Free movement of services

Hospitals are service consumers. The freedom to provide services between Member States is provided for in Articles 49 and 50 of the treaty. Community provisions were adopted for the different services used by hospitals: finance, insurance, consultancy, etc. The re-launch of the internal market for this sector through the Services directive, which needs to be transposed by Member States by 2009, is a recent point reinforcing this policy.

But, more important, by virtue of their care activity, hospitals are now defined as service providers in terms of Community law. The European Court of Justice has recognised that health activities are services in the sense of article 49, whether this refers to ambulatory or hospital care, or whether they are eligible for reimbursement from social insurance regimes or performed free of charge.

On the basis of this jurisprudence, health services were integrated in the first draft of the Directive on services, commonly known as the “Bolkestein Directive” named after the Commissioner behind the initial proposal. The subsequent exclusion of health services from the directive did not put an end to the application of internal market rules to the health sector. The Commission’s proposal of a directive on cross-border care, postponed several times in late 2007 and adopted finally on 2 July 2008, thrusts health right back into the framework of the internal market. The main argument of the Commission is founded on European Court of Justice Jurisprudence, which defined hospital and ambulatory care as services.

A revised version of the draft directive was adopted by the European Parliament in April 2008 in first reading. It is still debated in the Council.

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