At present, European citizens cannot be guaranteed that the care they will receive in another part of the European Union (EU) is of high quality, warn researchers in this week's BMJ.
They call on national governments and other stakeholders to help bring about change.
There is an assumption that health services provided according to national regulations in any EU country will be of adequate quality, write Professor Martin McKee and colleagues. Yet within Europe the approach to assuring quality in different countries varies.
These differences are becoming increasingly important due to growing professional and patient movement within the EU. So can Europe's citizens be confident that care received in another EU country will be safe and of high quality, they ask?
The authors identify several initiatives that illustrate both the similarities and the diversity within European health systems. They point out that, while there are policies to ensure consistent quality of some elements of health care at a European level (for example by the creation of centralised drug approval systems) for many others, such as the quality of healthcare systems, organisations and clinical processes, there is no co-ordination.
This reflects diversity among countries. While some have well developed quality assurance systems, in others there is very little evidence of any concrete progress, and often what exists has little impact on the majority of health professionals, they argue.
The delivery of health care is a national responsibility but, in a Europe characterised by free movement, national governments and other stakeholders must take account of the wider European context in health policymaking and planning, they write.
Europe-wide legislation to mandate a single approach to quality of care is not a realistic possibility, they say. How a country assures quality of care is a matter for it to determine; what is important is that it does so.
In the medium term, they argue, there is a need to support the emerging informal mechanisms, many led by professional bodies, that are designed to assure the quality and safety of care for European citizens.