Services of general interest provision through the third sector under EU competition law constraints: The example of organising healthcare in England, Wales and the Netherlands

It is commonplace that directly applicable eu treaty law exerts influence on various social fields at national level, including healthcare. There has been ample debate about the impact of free movement rights and public healthcare systems, recently complemented by an analysis of the relationship between public healthcare and eu competition law. This case study aims to highlight a different aspect of the tensions between social and economic dimensions of european integration. By providing healthcare as a service of general interest, some member states have taken recourse to the ‘third sector’, consisting of not-for-profit organisations offering social services based on a specific ethos. At the same time, a need to respond to ever diversifying social demands has developed. Co-operating with not-for-profit organisations as service providers as well as including them in the process of conceptualising services may be one way to respond to this. Such inclusion can be perceived as enhancing social integration through active civil society participation – a strategy which may also be suitable to enhance social dimensions of european integration.