Legal thoughts on the implications of cost-reducing guidelines for the quality of health care

Health care expenditures in European countries are increasing. Many cost containment mechanisms have been developed, one of which is the introduction of clinical practice guidelines in binding legislation. In developing recent patients’ rights laws, many legislators refer to practice guidelines when specifying the right to quality in health care. The courts often follow this example. Initially, practice guidelines were used to improve the quality of care. Recently, their potential to reduce costs is being discovered by policy makers and compliance with the cost-controlling guidelines is mandatory and subject to financial sanctions. This article will question the impact of the ‘new generation’ guidelines aimed at reducing health care costs and their impact on the quality of care, in particular. The authors will analyse whether a physician, in case of a conflict with a patient, who claims that his right to quality care has been violated, can defend himself in court by stating that he complied with ’financially’ inspired guidelines, especially now that non-compliance with these guidelines is sanctioned.