The article analyses the BUPA judgment and the considerable changes that it has brought to the interpretation and application of the four Altmark criteria to services of general economic interest. By making the criteria more flexible, the General Court has put in question the definition of the basic features of those services, e.g. universal coverage. As a result, it would be easier for a service to be considered as a service of general economic interest, which in turn may undermine the effectiveness of the Services Directive. In addition, it is argued that there is value added in the adoption of a framework directive for services of general economic interest in order to mitigate the resulting legal uncertainty and to establish broad principles and conditions for the provision of services of general economic interest.