It’s official: Portuguese citizens and foreign residents requiring medical treatment not offered in Portugal will be able to seek treatment in Spain, or any other country within the European Union, and be reimbursed by the State – as long as their family doctor confirms it is necessary.
The good news is tempered by the fact that the new ruling will almost certainly “only benefit the wealthy” – and those who live near frontier countries.
Directive 2011/24/EU issued by the European Parliament aims to establish rules for easy access to safe, high-quality cross-border healthcare and ensure patient mobility within the Union.
Portugal has actually had more than two years to discuss the ruling but little, if anything, has been publicised. Indeed, the deadline for changes expired on October 25.
Nonetheless, a recent report in “i” newspaper reveals that the government is now working on a new law, which places the decision for seeking cross-border medical care in the hands of family doctors from the national and regional health services.
The proposal is open for public discussion until November 25 – with 2014 being the most likely time for the law to come into effect.
Approved in March 2011, Directive 2011/24/EU assures the mobility of patients for scheduled consultation and surgery, treatment and tests.
The pledge guarantees that the Portuguese State reimburses citizens seeking health care abroad when its own health service fails to respond in time.
Up until now, Portugal has only supported treatment abroad when its own care facilities lack the necessary human and technical resources, and where treatment is “impossible”.
Last week, the European Commission drew attention to the implementation of the Directive.
A memo issued at the same time underlined the “rights of patients who rely on free movement” that were “detailed in various agreements drawn up by the European Court of Justice”.
“In the case of hospital care”, the Court stated, “one of the greatest achievements is the fact that patients can choose their own health care provider”.
But in Portugal, many experts believe this legislation will only benefit those with high incomes – because patients will initially have to stump up for all costs, only receiving reimbursement up to 90 days later.
Also, the State will only pay treatment costs. It will not reimburse travel or accommodation expenses.
And in some cases, patients will still need prior authorisation – for example where care requires a hospital stay of at least one night, or if it is highly specialised or expensive.
Professor Adalberto Campos Fernandes of the National School of Public Health stressed that the new directive will, first and foremost, “benefit the wealthy”, as well as those living near [country] frontiers.
And while the ruling will also pave the way for foreign patients to come to Portugal for surgery – thus opening a new window of opportunity for the country – Campos Fernandes believes government expenditure will outweigh any income, at least at the very beginning.
“The country needs to build up a significant reputation in the health care sector in order to export that kind of reputation,” he told Público newspaper.
In a preliminary study back in 2011 examining the advantages and disadvantages of the Directive for Portugal, the Entidade Reguladora da Saúde (Portuguese Health Regulation Authority) estimated that initially any negative impact on the economy would be minimal and that, on balance, Portugal would benefit from a surplus of revenue.
But it then did a curious backflip and admitted that its estimations could be “far from reality”.
