Patients who face undue delays for medical care are entitled to get the treatment in another EU country and receive refunds of all medical costs from their health authorities, according to a European Court ruling.
In a case involving two Dutch nationals, the European Court of Justice ruled that health authorities may only refuse to pay for treatment elsewhere in the EU if an equal quality of care is available locally without undue delay.
In many EU member-states, including Ireland, health authorities can authorise patients to seek treatment abroad and agree to pay for costs of treatment.
Mrs B.S.M. Geraets-Smits, a Dutch woman suffering from Parkinson's disease, was treated at a German clinic without asking for authorisation from her Dutch health insurance fund. She asked the fund to pay her medical bill, but was refused as adequate treatment for Parkinson's disease was available in the Netherlands. Her compatriot, Mr H.T.M. Peerbooms, fell into a coma and received treatment at a specialist clinic in Austria. His health insurance fund refused to pay the bill, arguing treatment she received was no better than what was available at home.
The court found against the plaintiffs and ruled that EU member-states are entitled to organise social security systems and to determine the conditions under which patients receive benefits. The decision to allow health authorities to determine when patients should be reimbursed for treatment in other EU countries constituted an obstacle to the freedom to provide services throughout the EU.
But the court ruled that the system was justified by the need to control costs and maintain financial balance of the social welfare and health systems.
"The condition that the proposed hospital treatment in another member-state must be regarded as `normal' is acceptable only in so far as it refers to what is sufficiently tried and tested by international medical science," the court said.
It continued this "must mean that authorisation can be refused only if the patient can receive the same or equally effective treatment without undue delay from an establishment with which his sickness insurance fund has contractual arrangements".
Lawyers at the court in Luxembourg expect test cases from member-states aimed at determining what constitutes an "undue delay" in medical treatment. One court official suggested the ruling could open the way for thousands of Irish patients to seek treatment elsewhere in the EU to avoid waiting lists here - with the State picking up the bill.
