Health issues in the EU, 2009-2014
- 1. EU to 2009 and beyond Tamsin Rose, 11 October 2007
- 2. Framework for health Limited legal basis for health laws Limited financial and human resources Better Regulation agenda and greater use of non-legislative instruments ‘ Subsidiarity’ is being used as a reason to block or limit EU initiatives on health - e.g the mental health strategy, alcohol strategy.
- 3. Whose hands are driving Europe? ECJ increasingly interventionist on areas of national competence - e.g health systems, taxation, criminal justice European Parliament flexing their muscles and getting greater control over comitology, budgeting and executive agencies.
- 4. Getting serious about health inequalities Widespread, long-term and intergenerational. Linked to social stigma and poverty. Least access to healthcare systems, less opportunity to exercise ‘choice’, poorer health outcomes, less likely to complain. 90/10 gap : contradiction between diseases of affluence and diseases of poverty. Does anything really work?
- 5. Globalisation or the end of the European age EU is pushing bilateral trade agreements as well as multi-lateral negotiations to open up third country service sectors. EU farming subsidies are harmful to developing world Net importer of healthcare professionals Losing predominant role in development and aid policy - see the growing rise of BRIC Need to find a practical solution on immigration
- 6. Crisis management as catalyst BSE, SARS: Crises make the EU role on public health more apparent to Member States. They have been the impetus for new responsibilities and structures such as EFSA and ECDC. Emerging threats (HIV, TB) and future hazards and risks. Big rise in EU technical agencies dealing with issues related to health - creating oversight and governance issues.
- 7. Healthcare: the big themes Unequal access to treatment and care Rising healthcare costs and higher drug prices Differential pharma pricing and the impact of the market (parallel trading) PPP are a growing trend whether for information, product development Patient empowerment
- 8. Food & Drink - an EU test case Key area of EU regulation, covering hygiene standards, safety of ingredients, consumer labelling, protection of traditional products, nutrition and health claims, packaging etc. Also strongly linked to national and regional cultural identity. Multi-stakeholder approaches and voluntary commitments and peer pressure
- 9. The key themes for 2004-2009 prosperity: Growth and jobs (Lisbon agenda) reinforcing the commitment towards solidarity strengthening citizens' security projecting and promoting these priorities outside our borders with a stronger voice in the world. 2005: Globalisation was added as a priority. An EU response was needed on research and development, universities, demography, and energy, along with security and a more effective external response. May 2007: Launch of the Citizen’s Agenda and emphasis on delivering results
- 10. 2004-2009: What’s left to do? EU reform treaty (2007) Energy security Tackling climate change Organised crime and anti-terrorism Immigration and frontier controls Review of the EU budget (2008)
- 11. Health - a key Treaty reform issue Member States have downgraded their agreement from 2004. Now monitoring, early warning and combating of cross- border health threats can only be “i ncentive measures ” and not harmonising legislation “ The Conference declares that the measures to be adopted pursuant to Article 152(4)(c) must meet common safety concerns and aim to set high standards of quality and safety where national standards affecting the internal market would otherwise prevent a high level of human health protection being achieved.”
- 12. Health and trade in the Treaty New in the current Treaty revision (June 2007) The Council must act in unanimity on the following: in the field of trade in social, education and health services, where these agreements risk seriously disturbing the national organisation of such services and prejudicing the responsibility of Member States to deliver them.
- 13. Do we have a new Treaty yet? October 2004, Constitutional Treaty adopted 2005: ratifications by many countries but ‘NO’ votes in referenda in France and Netherlands EU Member States call for a period of ‘reflection’ June 2006: German Presidency asked to prepare a report on the way forward June 2007: EU Council decides to set up an IGC and the mandate to negotiate a ‘Reform Treaty’ Oct 2007: draft Treaty discussed at summit Portuguese Presidency aims to finalise before the end of the year
- 14. European Parliament, 2009-2014 Limited to 750 seats - may temporarily become larger following an enlargement No country = > 96 seats or < 6 seats Degressive proportionality - less densely populated countries receive more seats Up to 50 % of the MEPs will be ‘new’ to the Parliament. They will have the same conditions: €7000 a month salary, travel expenses reimbursed only on real costs New political groupings in the Parliament New arrangement of Committees and mandates
- 15. 2009, a year of change Easter 2009: European Parliament breaks for campaigning Election of President of European Council June 2009: European Parliament elections Summer: Nomination of Commission President Summer: Nomination of Commissioners by MS Sept/Oct 2009: European Parliament hearings for incoming Commissioners November 2009: Commission takes office
- 16. SANCO’s view of 2009-2014 Four key drivers of change: Governance : accountability with delivery in a multi-level world Consumer Confidence : communicating knowledge, risk and science with citizens Globalisation : multiple divides in an information driven context Changing society : influencing standards and managing risks from the outside