5 most-mentioned reasons why respondents would consider receiving treatment abroad

The article has been prepared on the basis of a report on “Patient Rights in the Cross-Border Directive within the European Union” prepared for the European Commission.

In this article, we will analyze the most common reasons why patients opt for treatment abroad. We will also deal with some myths that have been created around cross-border healthcare

5 most-mentioned reasons why respondents would consider receiving treatment abroad


The 5 most-mentioned reasons why respondents would consider receiving treatment abroad are:

–quick access to treatment
–access to higher quality treatment.
–obtaining treatment with recognized specialists,
–receiving cheaper treatment than that available in their country of residence
–getting access to treatment unavailable in your own country

NHS queues and quick access to treatment abroad

Quick access to treatment was reported by 44% of both Poles and Britons as a reason to go abroad for treatment.

Problems with access to treatment have their source in waiting times for treatment or in restrictions on access to specialist treatment. Limited access to specialists is one of the hallmarks of the NHS – in England, a functioning healthcare model favors visits to internists (GPs), with only serious cases addressed by specialist doctors.

NHS queues are particularly painful in the context of planned operations. In July 2017 in England, the number of patients waiting for planned hospitalizations exceeded 4 million, and according to the researchers cited by The Telegraph, this figure will increase to 5 million by 2020. More information on the prognosis of the waiting times for planned operations for the next years, see the analysis by The King’s Fund – an independent foundation working to improve the state of health care in England.

Going abroad to receive treatment allows patients to bypass the NHS queues by receiving treatment in private hospitals, e.g. in Poland. The entire treatment process – from the first specialist consultation, through diagnostics, to operations and physiotherapy can take place abroad, with a subsequent refund of costs from the NHS.



Access to higher quality treatment

Under the Cross-Border Directive, patients can choose state-owned or private hospitals abroad in which they receive treatment and later get the treatment costs reimbursed by their national healthcare fund (in case of England, by the NHS).

Treatment in specialized, private hospitals abroad usually significantly increases the standard of care. For example, in orthopedic operations, invasive, open surgery planned in public hospitals, can be replaced by laparoscopic (keyhole) operations to minimize convalescence time.

In one of our previous articles, we discussed an example of our patient who underwent arthroscopic hip surgery at the Carolina Medical Center in Warsaw. Thanks to the treatment in Poland under the Directive, our patient was operated on by one of the best orthopedic surgeons in Poland using the best medical materials, and the operation took place in a modern hospital. The costs of the operation were high or even very high (about PLN 25,000), but due to the difference in the prices of medical services in Poland and in England, they still did not exceed the NHS valuation. This means that the entire cost of the operation was refunded to the patient by the NHS.

It is worth noting that many patients under normal conditions (ie, being privately treated in their own country and paying for treatment from their own funds) would not be able to afford the price of such an operation, so the highest standard of healthcare would not be within reach of many people, if it was not for the Directive.

Treatment with renowned specialists

Under the Cross-Border Directive, patients can go to any physician treating patients privately or as part of a public system. This means that patients can choose the best, most specialized centers. For example, Med4EU works with orthopedic clinics that have FIFA accreditation.

At Med4EU, we help patients by arranging medical treatment with the highest quality of care and shortest waiting times and subsequently obtain reimbursement of treatment costs from the NHS. We believe that the Cross-Border Directive is a great tool to bypass the limitations (time or technical) of domestic health systems, with the right to reimbursement of all or a significant part of medical costs abroad, with the possibility of significantly increasing the quality of treatment and the shortest waiting time for specialized treatment.

Our services are based on the law of patients described in the Cross-Border Directive. This model in practice includes:

–Access to treatment with a higher quality of care than in the public system
–Treatment in reputable hospitals and recognized specialists with the right to choose a hospital and doctor, which is not possible in the public healthcare system
–Quick access to treatment and organising it in a short span of time in one place, so that it’s convenient for visitors

Availability of cheaper treatment

An important element determining the tendency to choose treatment abroad is the availability of cheaper treatment than in your own country. It is worth citing key differences between specific groups of patients.

Patients looking for treatment that is not covered by the guaranteed scope of benefits and, consequently, financed financially from their own funds, will naturally look for services of the required quality abroad, but with a lower price than those offered at home. This applies, for example, to a wide range of dental services or plastic surgery services. Receiving this type of treatment in cheaper countries, e.g. in Poland, brings the expected results in the form of high quality and relatively low price compared to standard valuations from the Patient’s countries of origin (e.g. the UK). This treatment in not within scope of the Cross-Border Directive and cannot be reimbursed.

The situation is clearly different in the case of treatment under the Cross-Border Directive, especially for Western European patients.

Our experience shows that in the vast majority of cases, the budget allocated to the treatment of a given episode under the NHS is sufficient to cover the costs of commercial treatment in Poland. What’s more, often NHS valuations significantly exceed the valuation of analogous standard commercial procedures offered in Poland, giving the Patient the ability to get additional quality of treatment for this difference and to increase the standard of treatment still within the NHS limit.

As an example illustrating the above rule, one can cite the situation of hip joint treatment in the elderly using hip prostheses. The limit of public health systems usually includes basic prostheses.

The commercial market, which is within the scope of the Directive, offers many more types of advanced solutions, such as half and total endoprostheses, two-, three- and more elemental and bipolar, with different joint connection and different length of the stem and the method of fixing it, ie cement, hybrid and uncemented. There are also less invasive solutions postponing the implantation of the prosthesis by reconstructing the surface of the femoral head, utilising metal overlay cooperating with the hybrid acetabulum. In the end, different solutions imply different, to the depth, interferences in the bone structure of the patient, and the prostheses themselves offer different range of joint movements after surgery.

If we add to this various materials from which dentures and their active surfaces are made, we get a spectrum of choices not available in the public system, which, with the application of the Directive and the relocation of treatment from England to Poland, become available to the patient.

An important differential point to other treatment paths is also that the patient can consciously choose the solution from the highest shelf beyond the limit of refund and in this case will be obliged only to subsidize such treatment above the level of refunds.

Such a solution can not be applied to a typical model of treatment in the public health service, and those interested in it. Patients wishing to cure themselves in their own countries have the only option to transfer treatment to the private system with the obligation to cover 100% of the costs of treatment from their own pocket without the right to even a partial refund.

Here again, the advantages of treatment under the Cross-Border Directive co-ordinated by Med4EU reveal the access to private treatment in Poland resulting in the right to refund all or most of the expenses incurred with the possibility of obtaining solutions unavailable in the public system.

Access to treatment not available in your own country of residence

Many respondents, as many as 68% of UK patients, cited access to treatment unavailable in their own country as the main reason why they would be willing to travel to another EU country for treatment.


We have to deal with one of the most common myths here – if treatment is not available in the country of residence, it means that it will most likely not be refunded.

As a rule, only the treatments identical or equivalent to those available to the patient on the NHS are refundable from the national health fund in the light of the EU Directive. The lack of the right to a refund results not only from the provisions of the Cross-Border Directive, but also does not follow from any other provision on the coordination of medical care within the European Union.

What non-invasive treatment can be mentioned here? Experimental therapies that have not yet been introduced into common health systems are a popular example, but are available outside the country as part of private treatment or clinical trials.

We would like to point out here that in Med4EU we do not deal with experimental therapies, due to the lack of consolidation of these methods of treatment in public health systems, and thus – the lack of the right to a refund.

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