 20
December 2001, is to be interpreted as allowing a Member State
to enact legislation, such as that in issue in the main proceedings,
which provides that a taxable person, to whom a supply of goods