A4-0092/96

Proposal for a European Parliament and Council Decision adopting a programme of Community action on health monitoring in the context of the framework for action in the field of public health (COM(95)0449 - C4-0443/95 - 95/0238(COD))

The proposal was approved with the following amendments:

(Amendment 1)

Recital 3

>Original text>

3. Whereas, the European Parliament, in its report on public health policy after Maastricht, has stressed the importance of having sufficient and relevant information as a basis for the development of Community actions in the field of public health; whereas the European Parliament called on the Commission to collect and examine health data from the Member States and analyse trends and assess the effects of public health policies, as well as the impact of other policies;

>Text following EP vote>

3. Whereas, the European Parliament, in its resolution on public health policy after Maastricht, called on the Commission to establish a transfrontier network responsible, in cooperation with the competent national and international organizations, for devising working definitions and collecting, analysing and disseminating information relating to diseases; whereas it also called on the Commission to collect and examine health data from the Member States in order to assess the effects of health policies, as well as the impact of other policies, on the state of health in the European Union;

(Amendment 2)

Recital 3a (new)

>Text following EP vote>

3a. Whereas the setting by Member States of time-based targets for improving public health, appropriate to their national conditions, would focus the effort, enhance the cost-effectiveness and facilitate the assessment of the Union's health policies;

(Amendment 3)

Recital 3b (new)

>Text following EP vote>

3b. Whereas, at the conciliation meeting on the Community action programme on health promotion, information, education and training, the Commission undertook to consider the idea of a European Health Observatory;

(Amendment 4)

Recital 6a (new)

>Text following EP vote>

6a. Whereas it is only from knowledge of the facts of public health in Europe, obtained by setting up a Community health monitoring system, that it will be possible to monitor public health trends and define public health priorities and objectives;

(Amendment 5)

Recital 11

>Original text>

11. Whereas, in order to give full effect to requirements and expectations in this area, a Community health monitoring system should be developed, comprising the establishment of health indicators and the collection of health data, a network for transmission and sharing of health data and indicators and a capacity for analysis and dissemination of health information;

>Text following EP vote>

11. Whereas, in order to give full effect to requirements and expectations in this area, a Community health monitoring system should be developed, involving the establishment of health indicators on the basis of comparable health data, the establishment of a network for transmission and sharing of health data and indicators and building a capacity for analysis and dissemination of health information;

(Amendment 6)

Recital 11a (new)

>Text following EP vote>

11a. Whereas the health monitoring system based on cooperation between the Member States will be enhanced by setting up a permanent body responsible for monitoring and evaluating health data and indicators in the Community area;

(Amendment 7)

Recital 12

>Original text>

12. Whereas available options and possibilities for developing the various parts of a Community health monitoring system should be carefully assessed with respect to the desired performance, flexibility and the costs and benefits involved; whereas a Community health monitoring system should include the definition of sets of Community health indicators and the collection of the data necessary for the establishment of such indicators;

>Text following EP vote>

12. Whereas a flexible system is required which can incorporate features which are valuable at present while adapting to new requirements or other priorities and taking into account the costs and benefits involved; whereas a Community health monitoring system must include the definition of sets of Community health indicators and the collection of the comparable data necessary for the establishment of such indicators;

(Amendment 8)

Recital 13

>Original text>

13. Whereas Community health data and indicators should draw from readily available European data and indicators, such as those held by Member States or transmitted by them to international organizations, so as to avoid unnecessary duplication of work;

>Text following EP vote>

13. Whereas existing, readily available European data and indicators, such as those held by Member States and transmitted by them to international organizations, should be used so as to avoid unnecessary duplication of work;

(Amendment 9)

Recital 13a (new)

>Text following EP vote>

13a. Whereas the situation with regard to the collection of data varies from Member State to Member State; whereas Community support is needed for the establishment or improvement of databases in the Member States;

(Amendment 10)

Recital 14

>Original text>

14. Whereas a Community health monitoring system would benefit from the establishment of a network, the backbone of which relies on telematics, for the collection and distribution of Community health data and indicators;

>Text following EP vote>

14. Whereas the Community health monitoring system must be based on a network, the backbone of which relies on telematics, for the collection and distribution of Community health data and indicators;

(Amendment 11)

Recital 15

>Original text>

15. Whereas a Community health monitoring system should be capable of encouraging and assisting in the production of analyses of health status, trends, and health problems throughout the Community, and in the availability and dissemination of health information;

>Text following EP vote>

15. Whereas a health monitoring system must provide material for regular reports on health status in the European Community, analyses of trends, and health problems, and must make available and disseminate health information;

(Amendment 12)

Recital 15a (new)

>Text following EP vote>

15a. Whereas importance must be attached to cooperation in the field of occupational health and safety, from which a picture of the prevalence of occupational diseases and accidents at work can be built up;

(Amendment 13)

Recital 16

>Original text>

16. Whereas overriding considerations in the development of a Community health monitoring system are the respect of legislative provisions on data protection, and the implementation of appropriate confidentiality and security arrangements;

>Text following EP vote>

16. Whereas it is necessary in the development of a Community health monitoring system to ensure the respect of legislative provisions on data protection, and the implementation of appropriate confidentiality and security arrangements; whereas before adoption it must be ascertained that there are no objections on grounds of data protection;

(Amendment 14)

Recital 17

>Original text>

17. Whereas a multiannual programme should be launched within the context of the framework for action in the field of public health, in order to permit the development of a Community health monitoring system and of appropriate mechanisms for its evaluation;

>Text following EP vote>

Deleted

(Amendment 15)

Recital 20

>Original text>

20. Whereas cooperation in this area with the competent international organizations and with third countries should be fostered;

>Text following EP vote>

20. Whereas cooperation should be strengthened with the competent international organizations, including the WHO and OECD, health professionals and governmental or non-governmental organizations in the area covered by this programme and with third countries;

(Amendment 16)

Recital 20a (new)

>Text following EP vote>

20a. Whereas, from an operational point of view, the investments made in the past both in terms of the development of Community networks and cooperation with international organizations competent in this field should be safeguarded and further developed;

(Amendment 17)

Recital 21

>Original text>

21. Whereas it is important that the Commission ensure implementation of the programme in close cooperation with the Member States;

>Text following EP vote>

21. Whereas the Commission should implement this programme in close cooperation with the Member States;

(Amendment 18)

Recital 23

>Original text>

23. Whereas, from an operational point of view, the investments made in the past both in terms of the development of Community networks and cooperation with international organizations competent in this field should be safeguarded and further developed;

>Text following EP vote>

Deleted

(Amendment 19)

Recital 24

>Original text>

24. Whereas unnecessary duplication of effort should be avoided by the joint development of methodologies, comparison and conversion criteria and techniques, progressively harmonized data collection tools such as surveys, questionnaires or parts thereof, and content specifications for health information to be shared using in particular a telematics network;

>Text following EP vote>

24. Whereas, because at present data is insufficiently comparable, there is a need for the joint development of definitions, methodologies and comparison and conversion techniques, progressively harmonized data collection tools such as surveys, questionnaires or parts thereof, and content specifications for health information to be shared using in particular a telematics network;

(Amendment 46)

Recital 26

>Original text>

26. Whereas this decision lays down, for the entire duration of the programme, a financial framework constituting the principal point of reference, within the meaning of point 1 of the Declaration of the European Parliament, the Council and Commission of 6 March 1995, for the budgetary authority during the annual budgetary procedure;

>Text following EP vote>

26. Whereas this decision lays down the financial framework for the programme for its entire duration; whereas that amount shall constitute the principal point of reference for the budgetary authority during the annual budgetary procedure within the meaning of point 1 of the Declaration of the European Parliament, the Council and the Commission of 6 March 1995;

(Amendment 21)

Article 1(2a) (new)

>Text following EP vote>

2a. To complement this programme, health care authorities and providers in all Member States shall, in consultation with the health profession, set measurable, time-based targets for health improvement appropriate to their national conditions.

(Amendment 47)

Article 2(1)

>Original text>

1. The Commission shall ensure implementation, in close cooperation with the Member States, of the actions set out in the Annex in accordance with Article 5.

>Text following EP vote>

1. The Commission, with due regard for Article 205 of the Treaty, shall ensure implementation, in close cooperation with the Member States, of the actions set out in the Annex in accordance with Article 5.

(Amendment 22)

Article 3(1)

>Original text>

1. The total appropriation for implementation of this programme for the period referred to in Article 1 shall be ECU 13.8 million.

>Text following EP vote>

1. The total appropriation for implementation of this programme for the period referred to in Article 1 shall be ECU 20 million.

(Amendment 23)

Article 4

>Original text>

The Commission and the Member States shall ensure that there is consistency and complementarity between actions to be implemented under this programme and other relevant Community programmes and initiatives, including the framework programme for statistical information, the projects in the field of telematic interchange of data between administrations, and the framework programme for research and technological development and in particular the telematics applications of the latter.

>Text following EP vote>

The Commission shall ensure that there is consistency and complementarity between actions to be implemented under this programme and other relevant Community programmes and initiatives, including the framework programme for statistical information, the projects in the field of telematic interchange of data between administrations, and the framework programme for research and technological development and in particular the telematics applications of the latter.

(Amendment 42)

Article 5(1)

>Original text>

1. The Commission shall be assisted by a Committee composed of two members designated by each Member State and chaired by a representative of the Commission, hereinafter referred to as 'the Committee'.

>Text following EP vote>

1. The Commission shall be assisted by a Committee of an advisory nature, hereinafter referred to as 'the Committee', composed of one representative per Member State and chaired by the representative of the Commission.

(Amendment 43)

Article 5(4a) (new)

>Text following EP vote>

4a. The Committee shall in principle meet in public, unless a specific, duly substantiated decision to the contrary is taken and published in good time. The Committee shall publish its agendas two weeks in advance of its meetings. It shall publish the minutes of its meetings. It shall draw up a public register of the declarations of its members' interests.

(Amendment 25)

Article 6(1)

>Original text>

1. In the course of implementing this programme, cooperation with non-member countries and with international organizations competent in the field of public health, in particular the World Health Organization and the Organization for Economic Cooperation and Development, shall be fostered and implemented in accordance with Article 5.

>Text following EP vote>

1. In the course of implementing this programme, cooperation with non-member countries, international organizations competent in the field of public health, including the World Health Organization and the Organization for Economic Cooperation and Development, health professionals and governmental or non- governmental organizations active in the field covered by this programme, shall be developed and implemented in accordance with Article 5.

(Amendment 26)

Article 6a (new)

>Text following EP vote>

Article 6a

Results of the health programmes

In the course of implementing this programme, the Commission shall submit to the European Parliament reports evaluating and presenting the results of the Community health programmes.

(Amendment 27)

Article 7(1a) (new)

>Text following EP vote>

1a. The Commission shall ensure that the results of the implementation of this programme are published regularly and sent for information to the European Parliament, the Council, the Economic and Social Committee and the Member States.

(Amendment 45)

Article 7(2)

>Original text>

2. The Commission shall submit to the European Parliament and the Council an interim report half-way through, and a final report on completion of this programme. It shall incorporate into these reports information on Community financing in the various fields of action and on complementarity with the other actions referred to in Article 4, as well as the results of the evaluations. It shall also send them to the Economic and Social Committee and the Committee of the Regions.

>Text following EP vote>

2. The Commission shall submit an interim report to the European Parliament and the Council by 30 June 1999 and a final report by 30 June 2002. It shall incorporate into these reports information on Community financing in the various fields of action and on complementarity with the other actions referred to in Article 4, as well as the results of the evaluations. It shall also send them to the Economic and Social Committee and the Committee of the Regions.

(Amendment 28)

ANNEX (A), introduction

>Original text>

Objective: To establish Community health indicators by a critical review of existing health data and indicators, and develop appropriate methods for the collection of comparable and progressively harmonized data.

>Text following EP vote>

Objective: To establish Community health indicators by a critical review of existing health data and indicators, and develop appropriate methods for the collection of comparable and progressively harmonized data, so as to permit better monitoring and control of Community public health and help the Member States to cooperate on and evaluate national health policies.

(Amendment 29)

Annex (A)(2)

>Original text>

2. Creation of a set of Community health indicators, including a sub-set of core indicators for the monitoring of Community programmes actions in public health, and a sub-set of background indictors for the monitoring of other Community policies, programmes and actions, and for providing Member States with common measures for making comparisons.

>Text following EP vote>

2. Creation of a set of Community health indicators, including a sub-set of core indicators for the monitoring of Community programmes actions in public health, and a sub-set of background indictors for the monitoring of other Community policies, programmes and actions, and for providing Member States with common measures for making comparisons. Details of these indictors are given in Annex a to this programme.

(Amendment 30)

ANNEX (A)(3)

>Original text>

3. Development of the routine collection of comparable and/or progressively harmonized data in the Member States, including support for the elaboration of data dictionaries, and the establishment of appropriate conversion methods and rules.

>Text following EP vote>

3. Development of the routine collection of data made comparable by the elaboration of data dictionaries, the establishment of appropriate conversion methods and rules and the harmonization of definitions and methods of collecting national health data.

(Amendment 31)

ANNEX (A)(4)

>Original text>

4. Contributing to the collection of comparable data by supporting the elaboration of surveys including Community-wide surveys in support of Community policies, or modules or agreed forms of words for questions in existing surveys.

>Text following EP vote>

4. Contributing to the collection of comparable data, the origin of which is guaranteed by the Member States, by supporting the elaboration of surveys including Community-wide surveys in support of Community policies, or modules or agreed forms of words for questions in existing surveys.

(Amendment 32)

ANNEX (A)(4a) (new)

>Text following EP vote>

4a. Financial support for the Member States in connection with the establishment or improvement of their health data collection systems.

(Amendment 33)

ANNEX (A)(6)

>Original text>

6. Support for the assessment of the feasibility and cost-effectiveness of developing standardized health resource statistics with the aim of including them in a future Community health monitoring system.

>Text following EP vote>

6. Assessment of the feasibility and cost-effectiveness of developing standardized health resource statistics with the aim of including them in the Community health monitoring system.

(Amendment 34)

ANNEX (A)(6a) (new)

>Text following EP vote>

6a. Carrying out feasibility studies on setting up a permanent body (the European Health Observatory) responsible for monitoring and evaluating health data and indicators in the Community area.

(Amendment 35)

ANNEX (B)(7)

>Original text>

7. Encourage and support the development of a network for sharing health data, mainly using telematic interchanges and a system of distributed databases, in particular by the establishment of data specifications and of procedures with regard to the access, retrieval, confidentiality and security for the different types of information to be included in the system.

>Text following EP vote>

7. Development of a Community network for transferring and sharing health data, mainly using telematic interchanges and a system of distributed databases, in particular by the establishment of data specifications and of procedures with regard to the access, retrieval, confidentiality and security for the different types of information to be included in the system.

(Amendment 36)

ANNEX (C)(8)

>Original text>

8. Encourage the development of a capacity for analyses, including comparative and predictive methodologies and tools, the testing of hypotheses and models and the evaluation of health scenarios and outcomes.

>Text following EP vote>

8. Development of a capacity for analyses, including comparative and predictive methodologies and tools, the testing of hypotheses and models and the evaluation of health scenarios and outcomes.

(Amendment 37)

ANNEX (C)(9)

>Original text>

9. Support for the analysis and evaluation of the impact of Community action and programmes in public health.

>Text following EP vote>

9. Support for the analysis of and drafting of reports evaluating the impact of Community action and programmes in public health.

(Amendment 38)

ANNEX (C)(10)

>Original text>

10. Support for the production and dissemination of reports and other information material on health status and trends, health determinants and the impact on health of other policies.

>Text following EP vote>

10. Support for the drafting of reports and other analyses on health status and trends, health systems in the European Union and their cost-effectiveness, health determinants and the impact on health of other policies.

(Amendment 39)

ANNEX (C)(10a) (new)

>Text following EP vote>

10a. Support for the dissemination of reports and information to the Member States, international organizations, professionals and bodies in the health sector and the general public.

(Amendment 40)

ANNEX a (new)

>Text following EP vote>

Annex a

Non-exhaustive list of areas in which health indicators may be established under a future Community health monitoring system

>Text following EP vote>

A. Health status

1. Life expectancy:

- life expectancy at certain ages

- health expectancies

>Text following EP vote>

2. Mortality:

- overall

- causes of death

- disease-specific survival rates

>Text following EP vote>

3. Morbidity:

- disease-specific morbidity

- co-morbidity

>Text following EP vote>

4. Functioning and quality of life:

- self-perceived health

- physical disability

- activity limitations

- functional status/ability

- health-related work loss

- mental health

>Text following EP vote>

5. Anthropometric characteristics

>Text following EP vote>

B. Life Style and Health Habits

1. Tobacco consumption

2. Alcohol consumption

3. Drug consumption

4. Physical activities

5. Diet

6. Other health-promotion-related activities

>Text following EP vote>

C. Living and working conditions

1. Employment/unemployment:

- occupation

>Text following EP vote>

2. Work environment:

- accidents

- exposure to carcinogenic and other dangerous substances

- occupational diseases

>Text following EP vote>

3. Housing conditions

>Text following EP vote>

4. Home and leisure activities:

- accidents at home

- leisure

>Text following EP vote>

5. Transport

- car accidents

>Text following EP vote>

6. External environment:

- air pollution

- water pollution

- other types of pollution

- radiation

- exposure to carcinogenic and other dangerous substances outside the work environment

>Text following EP vote>

D. Health Protection

1. Sources of financing

>Text following EP vote>

2. Facilities/manpower

- Health resource utilisation

- Health care personnel

>Text following EP vote>

3. Cost/Expenditure

- In-patient care

- Out-patient care

- Pharmaceutical products

>Text following EP vote>

4. Consumption/uses

- In-patient care

- Out-patient care

- Pharmaceutical products

>Text following EP vote>

5. Health promotion and disease prevention

>Text following EP vote>

E. Demographic and Other Social Factors

1. Gender

2. Age

3. Marital status

4. Region of residence

5. Education

6. Income

7. Population subgroups

8. Health insurance status

>Text following EP vote>

F. Miscellaneous

1. Product safety

2. Others

Legislative resolution embodying Parliament's opinion on the proposal for a European Parliament and Council Decision adopting a programme of Community action of health monitoring in the context of the framework for action in the field of public health (COM(95)0449 - C4-0443/95 - 95/0238(COD))

(Codecision procedure: first reading)

The European Parliament,

- having regard to the Commission proposal to Parliament and the Council, COM(95)0449 - 95/0238(COD) ((OJ C 338, 16.12.1995, p. 4.)),

- having regard to Articles 189b(2) and 129 of the EC Treaty, pursuant to which the Commission submitted the proposal to Parliament (C4-0443/95),

- having regard to Rule 58 of its Rules of Procedure,

- having regard to the report of the Committee on the Environment, Public Health and Consumer Protection and the opinions of the Committee on Budgets and the Committee on Social Affairs and Employment (A4-0092/96),

1. Approves the Commission proposal, subject to Parliament's amendments;

2. Calls on the Commission to alter its proposal accordingly, pursuant to Article 189a(2) of the EC Treaty;

3. Calls on the Council to incorporate Parliament's amendments in the common position that it adopts in accordance with Article 189b(2) of the EC Treaty;

4. Points out that the Commission is required to submit to Parliament any modification it may intend to make to its proposal as amended by Parliament;

5. Instructs its President to forward this opinion to the Council and Commission.