Transposition of the patients' rights directive 2011/24/EU

The Directive on the application of patients´ rights in cross-border healthcare was adopted by the Council of the European Union and the European Parliament on March 9th, 2011. In the context of the adoption deadline on October 25th, 2013, as well as considering the national positioning towards the Directive and the interpretational leeway, it is interesting to see how and to what extent national legislators transpose the Directives´ implications. This paper will focus on the process of transposition, specifically domestic public consultations. The analysis is a two-level comparison: on the one hand, it presents an intrastate study of the various stakeholders involved in the discourse during the transposition process, whereby a country-specific picture of diverse proposals, opinions and challenges can be drawn. On the other hand, the paper marks an inter-country comparison, offering a sample of European adaptational patterns. The healthcare systems of the analysed countries Germany, Poland and Austria are characterised by a Statutory Health Insurance (SHI) system, nevertheless they differ concerning systemic specifics of healthcare, their voting behaviours towards the Directive and initial situations regarding transposable provisions. The study of domestic discourses from an actor-centred perspective concludes on the most critical points of the Directive, which reflect on prior authorisation, reimbursement, information provision and National Contact Points, and on transposition patterns in the member states. Hypotheses on the goodness of fit, the scope of patients´ rights and difficult interpretational areas of the Directive were tested and partly verified. The intrastate study and cross-national comparison revealed considerable differences among a small sample of EU-states, with only some analogies regarding stakeholder and governmental behaviour. The contrast is visible in the number and type of stakeholders, timing of public consultations, the emphasis set in the discourse, frequency of discussed articles and accurateness of implementation. This results not only from the difficult and debated area of health policy, but also from country-specific characteristics. Overall, the analysis indicates how important the process of transposition, as part of EU law-making, is for the correctness and success of European policies. An emphasis on the implementation phase is required to closely understand, analyse and improve the functioning of the Acquis Communautaire.