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Tuesday, May 16, 2006

NHS told to fund treatment abroad in landmark court ruling

UK patients who are forced to wait longer than they should for NHS treatment are entitled to reclaim the cost of being treated in Europe, a court has ruled. The European Court of Justice said the NHS must refund costs if patients waited longer than clinicians advised, even if waiting time targets were met. The case, which centres on the definition of "undue delay", could have a significant impact on the whole NHS.

The court was ruling in the case of Yvonne Watts, 75, of Bedford, who paid £3,900 for a hip operation in France. But it said in her case UK courts would have to decide if she got a refund.

Mrs Watts said the news was "wonderful" and that if she got the money back she would donate it to a medical charity.

The case, which centres on the definition of "undue delay", could have a significant impact on the NHS. It will allow any patient facing an unacceptable delay who has the funds to pay for an operation upfront to seek treatment abroad and recoup the costs from the NHS.

The Department of Health said it did not expect the judgment to make a big difference to the numbers travelling abroad to receive hospital treatment. But it has already said it would be issuing new guidance on the issue in June.

Mrs Watts said: "I welcome it for what it means for other NHS patients. That's why I did it. If other people have to have hips done and have to go abroad, they'll be encouraged."

Her solicitor, Richard Stein, said their victory would now act to regulate possible cutbacks in the NHS and increases in waiting times caused by financial constraints. It should also help to make sure that the concept of "undue delay" was based on a medical decision, not just an arbitrary timeframe.

NHS treatment abroad:
The European Court of Justice in Luxembourg was asked to rule on the case after the English Court of Appeal sought its guidance. The ECJ said the UK government wrongly interpreted patients' rights to access services in other EU countries.

It said just because waiting list targets had been met did not necessarily mean that a patient had not had to wait for an undue length of time for treatment.

Instead primary care trusts must ensure a patient's waiting time "does not exceed the period which is acceptable in the light of an objective medical assessment" of clinical need.

'Flexible targets'
The court added the degree of pain the person is in and the nature of his or her disability must be taken into account. Also waiting time targets must be set "flexibly and dynamically" and reassessed if there is a deterioration in condition.

As authorisation for reimbursements of costs was usually sought before treatment was obtained, the primary care trust would be the body to decide on whether the patient was facing an undue delay.

However, the court found that it was for the British courts to decide whether Mrs Watts faced an undue delay and thus whether she should recoup her costs.

http://news.bbc.co.uk/1/hi/health/4985190.stm

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