On 25 May 2011, the ENVI Committee in the European Parliament organised a ’’Workshop on Health in All Policies’’ (HIAP) that brought together representatives of different Directorate-Generals as well as external stakeholders. EPHA proposed that a children’s health strategy to complement the European Innovation Partnership on Healthy and Active Ageing and to put the focus firmly on prevention in the framework of HIAP.
The event was hosted by Alojz Peterle MEP, Slovenia, EPP and Glenis Willmott MEP, UK, S&D, co-chairs of the Working Group on Health, who welcomed the audience and stated the importance of working together to achieve an effective HIAP approach.
The first speaker was Paola Testori Coggi, Director General of DG SANCO, who provided an overview of the principle of HIAP, calling it an incredible achievement but cautioning that a number of problems remain to be solved. She reiterated that HIAP is one of the core principles in the EU Health Strategy 2008-2013 and referred to Article 168 of the Lisbon Treaty which states that health protection should be ensured in the definition and implementation of all EU policies and activities.
She then provided examples of cross-policy work in order to tackle health risks and the challenges of health systems, stressing that many policy areas are important partners for health, e.g. employment, social policy, research, regional policy, and agriculture.
In the Europe 2020 strategy, health stands at the core of various cross-cutting initiatives. Crucially, ’’health needs to be a partner of economic policies’’ and an EU-wide reflection process on sustainable health systems would be launched to involve stakeholders across sectors. Integrated governance was the key for achieving this, and examples of this at Commission level included thematic Working Groups on health-related issues, joint policy-making, and finding innovative ways of working with stakeholders to build synergies (such as the European Innovation Partnership on Active and Healthy Ageing). Health demanded a ’’working together’’ attitude and its scope encompassed Member States and regions, health organisations (including NGOs), industry, and the European Parliament.
This was followed by Nicoline Tamsma, Senior Advisor for International Affairs at the National Institute for Public Health and the Environment (Netherlands), who showed how HIAP is approached in the Dutch context - where it has been on the national agenda since 1986 - underlining that HIAP requires vision and strategy in order for all actors at different levels (national, regional, local, public-private partnerships, etc.) and in different policy areas to collaborate successfully. HIAP is a long-term commitment that requires a consistent approach from planning to impact assessments and evaluation.
In the following Q&A session, Mr Peterle MEP stated that in spite of all the effort made on implementing the integrated approach described thus far, the statistics remained bad and the costs to health systems were getting higher. He asked whether a paradigm change was needed and whether there was a strategic debate about this at Council-Commission level. Ms Testori Coggi said that a shift was indeed needed from treatment/care to prevention.
Luiza Bara, EPHA Director for Policy and Strategy, commented that this shift could best be achieved by focusing on early intervention, which is most effective from a public health perspective. She proposed a children’s health strategy as a powerful tool for the Commission to successfully implement HIAP and complement the already existing EIP on Healthy and Active Ageing. Ms Testori Coggi replied quite positively.
The second part of the event took the form of a Round Table to discuss technical aspects of the HIAP approach across six different Commission Directorate-Generals. The group was composed of Mr. Peteris Zilgalvis (DG INFSO, Head of Unit ICT for Health) who presented the sustainability potential of eHealth in the framework of the Digital Agenda and Innovation Union, reviewed the existing initiatives and highlighted the importance of stakeholder input in defining the next eHealth Action Plan 2012-2020 (see EPHA’s response to the public consultation on the eHAP); Ralf Jacob (DG EMPL, Head of Unit Active Ageing, Pensions, Healthcare) who argued that health policy is not the most important determinant of health and that progress in public health can only be made through a health inequalities focus, Kevin McCarthy (DG RTD, Head of Sector, Public Health and Health Services Research) who emphasised the need to debate the relevance of social innovation to EU health, Gabriella Fesus (DG REGIO, Policy Analyst, Unit Conception, Forward Studies, Impact Assessment) and Lars Hoelgaard (DG AGRI, Special Advisor and Head of Task Force in charge of new measures) who cited the School Milk Programme and School Fruit Scheme as examples of successful cooperation between policy-makers in agriculture, health and education that had created a snowball effect but at the same time depended on effective national strategies.
In the final Q&A round, Robert Pederson of the European Public Health and Agriculture Consortium expressed his hope that the nutrition focus of the post-2013 CAP will generate similar schemes so that other population groups can be reached, e.g. in the workplace.
Ms Testori Coggi summarised the main messages by saying that:
Europe will require high quality health systems and also have to guarantee the sustainability of public finances
There needs to be more work on prevention and health promotion
An integrated approach is vital for HIAP, and therefore health must remain a close partner of other policy areas
Ms Willmott closed the meeting by saying that it was a question of mainting the political will and the commitment to public health, especially after the economic downturn. Mr Peterle added that the Lisbon Treaty provided political actors with enough scope to do more.
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