Security and crossborder care to dominate EU health agenda

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Tackling health threats such as avian flu and ensuring safe, efficient and equitable access to cross-border healtcare will be top priorities of the EU public health policy agenda in the years to come, predicted the Commission’s public health director Andrzej Ry? in an interview with EURACTIV. 

Andrzej Ry? is the public health and risk assessment director at the European Commission.

To read a shortened version of this interview, please click here.  

What will be the major EU health policy issues in the years to come? 

First, I think there will be important developments in the implementation mechanism of the EU health strategy. Here we talk about the responsibility of the member states for healthcare systems and, at the same time, discuss how much the EU should be involved in the development of a health strategy. This means a structure allowing us to have a strategic Commission-Council group which will plan the development of a strategy, run working groups and steer high-level groups on different issues in order to make sure that our work focuses on the real health problems faced by member states and their citizens. 

Second, we will start, during the French Presidency, discussions on health security issues and the way we should structure EU action on this in the coming years. Here we already have some experience with issues like avian flu and discussions around the role of the European Centre for Disease Prevention and Control (ECDC). We plan to present a specific health security package. 

We are still discussing whether climate change will be part of that package, because the logic says that the climate change itself can not be part of it but the effects of climate change like heat-waves, floods and new diseases will naturally affect health systems. 

The third important area is cross-border health care and patient rights in cross-border care. This is an issue that will be discussed by the College of Commissioners on 25 June 2008 as part of the social agenda package and we hope this will provide a kind of a new legal framework for the cross-border healthcare area for the coming years – to allow us implement the European Court of Justice rulings on cross-border access to care as well as to ensure that eHealth or telemedicine services can be sent from one country to another safely and efficiently. 

The Commission has also promised to draft a cancer action plan for next year. There are many expectations for Community action in this area – we will need to consider how far we can respond within the current budget, and whether we need to look again at the overall allocation of funds. 

The long-awaited cross-border health care proposal will be presented in June 2008 as part of a ‘social agenda package’. What is this package about and what is the cross-border health care proposal’s role in it? 

There will be several initiatives in the area of social affairs and with this package we try to review different policies in the social area. 

The final package will bring together interests of several commissioners and portfolios – for example, employment, development, health, consumer protection and education and culture. 

Cross-border health care is part of the package because there are specific problems with safe, efficient and equitable access to cross-border health care that we are trying to solve, and of course such access to health care is also an important social issue. But in the package there will be issues like handicapped people’s access to services and exchange of researchers and workers. 

How can the EU and member states tackle the health challenges of an ageing population?

There are all kinds of solutions, starting from technology, and in this sense telemedicine is of course one solution, in particular as ageing populations are increasingly educated and have technological skills. 

However, the challenges ahead are to know how we can co-ordinate telemedicine activities between the different actors and whether people’s homes are prepared for the follow-up after hospital treatment. It is thus about organising these services. 

Another solution, already in practice in some countries, is to financially support families to keep a member at home and organise the care. 

The Commission can help here by setting a clear goal at European level of allowing older people to live as independently as possible for as long as possible. We can also help member states by highlighting some examples of good practice of how this can be done in practice, and what issues they need to address to make it happen. For example, in many countries, it is not legally possible for doctors to make a diagnosis or provide treatment remotely. This is something that needs to be addressed – maybe through EU legislation. 

What can the Commission really do and what is the value added of the EU in the field of health policy, except the traditional exchange of best practice?

Exchange of best practice is a value in itself and a cheap way of gathering experience of, for example, rare disease. 

Another mechanism is the building of health information and statistics. A European cancer register, for example, can help plan better research, give access to a pool of patients and help understand how we are treating the patients – allowing patients to get better care and doctors to be more effective. 

Allowing national data to be compared with results elsewhere can be a very powerful driver for change – some countries have re-organised their entire cancer services prompted by European comparisons, for example. We all share common health objectives in Europe – these reflect common values shared throughout the Union. But everyone has difficulties in achieving those goals. 

Providing comparable data and analysis, sharing best practice, allowing practical cooperation to bring together expertise through networks of centres of reference, for example – all of these are actually very important and quite powerful tools. 

Moreover, health policy is not only about measures under Article 152. Health is integrated throughout the Treaty – in the high environmental standards that ensure that we all have clean water and air, in the strict legislative requirements for health and safety at work from working time to lifting heavy loads, in the licensing and surveillance rules for goods and services sold throughout the internal market from food to toys to pharmaceuticals, in the research that we fund to develop new treatments and therapies. The added-value of the EU in health is enormous, and health is a part of all EU policies. 

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