New developments in the medical tourism industry also had a legal impact in the European Union. Until recently, the top five destinations preferred by Europeans were the United Kingdom, Germany, France, Italy and Spain. However, a new European Directive on Cross-Border Healthcare stipulating free access to treatment in the community space for all EU citizens was implemented in 2014.
Following this directive, a new public-pay medical tourism market appeared and "newly entered" countries from Central Europe, such as Hungary, Poland, the Czech Republic, Romania and Latvia, became popular destinations for Western Europeans willing to exercise their right to be treated cross-border. Among the main reasons why these patients would choose to travel abroad are: the possibility to have access to specific treatments that are not available in their homelands, the high quality and lower cost of such treatments, and the chance to combine them with a holiday for rest and recovery in the destination country.