EU court says Brits who seek treatment abroad should be reimbursed by NHS

May 16 2006

A European Court has ruled that National Health Service (NHS) patients who seek treatment abroad because they face "undue delay" in Britain, must be reimbursed by the NHS.

In a case taken to the European Court of Justice (ECJ) a 74-year-old British woman, Yvonne Watts, who travelled to France to have a hip operation, has won her fight for compensation.

In the landmark decision, the judges have decreed that, under European Union rules on freedom to services, one EU healthcare system must pay the bill if a patient has waited too long and chooses to go to another EU country for treatment.

The judgment is one of a series on healthcare by the ECJ, and is expected to have implications across the EU.

It also augers serious cost implications for the NHS, following recently announced job losses in the thousands due to spiralling deficits.

The court says that in order to be entitled to refuse a patient authorisation to receive treatment abroad on the ground of waiting time for hospital treatment in the state of residence, the NHS must show that waiting time does not exceed a medically acceptable period, having regard to the patient's condition and clinical needs.

It is now apparently up to the British courts to decide whether Mrs Watts had faced an unacceptable delay.

Mrs Watts who travelled to France to have the 4,000-pound hip operation, had been told the NHS would not pay for it.

If reimbursed she says she will give the money to a medical charity.

She had initially been told by the NHS that she would have to wait a year for her operation, but that waiting time was subsequently reduced to three or four months.

The Department of Health says it does not expect the verdict to make a big difference to the numbers of people travelling abroad for treatment.

A department spokesman said the government "expected to continue with a system that requires any patient who wants to travel abroad for elective hospital treatment paid for by the NHS" to have authorisation first.

Mrs Watts's case will now be referred back to the Court of Appeal in London to decide on the implications of the ECJ's guidance in her circumstances.

The court's decision is seen by some as another step towards the establishment of a single market for healthcare in the EU, despite the member countries' very different health systems.

Lawyers say the ruling it will place an obligation on primary care trusts to individually assess each patient who claims that a waiting list is too long and seeks treatment overseas, rather than make blanket judgments on waiting times.

Currently NHS patients under UK law can seek treatment abroad if there is "undue delay" in receiving treatment at home.

However, the phrase "appropriate time" is a key factor in this case as it draws a line between waiting list targets and an individual patient's needs.

Many say that in effect the ECJ has declared that a healthcare system can not refuse to fund treatment overseas just because it had a waiting-list system designed to manage the supply of hospital care.

In 2005 it seems the NHS paid for 232 patients to go abroad.