WRITTEN QUESTION E-0889/02

by Antonio Mussa (UEN) to the Commission

(3 April 2002)

Subject: Future of public health in the Member States following enlargement of the European Union

The protection of human health is the primary objective of all development policies in the countries of the European Union. The Treaty of Amsterdam says that a high level of human health protection shall be ensured in the definition and implementation of all Community policies and activities.

The protection of the health of citizens is primarily ensured by guaranteeing an efficient common health system with high quality standards, as proposed in the Community action programme in the field of public health 2001-2006.

In order to achieve these objectives it is necessary to develop specific policies designed to ensure the gradual improvement of professional standards and a high level of scientific research and health care facilities in EU Member States. As current health structures and health policies in the applicant countries are clearly lagging behind those in the European Union, can the Commission answer the following questions:

- are there studies or simulations of the consequences of enlargement of the Union on public health in the Member States?

- does the Commission carry out regular monitoring of the effective transposition of the Community acquis in the health sphere in the countries of Central and Eastern Europe?

- are there measures designed to prevent the accession of the applicant countries entailing a fall in quality standards in health services in the existing Member States of the Union and, if so, what are the deadlines for their implementation?

Answer given by Mr Byrne on behalf of the Commission

(29 April 2002)

As stated by the Honourable Member, the Treaty of Amsterdam provides for ensuring a high level of human health protection in the definition and implementation of all Community policies and activities.

The Commission is taking steps to do so when designing and implementing Community policies. The health strategy set out in the communication(1) of May 2000 and the proposed action programme in the field of public health underpin these actions. However, the Treaty also stipulates that Community action in the field of public health shall fully respect the responsibilities of the Member States for the organisation and delivery of health services and medical care. There is therefore no question of this programme setting up a common health system in Europe.

With regard to candidate country health structures and health policies, the Commission is making every effort, within the limits set by the Treaty, to assist their preparations for accession. Technical assistance actions funded by PHARE are also provided.

As regards studies on the impact of enlargement on public health in the Member States, the Commission is co-operating with other bodies active in this field, including the World Health Organisation and the European Observatory on Health Care Systems. The Commission has for example co-financed the preparation and publication of a series of Highlights on Health for the ten Central and Eastern European candidate countries.

The public health acquis is currently limited to the areas of tobacco control and communicable disease surveillance and control. The Commission regularly monitors the effective transposition and implementation of the acquis in its annual progress reports and regular monitoring reports. This year the Commission is also carrying out an enhanced monitoring exercise which includes peer reviews to be carried out in candidate countries together with Member State experts and by detailed questionnaires on the state of play in each country. Moreover, the Commission is consulting the candidate countries with regard to future public health acquis in the field of the quality and safety of blood and that of tissues and cells.

As mentioned earlier, under the Treaty health services delivery is a matter for the Member States. However, the Community has made efforts to involve candidate countries in exchanging information and know-how about issues relating to health services. Some Community financial assistance is also being given in this context through the pre-accession funds in relation to health services. With regard to the specific issue of quality standards, there is an evolving discussion in the Community on the impact of Community law on the functioning of health systems, notably in relation to the cross-border flow of patients between Member States. Attention is being directed at, among other things, the important question of quality of health care, and whether further action needs to be developed in this area.

(1) COM(2000) 285 final.