AKEL MEP George Georgiou highlighted the need for a substantive overhaul of the EU framework for cross-border healthcare, so that access to treatment in another member state no longer depends on a patient's financial means, during a working lunch with journalists on Thursday in Nicosia.

At the centre of the discussion was report 2025/2206(INL) on revising the rules governing patients' rights under the cross-border healthcare directive, for which Georgiou serves as rapporteur on the European Parliament's Committee on Public Health.

Thirteen years after Directive 2011/24/EU came into practical effect, he said, thousands of European patients still face financial, administrative and practical obstacles when they need care in another EU country. According to the data he presented, the ability to make use of the directive is affected, among other things, by a patient's country of residence, financial situation and level of familiarity with the system.

Scrapping upfront payments

One of the central proposals in the report concerns removing the requirement for patients to pay the cost of treatment upfront and wait for reimbursement afterwards.

Georgiou said the current process can act as a deterrent, particularly for low earners, pensioners and families with limited financial means.

The proposal envisages setting up mechanisms for direct financial reimbursement between the responsible bodies of member states, similar to the coordination already used in social insurance.

It also proposes amending Article 7 of the directive to allow, based on income criteria, coverage of additional costs linked to treatment abroad, such as travel and accommodation.

Along the same lines, the report proposes creating a European support and solidarity mechanism that could provide financial assistance to member states struggling to meet their obligations, particularly regarding vulnerable categories of patients.

Prior authorisation a 'labyrinth'

Particular attention was also given to the prior authorisation regime required for certain treatments abroad.

The AKEL MEP acknowledged the need for member states to protect the planning and sustainability of national health systems, but said the authorisation process must not become an "administrative labyrinth" for patients, particularly when the necessary treatment cannot be provided in their own country within a medically justified timeframe.

To that end, the report proposes that member states publish clear lists of the treatments that require prior authorisation.

Only one in ten aware of national contact points

A significant part of the proposals also concerns patient information.

Citing a European Commission survey, Georgiou said just 10% of patients are aware of the existence of National Contact Points, the main source of information on cross-border care.

According to his presentation, National Contact Points face chronic problems of understaffing and limited resources. The proposal envisages strengthening their role and formally involving patient organisations and health professionals in how they operate.

It also proposes creating a central European information hub to serve as a single, reliable, multilingual point of entry for citizens seeking information about their rights before starting national procedures.

Special provisions for children

Children needing specialised treatment abroad occupy a distinct place in the proposals.

The report proposes faster procedures for accessing specialised care and mandatory coverage of travel and accommodation costs for both the child and their companions.

"It is unthinkable for a family travelling abroad for their child's treatment to be left without financial support, forced to fend for themselves through fundraisers," Georgiou said in his remarks.

It also proposes that each member state set up services to provide free, personalised guidance to children, families and carers at every stage of cross-border treatment.

Multi-year permits for rare diseases

Special arrangements are also proposed for patients with rare and complex conditions, for whom, it was stressed, access to specialised centres in other countries is in many cases an integral part of their treatment.

Among the proposals is the introduction of multi-year, renewable permits for cross-border care, so that patients are not required to repeat the same administrative procedures over and over.

The report also calls for the European framework to explicitly cover the participation of patients with rare and complex diseases in clinical trials conducted at specialised centres in other member states.

Telemedicine and digital records

The report also proposes modernising the rules governing telemedicine, electronic prescriptions and the interoperability of health systems.

Among the proposals is extending the directive to explicitly cover care provided via telemedicine, as well as full implementation of the MyHealth@EU infrastructure for the cross-border exchange of patients' electronic data and medical history.

Georgiou also set the protection of personal data and the maintenance of high quality and safety standards as a precondition.

The process is not yet complete

The MEP clarified that the report constitutes a legislative initiative of the European Parliament and does not yet amount to a new binding legislative framework.

He said proposals from the other political groups were received on 12 September, with negotiations to follow on shaping a compromise text. The text will then need to go before the Committee on Public Health and, if approved there, to the European Parliament's plenary session.

Georgiou's central position is that cross-border care should function as a complement to strong public national health systems, rather than leading to greater commercialisation or privatisation of health services.

As he stressed, the aim of the initiative is for the rights provided for at European level to be exercised in practice by all patients, regardless of income or country of residence.

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