Following this consultation, the Commission intends to bring forward appropriate proposals in 2007.
Commission report on responses to the consultation
According to the European Commission report summarising responses received, a total of 276 responses have been registered from national governments, regional authorities, international and national umbrella organisations, social security institutions, universities, industry and individual citizens.
Facilitating cross-border mobility is the main motto of the report, rather than promoting accessible, sustainable, high-quality local health care services.
The only consensus which appeared in this report is the lack of information and up-to-date data which could illustrate a significant development of European patients mobility across Europe.
Strinkingly, there were no consensus on the fact that the basis for the Commission’s proposal should be the “Conclusions on Common values and principles in EU health systems”, which include the overarching values of universality, access to good quality care, equity, solidarity as well as the operating principles of quality, safety and care. It was also mentioned that the rights to healthcare set out in the Charter of Fundamental Rights of the EU should be taken into account in any Community action, as well as special attention to disadvantaged groups such as mentally ill, women, the elderly, etc.
It appears that those values are unfortunately not commonly shared yet. Some contributors hence argued that the technology development in the health area do not allow an approach based on “universality” principle. They argue for a responsibility to be the benchmark.
In line with EPHA position, most of the contributors argued for the overall approach that combine “supportive” tools such as practical cooperation and the Open Method of Coordination, and legally binding measures.
Many contributors wish to maintain the subsidiarity principle set by art. 152 of the Treaty as the basis.
At the EU level the division and duplication of work on health are mentioned and contributors ask for rationalisation of activities and resources, notably in increasing the interrelation between the health and social services, which present the same characteristics and should thus be governed by the same principles.
However, the report does not mention that health services shall be considered as services of general interest.
EPHA and EPHA members’ responses
Drawing on the expertise of its membership, the EPHA response (attached) highlights the following principles:
Any European initiative on health services must contribute towards improving the health status of people living in Europe. This means aiming for a high level of health protection, while fully respecting the subsidiarity principle and allowing Member States to organise effectively their health system. The objective should be to support accessible, financially sustainable and high quality healthcare organised on the basis of solidarity for all people living in the European Union.
Health services are an integral element of services of general interest and this should be reflected in a comprehensive legal framework which would protect the right to health and access to healthcare, rather than just a narrow focus on facilitating cross-border mobility.
Royal College of Physicians response attached
European Federation of Nurses Associations response
EAHM - European Association of Hospital Managers
Royal College of Nurses response attached
Cheshire and Merseyside Public Health Network (ChaMPS) attached
Background: content of the consultation document
In the consultation, the Commission argues the need for legal certainty and support for Member States in areas where EU action can bring added value. It also recognises that this should include the shared values and principles for health services throughout the EU and the link between health services and related services such as social services and long-term care.
In addition, it should be note that there is a reference to the need of prevention and health promotion measures to contribute to the sustainability of health care systems.
In September 2006, the Social Platform sent a letter to the college of Commissioners calling for more cohesion and coherence of the different initiatives of the European Commission in the field of health and social services. They notably stressed that the separation between health and social services is not sustainable. (attached)
Background: steps leading to the consultation
The European Commission consultation builds on several initiatives:
Several rulings from the European Court of Justice on patients mobility;
Healthcare services are excluded from the scope of the directive on services in the internal market;
European Commission Communication on Social Services of General Interest, which also excludes health services;
Health services under attack in the European Parliament
Related information
European Commission Questions and Answers on Health Services in the EU
