Hospital, health care and internal market

The European Union has very limited direct competences in the healthcare field and has only been able to develop a rather constrained public health policy. According to the principle of subsidiarity, the organisation and financing of healthcare remains a Member State’s competence. However, the European Union has developed other policies that have been influencing hospital and health services.

The European Union is above all economy-oriented, founded on the principles of the free circulation of goods, services, persons and capital, as well as on the rules of competition. These rules and principles apply one way or another to almost all sectors of activity, including the hospital sector. Although they do not necessarily measure its impact on a daily basis, hospitals thus live in an environment that is governed to a great extent by community legislation.

As purchasers of goods, hospitals and healthcare services have been affected by the removal of barriers to free movement of all kind of goods. Within this framework, a special attention has been directed to pharmaceuticals and medical devices, leading to specific legislation in this field. The same goes for services, of which hospitals are also purchasers. The European Court of Justice even confirmed that medical care and hospital care were themselves services and as such falling under the scope of the free movement principles.

Mobility is also meant for workers as well as for other persons. For health professionals, European directives have harmonized the minimum conditions of training and provided for mutual recognition of professional qualifications and introduced some specificity for health professions (doctor, nurse, midwife, dentist and pharmacist). More generally other measures have been adopted in the social sphere to avoid social dumping, following in particular the coordination of social protection. All of this had an impact of the hospital and healthcare workforce.

At the same time European rules on competition are also growingly interfering with the healthcare sector and as the major part of hospital and health financing are public, the various questions of their position regarding the Community legislation on state aid is currently raised.

Activities

Hospitals in the 27
EU Member States

Quality of care

Human resources

Public health

Hospital, health care
and internal market
Free movement of goods
Free movement of persons
Free movement of services

e-Health

Cross-border
co-operation

Green hospitals

Networking