A4-0008/95

Proposal for a European Parliament and Council decision adopting an action plan 1995-1999 to combat cancer within the framework for action in the field of public health (COM(94)0083 - C3-0241/94 - 94/0105(COD))

The proposal was approved with the following amendments:

(Amendment 1)

Recital 1a (new)

>Text following EP vote>

Whereas the Treaty states in Article 129(1) that 'health protection requirements shall form a constituent part of the Community's other policies', with very particular reference to the quality of the general environment, the quality of the working environment and a healthy diet;

(Amendment 2)

Recital 4a (new)

>Text following EP vote>

Whereas cancer research is also covered in the 'Biomedicine and Health' (1994- 1998) specific research and technological development programme;

(Amendment 3)

Recital 6

>Original text>

Whereas, in accordance with the principle of subsidiarity, action on matters not under the exclusive competence of the Community, such as action on cancer prevention, must be undertaken by the Community only when, by reason of their scale or effects, it may be better carried out at Community level;

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Whereas, in accordance with the principle of subsidiarity, action such as cancer prevention must, by reason of its scale or effects, be undertaken by the Community at Community level;

(Amendment 4)

Recital 6a (new)

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Whereas, in accordance with the principle that 'prevention is better than cure', the level of funding for public information campaigns and health education should be increased;

(Amendment 6)

Recital 8a (new)

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Whereas priority should be given to combating cancer in children; whereas nurses should receive appropriate additional training so as to be able to deal with the psychological problems of children suffering from cancer;

(Amendment 7)

Recital 9

>Original text>

Whereas, by ensuring wider dissemination of knowledge of the causes of cancer and of its prevention, ensuring improved comparability and dissemination of information on these subjects, and developing complementary actions especially in health education, the programme will contribute to the achievement of the Community objectives set out in Article 129;

>Text following EP vote>

Whereas, by ensuring wider dissemination of knowledge of the causes of cancer and of its prevention, ensuring improved comparability and dissemination of information on these subjects, and developing complementary actions especially in health education for specific groups, particularly those concerned with children, the programme will contribute to the achievement of the Community objectives set out in Article 129;

(Amendment 8)

Recital 9a (new)

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Whereas steps should be taken to combat media promotion of dietary and other habits that may cause cancer;

(Amendment 9)

Recital 10a (new)

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Whereas an effective way must be found of making good use of the experience and involvement of organizations of cancer patients themselves through their active participation on the advisory committee together with the representatives of the national authorities and of the health sector in broad terms (including psychologists, psychiatrists, social workers and hospital staff);

(Amendment 10)

Recital 12a (new)

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Whereas the principles of sound financial management must be observed if this action plan is to be fully effective;

(Amendment 42)

Recital 14a (new)

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Whereas a systematic policy for combating cancer must include primary and secondary prevention, specific treatment of the disease and palliative care in order to reduce the impact of cancer, increase the cure rate and improve the quality of life in all cases;

(Amendment 12)

Recital 14b (new)

>Text following EP vote>

Whereas, for an effective assessment of the measures, full statistical data for each case must be compiled in special registers according to age (adults - adolescents - children);

(Amendment 13)

Article 1a (new)

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The essential objective is to establish a cooperation network linking the Commission and the national committees so as to ensure that Community action serves as a catalyst for the action of the Member States in combating cancer.

(Amendment 14)

Article 2, sole paragraph a (new)

>Text following EP vote>

As regards informing the public, priority shall be given to jointly preparing basic public information modules, health education and the training of health- care personnel. A European database of cancer registers and epidemiological studies shall be set up in cooperation with the International Cancer Research Centre.

(Amendment 15)

Article 2a (new)

>Text following EP vote>

Primary prevention shall have priority, in order to raise levels of public awareness of the European Code against Cancer and to encourage the adoption of a healthy lifestyle, involving the consumption of fruit and vegetables and stepping up action designed to prevent passive smoking. Within the field of secondary prevention, early detection shall also continue to constitute a priority objective.

(Amendment 16)

Article 2b (new)

>Text following EP vote>

The emphasis shall be on information, education and the role of the media as well as on research and measures relating to early detection, the concept of a finite amount of health in the case of children with cancer (education of children) and on the quality of life during treatment and the terminal stage of cancer patients (psycho-social dimension).

(Amendment 17)

Article 2c (new)

>Text following EP vote>

The European Parliament recalls its call for any kind of direct or indirect advertising relating to any tobacco product to be banned since the action programme would otherwise lose much of its value.

(Amendment 18)

Article 4

>Original text>

The Commission shall ensure that there is consistency and complementarity between the Community actions to be implemented under this action plan and the other relevant Community programmes and initiatives, including the Biomedical and Health Research Programme under the Community's framework programmes for research.

>Text following EP vote>

The Commission shall ensure that there is consistency and complementarity between the Community actions to be implemented under this action plan and the other relevant Community programmes and initiatives, including the Biomedical and Health Research Programme under the Community's framework programmes for research, primary prevention programmes for AIDS, drugs, accidents and alcohol and programmes to establish an integrated information network (information technology in areas of general interest).

(Amendment 19)

Article 5a (new)

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The Commission shall encourage real cooperation between multinational working parties in a spirit of competition and partnership. Once a specific project has been approved, other working parties shall have the opportunity of joining the project.

(Amendment 20)

Article 5b (new)

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The Commission, in close cooperation with the national committees, shall make every effort to simplify and expedite the programme's basic administrative procedures; these procedures shall be properly publicized, and the results of research and other action under the programme shall be properly disseminated and utilized.

(Amendment 21)

Article 7(1)

>Original text>

1. The Commission will publish an annual report on the progress of the action plan and on potential Community financing in the various fields of action, taking into account the reports to be drawn up by each of the Member States. It shall be forwarded to the European Parliament, the Council, the Economic and Social Committee and the Committee of the Regions.

>Text following EP vote>

1. The Commission will publish an annual report on the progress of the action plan and on potential Community financing in the various fields of action, taking into account the reports to be drawn up by each of the Member States. The report shall pay particular attention to the complementarity between this action and those mentioned in Article 4. It shall be forwarded to the European Parliament, the Council, the Economic and Social Committee and the Committee of the Regions by 30 September each year.

(Amendment 22)

ANNEX (I)(1)

>Original text>

1. Support for exchanges of information and experience relating to the collection and dissemination of reliable and comparable data for cancer registers (incidence, mortality and survival rate). Development and strengthening of a European network in cooperation with the International Agency for Research on Cancer (IARC).

>Text following EP vote>

1. Support for exchanges of information and experience relating to the collection and dissemination of reliable and comparable data for cancer registers (prevalence, incidence, mortality and survival rate). Development and strengthening of a European network in cooperation with the International Agency for Research on Cancer (IARC).

(Amendment 23)

ANNEX (I)(2)

>Original text>

2. Support for the carrying out for epidemiological studies at European level and for the dissemination of their conclusions with regard to the identification of carcinogens (physical, chemical and biological), the risks arising from exposure to them, methods of prevention and for estimating survival rates and sources of disparities in those rates. On the basis of these conclusions, support for the drawing up and dissemination of recommendations. Cohort studies on cancer, diet and health (EPIC network), support for epidemiological studies based on research into nutrition as a potential preventive factor (identification of protective agents, modification of specific dietary factors) and, where appropriate, preventive chemical agents.

>Text following EP vote>

2. Support for the carrying out for epidemiological studies at European level and for the dissemination of their conclusions with regard to the identification of carcinogens (physical, chemical and biological), the risks arising from exposure to them (types of exposure and the population subgroups affected) and methods of prevention, together with the introduction of programmes designed to estimate survival rates objectively on the basis of certain criteria (age, sex, location of the tumour, evolutionary stage, histological type, etc). On the basis of these conclusions, support for the drawing up and dissemination of recommendations. Cohort studies on cancer, diet and health (EPIC network), support for epidemiological studies based on research into nutrition as a potential preventive factor (identification of protective agents, modification of specific dietary factors) and, where appropriate, preventive chemical agents.

(Amendment 25)

ANNEX (II)(4)

>Original text>

4. Improving the effectiveness of cancer prevention messages, in particular the recommendations of the European code against cancer, by supporting targeted measures (for teachers, general practitioners, etc.) and pilot projects, studies and analyses of health promotion techniques and assessments of action in this field.

>Text following EP vote>

4. Improving the frequency and the effectiveness of cancer prevention messages, in particular the recommendations of the European code against cancer, by supporting targeted measures (for educators, oncologists, general practitioners, pharmacists, journalists and other media persons) and pilot projects, studies and analyses of health promotion techniques and assessments of action in this field.

(Amendment 26)

ANNEX (II)(5)

>Original text>

5. Supporting pilot action networks for providing information and exchanges with regard to cancer prevention, taking into account the recommendations of the European code against cancer and those of the committees of experts meeting for this purpose in order to contribute to the highlighting and dissemination of best practice.

>Text following EP vote>

5. Supporting and expanding pilot action networks for providing information and exchanges with regard to cancer prevention, taking into account the recommendations of the European code against cancer and those of the committees of experts meeting for this purpose in order to contribute to the highlighting and dissemination of best practice.

(Amendment 27)

ANNEX (II)(7), sole subparagraph a (new)

>Text following EP vote>

Mounting a pilot scheme in the mass media involving 'European leaders against passive smoking', in which political leaders, leaders of social groups, scientists and artists will undertake not to smoke in public.

(Amendment 46)

ANNEX (II)(7), sole subparagraph b (new)

>Text following EP vote>

Setting by the European Parliament of a good example by banning smoking in its buildings except in one bar in each of the three buildings in Brussels, Luxembourg and Strasbourg and except inside offices where smoking may be allowed.

(Amendment 28)

ANNEX (II)(9)

>Original text>

9. Contributing to the formulation and implementation of integrated health education programmes in different contexts, with cancer prevention given a particularly important role. Definition and implementation of supplementary cancer prevention projects for specific groups in different contexts. Evaluation of health education initiatives with priority being given to making individuals more aware of their responsibility for their own health, preventing tobacco consumption, promoting a healthy diet and making people aware of the risks associated with excessive exposure of the skin to ultraviolet radiation, targeted at young people.

>Text following EP vote>

9. Contributing to the formulation and implementation of integrated health education programmes in different contexts, with cancer prevention given a particularly important role. Definition and implementation of supplementary cancer prevention projects for specific groups (town planners, environmental experts, architects, radiologists) in different contexts. Evaluation of health education initiatives with priority being given to making individuals more aware of their responsibility for their own health, preventing tobacco consumption, promoting a healthy diet and making people aware of the risks associated with excessive exposure of the skin to the rays of the sun, targeted at young people.

>Text following EP vote>

Broadening and deepening the action initiated under the second programme to encourage a change in dietary habits in schools, with increased consumption of fruit and vegetables. This action should be extended to the population at large accompanied by advertising activity in the media, coupled with action to support the consumption of fruit and vegetables throughout the European Union, as a result of the essential link between agriculture policy, consumer protection policy and diet.

>Text following EP vote>

As a result of the essential link between environmental protection policy and health protection policy, the increase in malignant melanoma due to exposure to the sun demands not only increased public information but also more resolute Community action as regards ozone layer protection.

(Amendment 29)

ANNEX (II)(12)

>Original text>

- -12. Implementation of studies and dissemination of their conclusions, making it possible to improve the level of knowledge on the perceptions of young people with regard to cancer, tobacco, diet and the risks associated with excessive exposure to the skin to ultraviolet radiation. Carry out analyses with the aim of increasing the effectiveness of preventive programmes among children and young people.

>Text following EP vote>

12. Implementation of studies and dissemination of their conclusions, making it possible to improve the level of knowledge on the perceptions of young people with regard to cancer, tobacco, diet and the risks associated with excessive exposure to the skin to the rays of the sun. Carry out analyses with the aim of increasing the effectiveness of preventive programmes among children and young people.

(Amendment 30)

ANNEX (II)(13)

>Original text>

13. Pursuing the implementation of the Commission recommendation of 8 November 1989 concerning the training of health personnel in the matter of cancer, assistance with the introduction and periodic assessment of the impact of the European pilot networks on initial and continuing training in cancer for the medical, nursing and dentistry professions.

>Text following EP vote>

13. Pursuing the implementation of the Commission recommendation of 8 November 1989 concerning the training of health personnel in the matter of cancer, promoting initiatives aimed at introducing quality standards into undergraduate and post-graduate training in the various aspects of oncology; assistance with the introduction and periodic assessment of the impact of the European pilot networks on initial and continuing training in cancer for the medical, nursing and dentistry professions, particularly for health workers caring for sick children.

(Amendment 31)

ANNEX (II)(14)

>Original text>

14. Support the mobility of the health professions (particularly trainers) in order to improve theoretical and practical knowledge of cancer (primary prevention, mass screening, particularly for cervical and breast cancer, early diagnosis and quality of care) between those centres of excellence in Member States offering training of a high quality, where such mobility is not ensured under existing Community programmes such as COMETT II or FORCE.

>Text following EP vote>

14. Support the mobility of the health professions (particularly trainers) in order to improve theoretical and practical knowledge of cancer (primary prevention, early diagnosis, mass screening, therapeutic principles, health- care conventions, individualized treatment) between those centres of excellence in Member States offering training of a high quality, where such mobility is not ensured under existing Community programmes such as COMETT II or FORCE.

(Amendment 32)

ANNEX (III)(18a) (new)

>Text following EP vote>

18a. In order to improve early techniques and systematic screening, promotion of pilot actions involving the collaboration of interdisciplinary teams specialized in a broad spectrum of fields such as immunology, genetics, anatomy, cytopathology and molecular biology, with a view to increasing biomedical and clinical cooperation. Diagnosis of tumours also needs to be improved with a view to more effective therapeutic planning.

(Amendment 33)

ANNEX (IV)(19)

>Original text>

19. Support European studies and dissemination of their conclusions, particularly in the context of European-level meetings and exchanges of experience, in order to gain a better understanding and improve the effectiveness of quality control methods both in diagnosis (radiological and anatomocytopathological examination) and in treatment (radiation therapy and chemotherapy), including palliative care, taking into account the psychological and social aspects, with particular regard to the quality of life of patients. Dissemination and evaluation of best practice in quality assurance in the pilot project networks.

>Text following EP vote>

19. Promote initiatives and support European studies and dissemination of their conclusions, particularly in the context of European-level meetings and exchanges of experience, in order to detect shortcomings and improve quality control methods both in diagnosis (radiological and anatomocytopathological examination) and in treatment (radiation therapy and chemotherapy), including palliative care, correctly administered at a sufficiently early stage, taking into account the psychological and social aspects, with particular regard to the quality of life of patients. Evaluation and dissemination of the care quality assurance procedures which are regarded as most appropriate in the pilot project networks. Support for European studies on the introduction of a common terminology for the classification and evaluation of complications arising from the treatment in patients affected by various forms of cancer.

>Text following EP vote>

Improving the quality of cancer treatment by means of more rigorous checks on radiotherapy installations and the training of healthcare personnel. Organization of a European conference in order to reach consensus on the conventions to be reserved in antiblastic chemotherapy, whose effectiveness has been demonstrated at the preliminary stage, but which is tending, rather groundlessly, to become general practice, to the considerable detriment of patients in terms of quality of life. Introduction of stringent clinical tests in this field.

(Amendment 34)

ANNEX (V)(20)

>Original text>

20. Make a supporting contribution to selecting priorities for cancer research to be carried out under the Community's framework programmes for research and specifically the biomedical and health research programme which includes basic and clinical cancer research. Support for the establishment of an inventory of European basic and clinical cancer research measures; help with the transfer to clinical trials of the results of basic research; information exchange networks for clinical trials in progress, and help with the launching of multiple-centre and multinational clinical trials in order to speed up the assessment of new methods of care.

>Text following EP vote>

20. Make a supporting contribution to selecting priorities for cancer research to be carried out under the Community's framework programmes for research and specifically the biomedical and health research programme which includes basic and clinical cancer research. Support for the establishment of an inventory of European basic and clinical cancer research measures; help with the transfer of the results of basic research to clinical trials and from there to standard therapeutic practice. Help with the setting up and establishment of information exchange networks for clinical trials in progress and access systems for involvement in such trials, and help with the launching of multiple-centre and multinational clinical trials in order to speed up the assessment of new methods of care.

(Amendment 35)

ANNEX (V)(20a) (new)

>Text following EP vote>

20a. In the field of innovation, support for research projects leading to proper, reliable early diagnosis by means of laboratory diagnosis techniques with an immunological, genetic or other basis which will prevent the current high percentage of late terminal diagnoses.

(Amendments 36 and 43)

ANNEX (Va) (new)

>Text following EP vote>

Va CONSULTATION, PARTICIPATION AND COORDINATION MECHANISMS

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20b. The Commission shall be assisted by the advisory committee set up under Article 5 of the Decision and also by a group of experts comprising prominent figures in the sector. The group of experts, whose members shall be drawn from the Member States, shall advise the Commission on the scientific, technical and psycho-social aspects of prevention, cancer treatment and palliative care and shall be called the Group of Cancer Specialists.

>Text following EP vote>

To ensure consistency, complementarity, participation and coordination in the Community projects undertaken in connection with this action plan, the biomedical and health research programme and other programmes and initiatives connected with public health and other Community policies, the Commission shall set up a coordinating committee involving the various groups of experts of the above-mentioned programmes, the existing national cancer programme committees and non-governmental organizations operating in the sector.

Legislation resolution embodying Parliament's opinion on the proposal for a European Parliament and Council Decision adopting an action plan 1995 to 1999 to combat cancer within the framework for action in the field of public health (COM(94)0083 - C3-0241/94 - 94/0105(COD))

(Codecision procedure: first reading)

The European Parliament,

- having regard to the Commission proposal to Parliament and the Council, COM(94)0083 - 94/0105(COD) ((OJ C 139, 21.5.1994, p. 12.)),

- having regard to Articles 189b(2) and 129 of the EC Treaty, pursuant to which the Commission submitted the proposal to Parliament (C3-0241/94),

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

- having regard to the report of the Committee on the Environment, Public Health and Consumer Protection, the opinions of the Committee on Budgets and the Committee on Research, Technological Development and Energy and the opinion of the Committee on Culture, Youth, Education and the Media (A4- 0008/95),

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

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

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

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

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