EN Official Journal of the European Union CE 9/56

Thursday 9 October 2008

Together for Health: A Strategic Approach for the EU 2008-2013

P6_TA(2008)0477

European Parliament resolution of 9 October 2008 on ‘Together for Health: A Strategic Approach for the EU 2008-2013’ (2008/2115(INI))

2010/C 9 E/10

The European Parliament,

having regard to Article 152 and Articles 163 to 173 of the EC Treaty,

having regard to the Commission White Paper of 23 October 2007 entitled ‘Together for Health: A Strategic Approach for the EU 2008-2013’ (COM(2007)0630),

having regard to the Council Conclusions of 5-6 December 2007 on the White Paper entitled ‘Together for Health: A Strategic Approach for the EU 2008-2013’,

having regard to the opinion of the Committee of the Regions of 9 April 2008 on the White Paper entitled ‘Together for Health: A Strategic Approach for the EU 2008-2013’ (1),

having regard to Decision No 1350/2007/EC of the European Parliament and of the Council of 23 October 2007 establishing a second programme of Community action in the field of health (2008-2013) (2),

having regard to the Council Conclusions of 1-2 June 2006 on common values and principles in European Union health systems (3),

having regard to Council Decision 2004/513/EC of 2 June 2004 concerning the conclusion of the WHO Framework Convention on Tobacco Control (4),

having regard to the Council Conclusions of 1-2 June 2006 on women’s health (5),

having regard to the Seventh Framework Programme of the European Community for research, technological development and demonstration activities (2007-2013) (6),

having regard to the Commission White Paper of 30 May 2007 on ‘A Strategy for Europe on Nutrition, Overweight and Obesity related health issues’ (COM(2007)0279),

having regard to its resolution of 6 July 2006 on protecting European healthcare workers from blood-borne infections due to needlestick injuries (7),

having regard to the World Health Organisation (WHO) guidelines in the framework strategy on ‘Health for All in the 21st Century’,

having regard to its resolution of 22 April 2008 on organ donation and transplantation: Policy actions at EU level (8),

having regard to its resolution of 10 April 2008 on combating cancer in the enlarged European Union (9),

having regard to its resolution of 15 January 2008 on the Community strategy 2007-2012 on health and safety at work (10),

having regard to its resolution of 12 July 2007 on action to tackle cardiovascular disease (11),

having regard to its resolution of 6 September 2006 on improving the mental health of the population — towards a strategy on mental health for the European Union (12),

having regard to its resolution of 23 February 2005 on the European Environment and Health Action Plan 2004-2010 (13),

having regard to its declaration of 27 April 2006 on diabetes (14),

having regard to Rule 45 of its Rules of Procedure,

having regard to the report of the Committee on the Environment, Public Health and Food Safety and the opinions of the Committee on Employment and Social Affairs and the Committee on Women’s Rights and Gender Equality (A6-0350/2008),

A. whereas health is one of the most precious things, whereas our goal is health for all and whereas we must guarantee a high level of health,

B. whereas Article 21 of the Charter of Fundamental Rights of the European Union states that any discrimination inter alia on grounds of sex, race, colour, ethnic or social origin shall be prohibited and Article 35 states that everyone has the right of access to preventive health care and the right to medical treatment and that a high level of human health protection shall be ensured,

C. whereas the positive effect of developments in health is that more and more people are living longer,

D. whereas increasing rates of cancer, diabetes, cardiovascular disease, rheumatic diseases, mental illness, overweight and obesity problems, along with malnutrition and inadequate nutrition, HIV/AIDS, the poor quality of the environment and the re-emergence of certain diseases associated with growing social inequalities, as well as new challenges, are increasingly threatening health in the EU and beyond, thus increasing the need for prevention and formal and informal health and care provision as well as rehabilitation after sickness,

E. whereas new threats to health with cross-border dimensions, such as pandemics, new communicable disease patterns, tropical diseases and biological terrorism, and the consequences of climate change and globalisation, particularly as regards water, food, increased poverty and migration, as well as existing threats such as environmental pollution, are becoming more serious,

F. whereas supportive health care systems are an essential element of the European Social Model and social and health services of general interest perform a general interest task, thus making a major contribution to social justice and social cohesion,

G. whereas population ageing is changing disease patterns thus increasing the need for formal and informal health and care provision and putting pressure on the sustainability of health systems, and whereas therefore special attention needs to be devoted to support for research and innovation by both the public and the private sector, and whereas strong policies are called for in support of the first stages of life, particularly in some Member States,

H. whereas there are wide disparities in health care between and within Member States,

I. whereas citizens increasingly expect common and effective action on health,

J. whereas at the same time the competences of Member States in the field of health and their freedom to decide what kind of health services they consider appropriate to provide must be respected, in strict compliance with the principle of subsidiarity, including respect for the different management systems and for the specific approaches chosen by the Member States in integrating public and private provision of health care services,

K. whereas in the event of concerns based on ethical grounds, it remains within the competence of the Member States to determine whether or not a certain service constitutes a health service,

L. whereas occupational health and safety is a health area in which the EU has a clear remit for action,

M. whereas there are areas where Member States cannot act alone effectively and whereas the EU is committed to a common health policy with which it can provide added value (e.g. exchange of information and good practice),

N. whereas investment in health is essential for human development and has an indirect impact on the various sectors of the economy,

O. whereas there is a lack of clarity about the number of different work streams and work programmes in the field of health,

P. whereas opportunities for disease prevention remain unexploited,

Q. whereas antibiotics are becoming increasingly useless as antibiotic resistance rises, whereas resistance levels vary across the EU, resulting from different attitudes to the use and control of antibiotics (3 to 4 times greater consumption of antibiotics in some Member States than in other Member States), whereas antibiotic resistance is a European problem as frequent movements including tourism take place, increasing the risk of spreading resistant bacteria, and inappropriate use of antibiotics should therefore be monitored and prudent use of them encouraged, and whereas the European Centre for Disease Prevention and Control (ECDC) serves as the appropriate agency to coordinate these activities,

R. whereas 40 % of health spending is linked to unhealthy lifestyles (arising for instance from consumption of alcohol, tobacco, inactivity and poor diet),

S. whereas effective protection of health and safety at work can prevent industrial accidents, inhibit the emergence of occupational diseases and reduce the number of people permanently disabled for work-related reasons,

T. whereas Directive 2004/37/EC of the European Parliament and of the Council of 29 April 2004 on the protection of workers from the risks relating to exposure to carcinogens and mutagens at work (15) does not adequately cover EU citizens at work from exposure to substances toxic for reproduction,

U. whereas malnutrition, which affects a significant number of EU citizens, including an estimated 40 % of patients in hospitals and between 40 % and 80 % of older people in care homes, costs European health care systems similar amounts to obesity and overweight,

V. whereas health is not only influenced by alcohol, tobacco, inactivity, diet and similar external factors, and therefore more attention should be devoted to the psychosomatic dimension of many diseases and to the deeper causes of the growing number of people affected by depression and other mental disorders,

W. whereas Member States should further promote assistance to people affected by a chronic disease and/or by a disability so as to allow them to be integrated into society to the fullest extent possible,

X. whereas, in many Member States, the increasing demand for health care services is creating an urgent need to take active steps to recruit and retain health care professionals and to provide services to support relatives and friends who provide unpaid care for dependants,

Y. whereas more attention should be paid in the EU’s health strategy to long-term care using new technologies, the care of persons suffering from chronic diseases and the provision of home-based health care for the elderly and for people with physical or mental disabilities and services for those who care for them and whereas, in this context, synergies between health services and social services should be sought,

1. Welcomes the abovementioned Commission White Paper on an EU health strategy for the period 2008-2013 and supports the values, principles, strategic goals and specific actions set out therein;

2. Calls on the Commission to review existing work in the field of health to determine which work streams are delivering value for the Community and Member States; as part of this work calls on the Commission to determine which working methods and practices add value to the work of Member States in the field of health and which should be better coordinated;

3. Believes that, given the existence of new threats to health, there is a need to address health as a key political issue in the Lisbon Strategy, which includes the need to provide citizens with access to decent health care of the highest quality available to ensure a healthy and competitive workforce;

4. Deplores the fact that the White Paper does not set specific quantifiable and measurable objectives whose attainment could produce tangible results, and recommends that such objectives be adopted;

5. Stresses that health care needs the support of effective policies in all areas and at all levels in the Member States and the EU (‘Health in All Policies’) and at a global level;

6. Stresses the fundamental importance of recognising the right of men and women to have a greater say on matters concerning their health and care and the right of children to unconditional protection of their health, on the basis of the general principles of universality, equality and solidarity;

7. Notes that, according to the WHO, chronic diseases and particularly strokes and heart disease are steadily overtaking infectious diseases;

8. Recommends, as part of efforts to prevent disease, the widespread adoption of the practice of performing health impact assessments, as the impact on human health of the decisions of decision-making bodies at various levels including local and regional authorities and national parliaments is measurable;

9. Stresses that action plans should address, in particular, the causes of certain diseases and the need to reduce and prevent epidemics and pandemics; points out that problems also exist which are linked to gender, such as prostate cancer in the case of men and cervical cancer in the case of women and that specific policies should be developed on these;

10. Recommends that the mandate of the ECDC be extended to non-communicable diseases;

11. Proposes that the Commission set as a priority goal a reduction in avoidable health inequalities and inequities between and within Member States, as well as between different social groups and sections of the population, including men and those with mental health problems; moreover, calls on the Member States to fully enforce such Community legislation as the Transparency Directive (16);

12. Stresses that actions aimed at reducing inequities in health should include targeted promotion, public education and prevention programmes;

13. Believes that disease prevention efforts and vaccination campaigns, where effective products exist, should be stepped up significantly; therefore urges the Commission to draw up an ambitious plan for preventive actions for the entire 5-year period; agrees that spending on health, particularly on prevention and early diagnosis of diseases, is not only a cost but also an investment that could be evaluated in terms of Healthy Life Years as a Lisbon Structural Indicator;

14. Underlines the fact that health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity;

15. Stresses that access to reliable, independent and comparable information about healthy behaviours, diseases and treatment options is a prerequisite for an effective disease prevention strategy;

16. Stresses that the desire to prevent diseases must not lead to a climate in society that would prevent children with a chronic disease or a disability from being born; asks the Commission to promote concrete assistance to parents of children with a chronic disease and/or a disability;

17. Stresses furthermore that, in order to promote investment in health, it is vital to measure the effectiveness of investments to date and to publish the findings;

18. Stresses the importance of carrying out well-organised, comprehensive and effective screening programmes to facilitate the early detection and immediate treatment of disease, thereby reducing the associated mortality and morbidity;

19. Believes that the rights of citizens to have access to health care and their responsibility for their own health should be fundamental given that the EU imposes high health and food safety standards throughout people’s lifetimes and calls for further investment in research on health literacy in order to identify the most appropriate strategies to address this issue across different groups of the population; encourages all sectors of society to lead healthy lifestyles;

20. Stresses that the concept of ‘healthy lifestyle’ (i.e. a healthy diet, the absence of drug abuse and sufficient physical activity) needs to be complemented by a psychosocial dimension (i.e. a balanced approach to work and family life); argues that a healthy lifestyle includes good mental and physical health and that these are also important factors in maintaining a competitive economy;

21. Expects the Commission to pay particular attention to the question of the sustainability of health systems and, in that context, also to the role and responsibility of the pharmaceutical industry;

22. Welcomes the Commission’s intention to define fundamental health values and establish a system of health indicators (at national and sub-national level) and to promote health literacy programmes and programmes to prevent health problems;

23. Stresses that the prohibition on making the human body and its parts as such a source of financial gain, as mentioned in Article 3 of the Charter of Fundamental Rights of the European Union, should be considered a guiding principle in the area of health, especially in the field of cell, tissue and organ donation and transplantation;

24. Welcomes the Commission’s intention, in the spirit of ‘health for all’, to promote health and disease prevention among all age groups; stresses the need to highlight key health-related issues, such as nutrition, obesity, malnutrition, physical activity, consumption of alcohol, drugs and tobacco and environmental risks, including air pollution, both at the workplace and at home, and in compliance with the principle of equality between men and women, providing support for healthy ageing and reducing the burden of chronic illnesses;

25. Urges the Commission to take a more holistic approach to nutrition and make malnutrition, alongside obesity, a key priority in the field of health, incorporating it wherever possible into Community-funded research, education and health promotion initiatives and EU-level partnerships;

26. Calls on the Commission and the Member States, in the framework of the EU’s health strategy, to work towards the development of guidelines for a common definition of disability, which may include people with chronic illnesses or cancer and, in the meantime, for Member States that have not yet done so, to act as quickly as possible to include such people within their national definitions of disability;

27. Furthermore, requests that priority be given to ensuring that persons with disabilities are given equal access to health care and that funding is granted to reflect this focus;

28. Demands effective measures to combat antibiotic resistance including measures to make antibiotics prescription only, guidelines to decrease the prescription of antibiotics to limit it to cases in which the use of an antibiotic is indeed necessary, efforts to improve marker tests in order to encourage a more cautious use of antibiotics, and, where appropriate, hygiene codes; calls for special attention to be paid to the methicillin-resistant Staphylococcus aureus (MRSA) bacteria; points out that the ECDC should monitor and evaluate the application of the guidelines and codes;

29. Draws the attention of the Commission and Member States to the need to support research and promote the prevention, early diagnosis and suitable treatment of chronic diseases in order to ensure sufferers’ welfare and quality of life;

30. Acknowledges the vital role of carers in health and health care provision and therefore requests that attention be given to policies which support carers and protect their health alongside the health of those who they care for;

31. Notes that in order to facilitate the mobility of health care professionals and ensure patient safety throughout the EU, the sharing of information between Member States and between their respective regulatory bodies for health care professionals is essential;

32. In the framework of the EU’s health strategy, calls for more effective exchanges of best practices within the EU in all areas of health-care provision, in particular in relation to screening programmes and the diagnosis and treatment of serious illnesses such as cancer;

33. Believes that the EU should take further steps to protect health care workers from accidents and injury in the workplace where there is scientific or medical evidence of need;

34. Urges the Commission to include substances toxic for reproduction in its forthcoming proposal for amendment of Directive 2004/37/EC;

35. Endorses the action called for in its abovementioned resolution of 15 January 2008 and urges the Commission to respect Parliament’s opinion and take the measures called for and come forward with the necessary initiatives which should include: — Setting targets for the reduction of occupational illnesses; — A proposal for a directive on musculoskeletal disorders; — A proposal for a revision of Directive 2004/37/EC; — Measures to address the growing problem of third party violence;

36. Regrets that, despite Parliament’s repeated and specific requests, the Commission has yet to propose amending Directive 2000/54/EC of the European Parliament and of the Council of 18 September 2000 on the protection of workers from risks related to exposure to biological agents at work (17) with a view to addressing the serious risks to health care workers arising from working with needles and medical sharps; calls on the Commission to expedite the completion of the impact assessment via the Tender (2007/S 139-171103) and calls for an appropriate amendment to be adopted well before the end of the current parliamentary term in line with its abovementioned resolution of 6 July 2006;

37. Considers that poor application of Community environmental legislation also has an adverse impact on the state of health of EU citizens;

38. Stresses that, in certain situations, EU citizens face health problems such as air pollution which represent a considerable threat to health, affecting the proper development of children and reducing life expectancy in the EU (18);

39. Believes that action to promote healthy lifestyles in families, schools, hospitals, care homes, workplaces and places of leisure is essential to successful disease prevention and good mental health; recognises that the family is of vital importance in establishing a ‘healthy lifestyle’ model which is often replicated in later life;

40. Draws the attention of the Commission and the Member States to Article 3 of the UN Convention on the Rights of the Child, which calls for legislative bodies to treat the interests of children as a primary consideration, one way being to make the necessary provision for maternity and parental leave, for health protection and access to health services during maternity, taking into account in particular the effect that parents’ presence and affection, as well as breastfeeding, have on an infant’s mental and physical development;

41. Stresses the need to improve health care and information for pregnant and breastfeeding women concerning the risks associated with alcohol, drug and tobacco consumption during pregnancy and breastfeeding;

42. Stresses the need to increase public awareness of reproductive and sexual health in order to prevent unwanted pregnancies and the spread of sexually transmitted diseases and reduce the social and health problems caused by infertility;

43. Supports action on specific types of disease and believes that, in order to be more effective, suitable working methods and organisation need to be found to improve interinstitutional cooperation;

44. Calls on the Commission and Member States to consider the contribution which integrated social and health policies (socially relevant health service provision) could make to a modern approach to the promotion and protection of health, particularly for the most vulnerable sections of the population such as young children and those who are not self-sufficient;

45. Believes that the EU should increasingly focus its research programme efforts on important but often neglected patient groups, such as those with mental health problems and men;

46. Invites the Commission and the Member States further to explore, in the framework of the EU health strategy, the synergies between scientific and technological research, particularly as regards new kinds of research in medical areas that are currently underfunded, on the one hand, and the development of new medical sectors and therapies on the other, in order to make it possible for everyone to have access to these therapies as they can have a very positive impact on the health status of EU citizens and in terms of increasing the efficiency of the system;

47. Welcomes the approach proposed by the Commission with a view to combating effectively the counterfeiting of medicines and encourages the Commission to promote the drafting of an international convention on this subject or the appending of an additional protocol to the UN Convention against Transnational Organised Crime (Palermo Convention);

48. Calls on the Commission and the Member States to establish centres of excellence for each important disease group, which should serve as a point of reference, information and guidance for patients and their families, doctors, health care workers, industry and others;

49. Points out that regional and local health authorities in many Member States are often responsible for the planning, management, operation and development of the health sector and often also bear the financial responsibility for the sector, have a thorough knowledge and understanding of the health sector and are essential partners in the formulation and implementation of health policy;

50. Calls on the Commission and Member States to consider the recognised positive impact of thermal cures on the convalescence and on preserving people’s health;

51. Calls on the Commission to support the development of e-health, new health care technologies and user-driven innovation in medical devices;

52. Welcomes the Commission’s proposal to set up an EU-level structured cooperation mechanism and to establish closer cooperation with stakeholders, with the participation of civil society; stresses the need to include employers’ and employees’ organisations in partnership;

53. Calls on Member States, along with regional and local authorities, to use the cooperation mechanism to improve the exchange of best practice; calls on the Commission to be proactive in producing guidelines and recommendations based on such good practice;

54. Agrees that actions under the EU health strategy must be supported by existing financial instruments until the end of the current Financial Framework (2007-2013), without additional budgetary consequences;

55. Calls upon the Commission to recommend to Member States, when they formulate national health strategies, to include priorities to be pursued in other projects not confined to the field of public health;

56. Instructs its President to forward this resolution to the Council and the Commission and to the governments and parliaments of the Member States.

(1) OJ C 172, 5.7.2008, p. 41.

(2) OJ L 301, 20.11.2007, p. 3.

(3) OJ C 146, 22.6.2006, p. 1.

(4) OJ L 213, 15.6.2004, p. 8.

(5) OJ C 146, 22.6.2006, p. 4.

(6) Decision No 1982/2006/EC of the European Parliament and of the Council of 18 December 2006 (OJ L 412, 30.12.2006, p. 1).

(7) OJ C 303 E, 13.12.2006, p. 754.

(8) Texts Adopted, P6_TA(2008)0130.

(9) Texts Adopted, P6_TA(2008)0121.

(10) Texts Adopted, P6_TA(2008)0009.

(11) OJ C 175 E, 10.7.2008, p. 561.

(12) OJ C 305 E, 14.12.2006, p. 148.

(13) OJ C 304 E, 1.12.2005, p. 264.

(14) OJ C 296 E, 6.12.2006, p. 273.

(15) OJ L 158, 30.4.2004, p. 50. Corrected version in OJ L 229, 29.6.2004, p. 23.

(16) Council Directive 89/105/EEC of 21 December 1988 relating to the transparency of measures regulating the prices of medicinal products for human use and their inclusion in the scope of national health insurance systems (OJ L 40, 11.2.1989, p. 8).

(17) OJ L 262, 17.10.2000, p. 21.

(18) ‘Europe’s environment: The fourth assessment’ — European Environment Agency (10 October 2007).