EN Official Journal of the European Union CE 88/461

(2004/C 88 E/0473)

WRITTEN QUESTION E-3347/03

by Esko Seppänen (GUE/NGL) to the Commission

(13 November 2003)

Subject: Enlargement and social security advantages

Once EU enlargement is completed and EU citizens are free to move within new areas, new kinds of problems will arise. One such problem is the different standard of public health in the old and new Member States. In Estonia, for example, there are diseases highly resistant to antibiotics that will spread more easily from one country to another when Estonia belongs to the Union. Estonia has as many carriers of the HIV virus as Finland, even though, in population terms, it is less than a third of Finland's size. Given that the care of persons with HIV is expensive in any case but standards in the present EU countries are higher than in the new Member States, the movement of sick people to other EU countries in search of better care may pose a problem. Does the Commission think that it will be possible to prevent carriers of dangerous diseases seeking a better standard of care from moving freely from country to country? What progress has been made with the plans to set up a communicable diseases agency and is there any proposal regarding its seat?

Answer given by Mr Byrne on behalf of the Commission

(18 December 2003)

The Honourable Member has raised a number of topics. The first relates to the spreading of communicable diseases from one country to another. In order to provide a mechanism to observe and respond to patterns in disease development, the Community has put in place a Community network for the epidemiological surveillance and control of communicable diseases under Parliament and Council Decision No 2119/98/EC of 24 September 1998 (1). This mechanism allows for continuous surveillance for diseases constituting a major public health threat and for an alert and response system that enables the competent national authorities to rapidly exchange relevant information. Accession countries have made considerable progress in taking action to meet the provisions laid down by this Decision.

As regards questions relating to the mobility of patients between Member States, these issues are being considered as part of the high-level reflection process on patient mobility and healthcare developments in the Union.

The final meeting on this reflection process took place on 8 December 2003. The Commission plans to respond to the recommendations of the process through a Communication in early 2004. As regards more specifically the issue of assumption of medical costs incurred in another Member State, it should be pointed out that the Court, in a series of judgements (2), has recognised rights for patients to benefit from medical treatment in another Member State and be reimbursed. Furthermore, the Court has clarified conditions subject to which rights may be exercised in order, in particular, to guarantee the financial balance of Member States' social security systems and to ensure a high level of public health.

Finally, as regards the progress made in setting up the European Communicable Diseases Agency, the Commission adopted in July 2003 the proposal for a Regulation establishing a European Centre for Disease Prevention and Control (ECDC) (3). The proposal aims at creating a European Centre able to provide a structured and systematic approach to the control of communicable diseases and other serious health threats which affect Union citizens. The creation of the ECDC as an independent European agency would mobilise and significantly reinforce the synergies between the existing national centres for disease control. It is expected to start operation in 2005. The Commission did not propose a site for the Centre, as this issue will be addressed by the Institutions once the substance of the proposal has been agreed.

(1) OJ L 268, 3.10.1998.

(2) Kohll, case C-155/96, 28.04.98, ECR 1998 1-1931; Decker, case C-120/95, 28.04.98, ECR 1998 1-1831; Smits and Peerbooms, case C-157/99, 12.07.01, ECR 2001 1-05473; Vanbraekel, case C-368/98, 12.07.01, ECR 2001 I-05363; V.G. Müller-Fauré v Onderlinge Waarborgmaatschappij O.Z Zorkverzekeringen UA and E.E.M. Van Riet v Onderlinge Waarborgmaatschappij ZAO Zorkverzekeringen, case C-385/99, 13.05.03 (not yet published); Patricia Inizan v Caisse Primaire d'Assurance Maladie des Hauts de Seine, case C-56/01, 23.10.03 (not yet published).

(3) COM(2003)441 final.