On 2 June 2014, the European Commission published its annual series of Country Specific Recommendations (CSRs). CSRs are issued for each member state, as well as for the collective group of Euro area countries, and offer tailored guidance on how states can best achieve the goals of the Europe 2020 Strategy. The Strategy was launched in 2010, as an extension of the Lisbon Strategy, with the aim of delivering smart, sustainable and inclusive growth.

The implementing mechanism of the Strategy is the European Semester, a cycle of economic coordination designed to ensure that national economic planning takes account of EU-level priorities and concerns. The Semester begins with the publication of the Annual Growth Survey (AGS), in which the Commission outlines the relevant EU priorities. This informs the construction of the National Reform Programmes (NRPs), drafted by each member state, to illustrate how the goals of the AGS will be pursued in its fiscal and structural policies. Finally, the Commission evaluates the NRPs and other relevant documents and drafts a series of CSRs, which are debated and approved by the Council of the EU.

The content of the CSRs varies from country to country and year to year – in the first European Semester cycle in 2011, health was barely mentioned, featuring for the first time in the 2012 AGS and the corresponding CSRs of ten member states. The broad references to cost-effectiveness and competition were built upon in 2013, with a shift to specific recommendations on the reform of health systems, issued to almost all member states. In the latest cycle, health-related recommendations have been issued to fewer states but call for concrete action on hospital sector, primary care and pharmaceutical spending reform.

The 2014 CSRs were published alongside a Commission Press Release, a set of ‘frequently asked questions’ and a Memo on the recommended closure of the Excessive Debt Procedure – a new feature of the EU’s economic governance framework – for six member states. Each CSR is also accompanied by a Staff Working Paper (SWP), which outlines the measures taken and progress made in response to the previous year’s CSRs and gives further background information. Both documents are reviewed below and some tentative conclusions – to be supplemented and expanded in EPHA’s upcoming detailed analysis – are offered.


EPHA Analysis - Health in the 2014 Country Specific Recommendations


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Last modified on July 17 2014.