1. The Citizen in the centre in EU, Bratislava 25-26 November,2005
European Public Health Alliance
The EU Directive on "Services in the internal market", COM(2004) 2 final/3
Agnese Knabe
Project coordinator
European Public Health Alliance
Civic Alliance – Latvia
The Citizen in the centre in EU, Bratislava November,2005

2. Background (1/2)
As part of the completion of the internal market, on 13 January 2004 the European Commission adopted a draft Directive on Services in the internal market.
This Directive will establish a general legal framework applicable to all economic activities involving services with some exceptions, such as financial, electronic communications and transport services (which are already regulated by other EU legislation).
In January 2004, the European Commission presented a proposal for a Directive to create a internal market in services.
The proposal has been controversial and faced strong opposition by civil society groups, trade unions and some Member States.
In October 2004, DG Internal Market posted some additional documents:
* an updated Frequently Asked Questions.
* an explanation of how the Directive would change service organisation and delivery.
* detailed case studies on problems faced by service providers and how the Directive would help.
* a one page overview of the services to be covered, and a longer explanation note on the activities and services affected,
* explanatory notes on the way the healthcare costs would be covered.
The proposal is now in the process of being discussed by the European Parliament Committees. The lead Committee is the newly-formed Committee on Internal Market and Consumer Protection (IMCO) which held a public hearing on the issue on 11 November 2004.

3. Background (2/2)
The main goal of the proposal is to eliminate all obstacles to the free movement of services and to the establishment for service providers.
The Directive is horizontal in nature, which means that it covers everything that is not explicitly excluded. As such, the original text also includes the provision of healthcare services and other health related services.
The original text included healthcare, the EP committee now voted to exclude it – see recent developments slide.
More on the technicalities of the Directive:
(see slides)

4. Content In terms of content, the Directive on Services:
· country of origin principle: service providers could be subject to the laws of their country of origin rather than of the country where the service is provided
· Improved national co-operation: national authorities to exchange information and work together more closely to replace the current duplication of national regulations and controls with a more coherent and business-friendly system. (single contact points, electronic procedures, requirement to justify authorisation systems, no obligation to translate documents)
· Basic common rules: in order to increase trust and confidence in crossborder services (appropriate professional indemnity insurance for services giving rise to particular risks, information to consumers, codes of conduct)
See notes on previous page, in particular
(see slides)

5. Content
Rights of service users:  the right of consumers to use services across the EU prevents member states from imposing restrictions on such services. This includes specific authorisations to use a service (for example architects or builders) or discriminatory tax rules.
Health care:  the directive clarifies the conditions under which national social security systems must reimburse the costs of medical care received in other member states.

6. European Health Policy Forum (EHPF) recommendations
Ensuring that the specificity of health services is adequately reflected in any EU initiative
Ensuring that sustainability and long-term objectives of health services are reflected in EU initiatives with an impact on health
Ensuring that adequate consultation takes place in EU initiatives: who is consulted and how the comments are taken into account depending on the representativeness and the weight of the respondent
Ensuring that a proper health impact assessment including health system impact assessment is performed prior to any legislative initiative
Coordination between Commission services to ensure consistency of initiatives
Exclusion of health services from the scope of the proposed Directive in view of examining these services within the framework of separate debate
On the Health Forum see
health_forum_en.htm
The European Health Policy Forum (EHPF) is a platform set up by DG Sanco in 2001 as part of its strategy to enhance the communication with the health community and to find ways to increase their participation and their involvement in health policy developments. The EHPF which meets twice a year, gathers 45 European associations including health care providers and health professionals, health insurance bodies, industry representatives, citizens and patients organisations and NGOs active in public health.

7. Recent developments
The Directive has to pass through both the European Parliament and the European Council.
The lead Committee was the Internal Market and Legal Affairs Committee
The Committee just voted: healthcare services have been excluded from the scope of the text, but the country of origin principle remains
The European Parliament will vote the text in Plenary in January or February 2006
Thisd just happened in the EP on 22 november 2005.
Generally speaking, the text looks closer to the Commission's original text than to the one suggested by the rapporteur for the Parliament.
Good points
- healthcare issues excluded
- gambling excluded
Bad points
- controversial country of origin principle stays there

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