Abstract

A fundamental freedom to receive cross border medical treatment is granted to citizens of the European Union under the internal market provisions of European Community Law. The European Court of Justice has interpreted the extent of, and the limits to, this freedom in a series of rulings, the most recent and controversial being the ruling delivered in the case of Yvonne Watts v Bedford Primary Care Trust in May 2006. Competence in the field of public health is retained by individual Member States who each have the responsibility for organising and delivering health services and medical care. The European Court of Justice acknowledges the need to balance the objective of the free movement of patients against overriding national objectives relating to management of the available hospital capacity, control of health expenditure and financial balance of social security systems. Nevertheless, the Court ruled, in the Watts case that this does not exclude the possibility that Member States may be required under European Community law to make adjustments to their social security systems. An obligation exists under Community law to authorise a patient registered with a national health service to obtain, at that institution’s expense, hospital treatment in another Member State where the waiting time exceeds an acceptable period having regard to an objective medical assessment of the condition and clinical requirements of the patient concerned.

It is the intention of this paper to examine the implications of this ruling for the National Health Service in the United Kingdom and the extent of, and the barriers which exist to, the freedom to choose to have urgent hospital treatment in another European Union Member State. This paper will also treat the Consultation on the need for Community action on health services, which was triggered by the Watts ruling, in order to establish legal certainty for patients and for Member States.