PARALLEL TEXTS
Secondo l’avvocato generale Cruz Villalón, uno Stato membro è obbligato ad autorizzare la prestazione di un servizio medico in un altro Stato dell’Unione quando l’impossibilità di prestarlo sul suo territorio dipenda da una carenza di carattere contingente e transitorio nei suoi centri ospedalieri
Inglese tratto da:
http://europa.eu/rapid/press-release_CJE-14-87_en.htm
Italiano tratto da:
http://europa.eu/rapid/press-release_CJE-14-87_it.htm
Data documento: 19-06-2014
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According to Advocate General Cruz Villalón, a Member State is obliged to authorise the provision of a service in another EU State when the fact that the service cannot be provided in its territory is the result of an occasional, temporary deficiency in its hospital facilities
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Secondo l’avvocato generale Cruz Villalón, uno Stato membro è obbligato ad autorizzare la prestazione di un servizio medico in un altro Stato dell’Unione quando l’impossibilità di prestarlo sul suo territorio dipenda da una carenza di carattere contingente e transitorio nei suoi centri ospedalieri
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The Advocate General however considers if the problem is structural in nature, the Member State is not obliged to authorise the provision of that service in another State, unless that authorisation would not put the viability of its social security system at risk
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Per contro, l’avvocato generale ritiene che in caso di problemi di carattere strutturale, lo Stato membro non è obbligato a autorizzare la prestazione di tale servizio in un altro Stato, salvo nel caso in cui tale autorizzazione non metta in pericolo la sostenibilità economica del suo sistema di previdenza sociale
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Under EU law, a worker can be authorised to go to the territory of another Member State to receive the medical treatment appropriate to his condition, receiving there the benefits he requires as though he were insured under the social security system of that State, and the costs being reimbursed by the State of residence.
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In forza del diritto dell’Unione, un lavoratore può essere autorizzato a recarsi nel territorio di un altro Stato membro per ricevere cure adeguate al suo stato, e ricevere in tale Stato le prestazioni necessarie come se fosse iscritto al regime previdenziale di detto Stato, con rimborso dei relativi costi da parte dello Stato di residenza.
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The Member State of residence may not refuse that authorisation when the treatment the worker requires is among the benefits provided for by its legislation and when he cannot be given that treatment in good time in its territory having regard to his current state of health and the probable course of the disease.
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Lo Stato membro di residenza non può negare detta autorizzazione quando l’assistenza di cui ha bisogno il lavoratore ricade tra le prestazioni ricomprese dalla propria normativa e non può essere opportunamente erogata nel proprio territorio in considerazione dello stato di salute del lavoratore e della probabile evoluzione della sua malattia.
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Ms Elena Petru, a Romanian national, suffers from a serious illness which, when her condition deteriorated, resulted in her being admitted to a specialist medical centre in Timisoara (Romania) where it was determined that her condition was so serious that she required an operation as a matter of urgency.
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La sig.ra Petru, cittadina rumena, soffre di una grave patologia che, in esito a un peggioramento, ha dato luogo al suo ricovero in un istituto specializzato a Timisoara (Romania), in cui si è attestato che il suo stato era così grave da rendere necessario un intervento chirurgico urgente.
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During her stay in that hospital, Ms Petru became aware that the centre lacked basic medical supplies and was overcrowded, and therefore, in view of the complex nature of the surgical operation which she had to undergo, she applied for authorisation to have the operation in Germany.
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Durante il periodo di degenza, la sig.ra Petru ha constatato che detto istituto non disponeva di materiali medici di prima necessità ed era saturo, sicché, in considerazione, inoltre, della difficoltà dell’intervento chirurgico al quale doveva sottoporsi, ha chiesto l’autorizzazione ad essere sottoposta all’intervento in Germania.
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Although her application was refused, Ms Petru decided to have the operation in Germany.
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Anche se la sua richiesta è stata respinta, la sig.ra Petru ha deciso di essere operata in Germania.
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The total cost of the operation was around € 18 000 and she is seeking to recover this sum from the Romanian authorities.
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Il costo complessivo dell’intervento è stato di circa EUR 18 000, di cui essa chiede rimborso alle autorità rumene.
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The Tribunalul Sibiu (Tribunal of Sibiu, Romania), which is hearing the case, has asked the Court of Justice to determine whether a widespread lack of basic healthcare resources in the State of residence is a situation in which it is impossible to provide treatment, so that a national of that Member State may exercise his right to be authorised to receive treatment in another Member State at the expense of the social security system of the State of residence.
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Il Tribunale di Sibiu (Romania), chiamato a decidere la controversia, ha chiesto alla Corte di giustizia se la carenza generalizzata di materiali medici di prima necessità nello Stato di residenza costituisca una situazione in cui risulti impossibile prestare il trattamento, sicché il cittadino di tale Stato membro possa esercitare il suo diritto ad essere autorizzato a ricevere tale trattamento in un altro Stato membro a carico del regime di previdenza sociale del suo Stato di residenza.
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Although case-law of the Court of Justice exists in this area, this is the first time that the necessity of receiving medical treatment in another Member State is based on the dearth of resources in the State of residence.
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Nonostante la sussistenza di una giurisprudenza della Corte di giustizia in materia, è la prima volta in cui la necessità di ricevere assistenza medica in un altro Stato membro trova giustificazione nella carenza di mezzi dello Stato di residenza.
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In today’s Opinion, Advocate General Pedro Cruz Villalón examines two separate issues:
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Nelle sue conclusioni presentate in data odierna, l’avvocato generale Cruz Villalón analizza due distinte questioni:
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(1) whether a deficiency or lack of resources in a hospital can, in certain circumstances, amount to a situation in which it is not possible to provide in good time in a Member State a particular healthcare service included among the benefits covered by that State’s social security system, and (2) whether the same also holds true when such lack or shortage affecting healthcare facilities is structural in nature.
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1) se la mancanza o carenza di mezzi in un centro ospedaliero, in determinate circostanze, possa equivalere a una situazione in cui non è possibile praticare in tempo utile in uno Stato una determinata prestazione sanitaria compresa tra le prestazioni dispensate dal proprio sistema di previdenza sociale e 2) se lo stesso si verifichi quando tali carenze o mancanze nelle strutture sanitarie siano di carattere strutturale.
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After noting that healthcare services, including public healthcare services, are economic in nature and subject to free movement of services, the Advocate General emphasises that, although Member States may make the provision of those services in another Member State at the expense of the State of residence subject to prior authorisation, they may withhold authorisation only when the same or equally effective treatment may be obtained in good time in its territory.
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Dopo aver ricordato che i servizi sanitari, compresi quelli pubblici, costituiscono servizi di carattere economico assoggettati alla libera circolazione dei servizi, l’Avvocato generale sostiene che gli Stati membri, anche se possono sottoporre ad autorizzazione la prestazione di tali servizi in un altro Stato membro con spese a carico dello Stato di residenza, potranno rifiutare l’autorizzazione solo nell’ipotesi in cui possa conseguirsi tempestivamente nel loro territorio un trattamento identico o che presenti lo stesso grado di efficacia.
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The Advocate General examines the case-law in this area, noting that a patient from a Member State, insured under a public health system, is entitled to travel to another Member State, at the expense of the social security system of the State of residence, if the same or equally effective treatment can be obtained without undue delay in that other Member State but not in the State of residence.
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L’Avvocato generale riprende la giurisprudenza in materia segnalando che un paziente di uno Stato membro, iscritto ad un sistema sanitario pubblico, ha il diritto di recarsi in un altro Stato dell’Unione, ponendo le spese a carico del sistema di previdenza sociale del suo Stato di residenza, quando in questo altro Stato, e non nel suo Stato di residenza, possa essere ottenuto tempestivamente un trattamento identico o che presenti lo stesso grado di efficacia.
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In such a situation, the system under which the patient is insured will cover the costs incurred abroad.
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In tal caso, il sistema assicurativo del paziente coprirà le spese sostenute all’estero.
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If those conditions are not satisfied, the patient will be able to go abroad to receive the service to which he was entitled in the State of insurance, but will be able to recover the cost of the treatment only at the price applicable in the State of insurance, and not at the price charged in the place where the service was provided.
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Se tali condizioni non sono soddisfatte, il paziente può recarsi all’estero e ottenere il servizio al quale aveva diritto nel suo Stato di iscrizione, potendo però chiedere solo il rimborso al costo previsto in tale Stato e non a quello fatturato nel luogo di prestazione del servizio.
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With regard to the first question, the Advocate General states that, given that the law of the EU draws no distinction as to the reasons why a particular service cannot be provided in good time, an occasional lack of material resources must be regarded as equivalent to a shortage connected with lack of medical staff.
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Quanto alla prima questione, l’Avvocato generale sottolinea che, dal momento che il diritto dell’Unione non opera distinzioni in merito alle ragioni per le quali una determinata prestazione non possa essere praticata tempestivamente, si deve ritenere che la carenza occasionale di mezzi materiali equivalga a una mancanza dovuta a carenze di personale medico.
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Therefore, in his opinion, the Member State is required to authorise the provision in another Member State of a medical service, included among the benefits covered by its social security system, when a cyclical shortage in one of its hospitals actually makes it impossible to provide the service.
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Conseguentemente, a suo parere, lo Stato membro è obbligato ad autorizzare la prestazione, in un altro Stato dell’Unione, di un servizio medico compreso nelle prestazioni coperte dal proprio sistema di previdenza sociale, nel caso in cui carenze delle proprie strutture ospedaliere, di carattere congiunturale, rendano effettivamente impossibile la prestazione stessa.
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In contrast, in answer to the second question under consideration, the Advocate General considers that, when the lack of material resources for carrying out the medical treatment in question is the result of a structural shortage, the Member State is not obliged to authorise the provision in another Member State of a service from among the benefits covered by its social security system, even though this could mean that certain healthcare services cannot actually be provided.
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Per contro, rispondendo alla seconda questione esaminata, l’Avvocato generale ritiene che, laddove la carenza di mezzi materiali necessari ai fini dell’effettuazione della prestazione sanitaria in questione dipenda da una mancanza strutturale, lo Stato membro non è obbligato ad autorizzare la prestazione, in un altro Stato dell’Unione, di un servizio compreso nelle prestazioni coperte dal proprio sistema di previdenza sociale, sebbene ciò possa comportare che determinate prestazioni sanitarie non possano essere effettivamente praticate.
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The Member State will be obliged to give that authorisation only if it does not put at risk the viability of its social security system.
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Tale obbligo sussisterà solamente qualora l’autorizzazione non metta in pericolo la sostenibilità economica del suo sistema di previdenza sociale.
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The Advocate General indicates, in this respect, that a Member State finding itself in such a situation of structural shortages would be unable to meet the costs arising from a mass health-related exodus of those insured under its social security system, and he stresses, in particular, that one of the limits to the freedom to provide services in the healthcare sector is that those services and the planning and rationalisation efforts in that vital healthcare sector in the patient’s State of residence should not be put at risk.
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Al riguardo, l’Avvocato generale fa presente che lo Stato membro che si trovi in tale situazione di carenza strutturale non potrebbe far fronte agli oneri economici derivanti da un’emigrazione sanitaria di massa degli iscritti al proprio sistema di previdenza sociale e sottolinea che uno dei limiti all’esercizio della libera prestazione dei servizi nel settore dei servizi sanitari consiste proprio nel non mettere in pericolo né la prestazione dei servizi stessi né tutti gli sforzi di pianificazione e di razionalizzazione effettuati in tale settore vitale nello Stato di residenza del paziente.
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NOTE:
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IMPORTANTE:
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The Advocate General’s Opinion is not binding on the Court of Justice.
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Le conclusioni dell'avvocato generale non vincolano la Corte di giustizia.
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It is the role of the Advocates General to propose to the Court, in complete independence, a legal solution to the cases for which they are responsible.
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Il compito dell'avvocato generale consiste nel proporre alla Corte, in piena indipendenza, una soluzione giuridica nella causa per la quale è stato designato.
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The Judges of the Court are now beginning their deliberations in this case.
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I giudici della Corte cominciano adesso a deliberare in questa causa.
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Judgment will be given at a later date.
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La sentenza sarà pronunciata in una data successiva.
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NOTE:
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IMPORTANTE:
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A reference for a preliminary ruling allows the courts and tribunals of the Member States, in disputes which have been brought before them, to refer questions to the Court of Justice about the interpretation of EU law or the validity of a European Union act.
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Il rinvio pregiudiziale consente ai giudici degli Stati membri, nell'ambito di una controversia della quale sono investiti, di interpellare la Corte in merito all’interpretazione del diritto dell’Unione o alla validità di un atto dell’Unione.
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The Court of Justice does not decide the dispute itself.
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La Corte non risolve la controversia nazionale.
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It is for the national court or tribunal to dispose of the case in accordance with the Court’s decision, which is similarly binding on other national courts or tribunals before which a similar issue is raised. |
Spetta al giudice nazionale risolvere la causa conformemente alla decisione della Corte. Tale decisione vincola egualmente gli altri giudici nazionali ai quali venga sottoposto un problema simile. |
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According to Advocate General Cruz Villalón, a Member State is obliged to
authorise the provision of a service in another EU State when the fact that the
service cannot be provided in its territory is the result of an occasional,
temporary deficiency in its hospital facilities
The Advocate General however considers if the problem is structural in
nature, the Member State is not obliged to authorise the provision of that
service in another State, unless that authorisation would not put the viability
of its social security system at risk
Under EU law, a worker can be authorised to go to the territory of another
Member State to receive the medical treatment appropriate to his condition,
receiving there the benefits he requires as though he were insured under the
social security system of that State, and the costs being reimbursed by the
State of residence.
The Member State of residence may not refuse that authorisation when the
treatment the worker requires is among the benefits provided for by its
legislation and when he cannot be given that treatment in good time in its
territory having regard to his current state of health and the probable course
of the disease.
Ms Elena Petru, a Romanian national, suffers from a serious illness which,
when her condition deteriorated, resulted in her being admitted to a specialist
medical centre in Timisoara (Romania) where it was determined that her condition
was so serious that she required an operation as a matter of urgency.
During her stay in that hospital, Ms Petru became aware that the centre
lacked basic medical supplies and was overcrowded, and therefore, in view of the
complex nature of the surgical operation which she had to undergo, she applied
for authorisation to have the operation in Germany.
Although her application was refused, Ms Petru decided to have the operation
in Germany.
The total cost of the operation was around € 18 000 and she is seeking to
recover this sum from the Romanian authorities.
The Tribunalul Sibiu (Tribunal of Sibiu, Romania), which is hearing the case,
has asked the Court of Justice to determine whether a widespread lack of basic
healthcare resources in the State of residence is a situation in which it is
impossible to provide treatment, so that a national of that Member State may
exercise his right to be authorised to receive treatment in another Member State
at the expense of the social security system of the State of residence.
Although case-law of the Court of Justice exists in this area, this is the
first time that the necessity of receiving medical treatment in another Member
State is based on the dearth of resources in the State of residence.
In today’s Opinion, Advocate General Pedro Cruz Villalón examines two
separate issues:
(1) whether a deficiency or lack of resources in a hospital can, in certain
circumstances, amount to a situation in which it is not possible to provide in
good time in a Member State a particular healthcare service included among the
benefits covered by that State’s social security system, and (2) whether the
same also holds true when such lack or shortage affecting healthcare facilities
is structural in nature.
After noting that healthcare services, including public healthcare services,
are economic in nature and subject to free movement of services, the Advocate
General emphasises that, although Member States may make the provision of those
services in another Member State at the expense of the State of residence
subject to prior authorisation, they may withhold authorisation only when the
same or equally effective treatment may be obtained in good time in its
territory.
The Advocate General examines the case-law in this area, noting that a
patient from a Member State, insured under a public health system, is entitled
to travel to another Member State, at the expense of the social security system
of the State of residence, if the same or equally effective treatment can be
obtained without undue delay in that other Member State but not in the State of
residence.
In such a situation, the system under which the patient is insured will cover
the costs incurred abroad.
If those conditions are not satisfied, the patient will be able to go abroad
to receive the service to which he was entitled in the State of insurance, but
will be able to recover the cost of the treatment only at the price applicable
in the State of insurance, and not at the price charged in the place where the
service was provided.
With regard to the first question, the Advocate General states that, given
that the law of the EU draws no distinction as to the reasons why a particular
service cannot be provided in good time, an occasional lack of material
resources must be regarded as equivalent to a shortage connected with lack of
medical staff.
Therefore, in his opinion, the Member State is required to authorise the
provision in another Member State of a medical service, included among the
benefits covered by its social security system, when a cyclical shortage in one
of its hospitals actually makes it impossible to provide the service.
In contrast, in answer to the second question under consideration, the
Advocate General considers that, when the lack of material resources for
carrying out the medical treatment in question is the result of a structural
shortage, the Member State is not obliged to authorise the provision in another
Member State of a service from among the benefits covered by its social security
system, even though this could mean that certain healthcare services cannot
actually be provided.
The Member State will be obliged to give that authorisation only if it does
not put at risk the viability of its social security system.
The Advocate General indicates, in this respect, that a Member State finding
itself in such a situation of structural shortages would be unable to meet the
costs arising from a mass health-related exodus of those insured under its
social security system, and he stresses, in particular, that one of the limits
to the freedom to provide services in the healthcare sector is that those
services and the planning and rationalisation efforts in that vital healthcare
sector in the patient’s State of residence should not be put at risk.
NOTE:
The Advocate General’s Opinion is not binding on the Court of Justice.
It is the role of the Advocates General to propose to the Court, in complete
independence, a legal solution to the cases for which they are responsible.
The Judges of the Court are now beginning their deliberations in this case.
Judgment will be given at a later date.
NOTE:
A reference for a preliminary ruling allows the courts and tribunals of the
Member States, in disputes which have been brought before them, to refer
questions to the Court of Justice about the interpretation of EU law or the
validity of a European Union act.
The Court of Justice does not decide the dispute itself.
It is for the national court or tribunal to dispose of the case in accordance
with the Court’s decision, which is similarly binding on other national courts
or tribunals before which a similar issue is raised.
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