Healthcare Regulation in the European Union
EU regulation is becoming increasingly important, even in the area of health care which was previously regarded as the sole responsibility of the member states. For more than a decade, case-law interpretations by the Court of Justice of the European Union (CJEU) has gradually questioned the national demarcations and organizational boundaries within the member states and judicial activism has brought the healthcare sector far into the organizing principles of the internal market. In response, healthcare only slowly moved on the political EU agenda. Directive 2011/24/EU on the application of patients’ rights in cross-border healthcare constitutes one of the few instances of hard EU law that directly concerns healthcare. EU healthcare policy now also includes initiatives to foster the quality and safety of healthcare goods and services. As happened previously in other welfare policy areas, the EU now intervenes at the core of Member states’ healthcare policies, the delivery of services to patients.
THE PROJECT IS CLOSED
Project period: 2011-2016
Principal Investigator (PI): Dorte Sindbjerg Martinsen
The project has examined the policy-making process establishing the EU patients' rights directive and its subsequent transposition in selected member states. The project combined a focus on the inter-institutional and political dynamics of EU policy-making with comparative research on national implementation processes. Furthermore, the policy-making study compared the institutional and political dynamics of negotiating the patients' rights directive with the policy processes of the EU posting of workers regulation and the working time directive, thus investigating more current dynamics of social Europe.
The project aimed to contribute to our empirical and theoretical knowledge on the complex interplay between judicial and political policy-making and the impact of national institutions in subsequent processes of Europeanisation.
The project has been divided into two main parts:
Part 1 examined the policy-making process behind the now adopted Directive on Patients’ rights in cross-border healthcare 2011/24/EU, which grants patients’ rights to be treated in another member state, albeit under certain conditions. It examined the inter-institutional and political dynamics in the policy-process unfolding between the European Commission, the European Parliament and the Council of Ministers. Particular analytical attention was paid to the role played by the European Court of Justice, when negotiating 'in the shadow of the law'. The process unfolding around negotiating the patients' rights directive was compared to EU integration of social policies in a historical perspective as well as two other major policy-making processes, taking place in a post-Lisbon constitutional setting; 1) the EU posting of workers regulation, rejecting the European Commission’s Monti II proposal COM (2012) 130 but adopting the enforcement directive on the posting of workers, proposed as COM (2012) 131 and 2) the revision of the working time directive, proposed as COM (2004) 607.
Part 2 examined the subsequent transposition processes of the patients' rights directive in eight selected member states; Denmark, the Netherlands, Belgium, Spain, Austria, Poland, the Czech Republic and Bulgaria. The implementation studies include the PhD project of Nikolay Vasev, examining transposition and implementation in Austria and Bulgaria.
In terms of methods and data the project triangulated different sources. Large datasets of EUR-lex and the CJEU’s curia data were compiled. Official and unofficial documents were gathered and more than 150 research interviews with key respondents have been conducted.
Project Team
Dorte Sindbjerg Martinsen Professor MSO (Sapere Aude PI), Political Science, University of Copenhagen
Karsten Vrangbæk Professor, Political Science, University of Copenhagen
Hans Vollaard Assistant professor, Leiden University
Nikolay Vasev PhD candidate, Political Science, University of Copenhagen
Affiliated Researchers
Ayca Uygur PhD candidate,Political Science, University of Copenhagen
Filip Křepelka Associate professor, Faculty of Law, Masaryk University
Principal Investigator (PI)
Professor Dorte Sindbjerg Martinsen
Department of Political Science
Mail: dm@ifs.ku.dk
Phone: +45 35 32 34 26
The project was financed by
The project was financed by the Sapere Aude research grant, DFF-starting grant 2010, from the Danish Council for Independent Research.