June 6, 2017
Genval, 6th June 2017. – The European Integration is at crossroads, the EU is suffering from many crises, its legitimacy is questioned by populist forces and in order to respond to that what is the best idea President Juncker and his team could come up with? Bingo! Scrap the tiny health programme to alienate even more citizens from Europe and destroy remaining trust. Well done, #JunckerTeamEU!
Big on the big things and small on the small things. This is the Mantra of the Commission since 2014. But that only means in practice a deregulatory agenda focusing on jobs, growth and GDP and forgetting the social, environmental or eventually health aspects of the EU integration. It can be hardly said that health would be a priority for the Commission. It started in 2014, when President Juncker decided to move of medicinal products and health technologies to the portfolio of the Commissioner for internal market and industry. Only the strong and united opposition of the European public health civil society in the #Pharma4health campaign made him to – partially – change his mind and move – at least – medicinal products back to the health commissioner, but not the responsibility for health technologies.
And now, when Brexit is upon us, and the preparation of the post 2020 EU budget has started, one of the sudden moves of the Commission to demonstrate its commitment is to scrap EU programmes where it considers the EU has less added value. It is not a big surprise that the health programme is among the identified areas which should be axed. This is very dangerous, short sighted and damaging political choice which should be stopped.
What is the Health Programme about?
Health became an EU competence since 1993 when the treaty of Maastricht has entered into force. The EU is required to ensure that public health is protected as part of all its policies, and to work with the EU countries to improve public health, prevent human illness and eliminate sources of danger to physical and mental health. The EU health strategy “Together for Health” supports the overall Europe 2020 strategy. Europe 2020 aims to turn the EU into a smart, sustainable and inclusive economy promoting growth for all – one prerequisite of which is a population in good health.
According to the latest Eurobarometer survey, 70% of EU citizens want more EU action on health. Apparently, citizens have a different view on subsidiarity and EU added value than the Commission. They do better understand the use of the EU added value on health. Cross border health threats, antimicrobial resistance, air pollution, EU insurance card, free movement of health professionals, public health aspects of the internal market (movement of tobacco, alcohol and unhealthy food products within the EU) and the external trade, the non-communicable disease epidemic EU is facing, research about new medicines and the causes of ill health are just examples of the many health challenges the EU is facing. It must be obvious for all decision makers: due to the size of the problems, individual member states are not the best placed to cope with all of this alone without the help of the EU.
The European Health civil society showed a Yellow Card to the European Commission: today, on 6th June 2017, 39 health NGOs representing patients, health professionals, disease specific communities, persons living with disabilities and the homeless, women, migrants, organisations working on tobacco and alcohol related harm and the European Public Health community united their forces to demonstrate the value of Health Collaboration at EU level and the need to keep it. The European Commission realised that the social dimension is somehow missing from the EU agenda and now it tries to fix it by issueing the European Pillar of Social Rights and the European Solidarity Corps – to which the health sector could also contribute. Will the Commission listen to the expressed concerns as regards the value of the Health Programme or will just blatantly ignore the core demand of civil society and will continue to push its own agenda?
What is the fuss about? Health is a national competence, isn’t it? Well, actually the picture is much more complicated than that. As the core ‘Health in All Poplicies’ article TFEU 168 stipulates: ‘1. A high level of human health protection shall be ensured in the definition and implementation of all Union policies and activities.’ This basically means that all Commissioners should be Health Commissioners and all EU policies should be health policies: every EU actions should be assessed from the lens of its contribution to population health. It is quite a big competence – in theory. As in fact, the Commission apparently disregards this legal obligation and follows its own deregulation, self-regulation (= no regulation) agenda which considers measures protecting our health as red tape.
Health is not a cost but a value! European citizens need good health which is a prerequisite of any economic growth! The false decision to remove the health programme has to be reversed!
Article 168 (ex Article 152 TEC) – Treaty on the Functioning of the European Union (TFEU)
1. A high level of human health protection shall be ensured in the definition and implementation of all Union policies and activities.
Union action, which shall complement national policies, shall be directed towards improving public health, preventing physical and mental illness and diseases, and obviating sources of danger to physical and mental health. Such action shall cover the fight against the major health scourges, by promoting research into their causes, their transmission and their prevention, as well as health information and education, and monitoring, early warning of and combating serious cross-border threats to health.
The Union shall complement the Member States’ action in reducing drugs-related health damage, including information and prevention.
2. The Union shall encourage cooperation between the Member States in the areas referred to in this Article and, if necessary, lend support to their action. It shall in particular encourage cooperation between the Member States to improve the complementarity of their health services in cross-border areas.
Member States shall, in liaison with the Commission, coordinate among themselves their policies and programmes in the areas referred to in paragraph 1. The Commission may, in close contact with the Member States, take any useful initiative to promote such coordination, in particular initiatives aiming at the establishment of guidelines and indicators, the organisation of exchange of best practice, and the preparation of the necessary elements for periodic monitoring and evaluation. The European Parliament shall be kept fully informed.
3. The Union and the Member States shall foster cooperation with third countries and the competent international organisations in the sphere of public health.
4. By way of derogation from Article 2(5) and Article 6(a) and in accordance with Article 4(2)(k) the European Parliament and the Council, acting in accordance with the ordinary legislative procedure and after consulting the Economic and Social Committee and the Committee of the Regions, shall contribute to the achievement of the objectives referred to in this Article through adopting in order to meet common safety concerns:
(a) measures setting high standards of quality and safety of organs and substances of human origin, blood and blood derivatives; these measures shall not prevent any Member State from maintaining or introducing more stringent protective measures;
(b) measures in the veterinary and phytosanitary fields which have as their direct objective the protection of public health;
(c) measures setting high standards of quality and safety for medicinal products and devices for medical use.
5. The European Parliament and the Council, acting in accordance with the ordinary legislative procedure and after consulting the Economic and Social Committee and the Committee of the Regions, may also adopt incentive measures designed to protect and improve human health and in particular to combat the major cross-border health scourges, measures concerning monitoring, early warning of and combating serious cross-border threats to health, and measures which have as their direct objective the protection of public health regarding tobacco and the abuse of alcohol, excluding any harmonisation of the laws and regulations of the Member States.
6. The Council, on a proposal from the Commission, may also adopt recommendations for the purposes set out in this Article.
7. Union action shall respect the responsibilities of the Member States for the definition of their health policy and for the organisation and delivery of health services and medical care. The responsibilities of the Member States shall include the management of health services and medical care and the allocation of the resources assigned to them. The measures referred to in paragraph 4(a) shall not affect national provisions on the donation or medical use of organs and blood.