EU health strategy
The Commission proposal for the EU Health programme 2007-2013 aligns future health action with the overall EU objectives of prosperity, solidarity and security and aims to further exploit synergies with other policies.
The Commission launched a reflection process, in July 2004, inviting stakeholders to express their visions of a future EU health strategy. A paper by the Health Commissioner, entitled "Enabling Good Health for all - A reflection process for a new EU Health Strategy", and a complementary non-paper by the DG Health and Consumer Protection, entitled "Partnerships for Health in Europe", served as a basis for the consultation, the outcome of which was meant to help shape the future EU health strategy to be developed by the Commission.
In their contributions, stakeholders called for better co-ordination between public health and other policy areas, the need for more comparable data on the impact of investments in health and further debate on healthcare.
On 6 April 2005, the Commission adopted a strategy and a proposal for the Community Programme for Health and Consumer Protection 2007-2013. It brings together and extends the current EU Public Health Programme and the current programme in support of EU consumer policy. As public health and consumer protection policies share many objectives (e.g. promoting health protection, safety, information and education) the Commission aimed, in combining the two programmes, to exploit synergies between health and consumer policies. It also wished that bringing the two policies together would generate greater policy coherence, economies of scale, increased visibility and streamlining of procedures.
The idea of merging the health and consumer programmes met with a cautious welcome from both health and consumer stakeholders and the Parliament. The Conference of Presidents of the EP decided, in June 2005, to split the programme and assign it to both the Committee on the Environment, Public Health and Food Safety (ENVI) and the Committee on the Internal Market and Consumer Protection (IMCO) for the drawing up of two separate reports.
The Commission's amended proposal (May 2006) for establishing the Community Health programme 2007-2013 builds on the achievements of the existing programme of Community action in the field of public health (2003-2008) and aligns future health action more explicitly with the overall EU objectives of prosperity, solidarity and security and seeks to further exploit synergies with other policies.
The objectives of the programme are to:
1.) Improve citizens' health security (97.572 million euro)
- Protect citizens against health threats (e.g. develop strategies and mechanisms for preventing and responding to threats, support the development of prevention, vaccination and immunisation policies)
- Improve citizens' safety (e.g. support scientific advice and risk assessment by early identification of risks, patient safety, reduce accidents)
2.) Promote health to improve prosperity and solidarity (113.834 million euro)
- Foster healthy, active ageing and help bridge health inequalities (e.g. increase number of healthy life years)
- Promote healthier ways of life by tackling health determinants (e.g. healthy lifestyles, health effects of wider environmental and socio-economic determinants)
3.) Generate and disseminate health knowledge (113.82 million euro)
- Exchange knowledge and best practice
- Collect, analyse and disseminate health information
To implement the programme, a number of projects will be financed on each of the specific objectives and a number of new measures will be proposed and carried out. A number of scientific opinions are also expected to be given on for example improving citizens' safety. Thematic platforms are expected to be created on the are promoting healthy lifestyles.
An interim evaluation report on the results obtained and the qualitative and quantitative aspects of the implementation of the Programme is set to be conducted three years after the final adoption of the programme.
The budget foreseen for the new Programme is, after the inter-institutional agreement on the EU longterm budget 2007-2013, 365.5 million euro. The original Commission proposal for the budget was 1.203 million for the joint health and consumer programme.
The budget agreed upon in the financial perspective 2007-2013 being far less, the Commission's modified proposal no longer includes a specific action strand to tackle individual diseases, as in the Commission original proposal. Instead, in view of the limited resources, the Commission aims to help reduce the burden of diseases by tackling the most important health determinants. However, in cases where EU level action is judged to bring important added value, action on a specific disease (e.g. on rare diseases or mental health), is made possible.
The European Public Health Alliance (EPHA), which refers to itself as a 'platform of NGOs and not-for-profit organisations', calls for institutional funding for health NGOs, which, unlike other NGOs, receive none. EPHA has drafted a detailed opinion on the Commission's proposal and identified nine points that are missing compared to the previous health programme.
The European Men's Health Forum (EMHF) had tabled an amendment to the EU health strategy explicitly calling on the EU to aim to promote equality between men and women in all community activities including health protection. "A gender-sensitive approach to screening, disease and injury prevention programmes could help improve the effectiveness of resources dedicated to tackling priority health issues such as smoking, alcohol abuse, sexual health, nutrition and physical activity," said the director of the EMHF, Erick Savoye. Ludovic Lacaine, who is in charge of European Affairs at the EMHF called the Commission’s proposal for a new health programme "gender-blind". The Commission's amended (May 2006) proposal takes into account Parliament's request for action on gender aspect of health.
The European Heart Network (EHN), the Association of European Cancer Leagues, the International Diabetes Federation -Europe, and the European Cancer Patient Coalition call the Commission's rewrite of the Public health programme "a sad turn of event [...] as by tackling health determinants in isolation from the diseases they cause, the new proposal fails to convince that the EU has a real health agenda.
European Heart Network (EHN) believes that it is important to address cardiovascular disease (CVD) through its risk factors and the wider determinants and is disappointed with the Commission's amended health action programme proposal, as "it does not emphasise the key diseases in the way we had hoped".
The President of Pfizer's European pharmaceutical business, Ian Read, thinks that "Europeans need to challenge an entrenched point of view on healthcare - as a cost to government instead of an investment in people. For more than a decade, political debate has framed healthcare as an expense. A more far-sighted view would consider health spending as an investment in an economic engine. [...] Treating healthcare as an engine of growth is not only good economics; it is also good for business."
The European Health Management Association (EHMA) thinks that the Commission proposal is not sufficient in terms of ensuring the safety of patients and of citizens. Petra Wilson from EHMA said that "health is the fourth, forgotten daughter of Lisbon" and points out that the health sector is a huge employer.
Paul de Raeve from the European Federation of Nurses Associations (EFN) urges the national government and the Commission to keep in touch with the civil society health professionals. He also emphasises the importance of having "motivated nurses", referring to the mobility of nurses and recognition of their qualifications. EFN believes that future public health and health care strategies must focus on promoting health and reducing the present gap in health status between the member states as well as between different groups within each country. It also believes that "although it is the responsibility of individuals and families to make their own choices in relation to their lifestyle and health, public policies have an essential role to play in ensuring that the physical and social environment supports and facilitates healthy choices".
The European Patients Forum questions why "life-style education" is missing in the Commission proposal and urges the Commission to be more pro-active in health issues.
A Spanish government representative noted, in a stakeholder meeting in 2005, that, "member states are setting health policies at different levels - World Health Organisation, Council of Europe and the EU and are paying to all these organisations. The crucial question is about how much money we will get for the many actions envisaged. We should concentrate on something we can achieve."
- July 2004: Enabling Good Health for all - a reflection process for a new EU Health Strategy launched.
- Late 2004: Commission consultation on future EU action on health (see stakeholder contributions).
- Late 2006: The 2007-2013 Health programme adopted.
- Late 2006: Consultation on EU health strategy (contributions).
- 23 Oct 2007: Commission adopted a new EU health strategy - Together for Health: A Strategic Approach for the EU 2008-2013.