R (Watts) v Bedford Primary Care Trust
A patient in the NHS who faces an undue delay in receiving hospital treatment can go to another Member State for treatment and claim the cost, and the NHS must apply objective criteria.
Facts
Mrs Watts, who lived in England, needed a hip replacement. She was told that she would have to wait about a year for the operation on the NHS. She asked her primary care trust for authorisation to have the operation in France, under EU rules, but it was refused, because she could be treated within the government's NHS targets. She had the operation in France, and claimed the cost.
Legal principle
The Court of Justice held that the NHS was subject to the Treaty rules on freedom to provide services, even though it is funded from general taxation and free at the point of use. A requirement of prior authorisation for hospital treatment abroad could be justified, to allow planning and avoid waste, but authorisation could not be refused where the waiting time exceeded the period which is acceptable in the light of an objective medical assessment of the clinical needs of the person concerned. The national authorities must take into account the patient's medical condition, the degree of pain and the nature of the disability, not just waiting list targets.
Related cases on freedom of establishment and services
- Alpine Investments BV v Minister van Financiën Case C-384/93, [1995] ECR I-1141
- Carpenter v Secretary of State for the Home Department Case C-60/00, [2002] ECR I-6279
- Cartesio Oktató és Szolgáltató bt Case C-210/06, [2008] ECR I-9641
- Centros Ltd v Erhvervs og Selskabsstyrelsen Case C-212/97, [1999] ECR I-1459
- Gebhard v Consiglio dell'Ordine degli Avvocati e Procuratori di Milano Case C-55/94, [1995] ECR I-4165
- HM Customs and Excise v Schindler Case C-275/92, [1994] ECR I-1039
- International Transport Workers' Federation v Viking Line ABP Case C-438/05, [2007] ECR I-10779
- Kamer van Koophandel en Fabrieken voor Amsterdam v Inspire Art Ltd Case C-167/01, [2003] ECR I-10155
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