1. 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 25-26 November,2005 European Public Health Alliance

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).

3.  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. Background (2/2)

4. 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) Content

5.  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. Content

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

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

8. European Public Health Alliance 39-41 Rue d’Arlon B-1000 Brussels Belgium Tel: +32 2 230 30 56 Fax: +32 2 233 38 80 epha@epha.org www.epha.org