Cross-border healthcare in the twin cities of Valga and Valka


Once a single town, the Baltic twin cities of Valga (Estonia) and Valka (Latvia) are now an urban area split by an international border created in 1991 after the two countries gained independence from the Soviet Union.  

The only hospital in the area is the Valga Hospital, on the Estonian side, while the closest Latvian facility is 50 km away, in the city of Valmiera. The Valga hospital, therefore, accommodates patients coming from both countries and in fact ensures access to healthcare services to residents within 30 km of the twin-city. 

There are two types of medical treatment provided by the hospital: 

  • Emergency medical treatment which ensures that, in the event of a Latvian being brought to hospital by ambulance, no costs are charged to the patient 
  • Planned medical treatment

The healthcare services are provided in both languages, despite Estonian and Latvian idioms being very different. Most of the personnel are bilingual and this allows patients from both countries to have full access to information and treatment.



Valga (Estonia) and Valka (Latvia)




The hospital operates under the Directive 2011/24/EU on patients’ rights in cross-border healthcare that allows European patients to receive healthcare in another Member state. In terms of the governance model, Valga Hospital is owned by the Valga Municipality and the Tartu University Hospital (Estonia), while Latvian authorities have no shares in the facility. This means that the Estonian side is fully responsible for the management and delivery of healthcare in that area. The context of the twin city appears to be particularly favorable to cooperation, with many cross-border initiatives related to healthcare financed both at EU and local levels.  



The Valga Hospital contributes to facilitating cross-border mobility of both patients and health professionals. It has the following positive impacts for the residents of this twin-city and the surrounding area:

  • Stronger integration between the two twin cities which increases the attractiveness of the area 
  • Improved and easier access to healthcare services for Latvians who are no longer forced to travel long distances to get to the hospital
  • By accommodating more patients, more opportunities become available to the hospital, potentially leading to the enhancement of the services provided


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