Health care and the European Union

BMJ 2002; 324 doi: https://doi.org/10.1136/bmj.324.7344.991 (Published 27 April 2002) Cite this as: BMJ 2002;324:991

Profound but uncertain consequences for national health systems

  1. Elias Mossialos, research director,
  2. Martin McKee, research director
  1. European Observatory on Health Care Systems, London School of Economics, London WC2A 2AE
  2. European Observatory on Health Care Systems, London School of Hygiene and Tropical Medicine, London WC1E 7HT

    Education and debate p 1027

    Slowly, in health and social affairs ministries across Europe, the realisation is dawning that European Union law has profound consequences for the organisation of national healthcare systems. Even in the United Kingdom, which for many years was in a state of active denial about the influence of Europe, ministers are looking at how to exploit the opportunities offered by provisions on free movement of patients (to France) and professionals (bringing teams of German surgeons to operate at weekends in NHS hospitals).

    Yet the scope for action is often uncertain. A failure to address health care explicitly at a European level means that the evolving legal situation is based largely on policies designed to address broad principles, in particular the free movement of goods, services, people, and capital. These are then applied to the health sector in rulings on specific cases brought before the European Court of Justice, but leaving uncertainty as to how they should be interpreted in similar but slightly different circumstances. The situation is complicated further by the changing nature of healthcare delivery, such as public and private partnerships within publicly funded systems, potentially bringing new areas within …

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