What happens when an ambulance can't cross a border just four kilometres away?
In this conversation, Jean-Louis Valls, Director of the Pyrenees Working Community (Communauté de Travail des Pyrénées), the managing authority of the Interreg VI-A Spain–France–Andorra programme (POCTEFA), recounts a striking moment: during a 2016 visit to the Cerdanya Cross-Border Hospital, he saw two ambulances side by side, one Catalan and one from the French SAMU 66, yet the emergency doctor on board could not intervene across the border, not being registered with the neighbouring country's medical council.
To resolve it, the Pyrenees Working Community turned to b-solutions, the European Commission initiative (led by DG REGIO) that provides expert legal support to tackle concrete legal and administrative cross-border obstacles. Bringing together all stakeholders, cross-border health institutions and the professional medical councils, the team spent two years drafting a convention, drawing on similar agreements already in place between France and Belgium and between Alsace and the German Länder. Once approved by every party, the text still had to win over the Spanish and French health ministries, travelling back and forth between Madrid and Paris for six years.
On 6 November 2025, the first of five conventions was finally signed between the Occitanie Regional Health Agency (ARS Occitanie) and CatSalut, with four more to go to cover the full 650 km of shared border.
The project highlights how persistence, trust, and structured cooperation can turn a real-life border obstacle into lasting benefits for citizens on both sides.
Discover how #EUBorderRegions are turning cross-border cooperation into tangible benefits for communities and visitors.
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