[pic] | COMMISSION OF THE EUROPEAN COMMUNITIES |

Brussels, 6.4.2005

SEC(2005) 425

COMMISSION STAFF WORKING PAPER

Annex to the HEALTH AND CONSUMER PROTECTION STRATEGY AND PROGRAMME EXTENDED IMPACT ASSESSMENT {COM(2005)115 final}

TABLE DES MATIERES

1. INTRODUCTION 4

1.1. Objet et structure du rapport 4

1.2. Programmes financiers actuels 4

2. PROBLÈME POSE AUQUEL LA PROPOSITION VEUT

S’ATTAQUER 6

2.1. Quel est le problème et quelles en sont les causes ? 6

2.2. Y a-t-il nécessité d’une intervention communautaire ? 13

3. PRINCIPAUX OBJECTIFS GÉNÉRAUX, SPECIFIQUES

ET OPÉRATIONNELS QUE LA PROPOSITION VEUT

ATTEINDRE 17

3.1. Objectifs de la partie commune du programme santé et

consommation 17

3.2. Objectifs des actions santé 20

3.3. Objectifs des actions consommateurs 23

4. DIFFERENTES OPTIONS POSSIBLES 29

4.1. Aucune action 29

4.2. Continuité des deux programmes actuels avec des moyens

constants (statu quo) 29

4.3. Maintien de deux programmes séparés, chacun étant doté

de moyens accrus 30

4.4. Un programme fusionné doté de moyens accrus 31

4.5. Présentation d’un programme joint quand les deux programmes

actuels auront expiré 32

5. IMPACTS ECONOMIQUES, ENVIRONNEMENTAUX ET

SOCIAUX DES DIFFÉRENTES OPTIONS 33

5.1. Impacts de la partie commune du programme 33

5.2. Impacts des objectifs / actions santé 35

5.3. Impacts des objectifs / actions consommateurs 50

5.4. Conclusion sur le choix de l’option 58

6. CONSULTATIONS EXTERNES ET INTERNES 58

7. COUT –EFFICACITE 71

8. SUIVI ET EVALUATION DU PROGRAMME 77

1. INTRODUCTION

Health and Consumer policies and programmes have so far been carried out in parallel. However, many objectives of health and consumer action under Treaty articles 152 and 153 are similar: promoting health protection, information and education, safety and integration of health and consumer concerns into all policies are shared objectives. Health and consumer policies also use many similar types of actions to pursue their objectives, e.g. information to citizens, consultation of stakeholders, mainstreaming activities, risk assessment.

This impact assessment looks at the implications of bringing together the Public Health and Consumer protection programmes under a common framework with an increased budget. It concludes that this will lead to synergies between two complementary areas of action and in particular to more effective, efficient and coherent Community action in benefit of the citizens. By stepping up action in two areas that affect their daily lives - health and consumer protection – this option will also help to bring Europe closer to its citizens. In addition, merging the Public Health and Consumer Protection programmes is also due to streamline administrative procedures (with a common set of tools and a unified budget) and increase visibility of policy actions. While exploiting synergies, the new programme will develop the core elements and specificities of the actions in health and consumer policies.

In addition, this impact assessment analyses other possible options for action and their likely impact.

1.1. Objet et structure du rapport

Le présent rapport accompagne la Communication de la Commission au Parlement européen et au Conseil « « Healthier, safer more confident citizens : a Health an Consumer Protection Strategy » ainsi que la proposition de Décision établissant un programme d’action communautaire dans le domaine de la santé et de la protection des consommateurs pendant les années 2007 à 2013. Il combine les exigences d’une analyse d’impact avec celles d’une évaluation ex ante.

1.2. Les programmes financiers actuels

Actuellement, la politique de la santé et la politique des consommateurs font l’objet de deux stratégies et deux programmes financiers distincts.

Le programme « Santé » relève de la Décision n° 1786/2002/CE du Parlement européen et du Conseil du 23 septembre 2002 adoptant un programme d'action communautaire dans le domaine de la santé publique et couvre la période 2003-2008.

Le programme « Consommateurs » relève de la Décision n° 20/2004/CE du Parlement européen et du Conseil du 8 décembre 2003 établissant un cadre général pour financer les activités communautaires à mener à l'appui de la politique des consommateurs et couvre la période 2004 à 2007 ;

Le programme « politique de la santé » 2003-2008

Decision No 1786/2002/EC of the European Parliament and of the Council of 23 September 2002 adopted a programme of Community action in the field of public health (2003-2008). Based on Article 152 of the Treaty establishing the European Community, the Public health programme aims to complement national measures to protect and improve human health.

The programme is based on three general objectives: provide health information, react to health threats and promote health by addressing health determinants.

Every year the Commission adopts a Decision setting out a work plan with the priorities of the Public Health programme for the year ahead and publishes a call for proposals. Most of the budget of the programme is allocated to project grants, and a small proportion to tenders.

Le programme « politique des consommateurs » 2004-2007

La Décision n°20/2004[1], adoptée fin 2003, établit un cadre permettant de définir des activités communautaires à mener à l’appui de la politique des consommateurs arrêtée dans la Stratégie pour la politique des consommateurs 2002-2006[2] et fixant les objectifs suivants :

- un niveau commun élevé de protection des consommateurs,

- l’application effective des règles de protection des consommateurs,

- une participation appropriée des organisations de consommateurs à l’élaboration des politiques communautaires.

Le champ d’application de la Décision n° 20/2004 couvre les domaines spécifiques suivants :

- la protection de la santé et de la sécurité des consommateurs en ce qui concerne les produits non alimentaires et les services ;

- la protection des intérêts économiques et juridiques des consommateurs ;

- la promotion des activités visant à informer et éduquer les consommateurs ;

- la promotion de la capacité des organisations de consommateurs à apporter une contribution au niveau européen.

Afin de réaliser les trois objectifs décrits dans la Stratégie, la Décision n°20/2004 décrit en annexe les dix-huit actions qui vont être mises en œuvre au cours de la période 2004-2007. Certaines d’entre elles sont directement mises en œuvre par la Commission, d’autres sont financées conjointement par la Communauté et un ou plusieurs Etats membres tandis qu’un certain nombre d’actions bénéficient de contributions financières de la Communauté sous la forme de subventions.

2. PROBLÈME POSE AUQUEL LA PROPOSITION VEUT S’ATTAQUER

2.1. Quel est le problème et quelles en sont les causes ?

Problème général

The current Community public health policy and consumer protection policy impact on the daily lives of citizens. The two policies also share a number of problems and challenges.

First, health and consumer policies are closely intertwined: often, citizens’ health is affected by the choices they make as consumers. Areas such as nutrition or product safety c all for an integrated approach. There is therefore much benefit in bringing health and consumer protection policies closer together. We also have to take into account the need for coherence with food safety policy, among other policies.

Second, both health and consumer policies aim to improve citizens lives, either in their capacity of patients or consumers. Citizens are often unaware of their rights as patients or as consumers. It is therefore necessary to step up efforts to increase the ability of citizens to take better decisions about their health and consumer interests. This calls for a joint “communication to citizens” approach, building on economies of scale and on the similarities between health and consumer policies. In addition, both policies lack visibility vis-à-vis citizens, who are not aware of the impact the EU has on their health and consumer interests and how it can protect and enhance them.

Third, safety is an important concern of both policies. Certain risks cannot be tackled by citizens nor by national authorities acting on their own. Both policies deal with such risks. The consumption of certain products can entail damage to human health. The scientific assessment of possible health risks deriving from use of goods is a shared action area where important synergies can be explored. It is therefore necessary to act more and in a more co-ordinated manner to protect citizens from risks that are not in their control and that cannot be addressed alone by their national authorities.

Fourth, threats to the health, safety and economic interests of citizens are not limited to the borders of the Union. On the contrary, threats to health (such as HIV/AIDS) in neighbouring countries also represent a risk to health of nearby areas within the Union. Unscrupulous traders based outside the EU can attempt to mislead or defraud consumers within the EU, in particular through e-commerce. Tackling these dangers therefore requires the cooperation and involvement of countries outside the European Union.

Fifth, both health and consumer protection are affected by a wide range of other Community policies. For example, improving health is not a matter for health policy alone, as the environment, the work place, social and economic factors, or education strongly impact on health. Consumer interests should also be prominent in other policies including the internal market, competition, transport, energy, etc. In order to ensure that health and consumer interests are fully protected and reflected in community policies, it is therefore necessary to mainstream health and consumer issues in other Community policies.

Finally, both health and consumer protection policies require greater resources to fully meet their obligations respectively under articles 152 and 153 of the Treaty.

Problème santé

European citizens are living longer and in better health than ever before. However, Europe is facing a number of health problems that require the EU to respond.

First, there are wide inequalities within the EU. All citizens hope to live long in good health but the reality is that health status, life expectancy and access to healthcare vary widely between and within Member States. The average national life expectancy for men varies by 13 years. The EU can add value to national measures to help bridge the health gap by for example carrying out EU-wide analysis on health status and conditions and their impact on quality of life, labour participation and growth; and by helping Member States exchange best practice. Individual Member States by themselves cannot have a full picture of health inequalities across the EU and tackle fully effectively such inequalities.

Second, all Member States are facing a number of common challenges that require a more pro-active approach to promoting health and preventing illness . The changing disease pattern, with the increasing burden of avoidable diseases related to life-style and to addiction (for example tobacco smoking, alcohol consumption, drug use, nutrition), the spread of some diseases such as HIV , the weight of mental illness, all call for complementary action at EU level. However, the current level of budget limits considerably the possibility for the EU to meet its art 152 Treaty obligation as regards improving health and preventing diseases.

Third, global health threats such as SARS do not stop at national borders and cannot be effectively tackled by any Member States alone: they require co-ordinated action at European level. Member States’ interdependence and travelling within the EU means that communicable diseases spread easily across borders. Member States have very different levels of preparedness to counter such diseases or fight a health crisis. There is a clear need for EU level co-ordination to help Member States develop capacity to counter such threats so as to ensure that the health of EU citizens is not undermined by lack of capacity in one country (failure to counter a disease in one country translates into the potential for its spread into other countries). The obligation to counter health threats is enshrined in the Treaty, reinforced in the Constitution and reflected in the Commission Strategic objectives for 2005-2009[3]. However, the available budget is insufficient to build capacity to protect citizens against threats that require a response across Europe, and thus to fully implement article 152.

Fourth, while the Treaty stipulates Community action to encourage Members States’ co-operation on health, the current budget has not enabled the Commission to develop sufficiently activities in this area. So far, co-operation has been limited to the meetings of the High-level Group on health services which has no operational budget. Although health services are primarily the responsibility of the Member States , there is much scope for co-operation and exchange of good practices which could help Member States’ health systems become more cost-efficient and effective. The EU is well positioned to steer Member States’ co-operation and to monitor progress. But concrete progress in this area must depend on the necessary resources.

Fifth, health policy must be based on the best data and information. Despite much progress under the current Public Health programme, there is a need to step up efforts in the gathering, analysis and dissemination of comparable data at EU level .

Finally, health is increasingly global and the EU has been under pressure to take a stronger international role, in particular as regards global health issues such as HIV/AIDS and to help third countries, in particular neighbouring countries. To develop co-operation with international organisations and help third countries, the Commission needs additional financial and human resources.

The recent open consultation on health that generated about 200 responses from Member States, stakeholders and citizens stressed these problems and pointed to the need to boost European health action.[4] Major issues identified included mainstreaming health, tackling health determinants and boosting prevention of major diseases, investing in health research, improving health information, addressing health inequalities, and enhancing international co-operation. Stakeholders also asked to be involved more closely in policy-making and for more resources to be allocated to health. The external evaluation of the eight health programmes 1996-2002[5] also recommended that the EU puts more resources into prevention and steps up efforts on the dissemination of information and the exchange of knowledge between Member States.

Problème consommateurs

Les consommateurs européens ne sont pas aujourd’hui protégés de la même manière dans toute l’Union. Alors que les droits des consommateurs constituent un volet important des droits des citoyens européens, on constate que les règles de protection des consommateurs sont extrêmement hétérogènes d’un Etat membre à l’autre, avec des niveaux de protection très variés. Les consommateurs européens sont surpris quand ils découvrent que le rapprochement entre les différents droits n’est encore que partiel. C’est ainsi qu’interrogés dans le cadre d’un Eurobaromètre sur le commerce transfrontière[6], les consommateurs des anciens Etats membres ont déclaré qu’ils pensaient que leurs droits avaient déjà été harmonisés à travers l’Europe. Seuls les consommateurs des récents Etats membres pensent qu’il y a une différence de niveau de protection à l’avantage des consommateurs de l’ouest/nord de l’Europe.

Par ailleurs, il apparaît que le marché intérieur n’est toujours pas une réalité pour la majorité des consommateurs européens.

Alors que l’on constate que la différence de prix moyenne entre les Etats membres pour des produits de détail est d’environ 30%, (elle n’est que de 5% au sein des Etats membres), peu d’achats de produits et de services sont aujourd’hui effectués par les consommateurs en delà des frontières (seulement 12,4 % ont effectivement acheté quelque chose, autre que des services de transport et d’hôtel). Cependant, interrogés, 53% des consommateurs se disent prêts à effectuer des achats transfrontières s’ils devaient trouver des produits ou des services moins chers, ou de meilleure qualité et 51% d’entre eux déclarent avoir eu l’occasion de constater des différences de prix pour un même produit entre les Etats membres.

Par conséquent, il apparaît que les faibles niveaux de transactions transfrontalières limitent le choix offert aux consommateurs, réduisent la pression concurrentielle permettant une fixation efficace des prix et représentent une occasion manquée en termes de croissance économique.

Les causes du problème sont majoritairement de trois ordres : manque de confiance des consommateurs, insuffisante prise en compte des intérêts des consommateurs dans les autres politiques communautaires et faiblesse du mouvement consommateur.

a) Manque de confiance des consommateurs

Dans l’ensemble de l’Union, les consommateurs ont nettement moins confiance dans les achats transfrontaliers que dans ceux effectués dans leur propre pays. Seuls 31% des consommateurs estiment qu’ils seraient mieux protégés en cas de litige transfrontalier avec un fournisseur, tandis que 56% d’entre eux ont le sentiment qu’ils seraient bien protégés dans le cadre d’un litige similaire au sein de leur propre pays[7]. Si les consommateurs interrogés mettent souvent en avant la barrière de la langue, il s’avère que le manque de confiance repose aussi largement sur des éléments qui justifient une intervention publique communautaire.

C’est ainsi qu’il apparaît que les consommateurs manquent de données, d’information sur les possibilités offertes par le marché intérieur. Face à cela, sauf dans les zones frontalières, ils n’ont pas acquis de réflexes transfrontières. Même s’ils le souhaitent, ils ne savent pas forcément où trouver l’information pertinente. Ce qui vaut pour les produits est encore plus vrai pour les services.

Le manque de confiance des consommateurs tient aussi à l’existence de règles de protection des consommateurs très différentes selon les Etats membres. Ne sachant pas toujours très bien de quelle protection ils disposent au sein de leur propre pays[8], en étant encore moins familiers avec celles des autres Etats membres, les consommateurs restreignent leurs choix aux produits et services disponibles dans leur propre Etat membre. L’hétérogénéité des niveaux de protection a encore été accentuée par l’élargissement. En outre, les textes qui font partie de l’acquis communautaire en matière de protection des consommateurs présentent aussi des incohérences et comportent des lacunes.

A côté de l’existence de règles différentes, il a aussi été constaté que les consommateurs ne font pas toujours confiance dans les autorités publiques pour faire appliquer les règles édictées. Dans l’ensemble de l’UE 25, on peut d’ailleurs constater des différences importantes dans la mise en œuvre de la réglementation.

Un autre élément qui freine la confiance des consommateurs tient à un manque de mécanismes de règlement des litiges efficaces. En cas de litige, le consommateur est parfois confronté à un véritable parcours du combattant au niveau national. La démarche lui semble encore plus difficile lorsque le litige est transnational : à qui faut-il s’adresser en cas de difficultés ? Quelles sont les chances d’obtenir un règlement acceptable ? Combien de temps cela va-t-il prendre ? Combien est-ce que cela va coûter ?

b) Insuffisante prise en compte des intérêts des consommateurs dans les autres politiques communautaires

Les intérêts des 450 millions de consommateurs européens reposent aussi sur la prise en compte de leurs intérêts dans l’ensemble des autres politiques communautaires et particulièrement sur celles qui ont un effet sur les choix et les prix qui leur sont offerts.

Jusqu’à présent, priorité a été donnée au niveau communautaire à ce qui se passe du côté de l’offre, ce qui a conduit à rechercher en priorité l’élimination des barrières à l’entrée et amené à la libéralisation de nombreux secteurs. Ce qui se passe du côté de la demande, et particulièrement ce que sont les coûts et les obstacles pour les consommateurs, a été jusqu’à présent peu étudié et intégré dans les politiques communautaires autres que celle des consommateurs.

A ce jour, l’intégration des intérêts des consommateurs dans les politiques marché intérieur, transports, énergie, services d’intérêt général, etc. reste encore insuffisante, comme en témoignent les demandes des représentants des organisations de consommateurs, mais aussi du Parlement européen et du Comité économique et social. Les mesures récemment mises en places pour permettre une meilleure prise en compte des intérêts des consommateurs dans le domaine de la politique de la concurrence (recueil de l’avis des organisations de consommateurs dans certains dossiers, nomination d’un interlocuteur des organisations de consommateurs au sein de la DG Concurrence) pourraient être prises comme modèles dansd’autres politiques.

c) Faiblesse du mouvement consommateur

La situation du mouvement consommateur en Europe est extrêmement variée. Dans quelques anciens Etats membres, il existe des organisations de consommateurs reconnues et suffisamment puissantes pour jouer un véritable rôle sur leur marché national. Ces organisations ont cependant pas ou peu d’actions au niveau communautaire.

Dans de nombreux autres pays, le mouvement consommateur est éclaté entre de nombreuses organisations. Dans certains nouveaux Etats membres, il est même très difficile d’identifier les organisations de consommateurs.

La pluralité présente l’avantage de permettre l’expression de tous les courants. En revanche, l’éclatement du mouvement consommateur constitue un obstacle majeur à l’efficacité de leur action. On constate en effet que les actions de coordination sont rares au niveau national. Ceci est encore plus vrai quand il s’agit d’intervenir au niveau communautaire.

L’éparpillement des organisations de consommateurs conduit à un fractionnement des moyens financiers dont elles peuvent disposer. Les sources de financement des organisations sont limitées par nature (cotisations des membres, aides publiques dans certains pays et vente de services aux consommateurs pour les plus organisées d’entre elles). Il faut aujourd’hui constater dans les anciens Etats membres une diminution générale du nombre d’adhérents et dans les récents Etats membres une réticence forte à devenir membre d’une organisation et à payer une cotisation.

Faute de moyens, peu d’organisations sont à même de prendre part aux travaux de normalisation ou de développer une expertise suffisante notamment en matière économique, scientifique, sociologique, etc. qui les mettrait à même d’être davantage entendues des pouvoirs publics et des entreprises, tant au niveau national, européen qu’international.

La faiblesse du mouvement consommateur au niveau national ne permet pas non plus l’émergence d’un mouvement consommateur fort au niveau européen. A ce jour, seules deux organisations existent: le BEUC qui intervient dans toutes les questions intéressant les consommateurs et l’ANEC qui intervient dans les questions de normalisation, avec l’appui d’un fort soutien financier public.

Le mouvement consommateur européen ne peut se renforcer qu’avec des organisations nationales membres suffisamment fortes notamment financièrement. Le mouvement consommateur européen n’est pas aujourd’hui à même de produire de l’expertise de niveau communautaire, ni de constituer un véritable contrepouvoir face aux organisations professionnelles.

d) Insuffisance des données

La stratégie pour la politique des consommateurs 2002-2006 avait pointé la nécessité pour la Commission de développer un socle de connaissances contenant des informations et des données sur les consommateurs et le marché pour l’ensemble des pays de l’Union européenne. La politique des consommateurs, comme toutes les politiques, a en effet besoin de s’appuyer sur des informations et des données quantitatives et qualitatives fiables, pertinentes afin que les choix politiques puissent être modulés et classés par ordre de priorité de la manière la plus appropriée possible. Il est en effet difficile d’affirmer qu’une mesure est favorable ou non aux consommateurs ou qu’un marché fonctionne ou non correctement dans l’intérêt des consommateurs, sans recueillir l’avis des consommateurs eux-mêmes et sans disposer de données fiables et comparables sur le fonctionnement des marchés examinés sous l’angle consommateurs. Actuellement, les moyens financiers et humains mis à la disposition des responsables de la politique des consommateurs ne permettent pas de produire un effort général, systématique et soutenu en vue de mettre sur pied un tel socle de connaissances.

2.2. Y a-t-il nécessité d’une intervention communautaire ?

Nécessité d’une intervention communautaire (niveau commun)

The EU, national and regional authorities, citizens, businesses and civil society all have a role to play in improving the health, wellbeing and welfare of European citizens.

There are however several shared health and consumer policy challenges that only action at EU level can tackle. Greater mobility and more communication have benefited citizens. But they have also increased the risk of spreading health threats such as SARS and other communicable diseases (which cannot be addressed by individual Member States alone) and scams e.g. from bogus lotteries. The complexity of modern life has brought more choice for citizens. But it has also made it harder for them to make the best choices.

The proposed strategy and programme therefore aim to implement articles 152 and 153 of the Treaty as regards Community action on health and consumer protection, by complementing national action with value-added measures which cannot be taken at national level. The selected option aims to pursue the following joint objectives:

1. Protect citizens from risks and threats which are beyond the control of individual citizens and that cannot be effectively and completely tackled by individual Member States. This relates to problems brought by unsafe products or by health threats which are not limited to one Member State.

2. Increase the ability of citizens to take better decisions about their health and consumer interests. This means increasing the opportunities they have to exercise real choice and also equipping them with the knowledge they need.

3. Mainstream health and consumer policy objectives across all Community policies as stipulated in the Treaty[9] by developing an approach to integrate these policies into other Community policies (e.g. actions on shared concerns) and developing a Health impact assessment system to ensure that other policies do not harm health.

Nécessité d’une intervention communautaire (santé)

Article 152 of the Treaty establishing the European Community stipulates that the EU should ensure a high level of human health protection in all EU policies. The Treaty also defines several other areas in relation to improving public health, preventing human illness, and obviating sources of danger, such as the fight against major health scourges, where Community action should be taken to complement national action.

The EU is also asked to set high standards of quality and safety of organs and substances of human origin, blood and blood derivatives, and adopt incentive measures. In addition, the Treaty stipulates Community action to encourage and support cooperation between the Member States to coordinate their policies and programmes.

These Treaty provisions reflect the need for action at EU level. There are a number of reasons for this.

First, gathering and analysing data on health status and conditions throughout the EU , improving comparability of data, identifying trends, problems and inequalities, and feeding this information to policy-makers is a task that can only be done at European level . The EU can also provide important added-value in promoting awareness and disseminating information to citizens and stakeholders.

Second, because health threats such as SARS or HIV/ AIDS are not confined to the borders of individual Member States , there is a need for co-ordination of monitoring, surveillance and response to such threats at EU level. Similarly, a cross-border epidemic spread, or a bioterrorism attack, require preparedness and capacity to respond in a co-ordinated manner at European level. In addition, the safety of health products needs to be ensured in all Member States.

Third, the changing disease pattern in Europe - characterised by the increasing burden of avoidable diseases related to life-style, addiction, or the environment, requires a European response. EU action can support national health prevention and promotion measures by tackling health determinants: life style determinants (in particular obesity and smoking) and social and environmental factors. It can also help tackle specific diseases that represent an important burden across Europe, such as HIV or cancer.

Fourth, Member States’ health systems basically face the same challenges: mounting pressure on health budgets, need to invest in health technology, ageing, increasing patients’ expectations. While health systems are the responsibility of the Member States, there is a need to facilitate co-operation between Member States to help national systems become more cost-effective and efficient.

Finally, there are a number of issues that face the EU as a whole as regards for example health developments outside the EU, in particular in its neighbouring countries, which may impact on Europe’s health. The EU also needs to act in the international arena to help counter global threats and to ensure coherence with international health measures.

Over the last 5 years significant initiatives have been taken in addressing major health issues at EU level. These include the completion of eight public health programmes in 1996-2002[10], the creation of the Public Health Programme 2003-2008[11], work on developing a health information system, actions against tobacco, policy initiatives on alcohol and nutrition, legislation on the quality and safety requirements for blood, tissues and cells, communicable diseases surveillance, control and early warning.

Nécessité d’une intervention communautaire (consommateurs)

L’intervention communautaire en matière de politique des consommateurs est prévue par l’article 153 du Traité qui promeut l’intégration de la protection des consommateurs tant dans la définition que dans la mise en œuvre des autres politiques et qui insiste sur le droit à l’information, à l’éducation et à l’organisation des consommateurs. Cet article fait aussi un lien avec la réalisation du marché intérieur.

Il n’appartient certainement pas au niveau communautaire d’intervenir dans tous les aspects de la protection des consommateurs. En effet, certaines questions sont beaucoup mieux réglées au plus proche des consommateurs, au niveau national. Par ailleurs, d’autres questions de consommation n’ont aucun lien avec le marché intérieur.

Mais à partir du moment où la question est transnationale, l’intervention communautaire s’impose de manière à assurer un même niveau élevé de protection à tous les consommateurs et afin de contribuer à ce que tous les consommateurs profitent pleinement du marché intérieur, ce qui ne peut être réalisé individuellement par chaque Etat membre.

L’intervention communautaire s’impose ainsi pour protéger le consommateur pour tous ses achats de produits et de services. Qu’il les trouve à proximité de chez lui, qu’il se déplace pour les acquérir au-delà des frontières ou qu’il utilise toutes les possibilités offertes par les nouvelles technologies (e-commerce), le consommateur doit pouvoir être assuré de disposer des mêmes droits et ce à un niveau suffisamment élevé : informations préalables suffisantes, pertinentes et loyales, des produits et services sûrs, des contrats équilibrés, loyaux et complets ainsi qu’un accès à des modes de règlement des litiges rapides et efficaces.

En ce qui concerne les organisations nationales ou locales de consommateurs, le niveau d’intervention le plus approprié dépend de la question à traiter. C’est ainsi qu’il n’appartient pas au niveau communautaire de contribuer financièrement au développement des organisations nationales pour leurs actions purement nationales.

En revanche, l’intervention communautaire est justifiée pour favoriser la mise en réseau des organisations nationales, pour susciter des actions de coopération au niveau transnational, pour appuyer les échanges de bonnes pratiques, pour développer leur expertise notamment dans les domaines communautaires afin que les associations nationales soient à même de jouer un rôle essentiel sur le marché intérieur.

En ce qui concerne les organisations européennes, une intervention au niveau communautaire apparaît comme le niveau le plus approprié pour contribuer au développement d’un mouvement consommateur puissant et efficace.

3. PRINCIPAUX OBJECTIFS QUE LA PROPOSITION VEUT ATTEINDRE

3.1. Objectifs communs

General objective |

Healthier, safer and more confident citizens |

Common specific objectives | Result indicator | Common operational objectives | Output indicator |

Protect citizens from risks and threats which are beyond the control of individual citizens (e.g. threats to their health, unsafe products, unfair commercial practices). | Level of satisfaction of citizens with the safety of goods Safety level of health products Safety level of consumer goods Early identification and analysis of risks | Improve safety of products and substances of human origin Community legislation; information to citizens about legislation; guidance and training for implementation. Development of product safety standards. Enhance scientific advice and risk management | Number of product safety standards developed Number of scientific opinions given Community guidelines or decisions embodying the scientific opinions |

Increase the ability of citizens to take better decisions about their health and consumer interests. | Level of satisfaction/empowerment of citizens with Community information on health and consumer rights (via survey) Level of satisfaction of stakeholders (via consultation) Citizens are more aware of what to do to stay in good health; about the impact of lifestyles on their health; and about what the EU is doing to protect them against threats, to prevent illnesses and promote health. Citizens are more aware of their rights as consumers. | Donner la parole aux citoyens européens (forum de discussion « boite à idées » sur le portail) Improve communication with citizens on health and consumer issues Awareness-raising campaigns Surveys Conferences Publications Online information Information points Increase civil society and stakeholders’ participation in EU policy-making Promotion and strengthening of EU level health and consumer organisations Training and capacity building for health and consumer organisations Networking Strengthening of EU level consultative bodies and mechanisms. | Nombre de consultations Analyse des remarques et idées recueillies For all actions, number of citizens reached/target audience reached Number of campaigns Number of conferences & participants number of publications satisfaction with portal, n. of users number information points’ users number of public consultations, meetings, conferences number of responses to open consultations number of members of consultation bodies, number and regularity o meetings. |

Mainstream health and consumer policy objectives across all Community policies in order to put health and consumer issues at the centre of policy-making. | Health concerns and consumer interests are taken into account in other policies (and specificity of health and consumer issues respected in general policy making) Other policies (and budgets) serve health and consumer interests (Other Community policies have no negative impact on health) | Develop a common approach for integrating health and consumer concerns into other policies Joint measures with other DGs (either health with other policies or consumer with other policies) Create health impact assessment system Studies on impact of other policies on health Studies on impact of other policies on consumers Improve international co-operation | Number of joint measures with other DGs Budget allocated to health or to consumer issues by other policies Number of SANCO responses to other DGs Health Impact assessments undertaken Explicit references to health and consumer policy objectives in other policies Data collected regarding consumer interests in other policies Number of initiatives with International organisations Number of initiatives with third countries Health objectives in action plans with neighbourhood countries. Possibilities in external relation DGr programme to involve health and consumer civil society organisations |

3.2. Objectifs santé

General objective | Outcome/impact indicator |

European citizens across the EU enjoy healthier and longer lives | Better health measured by the Healthy Life Years Structural Indicator Reduction in life expectancy gap in the EU (increase life expectancy where it is relatively low) |

Specific objectives = Targets = influenced by other factors | Result indicators (many correspond to indicators of the “short list” of health indicators) | Operational objectives = Deliverables = under EC control | Output indicator |

Protect citizens against health threats | Monitoring and surveillance of threats is efficiently co-ordinated at EU level There is EU-wide capability to respond effectively to health crises | Creation of effective disease surveillance networking (in co-operation with the European Centre for Disease Prevention and Control (ECDC) Creation of reaction system linked to national reaction centres | ECDC becomes operational European co-ordination capacity for responding efficiently to threats is in place |

Promote policies that lead to a healthier way of life | There is increasing awareness of lifestyles’ impact on health Member States take up measures to tackle health determinants Citizens take up healthier lives Quantitative indicators Perceived general health Intake of fruit/intake of vegetables Alcohol dependence, related deaths, consumption Smoking related deaths, number of regular smokers Childhood obesity Use of illegal drugs | EU strategy on nutrition EU strategy on alcohol intake Anti-smoking campaigns EU strategy on HIV/AIDS Events showcasing best practice on childhood and youth health Thematic platforms with Member States and stakeholders | Number of new measures proposed and carried out in new strategies Number of projects in this area Number of citizens reached with prevention campaigns Number of events Number of thematic platforms created Number of information/awareness raising publications and target audience reached |

Contribute to reducing the incidence of major diseases | The incidence of major diseases is reduced; besides mental illness they may include e.g. HIV/AIDS, and cancer. Examples of quantitative indicators Depression prevalence, suicide attempts, psychological distress HIV/AIDS incidence Lung cancer incidence Diabetes prevalence The incidence of accidents is reduced: Incidence of injuries by intent and sector | EU strategies to prevent selected major diseases to be defined Strategy to prevent mental illness EU strategy to reduce accidents and injuries | Number of new measures proposed and carried out in new strategies Number of citizens reached with prevention campaigns Number of projects in this area Number of information/awareness raising publications and events and target audience reached |

Contribute to the development of more effective and efficient health systems | Member States co-operate and exchange good practices. As a result, national health systems are more cost-effective and more responsive to patients. There is a European system for centres of reference. There is a network for health technology assessment. A combination of quantitative indicators, including: Expenditure on health Insurance coverage Physicians employed | Commission steers co-operation with Member States on cross-border healthcare provision, including information exchange; developing European system for centres of reference; establishment and operation of a network for health technology assessment; information on health services; strategy on health professions and professional mobility; patient safety & high-quality care. | Structures for cooperation between health systems in place (measured by take up within Member States such as volume of cross-border agreements) Clear information and procedures for citizens on their rights to healthcare in other Member States under national and EU law (measured by extent of take-up, and proportion of complaints). Reduction in variation between Member States in health outcomes related to health systems (measured by direct outcomes from healthcare interventions and overall morbidity and mortality from conditions amenable to healthcare). Number of centres of reference identified Number of countries participating in HTA network Number of assessment reports |

Generate and disseminate more and better health information to citizens, health experts and policy-makers | The Community generates and disseminates more and better information Analysis of data is strengthened Information is disseminated widely in a user friendly manner | Implement health indicators’ short list and develop more indicators European health survey Health portal Actions targeting young people, vulnerable groups, migrants, prevention campaigns, information and training for health professionals Implementation of eHealth tools Regular EU health reports | Number of projects in this area Number of information/awareness raising publications and events and target audience reached For all actions, number of citizens reached/target audience reached Number of hits in health portal Number of Health reports |

3.3. Les objectifs consommateurs

OBJECTIFS GÉNÉRAUX | To ensure an equally high level of protection of all consumers, wherever they live, travel and buy from in the EU, from risks and threats to their interests | To increase the capacity of consumers to promote their own interests, as individuals or though consumer organisations |

OBJECTIFS SPÉCIFIQUES | Better consumer protection regulation | Better enforcement, monitoring and redress | A better understanding of consumers and markets | Better informed and educated consumers |

OBJECTIFS OPÉRATIONNELS | Réviser l’acquis communautaire pour le rendre plus cohérent et plus clair | Contrôler la qualité de la transposition de la législation et son application effective dans les Etats membres | Elaborer un plan d’action afin de développer un solide socle de connaissances, y compris dans le domaine de la sécurité | Contribuer au développement d’actions d’information à destination des consommateurs en collaboration avec les Etats membres |

Prendre en compte les intérêts des consommateurs dans les activités de normalisation | Renforcer la surveillance des opérations transfrontières | Mettre en place les outils nécessaires pour disposer de preuves non contestables pour mieux fonder la politique des consommateurs | Contribuer au développement d’actions d’éducation des consommateurs |

Renforcer la prise en compte des intérêts des consommateurs dans les autres politique (intégration) | Affirmer la place et le rôle des organisations de consommateurs dans la surveillance du marché | Développer des outils d’évaluation d’expositions des consommateurs aux produits chimiques | Aider au développement de la capacité des organisations de consommateurs à diffuser de l’information aux consommateurs |

Suivre de manière plus systématique les politiques des consommateurs dans les Etats membres | Contribuer au renforcement des modes alternatifs de résolution des litiges transfrontières | Développer les capacités d’expertise des organisations de consommateurs |

Contribuer au développement des normes de sécurité pour les produits et les services |

Objectifs généraux

Objectifs | Indicateurs |

1. To guarantee an equally high level of protection of all EU consumers, wherever they live, travel to or buy from in the EU, from those risks and threats they cannot address as individuals. 2. To increase the capacity of consumers to promote their own interests, as individuals or though consumer organisations | 1. Niveaux de protection de mise en œuvre des législations dans les Etats membres 2. Niveau de satisfaction des consommateurs |

Objectifs spécifiques

Objectifs | Indicateurs |

1. Better consumer protection regulation | Niveau de satisfaction des consommateurs sur la législation, le niveau d’infractions Niveau de satisfaction des professionnels |

2. A better understanding of consumers and markets | Nombre d’études et d’enquêtes lancées, Communication des données recueillies aux autres DG |

3. Better enforcement, monitoring and redress | Niveau d’efficacité des différents outils, instruments, réseaux mis en place Niveau de satisfaction des consommateurs dans le règlement des litiges |

4. Better informed and educated consumers | Niveau de satisfaction des consommateurs |

Objectifs opérationnels

Objectifs | Indicateurs |

Réviser l’acquis législatif pour le rendre plus cohérent | Rapports réguliers |

Propositions législatives ou non législatives |

Suivre de manière plus systématique les politiques des consommateurs dans les Etats membres | Rapports réguliers de comparaison des législations nationales de protection des consommateurs |

Réaliser un examen détaillé régulier des autres politiques afin d’arrêter des priorités d’action. | Réunions avec les Etats membres Réunions interservices |

Renforcer la prise en compte des questions d’intégration dans les programmes de travail des organisations européennes de consommateurs | Nombre de participations des organisations européennes aux réunions organisées par les autres DG Nombre de contributions écrites versées aux différents débats Nombre de réponses aux consultations publiques faites par les différentes DG |

Renforcer le rôle du ECCG dans la prise en compte des questions d’intégration | Nombre de contributions écrites versées par les membres du ECCG aux différents débats (publication sur le site Web) Participation des autres DG au ECCG |

Suivre et évaluer les activités de normalisation | Rapport régulier |

Vérifier l’application effective de la législation de protection des intérêts économiques des consommateurs: par le contrôle de la qualité de la transposition, par le contrôle de sa mise en œuvre, | Degré et niveau de la qualité de la transposition de la législation, Mesures éventuellement engagées contre les Etats membres. |

Nombre d’actions conjointes Commission/Etats membres, Nombre de cas enregistrés dans la base « coopération administrative », Nature des cas enregistrés (par législation, par secteur professionnel), Suites données aux cas enregistrés (rapports réguliers des autorités administratives nationales) Outils mis en place pour les fonctionnaires / agents en charge des contrôles (formation, manuels, etc.) |

Nombre et nature des cas enregistrés par les différents membres du réseau HelpNet, Nature des cas enregistrés (par législation, par secteur professionnel), Suites données aux cas enregistrés (rapports réguliers des membres du réseau HelpNet) |

Mesure de la satisfaction des consommateurs qui ont utilisé le HelpNet ou qui se sont adressées aux autorités administratives pour une plainte transfrontière (enquêtes ciblées). |

Vérifier l’application effective de la législation de protection de la sécurité des consommateurs : par le contrôle de la qualité de la transposition, par le contrôle de sa mise en œuvre. | Degré et niveau de qualité de la transposition de la législation, Mesures éventuellement engagées contre les Etats membres. |

Niveau de développement du réseau de coopération entre Etats membres (mise en œuvre de la DGSP), Outils mis en place pour les fonctionnaires / agents en charge des contrôles (formation, manuels, etc.) Nombre d’actions conjointes Commission/Etats membres, RAPEX : Nombre et nature des notifications enregistrées, Degré de sévérité des alertes, Temps de réponse aux alertes. |

Affirmer la place et le rôle spécifique des organisations de consommateurs dans la surveillance du marché | Diffusion des résultats des projets spécifiques portant sur des actions de surveillance du marché, Niveau de prise en compte tant par les autorités communautaires et nationales des informations fournies par les organisations de consommateurs sur la mise en œuvre de la législation communautaire. |

Contribuer au renforcement des modes alternatifs de résolution des litiges transfrontières | Mise en place d’une structure Helpnet dans chaque Etat membre Rapport régulier sur les modes de résolution existants |

Renforcer les compétences des personnels des organisations de consommateurs par le financement d’actions de formation en gestion, lobbying, relations avec les autorités de contrôle, réglementations de protection des consommateurs, etc. | Nombre d’organisations de consommateurs ayant inscrit leur personnel à ces actions de formation (mesure de la couverture UE 25) |

Nature des profils, des postes occupés par ceux qui ont participé aux actions de formation, 1 an, 2 ans et 3 ans après la formation |

Nombre et nature des actions mises en œuvre par les organisations de consommateurs ayant directement ou indirectement un lien avec la formation reçue, 1 an, 2 ans et 3 ans après la formation |

Elaborer un plan d’action afin de développer un solide socle de connaissances Mettre en place les outils nécessaires pour disposer de preuves non contestables pour mieux fonder la politique des consommateurs ; En confier la mise en œuvre à une agence exécutive afin de permettre un véritable saut quantitatif. | Nombre d’études produites et diffusées par la Commission Communication vers les autres DG Etablissement d’un réseau d’experts. |

Informer et éduquer les consommateurs en contribuant au développement d’actions de formation et d’information par le financement d’actions de type campagnes d’information ciblées, enquêtes comparatives sur les produits et les services offerts aux consommateurs en Europe, actions d’éducation à destination des jeunes consommateurs, réalisation de modules de formation, outils en ligne. | Nombre de consommateurs effectivement touchés par ces actions, Mesure de la satisfaction des consommateurs sur le niveau et la qualité des informations reçues (enquêtes) Tests de connaissances aux consommateurs qui ont utilisé les produits pédagogiques mis à leur disposition |

Affirmer la place et le rôle spécifique des organisations de consommateurs dans l’information des consommateurs | Diffusion des résultats des projets spécifiques portant sur des actions d’information |

Affirmer la place et le rôle spécifique des organisations européennes de consommateurs par une contribution financière à leur budget de fonctionnement | Nombre et nature des actions engagées par les organisations européennes |

Affirmer la place et le rôle spécifique des organisations européennes de consommateurs en matière de travaux de normalisation par une contribution financière à leur budget de fonctionnement | Nombre et nature des actions engagées par les organisations européennes |

4. PRINCIPALES OPTIONS POSSIBLES

A la lumière des objectifs identifiés, la présente section examine les différentes options possibles : aucune action, la continuité des programmes en cours à l’identique, le maintien de deux programmes séparés mais dotés de moyens accrus, la présentation d’un programme fusionné plus ambitieux avec des moyens accrus et la présentation d’un programme joint quand les deux programmes actuels auront expiré.

4.1. Option 1 : aucune action

Cette option serait non cohérente avec le Traité qui prévoit une intervention au niveau communautaire en matière de politique de la santé et de la protection des consommateurs ainsi que le disposent les articles 152 et 153 (Cf. paragraphe 2.3).

Cette option impliquerait par conséquent de remettre en cause tout ce qui a déjà été fait en matière de politique de la santé et de politique de protection des consommateurs au niveau communautaire. Cette option ne peut pas être envisagée.

4.2. Option 2 : continuité des deux programmes en cours avec le même budget (status quo)

Cette option consisterait à gérer l’acquis, avec deux programmes séparés, à l’aide d’un budget similaire à celui des deux présents programmes.

Le maintien de deux programmes séparés, comme actuellement, présenterait l’avantage d’une meilleure continuité d’approche de chacune des deux politiques auprès des autorités publiques nationales (Santé et Consommation relèvent en général de ministères différents) et des organisations non gouvernementales (les associations de consommateurs travaillant rarement de manière approfondie sur les questions de santé et vice versa).

Cette option présenterait pourtant plusieurs désavantages . Le maintien du budget actuel ne permet pas une mise en œuvre optimale des obligations du Traité, ni de répondre à la volonté politique d’en faire plus pour les citoyens en matière de santé et en matière de protection des consommateurs. En effet, les ressources financières existantes ne permettent pas à la Communauté d’assurer de façon exhaustive les actions nécessaires notamment en ce qui concerne la lutte contre les grands fléaux ou maladies importantes et la coopération entre les Etats membres en matière de santé.

This is evident in the current over-demand of the Public Health Programme: resources are not adequate to finance the large number of projects. For example, in its first year of operation, the Commission received 427 project proposals requesting Community funding of €500 million (total project costs of approximately € 1,000 million), which represents over 10 times the annual budget available (less than €50 million).

This has led the Commission to have to make invidious choices between projects and to be unable to fund high-quality projects in priority areas (as defined every year with a Commission Decision). The insufficient budget available to health actions has also forced the Commission to reduce its contribution to projects and has created difficulties in taking forward projects in relation to new Member States or proposed by NGOs with limited resources.

Les ressources financières existantes ne permettent pas non plus de développer de manière suffisamment conséquente les actions d’information et d’éducation des consommateurs, les actions destinées à renforcer les compétences des organisations de consommateurs et limitent les possibilités de mettre en place un véritable socle de connaissances. Elles ne permettent pas non plus d’accroître le développement d’actions conjointes avec les Etats membres tant pour la surveillance du marché que pour les structures d’aide aux consommateurs, actions indispensables à une véritable mise en œuvre de l’acquis communautaire. Par ailleurs, cette option ne permet pas de profiter des possibilités de synergies résultant de la fusion des deux programmes qui permettraient de gagner en efficacité.

Cette option serait aussi en contradiction avec la Communication de la Commission du 14 juillet 2004(COM (2004) 487 final) qui prévoit la fusion des programmes santé et consommateurs pour mieux répondre aux attentes des citoyens.

4.3. Option 3 : maintien de deux programmes séparés, chacun étant doté de moyens accrus

Comme pour l’option 2, le maintien de deux programmes séparés présenterait l’avantage d’une meilleure continuité d’approche de chacune des deux politiques auprès de nos interlocuteurs. L’augmentation du budget santé, comme du budget consommateurs, permettrait aussi à chacune des deux politiques de renforcer de manière conséquente la portée de ses actions.

As regards health policy, a larger budget would enable the Community to take further action in line with article 152 by developing three new action strands: response to health threats, prevention of diseases and co-operation between health systems. Even though these correspond to Treaty provisions, the Community has been unable to take adequate action due to insufficient budget. This increased budget would reinforce the existing three strands of the Public Health Programme (Information, Health threats, and health promotion through addressing health determinants). A larger budget will enable a wider range of measures and more effective and visible large-scale projects within these existing three strands.

En ce qui concerne la politique des consommateurs, le programme actuel n’est pas totalement satisfaisant parce qu’il ne permet pas d’atteindre complètement les objectifs qui lui ont été assignés en raison d’un budget trop limité et de ressources humaines insuffisantes au sein de la Commission pour suivre et évaluer les actions envisagées. Avec un budget plus important il sera notamment possible en matière de formation (à destination des Etats membres -surveillance du marché- et des organisations de consommateurs), d’information et de mise en place d’une base de connaissances, d’actions de coopération avec les Etats membres pour la mise en œuvre de l’acquis, de passer d’une phase actuellement pilote à un projet plus élaboré, plus conséquent devant permettre un saut qualitatif et quantitatif afin d’obtenir un véritable effet de masse. Les différents types d’actions envisagées resteront très proches de ce qui est prévu dans le programme consommateurs en cours, mais les besoins sont nettement supérieurs dans une Union à 25 membres. C’est l’ampleur et l’impact des actions qui seront renforcés ainsi que la participation accrue des différentes parties intéressées à la politique des consommateurs.

Cette option présente pourtant plusieurs désavantages. Cette option ne permet pas de profiter des possibilités de synergies résultant de la fusion des deux programmes qui permettraient de gagner en efficacité et en visibilité. Cette option serait aussi en contradiction avec la Communication de la Commission du 14 juillet 2004(COM (2004) 487 final) qui prévoit la fusion des programmes santé et consommateurs pour mieux répondre aux attentes des citoyens.

4.4. Option 4 : un programme fusionné doté de moyens accrus

La présente option permettra à l’action communautaire d’être plus efficace et plus efficiente en augmentant de manière substantielle le budget et en fusionnant les programmes santé et consommateurs. Cela permettra d’accroître le volume et l’ampleur des actions à entreprendre et permettra à la Communauté de mettre en œuvre de façon plus complète les articles 152 et 153 du Traité.

Fusionner les deux programmes présentera des avantages supplémentaires – budgétaires et administratifs ainsi qu’en matière de synergies et de visibilité .

Au niveau administratif, cette option permet une simplification des procédures et des outils de gestion entre deux Directions de la même Direction générale (une seule agence exécutive, des économies d’échelle, les mêmes outils pour l’organisation de réunions, de conférences, de campagnes d’information, des lignes budgétaires harmonisées).

En fusionnant les deux programmes, il sera par ailleurs possible de générer des synergies permettant d’exploiter au mieux les objectifs communs fixés par les articles 152 (santé publique) et 153 (protection des consommateurs) du Traité, par exemple dans les domaines de l’information et l’éducation des citoyens et en matière d’ intégration des politiques de la santé et des consommateurs dans les autres politiques communautaires . Il sera aussi possible de créer des synergies dans les méthodes de travail par exemple, dans les contacts avec la société civile, dans l’évaluation des risques et la coopération internationale.

C’est ainsi que cette option permet d’offrir une meilleure visibilité aux citoyens européens de ce que l’Union européenne fait pour eux. En proposant une approche intégrée pour deux sujets très importants pour les citoyens européens – leur santé et leurs droits en tant que consommateurs – la Communauté vise à se rapprocher de ses citoyens. La dispersion des actions à destination des citoyens en plusieurs programmes nuit en effet à l’image de cohérence de la Communauté auprès de ses citoyens.

Du point de vue purement financier, les avantages retirés de l’augmentation des moyens budgétaires octroyés aux deux programmes séparés ou à un seul programme fusionné sont pratiquement identiques (cf. option 3). Cette option respecte le engagement pris avec la Communication de la Commission du 14 juillet 2004(COM (2004) 487 final) qui prévoit la fusion des programmes santé et consommateurs pour mieux répondre aux attentes des citoyens.

Compte tenu de tous ces éléments, ainsi que de ceux détaillés dans l’analyse d’impact, l’option 4 est celle qui est retenue.

4.5. Option 5: présentation d’un programme joint quand les deux programmes actuels auront expiré

Cette option présente l’avantage de pouvoir tenir complètement compte des résultats de la mise en œuvre des programmes actuels. Elle permettrait par ailleurs de procéder à une consultation plus approfondie des Etats membres et de toutes les parties concernées. Il convient de noter cependant que les deux programmes n’expirent pas la même année : 2008 pour le programme santé et 2007 pour le programme consommateurs.

Par ailleurs, cette option ne permet pas de s’inscrire dans le calendrier fixé pour les discussions relatives aux perspectives financières 2007-2013. Elle perpétuerait en outre le manque de budget nécessaire pour respecter de façon complète les obligations de l’article 152 et 153. Elle ne sera donc pas examinée plus avant.

5. IMPACTS DES DIFFÉRENTES OPTIONS

5.1. Partie commune du programme

By bringing together action on health and consumer protection and by increasing the available budget, the selected option (4.4.) aims to impact positively on citizens’ daily lives. The selected option would pursue the following joint objectives: to protect citizens from risks and threats which are beyond the control of individuals; to increase the ability of citizens to take better decisions about their health and consumer interests; to mainstream health concerns and consumer interests across EU policies.

The common types of action envisaged aim to improve communication with EU citizens; increase civil society and stakeholders’ participation in EU policy-making; to develop the integration of health and consumer concerns into other EU policies; to enhance scientific advice and risk assessment; to promote the safety of products and substances of human origin; and to promote international co-operation.

As regards the social impact of common measures, communication and awareness raising measures in particular will help citizens have better access to healthcare and to cross border goods and services . In this context, such measures are likely to improve equal opportunities and equal treatment to all citizens and therefore to improve access for the most vulnerable by making citizens aware of their rights and opportunities.

The common actions foreseen under the selected option will also impact directly on the safety of citizens, in particular through the actions aimed at promoting the safety of products and at identifying at an early stage the risks to health caused by consumption/use of products. Common actions will therefore result on better protection against dangerous products and other health threats for all citizens.

Finally, common actions will also impact positively on governance across the EU by supporting networking of NGOs active in the health and consumer area and by enhancing their participation in EU policy making. As a result, stakeholders will see a more consistent and more effective approach to health and consumer issues and will have greater possibilities to help shape Community measures. The specific social impact of health and consumer measures is analysed under headings 5.2. and 5.3.

As regards economic impact , improving health and consumer confidence will also contribute to boost growth and employment by enhancing Europe’s competitiveness . Better health contributes to Europe’s productivity, labour force participation and sustainable growth. Bad health drives up costs and is a burden on employers and the economy in general. Similarly, achieving an Internal Market on goods and services that properly responds to consumer needs and demands will make the EU more competitive, as improved confidence will encourage consumers to buy goods and services across borders. The specific economic impact of both health and consumer measures is analysed under headings 5.2. and 5.3.

Common actions are not likely to impact directly on the environment . Strong synergies exist however between heath and environmental policies and are highlighted under heading 5.2.

Option 4.3. (two separate programmes, with higher funding) would mean that the EU would fail to exploit synergies between two policies which are closely linked as they both impact on citizens’ daily lives, either as patients or as consumers. The EU would therefore miss the opportunity to enhance policy coherence, to streamline procedures, to profit from economies of scale and to increase visibility and impact vis-à-vis citizens and stakeholders.

Option 4.2. (one merged programme but with same funding as currently) would also mean that the EU would have insufficient means to fully implement the provisions of articles 152 and 153 of the Treaty. As regards the common actions envisaged, there would be insufficient budget to carry out new measures to improve citizens’ safety (risk assessment and safety of products and substances of human origin), communication with citizens and involvement of stakeholders in policy-making. The Commission would fail to respond to stakeholders’ requests for more and better information, communication and partnerships. Finally, because of the insufficient budget, it would be very difficult for the EU to help shape international health and consumer policies and to take action to support and develop international initiatives.

No action (option 4.1.) would mean failure to implement articles 152 and 153 of the Treaty.

5.2. Impacts des objectifs / actions santé

Economic impact

Impact on competitiveness, direct and indirect costs to businesses and macro-economic environment

The selected option (4.4. merged programme with increase budget) aims to help citizens live healthier and safer lives. Population health has a clear impact on productivity , employment and labour costs and contributes to economic growth.

All health actions are therefore bound to have a positive, long term, indirect (and difficult to quantify) impact on growth and competitiveness. A recent study shows that, in several countries including EU-15, health improvement represented 11% of the causes of growth over a 25-year period[12]. However, most studies focus on developing countries: a WHO report shows that increasing life expectancy at birth by 10% increases the economic growth rate by 0.35% a year and that 50% of the growth differential between rich and poor countries is due to bad health.[13]. However, data is still scarce for EU countries, in particular for the new Member States. A study for the Commission, due to be published in April 2005, should provide additional evidence on health’s impact on the EU economy.

Health clearly impacts on productivity. People in good health potentially work better, quicker, are less likely to be absent from work and can work more years of life. When a worker is ill, the employer has additional costs – loss of working days, lower productivity, and replacement during absence. In the long-term, higher labour costs translate into lower international competitiveness and put a break on job creation.

Workers suffering from depression are 20% less productive: in Germany in 2002, 18 million working days were lost - the total cost to employers was €1.59 billion[14]. In England, alcohol related conditions cause a productivity loss of £ 6.4 billion/year[15].

Health problems at work caused 500 million lost workdays in EU-15 in 1998/99 [16]. The UK lost 33 million workdays in 2001-2002 due to work-related ill health[17].

Improved population health also helps counter labour shortages. To increase the proportion of older people working it is necessary to improve people’s health with a life course perspective. The health of the population and the rate of employment after 55 are interlinked. For example, the Member State with the highest EU life expectancy (Sweden, 78 years/men) and with the lowest incidence rates of some major diseases also has the highest EU rate of working people aged 55-64 (68.6%)[18]. In this context, the Communication to the Spring European Council on the Lisbon strategy” [19] , stressing the need to attract more people into employment , rightly underlined that “ increasing Healthy Life Years will be a crucial factor in achieving this objective ”.

The document supporting this Communication also said that “ a major challenge will be to reduce the important differences between Member States in terms of life expectancy, incidence of major diseases and health capability . Modernising the health sector (…) can make a substantial contribution to improving the health condition of the population and sustain labour supply ” [20]. The same document refers to “ health and health policies as a contributor to productivity, labour participation and economic growth ”, and to “ the need both for long-term cost-efficiency measures and for investment in health prevention”.

In conclusion, while health clearly impacts positively on growth, this impact remains difficult to quantify. Similarly, the chain of impacts “selected option: EU action on health – population health – economic growth” is not quantifiable at this stage.

Keeping the status quo, in particular option 4.2. ( same funding as currently) would mean that the Community would act less on health and fail to increase awareness and provide evidence to the Member States on health’s impact on the economy and on the cost-effectiveness of prevention. The Commission would also fail to respond to Member States’ requests (in the context of the open consultation on the EU health strategy), to position health as a driver of economic growth and to gather and disseminate evidence on health’s impact on the economy.

No action (option 4.1.) would mean failure to implement article 152 of the Treaty.

Impact on innovation and research

The selected option (merged programme with increase budget) aims at integrating health and consumer interests in other policies. Research for medical purposes will be a priority area, in response to repeated stakeholders’ requests in the framework of the open consultation on the EU health strategy. This consultation called on the EU to provide a co-ordinated approach to health research , to allocate more funding to health in the 7th Framework Research Programme, for more research on prevention, on the impact of health determinants, on specific diseases, on innovative medicines and new technologies.

By boosting co-operation between Health and Research policies (in the context of the common objective on mainstreaming), by fostering co-operation between Member States (new strand of action “achieving synergies between Member States”) in areas such as health technology assessment, by helping the development of European centres of excellence and by promoting the use of eHealth applications, the selected option will contribute to stimulate research in Europe.

Keeping the status quo (option 4.2. two programmes with same funding as currently) would mean that no resources would be available for example to foster exchange of good practice between Member States, nor for the development of centres of excellence.

No action would mean failure to implement articles 152 and 153 of the Treaty respectively stipulating the need to integrate health and consumer concerns in all Community policies and for the EU to promote health research. It would also fail to respond to repeated stakeholders requests to boost health research in Europe.

Impact on households

The selected option puts a strong emphasis on providing information to citizens to increase their ability to take better decisions both about their health and their consumer interests (as one of its common objectives). The two issues are linked: often citizens’ health is affected by choices they make as consumers and hence the need to provide user-friendly and accurate information to citizens. New action on Member States’ co-operation will help make national health systems more responsive to citizens’ needs, including easier access to healthcare. The selected option will therefore impact positively on citizens’ ability to take the right choices as regards their health and interests as consumers, potentially impacting on their quality of life.

The selected option responds to the results of the open consultation on the EU Health strategy. Many respondents asked the Commission to assume a stronger role in the collection of harmonised health data and its analysis and dissemination . Measures proposed include using health indicators to analyse trends, issuing health reports, carrying out surveys and presenting health information in a user-friendly web portal.

Option 4.2. (two programmes, same funding as currently) would impose important budget limitations to information gathering and dissemination activities. It would also mean failure to respond to stakeholders’ requests to improve the gathering, analysis and dissemination of EU health data.

Option 4.3. (two separate programmes, with higher funding) would mean the Community would fail to exploit synergies in terms of shared goals of health and consumer objectives and in terms of visibility for European citizens.

No action (option 4.1.) would mean failure to fulfil completely Treaty article 152, in particular as regards promoting health information and education, and also failure to respond to repeated Member States and stakeholders’ requests.

Impact on regions and sectors

The selected option aims to enhance health investment across Europe, in particular in the regions that need it the most, as a means to bridge the “health gap” (major differences across the EU in terms of life expectancy and health status). By providing EU-wide analyses on health status and conditions and their impact on growth, by helping Member States exchange best practice on health investment, the programme will stimulate investment in the health sector at regional level. In addition, the programme aims to bring closer together health and regional policies, building on the Commission legislative proposal of July 2004 which makes health a funding area of the Structural Funds’ convergence objective.

Encouraging health investment at regional level not only impacts favourably on the health sector, but also impacts positively on regional growth and development. First, because the health sector is an important employer and drives demand for goods and services. Second, because health is a productive investment: a healthy population translates into a more productive workforce. Third, because a population in bad health is a disincentive for regional investment.

In particular option 4.2. (two programmes, same funding as currently) would mean lack of resources to build synergies with regional policy, very limited action on co-operation between Member States which will benefit the regions involved in projects under this new strand and no budget to carry out studies on health impact on regional development.

No action would mean failure to fully implement article 152 of the Treaty stipulating the need to integrate health in all Community policies.

Impact on third countries and international relations

International organisations play an important role in addressing global health issues, including the United Nations and its specialised agencies such as the WHO. International cooperation is essential to enable the programme to achieve its objectives, given the transnational nature of the threats to the health, safety and economic interests of citizens and the inability of any one state or even the Union to tackle all these issues in isolation.

Currently, the existing Public Health Programme includes some elements of international cooperation. However, these are insufficient to address the current challenges, as shown by the increased need for international cooperation on issues such as surveillance and reporting of communicable diseases, or tobacco to be developed further. Therefore, the selected option is the most effective means for taking forward cooperation with key partner countries and international organisations in a streamlined and efficient manner. This will also allow synergies to be developed with other policy areas. For example, in development policy, enabling cooperation on issues such as HIV/AIDS is to the mutual benefit both of non-member countries and of the Union itself.

Addressing the 'brain drain' of health professionals from developing countries also requires coordination with strategies on training and mobility within recruiting countries inside the Union. Cooperation with international organisations will also help to maximise the overall resources available for work on health and consumer protection issues by ensuring an effective division of work and avoiding overlaps.

Option 4.2. (two programmes, same funding as currently) would mean a limitation on international co-operation (underlined in the framework of the reflection process on health) and failing to respond adequately even to major global health issues such as HIV.

Option 4.3. (two separate programmes, with higher funding) would greatly limit the potential for achieving synergies through similar approaches to international co-operation and health and consumer protection.

No action would mean failure to implement article 152 of the Treaty which stipulates that the Community shall foster co-operation with international organisations and third countries on health.

Impact on public authorities

Bringing together the two programmes under the selected option will impact positively in terms of increased coherence, and visibility of EU action vis-à-vis the Member States.

In the health area, two new action strands proposed will impact directly on the capacity and efficiency of national public authorities. The new strand “ deliver response to health threats” aims to help national authorities make the best use of existing resources to protect their citizens e.g. by exchanging best practice and fostering mutual assistance. Also the proposed new strand “achieve synergies between national health systems” aims to help national authorities respond to common challenges with the purpose of helping national health systems become more cost efficient and effective.

In addition, the Commission provides information and data that feeds into national policy making. At a time when the continuous growth in healthcare costs is increasing pressure on national public authorities and raising the need for cost-efficiency measures, analysis e.g. on the cost-effectiveness of prevention and promotion measures can help Member States realise important savings. Health action under this programme, in particular under the two strands “health determinants” and “preventing diseases” aims to help reduce illness, which leads not only to an increase in quality of life for citizens, but also to potential savings in national healthcare costs.

( National authorities in EU-15 spend 135 billion euros every year on cardiovascular diseases [21] including 8 million disability adjusted life years lost[22];

( National authorities in EU-15 spend €102 billion on the direct and indirect costs of respiratory diseases [23] ;

( The cost of mental health alone is estimated at 3% to 4% of GDP[24].

Option 4.2. (two programmes, same funding as currently) would mean insufficient resources to develop capacity at EU level to provide surveillance and monitoring of health threats and thus to fully implement its obligation under the Treaty (article 152). In particular, it would mean no resources to develop a reaction system with capacity to respond to emergencies in a co-ordinated manner, nor to help Member States to develop such capacity at national level. This option would moreover also represent limiting co-operation between national authorities. It would not be possible to implement the policy proposals of the High Level Group on health services and medical care e.g. on Health Technology Assessment and to take forward practical actions aiming to promote co-operation projects to help health systems across Europe work together.

No action (option 4.1.) would mean failure to implement article 152 of the Treaty which stipulates that Community action should complement national policies, obviate sources of danger to human health, fight health scourges and encourage co-operation between Member States.

Environmental Impact

The selected option seeks to increase capacity to fight natural or man made health threats. An increased capacity to co-ordinate a response at European level to counter the release of dangerous agents or an epidemic has the double effect of countering adverse effects both to the environment and to human health.

Action foreseen to reduce tobacco smoking (under the strand “promote health by tackling determinants”) will also impact positively on the quality of the air.

However, the impact that health policies may have on the environment is minor compared to the impact that the environment has on health.

( It is estimated that the environment is responsible for 25 to 33% of health problems[25].

( Each year between six and nine thousand French city dwellers die prematurely because of air pollution[26].

( About one sixth of the total burden of death and disease for children can be attributed to environmental factors[27].

The environment therefore has a potential negative impact on human health. In this context, in June 2003, the Commission launched an Environment and Health Strategy, developing a Community system linking information on the environment, the ecosystem and human health. The Strategy, which puts special emphasis on children is being implemented by the environment and health action plan 2004-2010 aimed at improving knowledge on how environmental factors impact on health. The plan will provide the basis for identifying possible additional measures to improve the well-being of people and the environment..

Work under the selected option will be taken forward in line with the environment and health action plan. The previous programme on pollution-related diseases, actions under the environmental determinants of health and health information strands of the current Public Health Programme, work on issues such air pollution & respiratory health and the health effects of climate aims to bring health and environment policies closer together.

In addition, many respondents to the open consultation on the EU health strategy asked the Commission to address the impact of air and water pollution on health as a priority, in particular traffic related pollution.

In this context, the selected option could include measures on the impact of the environment on health (e.g. awareness raising campaigns and other information tools). Also the new focus on children health proposed in the selected option is likely to tackle the important impact of the environment on children’s health.

The Commission plans to bring closer together its health and environmental policies in the context of the common mainstreaming objective of the joint programme. This will build on the various on-going environmental measures and thematic strategies that include a public health perspective (marine environment, sustainable use of pesticides, air quality (CAFE), urban environment, soil protection, waste prevention and recycling).

Keeping the status quo (option 4.2.) would mean very limited resources to integrate health and environmental policies. A higher budget will enable the EU to address more profoundly some of the key issues identified in the action plan, in particular indoor air quality, awareness raising, training of health professionals and risk communication.

No action would mean failure to implement article 152 of the Treaty which stipulates that Community action should integrate health concerns in all Community policies.

Social impact

Impact on employment and labour market access and on job quality

Some actions under the selected option by encouraging national and regional investment in health may lead, in the long term, to the creation of jobs in the health sector, in particular in the new Member States. All health measures aim at improving citizens’ health. In turn, the healthier the citizens the better his/her chances to obtain a job and to remain employed. Overall the programme will therefore contribute indirectly to labour market access.

Action to improve citizens’ health and to integrate citizens’ health concerns into all Community policy – as foreseen under the selected option - will indirectly impact on workers’ health.

For example, a healthy population is better equipped to profit from training measures and to acquire new skills. Measures to improve health therefore may impact indirectly on developing human resources and thus on improving job quality. However, such impact remains difficult to quantify.

As outlined above, the cost of not tackling preventable illness is high, and has a significant impact on overall workforce productivity. This is particularly important for many of the new Member States, where poor health represents a significant brake on overall economic development.

The current level of action is insufficient to enable the potential for European to be realised, and greater investment in needed. Keeping the status quo (action 4.2.) is therefore not an option.

No action would mean failure to implement article 152 of the Treaty.

Impact on social inclusion, equality of treatment and opportunities and social rights and standards

The selected option aims to promote health as a basic human right and to help enable citizens’ access to health information and treatment whoever and wherever they are. As such, equal access to health for all citizens is a cornerstone of Community action on health. The programme thus directly helps to implement Article 95 of the Charter of Fundamental Rights of the Union, which states:

“Everyone has the right of access to preventive health care and the right to benefit from medical treatment under the conditions established by national laws and practices. A high level of human health protection shall be ensured in the definition and implementation of all Union policies and activities.”

Health status varies widely across the EU, as illustrated by the following examples

( Life expectancy for men in EU-25 varies from 64.8 (Latvia) to 78 years (Sweden)[28].

( The incidence rate of lung cancer varies 5 fold between EU countries[29] (5 times higher in Hungary (102 per 100,000) than in Sweden (21).

( The incidence rates of ischaemic heart disease for women are almost 8 times higher in the Slovak Republic than in France[30].

( Example of a communicable disease related to poor socio-economic conditions : the incidence rate of tuberculosis varies 17 fold between EU countries[31] (17 times higher in Lithuania than in Sweden (86/100,000 people in Lithuania, 5.1 in Sweden).

Awareness raising measures and actions to encourage health investment in the regions and Member States that need it the most are directly targeted at bridging health inequalities between and within Member States so as to help citizens access healthcare wherever they are within the EU. Such differences can be explained by many factors, from lack of infrastructure, difficult access to healthcare, housing, poverty, education, lack of information, or the working environment. In addition, action foreseen on patients’ rights under the new strand “to achieve synergies between health systems” aims precisely at ensuring equal treatment for all. Given the link between ill-health, poverty and social exclusion, greater European action to help address inequalities in health and in access to healthcare is a key part of tackling social exclusion.

In the health area, measures targeting specific diseases, in particular mental diseases and HIV/AIDS, may also help reduce discrimination/stigma against vulnerable EU citizens suffering from these diseases. In turn, this may, indirectly, facilitate their access to employment or at least their acceptance in society. Proposed action on health provides a focused approach to two particularly vulnerable groups: children and older people.

Within its objective of mainstreaming health into other policies, the Commission will seek to bring its health and social protection policies closer together to exploit synergies.

The Commission has opted to take such action to respond to the results of the open consultation on the EU health strategy which asked the Commission to help bridge the health gap and address inequalities , to help increase funding for health investment in particular in the new Member States , to pursue the principles of equity, and health as a human right and to address the social determinants of health.

Keeping the status quo (option 4.2.) would mean limiting possibilities to help bridge health inequalities and to invest more in health in the regions and Member States that need it the most, no action on patients’ rights and fewer resources to bring health and social policies closer together. It would also mean no budget for the new strand to prevent/address important diseases and therefore failure to help some of the most vulnerable European citizens (those suffering from such diseases). In addition, it would also mean failure to respond to stakeholders’ requests in the context of the open consultation on health. This option is therefore not appropriate.

No action would mean failure to implement article 152 of the Treaty.

Impact on consumer rights

The selected option aims precisely at improving the ability of consumers to make properly informed choices and therefore to help citizens choose to make healthy choices of the products they consume. Action under the health determinants and the information strands is particularly relevant in raising awareness of the effects on health of food and drinks, alcohol, tobacco, and drugs. In addition, action under the strand “to achieve synergies between health systems” will impact positively on consumers’ access to cross border goods and services, in particular health services. A detailed analysis of impact on consumers is provided under heading 5.3.

Impact on governance and participation

Action envisaged in the selected option aims precisely at improving civil society’s participation in policy-making. The proposed strategy and programme seek to ensure that health and consumer protection policies are shaped in closer partnership with citizens and stakeholders and that their concerns are taken into account in policy-making.

Building on existing co-operation with the civil society, action foreseen under the selected option will strengthen existing mechanisms (e.g. the EU Health Forum) for consultation and dialogue with NGOs and professional organisations. It will also increase dissemination of information, promote consultation meetings and conferences, encourage the development of the health community in all Member States and foster links between organisations. This action will only be possible thanks to the larger budget requested. In addition, synergies with consumer protection action will be achieved in reaching out to citizens (be it in their capacity as patients or consumers), through increased visibility and economies of scale of common actions.

In the area of health, this responds to the results of the open consultation which called on the Commission to consult stakeholders more regularly and openly, and to help the civil society become more involved in health policy-making . Many organisations asked the Commission to help improve civil society’s capacity to participate in EU health debates and to create wider consultation mechanisms.

Keeping the status quo (option 4.2.) would mean no budget for a number of actions envisaged to strengthen civil society’s participation in policy making, such as enlarging the Health policy Forum, promoting the networking of NGOs and their representation at European level and less budget for consultation meetings and conferences. In addition, it would also mean failure to respond to stakeholders’ requests in the context of the reflection process on health. This option is therefore not appropriate.

Option 4.3. (two separate programmes, with higher funding) would deprive the Community of achieving synergies through similar approaches and tools to further develop partnerships with the civil society.

No action would mean failure to implement article 152 of the Treaty.

Impact on public health and safety

Improving public health and safety – making citizens healthier, safer and more confident - is precisely the fundamental goal of the proposed joint programme with an increased budget. The selected option seeks to improve the health status of European citizens to promote health as a human right, encourage health investment as a means to bridge the health gap by pursuing the following specific objectives:

First, to protect citizens against health threats .

Second, to promote policies that lead to a healthier way of life.

Third, to contribute to reducing the incidence of major diseases in the EU.

Fourth, to contribute to the development of more effective and efficient health systems .

Fifth, as an underlying objective, to generate and disseminate more and better health information to citizens, health experts and policy-makers.

While European citizens are living longer and in better health than ever before, all Member States are facing a number of health challenges that require the EU to respond.

First, lessons learnt with global health threats show the urgent need for the EU to increase capacity to protect citizens against threats that require a response across Europe, including bioterrorism . Threats do not stop at national borders and require co-ordinated EU action. The obligation to counter such threats is enshrined in the EU Treaty, and reflected in the European Commission Strategic objectives for 2005-2009[32], which underline that “C itizens legitimately expect that threats to their health and safety will also be countered at European level. The Constitution will strengthen the ability of the Union to act. But much can already be done now”. The EU needs to develop sustainable capacity to prepare for and respond to health threats.

In this context, the Commission proposes a new strand on reaction to threats in the joint programme.

Second, there is a need for more pro-active approach to promoting health and preventing illness at European level. The changing disease pattern, with the increasing burden of avoidable diseases related to life-style and to addiction (for example with tobacco smoking, alcohol consumption, drug use, nutrition), the spread of some diseases such as HIV , the weight of mental illness, all call for action at EU level. The need for the EU to increase prevention and help reduce diseases is one of the main results of the open consultation on the health strategy. Also the evaluation of the previous height public health programmes recommended that the EU invests more on prevention (both on determinants and on tackling diseases).

In this context, the Commission proposes that the existing health determinants strand of the Public Health Programme be reinforced in the joint programme, in order to promote health and prevent disease.

Third, linked to the above, the Commission proposes a new strand to “prevent diseases and injuries”, to help reduce the burden of disease, which would complement broad actions on health determinants with more focused actions on the prevention of specific diseases .

Fourth, Member States are increasingly aware of the potential contribution of the EU to help them achieve their objectives for national health systems. The support document on progress towards Lisbon underlines that European support to improve healthcare systems is “ envisaged and can provide important added value”. In this context, the Commission proposes a new strand “achieve synergies between health systems” in the joint programme (see further below impact on social protection).

Fifth, health policy action must be based on the best data and information and the best scientific advice. The open consultation on the EU health strategy asked the EU to assume a stronger role on the gathering, analysis and dissemination of data. Also the evaluation of the previous public health programmes recommended the EU to step up efforts in the dissemination of information. The Commission therefore proposes to expand health information action, with a stronger focus on analysis, on getting information across to citizens and using eHealth for better delivery of health services.

A larger budget will enable a wider range of measures, will give the EU the means to fulfil its obligations under article 152 of the Treaty more effectively, to assist Member States in developing health measures and to provide better added value with more effective and visible large-scale projects.. The selected option will increase the consistency of Community action and develop synergies between two policies that are closely inter-related and that impact on citizens’ daily lives.

Option 4.2. (status quo) would mean failure to effectively protect citizens against health threats, by keeping a situation where, should there be a disease outbreak, the EU does not have the capacity to co-ordinate a response. It would also mean insufficient resources to meet its Treaty obligations, in particular as regards addressing diseases and encouraging Member States’ co-operation, as there would be very limited budget to pursue action in these areas. It would also fail to respond to the results of the consultation process on health, which asked the EU to step up efforts in a number of areas, including prevention, to tackle a number of diseases, and to increase the budget allocated to health. This option is therefore not appropriate.

Option 4.3. (two separate programmes, with higher funding) would deprive the Community of achieving synergies through similar approaches/tools to communicate with citizens, develop partnerships with the civil society, carry out risk assessment and secure the safety of health and consumer products.

No action would mean failure to implement article 152 of the Treaty.

Impacts on access to social protection, health and educational goods and services

The selected option aims to impact positively on the cross-border provision of health services as well as on the mobility of health professionals.

The new strand proposed to “ achieve synergies betwe