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EU Citizens' Transnational Rights and Health-related Deservingness at the Street-level

Project description

Access to public healthcare anywhere in the EU

Free movement is a fundamental principle of the Treaty on the Functioning of the European Union. The right to work, study, live and retire in another EU Member State is one of the basic rights of EU citizens. While recognising transnational healthcare rights as a precondition for free movement within the EU, there are bureaucratic stumbling blocks. The EU-funded EU-TRHeaDS project will study how, why and to what extent street-level bureaucrats use their margins for discretion when providing access to healthcare for EU migrant citizens. It will focus on healthcare services in Belgium and Spain, combining qualitative policy analysis with a survey experiment. Finally, the project will link the bureaucracy perspective with the debate on health-related deservingness and intra-EU mobility.


The recognition of transnational healthcare rights of EU migrant citizens is a precondition for free movement within the Union. Although progressive coordination has been fostered by EU laws, the existence of bureaucratic barriers affecting the realisation of EU citizens’ rights at the point of access to Member States’ healthcare systems has been frequently reported. EU-TRHeaDS investigates how, why and to what extent street-level bureaucrats discriminate against EU migrant citizens who require access to public healthcare. It will combine qualitative policy analysis methodology with a survey experiment with street-level workers operating at the front-line of healthcare services in two Belgian Regions and two Spanish Autonomous Communities. In doing so, it will isolate the causal effect of citizens’ identity markers on street-level decisions, while assessing the impact of different political contexts and types of healthcare systems on street-level work. Theoretically, EU-TRHeaDS links the street-level bureaucracy perspective in public administration studies with the nascent debate on health-related deservingness to test the institutional, political and individual determinants of street-level decisions. Empirically, it fills two gaps in the welfare-mobility nexus scholarship, shifting the focus from welfare to healthcare entitlements, and focusing on implementation practices rather than on countries’ formal policies. Methodologically, it provides a comprehensive approach to the study of street-level decisions, carrying out an original comparative research that combines qualitative and experimental methods. Substantively, EU-TRHeaDS unveils how the complex equilibrium between EU citizens’ transnational rights and Member States’ bounded healthcare systems materialises, which is critical in times of renewed debates on “Social Europe” and the challenges posed by COVID-19 to intra-EU mobility.



Net EU contribution
€ 166 320,00
Place du 20 aout 7
4000 Liege

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Région wallonne Prov. Liège Arr. Liège
Activity type
Higher or Secondary Education Establishments
Other funding
€ 0,00