The initiative is in reaction to several rulings by the European Court of Justice boosting patients' mobility across the bloc - but leaving a legal minefield which the commission wants to clear up.

Brussels is also acting because health was removed from a law opening up the market in services, currently in the legislative pipeline in Brussels.

But a group of eight member states with social-democrat health ministers - which regularly meet to discuss problems of European legislation interfering with their countries' health systems - wants to see a more protectionist proposal than so far outlined by health commissioner Markos Kyprianou.

Germany, Spain, Belgium, Luxembourg, Portugal, Sweden, Italy and the UK form the so called "Aachen group" - after the location of their first session in Germany last year - which has already presented its views to other countries and the commission.

"We could see that the first orientation document by Mr Kyprianou has picked up some of the ideas we promote - such as the need to protect the national specifities of the health systems in member states," Stefaan Thijs from Belgium's health ministry told EUobserver.

"It would be wrong to focus too much on patients' mobility in the forthcoming law and avoid the existing problems of blind application of internal market rules in the health sector across the EU - often against the practices of individual countries," he added.

'EU should not put up obstacles'

He referred to several cases where the commission or the EU's top court forbad countries to restrict access to some health services providers or even health equipment or pharmacies as part of their national planning system.

"One of the key objectives of public health policy - apart from accessibility and quality - is financial sustainability and every government has its own ways how to achieve these aims, while the EU should not put up obstacles to its performance."

"Due to the specific nature of the health sector, governments can use means to reduce competition - like, say, in case of a limited number of pharmacies or special health equipment."

"If only the free market applied, we would see a higher consumption which would also boost state budget expenses, so this could directly affect our national governance," explained Mr Thijs.

He pointed out that Sweden and the UK were initially wary of calling for EU legislation to limit market impact, but "later they admitted we need a new European framework to limit the impact of competition rules vis-a-vis our systems."

The Belgian government official suggested some other countries - like France - have also expressed their support for the ideas presented by the Aachen group, but he still expects the issue to spark heated debate once it is formally opened.

After a short discussion on the subject at a July meeting of health ministers, the Finnish EU presidency is expected to conduct a deeper debate on health and competition after the commission unveils its policy in late September.

MEPs call for more legal clarity

Meanwhile, MEPs in the European Parliament's economic and monetary committee have also urged the EU executive to tackle health services in a report - adopted almost unanimously on Tuesday (12 September) - on so-called services of general interest.

The term "services of general interest" is often used in Brussels jargon to describe public services such as health and education.

The report by German socialist MEP Bernhard Rapkay argues that more clear legal distinction is needed between "services of general interest" and "services of general economic interest," as their precise definition will influence the application of EU competition rules as well as the way they can be financed.

"Services of general economic interest" are defined by the European Commission as services of an economic nature which are nevertheless "subject to specific public service obligations" - such as postal services, energy and communication.

But the parliament's document refrains from calling for an overall EU law on public and semi-public services and instead argues in favour of a sectoral approach.

The rapporteur highlighted the need to respect the so called "subsidiarity principle," stressing that it is up to member states to define their own services of general interest and the EU should respect their national traditions.

However, MEPs argued that countries should not exclude large parts of these services from the scope of EU competition rules through defining them at the national level.