Tuesday 16 June 2009

The work on patient rights

PatientView is a research-and-publishing organization that surveys the opinions of patients and health advocacy groups. In their Health and Social Campaigners' News International, you can read about the activities of health campaigners worldwide. Its usually a fantastic source of knowledge about healthcare issues. In the last issue the efforts by the Active Citizenship Network (ACN) leading up to the pan European celebration of the Patient Rights Day on April 18th and the European Commission and the current presidency trio campaign Europe of the Patients is described. ACN, originating from the Italian civic group Cittadinanzattiva, is campaigning for the legal basis of patients’ rights to be accepted as EU law and embraces 14 rights—called the European Charter of Patients’ Rights.

An important step towards this is as discussed in the magazine the Patient Rights at cross border care directive. For the first time the European Union is codifying the right to choose provider no matter borders etc. A choice that is not obvious in some countries that now will be given to the patients without borders. The costs covered by insurer and thus the purchase power patients can bring will still be the one stipulated by the healthcare system in their home country.

This makes the “correction” sent by ACN to Patient View and distributed by them to the subscribers very strange. In this correction it is said that their original aim with supporting this directive was to “guarantee that the rights are not only for the people that travel but all European citizens. This is an important aspect that is not included in the Directive on Cross border care and a reason the socialist are sustained from voting.” Now this must mean they have not read the directive and been seriously fooled by the socialist group.

(Now I will repete myself a bit - you who read my previous postings on this issue can jump to the end of this blog post directly.) The directive is dealing with those travelling for care – tourists and business travelers catching a cold or a more serious illness while travelling is already covered by other regulations. This directive aims to give patients the right to seek care cross border among others if they have to wait too long for treatment in their own country or if the treatment is not offered in their particular country. It does also put in place a framework for how much money one can bring – basically a care voucher system – and how to deal with quality and insurance issues etc. The socialist group has been fighting the directive all the way from autumn 2007 when the chairman of European Socialists Poul Nyrup Rasmussen wrote to all commissioners with a socialist background asking them to stop the directive on the grounds that it would make healthcare part of the common market. Later objections have been - also from quite many conservative governments - that this would mean that EU would decide on how healthcare is organized. This is not due to the directive not being for only those travelling but due the difference in beliefs of who should be in power in the healthcare system. The citizen or the government.

This is exemplified in a couple of issues. The first being that an EU law would give patients the right to go abroad and choose providers including private ones, which you do not have in all countries today. The second being the fears that the law could undermine the gatekeeper function. In the EP the socialists went so far that they tried to postpone the vote whishing for the new parliament to be a “better” one. In the end they was forced to negotiations when they was told that there would be a vote on the issue either with their co-operation or not. When they then had several of their demands meet they still did not vote for the final proposal. In the final vote, they abstained. So now a proposal have been voted upon that are quite weakened on for example the rights for patients to go abroad without prior authorization and the socialists have lost even more power in the newly elected Parliament.

However, the debate on this is still very low key – probably partly because organizations like ACN have bought the PSE description and defends the election talk from the PSE group.

But beside this the ACN Patient Charter is very good and the campaign for getting Patient Rights recognized by the European Union now running on its eight-year can see some signs that the goal is getting closer. There is quite a lot of support in the European Parliament for the idea – the liberal group has launched their own campaign on the issue. More and more countries do have Patient Rights legislations. However, I would like to end by pointing out that maybe it would be better if we stopped talking about patient and instead used people with HIV, people with rheumatism etc. If healthcare could be looked upon as normal services and products we would have rights, consumer rights, already now.

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