A new milestone in European cross-border healthcare has been reached in the Pyrenees. On 6th November 2025, in Perpignan, the Agence Régionale de Santé (ARS) Occitanie and the Generalitat of Catalonia signed the first bilateral agreement enabling emergency medical services to operate seamlessly across the Occitanie-Catalonia border in the Pyrenees.
The newly signed convention allows ambulances to cross the border without administrative hurdles, ensuring faster and more coordinated responses for citizens on both sides. For the first time, cross-border emergency intervention in the Pyrenees becomes officially regulated.
This signature marks a major achievement for the EU-backed initiative “When medical emergencies erase borders” supported through the first b-solutions call, and sets a precedent for the four remaining agreements currently underway between French and Spanish border territories. The Occitanie–Catalonia agreement is the first of five planned bilateral frameworks between border health authorities:
- Occitanie and Catalonia
- Occitanie and Aragón
- Nouvelle-Aquitaine and Aragón
- Nouvelle-Aquitaine and Navarra
- Nouvelle-Aquitaine and the Basque Country
This step forward builds on more than 15 years of cross-border health cooperation. The turning point came in 2008 with the construction of the “Hospital Transfronterizo de la Cerdanya” (HTC, Cross-border Hospital of the Cerdanya), Europe’s first fully integrated cross-border hospital. Approved under the POCTEFA 2007-2013 programme, the project received 18.6 million EUR in ERDF funding and introduced an unprecedented operational framework combining the French and Catalan health systems (becoming the biggest POCTEFA-funded project to date). The hospital opened its doors in 2014 and quickly became a reference point across Europe for cross-border public services and health innovation, a complete pioneer in its field of European cooperation in public health.
The urgent care convention signed in Perpignan is the direct result of the pilot work launched in 2018 by the Working Community of the Pyrenees (CTP) under b-solutions. Ensuring that legal obstacles that have long complicated emergency cooperation are removed and provide fair access to medical services for the 15 million people who live in or travel across the region.
Despite progress, some issues still demand attention. One key challenge is the mutual recognition of medical qualifications, with French doctors sometimes waiting up to six months to receive authorisation to practice in Spain. Addressing this challenge remains essential to ensure that talent can move as freely as ambulances.
Each agreement brings the European Union one step closer to a borderless space for healthcare, where emergencies are met with solidarity and action, regardless of where they occur.
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