The European Commission’s Communication COM(2017) 534 final makes clear that “encouraging cooperation between the Member States to improve complementarity of their health services in border regions is a priority for the EU”. This has never been more clear than in 2020, when additional challenges have put pressure on the healthcare systems of the EU Member States and especially their border regions.

However, many and various are the obstacles that still hamper the full implementation of cross-border healthcare structures or the smooth provision of medical services in border regions.

They are mainly due to the presence of non-coordinated principles to reimburse the costs for accessing medical services in the neighboring country or of legal constraints that limit the transit of emergency means of transport across the borders. Obstacles also arise because the access to specific type of medical goods or technology on the other side of the boundary is complicated or limited.

Under the 3rd call for proposals of b-solutions, four different hurdles were selected in the thematic area of “Healthcare (including emergency services)”. The types of obstacles identified by the applicants fall in the categories identified by the COM(2017) 534 final and reproduce situations that are partially similar to those already identified in the course of the first phase of b-solutions.

The geographical distribution of the advice cases varies, as they are identified along 6 different borders and involve 6 Member States. Interesting is the variety of applicants: they include one Euroregion, one EGCT, one municipality and one regional authority.

Below a short description of the four selected cases.

Transparent solutions in the border region for efficient treatment and reimbursement of medical expenses for Dutch and German patients

Ems Dollard Region (EDR)

Patients residing in the territory of the Ems Dollard Region - at the border between Germany and the Netherlands - face difficulties with the reimbursement of costs for the healthcare services benefited in the neighboring country, because of a lack of coordination between national health insurances. This situation also hampers the successful implementation of some Interreg projects that aim at strengthening the access to healthcare facilities and services at cross-border level.

A solution to the obstacle would be beneficial to the whole healthcare sector in this border region and, being the insurances regulated at a national level, it might be also replicated in other sections of the same border or different borders of the two countries.

Cross Border Transport of Medical Goods per Unmanned Aerial Vehicle (a.k.a. "drone")

City of Aachen

Drones have been identified as quick and efficient means to transport medical goods between hospitals located on the different sides of the German-Dutch border. Nevertheless, and despite their great potential, the lack of European unified standards in the field, the fragmented regulatory frameworks and the absence of coordination between medical and aviation laws across the border limit their use.

A solution to this obstacle would be beneficial not only to the entire healthcare sector in this specific cross-border region, but it would enable the use of drones also for other types of situations – for example in the field of rescue and emergency services – and it would be replicable in all the EU borders where there is the necessity to make cooperation between hospitals located on the different sides more efficient.

Introducing cross-border healthcare into regular operation

Lower Austrian Health Agency / EU Affairs & Healthacross

Unclear and uncoordinated rules on payments prevent Austrian and Czech citizens to benefit of healthcare services in the neighboring country. The removal of this obstacle would entail a general increase in cooperation in the field of health, giving the possibility to local citizens to access services close to their home and allowing regional healthcare institutions to plan more coordinated services.

A solution could also serve as a basis to trigger similar outcomes in other EU healthcare cross-border functional areas where this type of inequalities arise.

Cross-border emergencies team

EGTC Eurocity Chaves-Verín

The Eurocity Chaves-Verin at the Spanish-Portuguese border aims at implementing a pilot project to create a cross-border coordinated system for emergency responses – especially to act towards the numerous wildfires that hit the area every year.

The coordination between the actors involved in the emergency services in the two countries proves to be difficult because of the presence of diverging radio communication systems, incongruent rules on the insurances for the professionals involved and the impossibility to access information on the potential risks at cross-border level.

Solving these obstacles would increase the cooperation between all the institutions involved in emergency operations in both sides and would facilitate more coordinated actions with a significant impact on the environment. The solution could be also replicated in the territory of all the 8 Eurocities along the same border.