Fourth report on the integration of health protection requirements in Community policies (1999)
Date: 1999-11-16
Institutions: Directorate-General for Health and Consumers, European Commission
Subjects: EU policy, public health

* * * ** 

COMMISSION OF THE EUROPEAN  COMMUNITIES 

Brussels,  16.11.1999 
COM(1999)587  final 

Fourth report 

on the integration of health protection 
requirements 

in Community policies 

(1999) 

(presented by the Commission) 

Table of Contents 

Introduction 

The way  forward 

The need to focus 

A Community Health impact  assessment 

Conclusion 

Jb 

Introduction 

(1) 

(2) 

(3) 

(4) 

(5) 

Public  health  and  the  health  aspects  of  Community  policies  are  important  for  the 
European  Institutions  and the citizens  of  the European  Union.  This is recognised  by 
the  Treaty  and  the  Community  as  a  whole.  The  Commission  in  particular,  is 
committed  to ensure that Community policies  and activities  are directed towards  the 
attainment  of  a  high  level  of  health  protection  (Article  3  (P)  and  152  of  the 
Amsterdam Treaty). 

This  report  discusses  how  to  improve  further  the  integration  of  health  requirements 
in  Community  policies  in  the  future.  This  is  particularly  important  in  light  of  the 
increased  importance  given to health protection  requirements  in Community  policies 
which are provided in the Treaty of Amsterdam. 

On the basis of the experience with and reactions to the previous reports there is now 
a  need  for  a  critical  assessment  of  how  the  complex  issue  of  health  protection  in 
other  policies  should  be  dealt  with  in  the  future.  It  has  been  acknowledged  that 
keeping a 'health watch'  on all Community policies has not been easy and last  year's 
report  consequently  pointed  to  the  need  to  improve  the  way  in  which  health 
protection requirements are dealt with in the Community policy-making process. 

A detailed  overview  of health-related  Community  activities in  1997 is provided  in a 
separate Commission working document. 

This  fourth  report  analyses  the  present  situation  and  discusses  how  to  improve  the 
way  in  which  health  protection  requirements  are  integrated  in  Community  policy 
making. The purpose  of this report however is not to provide the definite  answers  to 
the problems  involved  in this  field,  but  to present  suggestions  on  the  way  forward. 
The  results  of  the  discussion  of  these  will  be  taken  into  account  in  developing  the 
new strategy on public health to be presented next year. 

The way forward 

(6) 

(7) 

the Amsterdam Treaty, which  strengthens the obligations on 
The entry into force  of 
the integration  of  health  in other Community  policies, means that the time is ripe  to 
reconsider the way  the Treaty obligations  have been implemented so far. 

It  is  worth  reiterating  that  Article  3(o)  in  the  Maastricht  Treaty  already  placed 
substantial  responsibility  on  the  Community  Institutions 
the 
Community  contributes  towards  ensuring  a  high  level  of  health  protection  and  that 
health  protection  requirements  form  a  constituent  part  of  the  Community's  other 
policies. It is clear that these obligations  apply to the formulation  and adoption  of  all 
policies  and  individual  measures  that  might  concern  health.  A  contribution  to 
ensuring  a  high  level  of  health  protection  must,  moreover,  be  obtained  in  the 
implementation  by  the  Commission  and  the  Member  States  of  such  Community 
policies and measures. 

to  ensure  that 

(8) 

Article  152  of  the  Amsterdam  Treaty  gives  even  greater  prominence  to  health 
protection  requirements  by underlining  that  a high  level  of  human  health  protection 

3> 

shall  be  ensured  both  in  the  definition  and  implementation  of  all  Community 
policies  and  activities. The provision  has now  become  the first  point  in this Article. 
The scope of the public  health  article has also been  broadened  to encompass  actions 
'directed at improving health  and  'obviating sources of danger to human  health'. 

(9)  Whereas  the  definition  of  Community  policies  and  activities  mainly  takes  place  at 
the  level  of  the  Community  Institutions, the  implementation  of  policies  or  activities 
involves the Community Institutions, and also the Member  States, inter alia, in  their 
transposition of Community legislation into national  legislation. 

(10)  The important  role that the Community Institutions play in ensuring  a high  level  of 
human  health  protection  has  already  been  considered  by  the  European  Court  of 
Justice. In its ruling on the UK request for interim relief  regarding the export ban  for 
cattle and related products in the context of BSE,  the Court  made  several  important 
that  health  protection 
points  on 
requirements are taken properly into consideration.1. 

the  Community's  responsibility 

to  ensure 

(11)  The  Court  confirmed  that  the  Common  Agricultural  Policy  cannot  disregard 
requirements of public interest, such as the protection  of consumers  or the health  and 
life  of humans  and  animals. Regarding public  health, the Court explicitly referred  to 
Articles 3(0)  and  129 (1) third  subparagraph  which  refers  to the high  level  of health 
protection in Art.  129 (1) first  sub-paragraph of the EC-Treaty. 

(12)  This  ruling  has  important  consequences  for  all  areas  of  Community  policy.  It 
clarified  the  obligations  of  the  Community  Institutions  regarding  the  integration  of 
health protection  requirements in Community policies laid down  in Article  129. This 
interpretation  must  also  be  applied,  mutatis  mutandis,  in  the  context  of  the 
Amsterdam Treaty. 

(13)  The  ruling  underlines  the  role  of  the  Court  of  Justice  in judging  on  the  manner  in 
which  these  requirements  are integrated  into policy. It  is  therefore  in  the  interest  of 
the  Commission,  of  the  other Community  Institutions  and  of  the Member  States, to 
demonstrate  clearly  how  health  requirements  are  integrated  into  Community  policy 
or  activities  and  how  they  are  subsequently  implemented  to  ensure  that  the 
obligations are met. To this end it would be valuable to obtain information  about  the 
impact of a given policy on health and its health consequences. 

(14)  The  previous  report  on  health  requirements  in  other  policies  stated  that  the 
to  these 

Commission  will  give  consideration 
commitments, and will return to these issues in the fourth  report.2 

to  instruments  to  give  effect 

(15)  Both  Council  and Parliament have repeatedly underlined the importance of this issue 
and recently, in its conclusions on the future  framework  for Community action in the 
the  Council  expressly  welcomed  the  Commission 
field 

of  public  health 

1  Cf. Case C-180/96 R, United Kingdom v Commission of the European Communities, ECR  1996,1-3903 

2  COM (98) 34 final of 27.1.1998/ 

u 

Communication  and made an explicit point of the need to strengthen  the  integration 
of health requirements in other policies.3, 4 

(16)  Moreover,  in  the  context  of  enlargement,  the  future  strategy  for  the  integration  of 
health  protection  requirements  in  Community  policies  should  also  bear  mind  the 
specific  needs of the candidate countries. 

The need  to focus 

(17)  Developing  a  strategy  for  the  effective  integration  of  health  requirements  in  policy 
and measures of wide scale and application  such as those developed and promulgated 
by the Community is not a simple and straightforward  matter. Moreover, there are no 
established  or  widely  used  tools  that  are  applicable  across  the  spectrum  of  policies 
and  measures.  At  the  Community  level,  for  instance,  it  has  not  proved  easy  to 
develop  and  apply  an  adequate  methodology.  Nor  has  it  been  possible  to  find 
promising  models  in  use  at  Member  State  level  that  could  be  adapted  for  use  in 
respect  of  Community  policies.  Worse  still,  there  is  insufficient  awareness  and 
recognition  of  the  importance  of  health  considerations  in  policy-making  so  as  to 
commit  the necessary  resources  in  terms  of  funds  and  expertise  at  organisationally 
strategic posts and levels in policy-making and implementation  structures. 

(18) 

In  addition,  the  nature  of  the  issues  involved  tend  to  vary  a  great  deal,  requiring 
different  methods to ensure their successful  incorporation  in policy-making. Whereas 
some  health  issues  are  of  a  more  technical  nature,  and  can  be  amenable  to 
quantitative  analysis  , other  health  issues  are  of  a rather  political  nature  requiring 
the careful  balancing  of various viewpoints and interests. 

(19)  Both  the  Parliament  and  Council,  in  their  comments  on  previous  reports,  have 
mentioned  the need  for  a clearer focus  and the need  to  single  out  specific  issues of 
particular importance to public health. In its report on the second Commission  report 
on  health  protection  requirements5,  the European  Parliament  also  suggested  that  a 
more  focused  approach  would  be  fruitful.6 
In  this  report,  Parliament  argued  that 
providing a complete annual overview of health related activities at Community level 
and  an  analysis  of  these  activities  was too  ambitious  and  that  a more  limited  and 
clearly defined  approach was called  for. 

(20) 

In its resolution  of 20 December  19957 the Council called upon the Commission to; 

achieve  early  and  transparent  evaluation  of 
giving  consideration  inter  alia 

the  impact  of  Community  policies 
to  initiatives  taken  in  the following  policy  fields: 

3 

4 

PE 223.766:fin 

European Union, The Council, Luxembourg, 30 April  1998 

5  COM (9.6) 0407-C4-0663/96 

6 

PE  223.766:fin 

7  Com(96)0407  C4-0663/96 

in  particular 

including  questions  of 
economic  policy, 
unemployment,  free  movement  of goods  and persons,  agricultural  and food  policy; 
consumer  protection,  research  and  technological  development;  environment  and 
transport. 

taxation,  social  policy 

(21)  Subsequently  the  Council  in  its  resolution  of  12  November  96  called  upon  the 
Commission  to  develop  a strategy  for  evaluating  the  impact  of  Community  policies 
on health. 

Developing afocussed  Community health impact assessment 

(22)  The Commission  agrees that, given the wide scope of  activities related to ensuring a 
high  level  of  health  protection  in  the  definition  and  implementation  of  Community 
policies,  there is a need to establish  priorities. A more  selective focus  where  certain 
issues are singled out would  make the development  of an effective  strategy to ensure 
the  integration  of  health  requirements  more  feasible.  The  Commission  would 
therefore  give  consideration  to  the  drawing  up  of  in-depth  reports  in  place  of  the 
present  system  with  general  reports  giving  only  brief  overviews  of  health-related 
activities. 

(23)  The  Commission  considers  that  the  best  way  forward  is  to  identify  topics  which 
would  be  the  focus  of  an  in-depth  assessment.  In  the  light  of  recent  events,  taking 
into account the BSE  and dioxin  crises, consumer protection  could  be the focus  of 
the next report.. 

(24)  Future  reports  should  contain 

information  on  a  given 

topic,  not  only  on 
developments  at the Community  level, but  also  at  the  Member  State  level.  Such  an 
approach  will  necessitate  a  strong  degree  of  co-ordination  between  the  Community 
and the Member States. This would involve a detailed assessment of how  policy and 
implementation  services integrate a high level of  health protection  in their activities, 
both at Member State and Community level.. 

(25)  An impact assessment of Community policies would require the careful  development 
of  a methodological  framework.  It will  be necessary  to develop  criteria  and  specific 
methodologies,  such  as  appraisal  guidelines  and  checklists,  against  which  both 
specific  policy  proposals  as  well  as  developments  in  a  health-related  policy  during 
implementation  could be measured. 

Conclusion 

(26)  This  report  has  pointed  to the  need  for  a strengthening  of  efforts  to integrate  health 
protection  requirements  in  Community  policies.  Such  a  strengthening  is  needed 
considering  the experience  so far  and the increased  weight  given  to this  issue  in  the 
Amsterdam Treaty 

(27)  The  report  then  argues  that  future  efforts  for  the integration  of  health  requirements 
must  take  into  consideration  the  complexity  of  the  issue  and  the  vast  number  of 
Community policies that have a bearing on health. The need for a step-wise approach 
involving  the  selection  of  one  policy-area  at  a  time  in  order  to  make  progress  is 
obvious,  something  which  has  been  recognised  by  both  Parliament  and  Council.  In 
order  to  accomplish  better  results,  it  has  also  been  argued  in  this  report  that  the 

G 

Member  States themselves  have  an important  role to play given  the fact  that they in 
large  part  are responsible  for  the  design  and  implementation  of  Community  policy, 
be it legislation or other instruments. 

(28)  The Commission  will therefore  give consideration  to the health  related policy  issues 
in  the  Council  resolution  of  1995  in  establishing  activities  for  future  reports. 
Consumer protection could be the object of the next report. 

(29) 

In  the  future,  the  report  on  health  requirements  should  form  part  of  this  work,  and 
replace  the  present  system  with  annual  descriptive  overviews  of  all  health-related 
Community activities. 

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ISSN  0254-1475 

COM(1999) 587  final 

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