Beyond the cross-border aspect, the draft directive on patients' rights and access to care in the EU, presented on 2 July, sets out a series of cooperation initiatives between national authorities. Less controversial aspects than cross-border access to health care that are proposed include putting in place European reference networks as well as provisions on medical technology and online health.

Such European reference networks could bring together, on a voluntary basis throughout the EU, specialised national centres in order to provide patients high quality expertise and care - with a corresponding cost. Patients may be able to visit these centres in other EU member states. To test the concept, the Commission is funding pilot projects, particular in the field of rare illnesses. The objective is the exchange of national experience, as is customary in the field of health in the EU. These first attempts will serve, for example, to identify practical and legal "obstacles" for future networks. The Commission wants to make medical training and research, as well as assessment and the dissemination of information, key elements. It believes that this will facilitate patients' access to highly specialised care. Another idea is for national health systems to link their resources to become more efficient.

INTEROPERABILITY

The Commission is also due to invite member states to cooperate more in the field of the "assessment of medical technology". Such an initiative involves numerous processes, which are meant to bring together ethical, economic, social and medical information on the use a piece of new technology. "It is a field where Europe can give clear added value, because Community cooperation can help reduce overlaps and duplicates and promote effective and efficient use of resources," says the Commission. Here too, the Commission is financially supporting a pilot programme dubbed EUnetHTA' (European network for Health Technology Assessment), which will serve as a basis for the European medical technology assessment network. Funded by the Commission and its members, it will link together the competent national agencies, research institutes and health ministries by serving as a platform for the exchange of information and the support of member states' political decisions.

The third key theme of this cooperation is online health services, the Commission's pet theme that it presented in its 2004 action plan. They need the same formats and information standards to be used by different systems and countries, stresses the Commission. The directive should therefore recommend the adoption of common formats and norms. Although it will not force member states to adopt such services, it should require compatibility (interoperability) between systems and services once they are in place.