natgillin/translations-raw huggingface dataset:
"92 Whilst it is not in dispute that Community law does not detract from the power of the Member States to organise their social security systems, and that, in the absence of harmonisation at Community level, it is for the legislation of each Member State to determine the conditions in which social security benefits are granted, when exercising that power Member States must comply with Community law, in particular the provisions on the freedom to provide services (see, inter alia, Smits and Peerbooms, paragraphs 44 to 46; Müller-Fauré and van Riet, paragraph 100; and Inizan, paragraph 17). Those provisions prohibit the Member States from introducing or maintaining unjustified restrictions on the exercise of that freedom in the healthcare sector."
"92 Iako nije sporno da pravo Zajednice ne oduzima ovlasti država članica da organiziraju svoje sustave socijalne sigurnosti i da u nedostatku usklađenosti na razini Zajednice svaka država članica u svojem zakonodavstvu treba utvrditi uvjete dodjele davanja socijalne sigurnosti, prilikom provedbe tih ovlasti države članice moraju poštovati pravo Zajednice, posebno odredbe o slobodnom pružanju usluga (osobito vidjeti ranije navedene presude Smits i Peerbooms, t. 44. do 46.; Müller-Fauré i van Riet, t. 100., kao i Inizan, t. 17.). Te odredbe zabranjuju državama članicama uvođenje ili održavanje neopravdanih ograničenja pri provedbi te slobode u području zdravstvene skrbi."
93 It is therefore necessary to ascertain whether there is any such restriction in a case such as that in issue in the main proceedings.
93 Stoga valja utvrditi postoji li takvo ograničenje u slučaju poput ovog koji je predmet glavnog postupka.
"94 It should be noted in this connection that according to well-established case-law, Article 49 EC precludes the application of any national rules which have the effect of making the provision of services between Member States more difficult than the provision of services purely within a Member State (Case C-381/93 Commission v France [1994] ECR I-5145, paragraph 17; Kohll, paragraph 33; and Smits and Peerbooms, paragraph 61)."
94 S tim u vezi valja podsjetiti da jee prema ustaljenoj sudskoj praksi članku 49. UEZ-a protivna primjena bilo kojeg nacionalnog propisa koji za učinak ima da je između država članica teže pružati usluge nego što je slučaj s pružanjem usluga isključivo unutar jedne države članice (vidjeti presudu od 5. listopada 1994., Komisija protiv Francuske, C-381/93, Zb., str. I-5145., t. 17., ranije navedenu presudu Kohll, t. 33., kao i ranije navedenu presudu Smits i Peerbooms, t. 61.).
95 In the present case it is clear from the decision of 20 February 2004 of the referring court and from the order for reference, in particular the third question, that, whilst NHS patients are free to go to a hospital in another Member State, they cannot have treatment in such an establishment at the NHS’s expense without prior authorisation.
95 U ovom slučaju iz odluke suda koji je uputio zahtjev od 20. veljače 2004. kao i iz zahtjeva za prethodnu odluku proizlazi, posebno u pogledu trećeg pitanja, da iako pacijenti u okviru NHS-a imaju mogućnost odlaska na bolničko liječenje u drugu državu članicu, u takvoj ustanovi ne mogu obaviti liječenje na trošak NHS-a bez prethodnog odobrenja.
96 It is true, as the United Kingdom, Spanish, Maltese and Finnish Governments and Ireland submit, that an NHS patient cannot choose when and where the hospital treatment required by his state of health will be provided under the NHS. However, it is not in dispute that the corollary of the Secretary of State’s duty under sections 1 and 3 of the NHS Act (see paragraph 6 of the present judgment) is the right to obtain treatment available under the NHS free of charge in NHS hospitals without having to seek prior authorisation.
96 Točno je, kako su navele vlada Ujedinjene Kraljevine te španjolska, malteška i finska vlada i Irska, da pacijent u okviru NHS-a ne može odabrati vrijeme i mjesto obavljanja bolničkog liječenja koje zahtijeva njegovo zdravstveno stanje u okviru ustanova NHS-a. Međutim, nije sporno da je posljedica obveze ministra zdravlja na temelju članaka 1. i 3. Zakona o NHS-u (vidjeti t. 6. ove presude) pravo na besplatno liječenje u ustanovama NHS-a u okviru istoga bez traženja prethodnog odobrenja.
97 Thus whereas according to the decision of 20 February 2004 and the order for reference prior authorisation is a prerequisite for the NHS to assume the costs of hospital treatment available in another Member State, the receipt of free NHS treatment does not depend on such authorisation, only the means of receiving that treatment being subject to a prior decision by the national competent authorities.
97 Međutim kako prema odluci od 20. veljače 2004. i zahtjevu za prethodnu odluku, prethodno odobrenje uvjetuje da NHS preuzme troškove bolničkog liječenja dostupnog u drugoj državi članici, dobivanje besplatnog liječenja u okviru NHS-a ne ovisi o takvom odobrenju, već samo načini dobivanja takvog liječenja podliježu prethodnoj odluci nadležnih nacionalnih tijela.
98 It must therefore be found that the system of prior authorisation referred to in paragraph 95 of the present judgment deters, or even prevents, the patients concerned from applying to providers of hospital services established in another Member State and constitutes, both for those patients and for service providers, an obstacle to the freedom to provide services (see to that effect Smits and Peerbooms, paragraph 69, and Müller-Fauré and van Riet, paragraph 44).
98 Stoga valja utvrditi da sustav prethodnog odobrenja naveden u točki 95. ove presude odvraća ili čak i sprečava dotične pacijente da se obrate pružateljima bolničkih usluga sa sjedištem u drugoj državi članici i čini, kako za pacijente tako i pružatelje usluga, prepreku slobodnom pružanju usluga (vidjeti u tom smislu ranije navedene presude Smits i Peerbooms, t. 69., kao i Müller-Fauré i van Riet, t. 44.).
99 That conclusion is not undermined by the fact, referred to in Question 1(b), that the NHS is not obliged to authorise and assume the cost of hospital treatment provided to patients in private non-NHS hospitals in England and Wales.
99 Ovu analizu ne dovodi u pitanje činjenica, navedena u prvom pitanju pod (b), da NHS nije obvezan odobriti i preuzeti troškove bolničkog liječenja pruženog pacijentima u privatnim ustanovama u Engleskoj i Walesu, koje nisu u okviru NHS-a.
100 In applying the case-law set out in paragraph 94 of the present judgment, the conditions for the NHS’s assuming the cost of hospital treatment to be obtained in another Member State should not be compared to the situation in national law of hospital treatment received by patients in private local hospitals. On the contrary, the comparison should be made with the conditions in which the NHS provides such services in its hospitals.
100 Za primjenu sudske prakse navedene u točki 94. ove presude, uvjete prema kojima NHS preuzima troškove bolničkog liječenja koje će se obaviti u drugoj državi članici ne bi trebalo uspoređivati sa situacijom u nacionalnom pravu u pogledu bolničkog liječenja pacijenata u privatnim lokalnim ustanovama. Suprotno tome, trebalo bi ih uspoređivati s uvjetima u kojima NHS pruža takve usluge u svojim bolnicama.
101 Since the existence of a restriction on the freedom to provide services has been established, and before ruling on whether an NHS patient is entitled under Article 49 EC to receive hospital medical treatment in another Member State at the expense of the national service concerned without such a restriction, it is necessary to examine whether that restriction can be objectively justified.
101 S obzirom na postojanje ograničenja na slobodno pružanje usluga, i prije odlučivanja o pitanju ima li pacijent u okviru NHS-a pravo na temelju članka 49. UEZ-a na bolničko liječenje u drugoj državi članici na trošak dotične nacionalne službe bez takvog ograničenja, valja ispitati može li takvo ograničenje biti objektivno opravdano.
102 As was done in a large number of the observations submitted to the Court, it is necessary to recall in this regard the overriding considerations capable of justifying obstacles to the freedom to provide hospital medical services.
102 S tim u vezi valja podsjetiti, kako je to bilo učinjeno u velikom broju očitovanja podnesenih Sudu, na potrebne zahtjeve za opravdanje ograničenja na slobodno pružanje bolničkih zdravstvenih usluga.
"103 The Court has already held that it is possible for the risk of seriously undermining the financial balance of a social security system to constitute an overriding reason in the general interest capable of justifying an obstacle to the freedom to provide services (Kohll, paragraph 41; Smits and Peerbooms, paragraph 72; and Müller-Fauré and van Riet, paragraph 73)."
103 Sud je već presudio da je moguće da rizik ozbiljnog narušavanja financijske ravnoteže sustava socijalne sigurnosti čini važan razlog u općem interesu koji može opravdati prepreku slobodnom pružanju usluga (ranije navedene presude Kohll, t. 41., Smits i Peerbooms, t. 72., kao i Müller-Fauré i van Riet, t. 73.).
"104 The Court has likewise acknowledged that the objective of maintaining a balanced medical and hospital service open to all may also fall within the derogations on grounds of public health under Article 46 EC in so far as it contributes to the attainment of a high level of health protection (Kohll, paragraph 50; Smits and Peerbooms, paragraph 73; and Müller-Fauré and van Riet, paragraph 67)."
"104 Sud je isto tako potvrdio da cilj održavanja uravnotežene zdravstvene i bolničke usluge koja je svima dostupna može također ulaziti u odstupanja na osnovi javnog zdravlja na temelju članka 46. UEZ-a u mjeri u kojoj taj cilj doprinosi postizanju više razine zdravstvene zaštite (ranije navedene presude Kohll, t. 50.; Smits i Peerbooms, t. 73. kao i Müller-Fauré i van Riet, t. 67.)."
"105 The Court has also held that Article 46 EC permits Member States to restrict the freedom to provide medical and hospital services in so far as the maintenance of treatment capacity or medical competence on national territory is essential for the public health, and even the survival, of the population (Kohll, paragraph 51; Smits and Peerbooms, paragraph 74; and Müller-Fauré and van Riet, paragraph 67)."
105 Sud je također pojasnio da članak 46. UEZ-a omogućuje državama članicama ograničavanje slobodnog pružanja zdravstvenih i bolničkih usluga u mjeri u kojoj je održavanje kapaciteta liječenja ili zdravstvenih mogućnosti na državnom području bitno za javno zdravlje, pa čak i preživljavanje stanovništva (ranije navedene presude Kohll, t. 51., Smits i Peerbooms, t. 74., kao i Müller-Fauré i van Riet, t. 67.)
106 It is therefore necessary to determine whether the restriction at issue can in fact be justified in the light of such overriding reasons, and if such is the case to make sure, in accordance with settled case-law, that it does not exceed what is objectively necessary for that purpose and that the same result cannot be achieved by less restrictive rules (see Smits and Peerbooms, paragraph 75, and the case-law cited).
106 Stoga valja utvrditi može li se predmetno ograničenje stvarno opravdati s obzirom na te važne razloge i, ako je to slučaj, osigurati u skladu s ustaljenom sudskom praksom da ne prelazi ono što je objektivno potrebno u tu svrhu te da se isti rezultat ne može postići manje restriktivnim pravilima (vidjeti ranije navedenu presudu Smits i Peerbooms, t. 75. kao i navedenu sudsku praksu).
107 As regards hospital medical services, the Court has already made the following observations in paragraphs 76 to 80 of Smits and Peerbooms.
107 U pogledu zdravstvenih usluga koje se obavljaju u bolničkoj ustanovi, Sud je već iznio sljedeća očitovanja u točkama 76. do 80. ranije navedene presude Smits i Peerbooms.
108 It is well known that the number of hospitals, their geographical distribution, the way in which they are organised and the facilities with which they are provided, and even the nature of the medical services which they are able to offer, are all matters for which planning, generally designed to satisfy various needs, must be possible.
108 Dobro je poznato da broj bolničkih ustanova, njihova geografska raspodjela, njihova organizacija i oprema kojom raspolažu, pa čak i priroda zdravstvenih usluga koju su u mogućnosti ponuditi, moraju biti predmet planiranja koji je u pravilu namijenjen zadovoljenju različitih potreba.
109 For one thing, such planning seeks to ensure that there is sufficient and permanent access to a balanced range of high-quality hospital treatment in the State concerned. For another thing, it assists in meeting a desire to control costs and to prevent, as far as possible, any wastage of financial, technical and human resources. Such wastage would be all the more damaging because it is generally recognised that the hospital care sector generates considerable costs and must satisfy increasing needs, while the financial resources which may be made available for healthcare are not unlimited, whatever the mode of funding applied.
109 S jedne strane, cilj takvog planiranja je osigurati na državnom području dotične države dostatan i stalan pristup uravnoteženom rasponu visokokvalitetnog bolničkog liječenja. S druge strane, time se nastoje kontrolirati troškovi i spriječiti, koliko je to moguće, svako rasipanje financijskih, tehničkih i ljudskih resursa. Takvo rasipanje bilo bi utoliko štetnije s obzirom da je opće poznato da sektor bolničke skrbi proizvodi znatne troškove i mora zadovoljiti rastuće potrebe, dok financijska sredstva koja se mogu staviti na raspolaganje za zdravstvenu skrb nisu neograničena, bez obzira koji se način financiranja primjenjuje.
110 From those two points of view, the requirement that the assumption of costs by the national system of hospital treatment provided in another Member State be subject to prior authorisation appears to be a measure which is both necessary and reasonable.
110 Iz ova dva stajališta, zahtjev da preuzimanje troškova od strane nacionalnog sustava bolničkog liječenja obavljenog u drugoj državi članici podliježe prethodnom odobrenju izgleda kao potrebna i razumna mjera.
111 As regards specifically the Netherlands system of health insurance, in issue in the cases giving rise to the Smits and Peerbooms judgment, the Court acknowledged in paragraph 81 thereof that, if patients were at liberty, regardless of the circumstances, to use the services of hospitals with which their health insurance fund had no agreement, whether those hospitals were situated in the Netherlands or in another Member State, all the planning which goes into the system of agreements in an effort to guarantee a rationalised, stable, balanced and accessible supply of hospital services would be jeopardised at a stroke.
111 U pogledu nizozemskog sustava zdravstvenog osiguranja, o kojem je riječ u predmetima koji su doveli do ranije navedene presude Smits i Peerbooms, Sud je utvrdio u točki 81. te presude da ako bi se pacijenti mogli slobodno i u svim okolnostima jednostavno obratiti bolničkim ustanovama s kojima njihov fond zdravstvenog osiguranja nema sklopljen nikakav sporazum, bez obzira imaju li te ustanove sjedište u Nizozemskoj ili nekoj drugoj državi članici, svi napori planiranja pomoću sustava sporazuma kako bi se zajamčila racionalizirana, stabilna, uravnotežena i dostupna ponuda bolničkih usluga bili bi ugroženi.
112 Those observations, expressed in relation to a system of social security based on a system of agreements between the public health insurance funds and the suppliers of hospital services, which permit, in the name of overriding planning objectives, limits to be placed on the right of patients to resort at the expense of the national system with which they are registered to hospital treatment not provided by that system, may be adopted in respect of a national health system such as the NHS.
112 Ova zapažanja, iskazana u odnosu na sustav socijalne sigurnosti koji se temelji na sustavu sporazuma između javnih fondova zdravstvenog osiguranja i pružatelja bolničkih usluga, koja u ime važnih ciljeva planiranja dozvoljavaju ograničenja prava pacijenata da se na trošak nacionalnog sustava pri kojem su registrirani obrate pružateljima bolničkih usluga koji ne pripadaju navedenom sustavu, moguće je usvojiti u pogledu nacionalnog zdravstvenog sustava kao što je NHS.
113 In the light of the foregoing, and in answer to Question 1(c), Community law, in particular Article 49 EC, does not therefore preclude the right of a patient to receive hospital treatment in another Member State at the expense of the system with which he is registered from being subject to prior authorisation.
113 S obzirom na prethodno navedeno i kao odgovor na prvo pitanje pod (c), pravo Zajednice, posebno članak 49. UEZ-a, stoga ne isključuje da pravo pacijenta na obavljanje bolničkog liječenja u drugoj državi članici na trošak sustava pri kojem je registriran podliježe prethodnom odobrenju.
114 Nevertheless, the conditions attached to the grant of such authorisation must be justified in the light of the overriding considerations mentioned above and must satisfy the requirement of proportionality referred to in paragraph 106 of the present judgment (see to that effect Smits and Peerbooms, paragraph 82, and Müller-Fauré and van Riet, paragraph 83).
114 Ipak, uvjeti za dodjelu takvog odobrenja moraju biti opravdani s obzirom na gore navedene potrebe i moraju udovoljavati zahtjevu proporcionalnosti navedenom u točki 106. ove presude (vidjeti, u tom smislu, ranije navedene presude Smits i Peerbooms, t. 82., kao i Müller-Fauré i van Riet, t. 83.).
115 It is settled case-law that a system of prior authorisation cannot legitimise discretionary decisions taken by the national authorities which are liable to negate the effectiveness of provisions of Community law, in particular those relating to a fundamental freedom such as that at issue in the main proceedings (see Smits and Peerbooms, paragraph 90, and Müller-Fauré and van Riet, paragraph 84, and the case-law cited in those paragraphs).
115 Iz ustaljene sudske prakse proizlazi da sustav prethodnog odobrenja ne može ozakoniti diskrecijske odluke nacionalnih tijela na način oduzimanja učinkovitosti odredbama prava Zajednice, posebno onih koje se odnose na temeljnu slobodu poput one u predmetu u glavnom postupku (vidjeti ranije navedene presude Smits i Peerbooms, t. 90., kao i Müller-Fauré i van Riet, t. 84. te sudsku praksu navedenu u tim točkama).
116 Thus, in order for a system of prior authorisation to be justified even though it derogates from a fundamental freedom of that kind, it must in any event be based on objective, non-discriminatory criteria which are known in advance, in such a way as to circumscribe the exercise of the national authorities’ discretion, so that it is not used arbitrarily. Such a system must furthermore be based on a procedural system which is easily accessible and capable of ensuring that a request for authorisation will be dealt with objectively and impartially within a reasonable time and refusals to grant authorisation must also be capable of being challenged in judicial or quasi-judicial proceedings (Smits and Peerbooms, paragraph 90, and Müller-Fauré and van Riet, paragraph 85).
116 Stoga, kako bi sustav prethodnog odobrenja bio opravdan iako odstupa od takve temeljne slobode, mora se u svakom slučaju temeljiti na objektivnim, nediskriminirajućim i unaprijed poznatim kriterijima, na način da se ograniči izvršavanje diskrecijske ovlasti nacionalnih tijela da to izvršenje ne bude samovoljno. Takav sustav odobrenja mora se nadalje temeljiti na proceduralnom sustavu koji je lako dostupan i koji može osigurati da će se zahtjev za odobrenje obraditi objektivno i nepristrano u razumnom roku te da će se osim toga eventualna odbijanja odobrenja moći osporiti pravnim sredstvima (ranije navedene presude Smits i Peerbooms, t. 90., kao i Müller-Fauré i van Riet, t. 85.).
117 To that end, refusals to grant authorisation, or the advice on which such refusals may be based, must refer to the specific provisions on which they are based and be properly reasoned in accordance with them. Likewise, courts or tribunals hearing actions against such refusals must be able, if they consider it necessary for the purpose of carrying out the review which it is incumbent on them to make, to seek the advice of wholly objective and impartial independent experts (see to that effect Inizan, paragraph 49).
117 U tu svrhu odbijanja odobrenja ili mišljenja na kojima se takva odbijanja mogu temeljiti, moraju upućivati na posebne odredbe na kojima se temelje i biti točno obrazloženi u skladu s njima. Isto tako, sudovi koji odlučuju o žalbama protiv takvih odluka o odbijanju moraju imati mogućnost, ako to smatraju nužnim u svrhu provođenja preispitivanja koje im je povjereno, dobiti mišljenje potpuno objektivnih i nepristranih nezavisnih stručnjaka (vidjeti, u tom smislu, ranije navedenu presudu Inizan, t. 49.).
118 In relation to the dispute in the main proceedings, it should be noted, as does the Commission, that the regulations on the NHS do not set out the criteria for the grant or refusal of the prior authorisation necessary for reimbursement of the cost of hospital treatment provided in another Member State, and therefore do not circumscribe the exercise of the national competent authorities’ discretionary power in that context. The lack of a legal framework in that regard also makes it difficult to exercise judicial review of decisions refusing to grant authorisation.
118 U pogledu spora u glavnom postupku valja istaknuti, kako je to učinila Komisija, da propisi u vezi s NHS-om ne navode kriterije dodjele ili odbijanja prethodnog odobrenja potrebne za nadoknadu troškova bolničkog liječenja obavljenog u drugoj državi članici. Navedeni propisi stoga ne ograničavaju izvršenje diskrecijske ovlasti nadležnih nacionalnih tijela u tom pogledu. Takvo nepostojanje pravnog okvira također otežava sudski nadzor nad odlukama o odbijanju odobrenja.
119 It should be noted with regard to the circumstances and factors referred to in the third and fourth questions that, given the findings set out in paragraphs 59 to 77 of the present judgment, a refusal to grant prior authorisation cannot be based merely on the existence of waiting lists enabling the supply of hospital care to be planned and managed on the basis of predetermined general clinical priorities, without carrying out in the individual case in question 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.
119 S obzirom na okolnosti i čimbenike navedene u trećem i četvrtom pitanju valja napomenuti da, uzimajući u obzir analizu iz točaka 59. do 77. ove presude, odbijanje prethodnog odobrenja ne može se temeljiti samo na postojanju lista čekanja koje omogućuju planiranje i upravljanje ponudom bolničke skrbi na temelju općenito prethodno utvrđenih kliničkih prednosti, bez provođenja u dotičnom pojedinačnom slučaju objektivne medicinske procjene zdravstvenog stanja pacijenta, anamneze i vjerojatnog tijeka bolesti, stupnja boli i/ili prirode nesposobnosti u trenutku podnošenja zahtjeva za odobrenje ili ponovnog podnošenja takvog zahtjeva.