Interim Report from the Commission to the Council, the European Parliament, the Economic and Social Committee and the Committee of the Regions on the implementation of the programme of Community action on health monitoring within the framework for action in the field of Public Health (1997-2001) (Decision No 1400/97/CE of the European Parliament and of the Council)
Date: 2002-10-21
Institutions: European Commission
Subjects: action programme, data processing, health care system, health policy, health statistics, public health, report

COMMISSION OF THE EUROPEAN COMMUNITIES

Brussels, 21.10.2002
COM(2002) 547 final

INTERIM REPORT FROM THE COMMISSION
TO THE COUNCIL, THE EUROPEAN PARLIAMENT,
THE ECONOMIC AND SOCIAL COMMITTEE
AND THE COMMITTEE OF THE REGIONS

on the implementation of the programme of Community action on health monitoring
within the framework for action in the field of Public Health (1997-2001)
(Decision No 1400/97/CE of the European Parliament and of the Council)

Table of Contents

1.

2.

3.

4.

5.

6.

7.

8.

8.1.

8.2.

9.

Summary.................................................................................................................. 3

Introduction.............................................................................................................. 4

Content of the programme ........................................................................................ 4

Consistency and complementarity............................................................................. 5

Effectiveness and achievement of objectives............................................................. 5

Monitoring ............................................................................................................... 6

Adjustments ............................................................................................................. 6

Excerpt from the expert’s report on the health monitoring programme...................... 6

Regarding health monitoring: ................................................................................... 7

Regarding the administration and management process: ........................................... 7

Financed projects and budget.................................................................................... 8

2

1.

SUMMARY

The programme of Community action on health monitoring was adopted by the European
Parliament and the Council on 30 June 1997 and came into force the same year. The general
aim of the programme is the contribution towards the establishment of a Community health
monitoring system. This aim is specified in a number of objectives and activities set out in
three pillars: Establishment of Community health indicators, development of a Community-
wide network for sharing health data, and analysis and reporting.

The EU health monitoring system will produce comparable information on health and health-
related behaviour of the population, on diseases and health systems. This will be based on
European-wide common agreed indicators with regard their definition, their collection and
use.

This mid-term evaluation report covers the implementation period 1997 to 1999. It is based
on an external evaluation.

the framework
The programme is consistent with other Community initiatives, e.g.
information, projects in the field of telematic interchange of
programme for statistical
information between administrations (IDA) and the other public health programmes that have
a component of health monitoring. The synergy with the framework programme for research,
technological development and demonstration has to be improved.

The external evaluation states that the objectives as described in the Decision 1400/97/EC are
already covered to the level of 60% by the actions supported so far through the Programme.
15 of 19 projects supported during the reference period cover different aspects involved in
establishing Community health indicators. The opinion of Member States was taken into
account in the Programme Committee. Annual work plans and a list of the annually selected
projects were transmitted to the European Parliament. Monitoring of the specific actions has
been performed by the Commission Services. Some adjustments have been carried out during
the implementation period to ensure the effectiveness of the programme. A discussion is
needed about the definition, features and limits of a Community-wide health monitoring
system.

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2.

INTRODUCTION

Following the adoption of the programme of Community action on health monitoring by the
European Parliament and the Council, the Commission presents hereunder an interim report
concerning the implementation period 1997 to 1999. Projects were accepted in 1998 and
1999, most of them having a duration of 2 years. The external evaluation report was received
only in November 2001, on the basis of which this report is drawn up. Due to the extension of
the programme, the final evaluation will not be submitted before June 2004.

In this report the Commission highlights the degree of consistency and complementarity
reached between the present programme and other relevant Community policies, programmes
and initiatives. To increase the value and impact of the programme the Commission has
performed an evaluation of the actions taken in accordance with the Decision’s article 7,
paragraph 2. Particular regard has been given to the effectiveness and the objectives of the
measures undertaken. For this purpose the Commission has drawn on the opinions of a group
of independent experts. The Commission also reports on the adjustments that are deemed
necessary as a consequence of the information gathered.

3.

CONTENT OF THE PROGRAMME

Decision No. 1400/97/EC, based on the former Article 129 of the Treaty (currently
Article 152 of the Treaty) covers a wide range of general and specific objectives. The general
aim of the programme is the contribution towards the establishment of a Community health
monitoring system.

The general aim is specified in a number of objectives and activities in three pillars:

A: Establishment of Community health indicators

B: Development of a Community- wide network for sharing health data

C: Analysis and reporting

Most of the actions supported were connected to pillar A. Out of 19 projects implemented in
the period for the evaluation (1997 – 1999), 15 were about different aspects of indicators
leading to recommendations either for the indicators for fields like mental health, health
expectancies, nutrition or for improvements in the data collection in relation to these
indicators. A first set of European Community Health Indicators was produced and widely
disseminated. 4 projects were connected to analysis and reporting such as the European health
status report or health technology assessment report. The objective by the end of the
programme is to continue the work on specific indicators in order to complete the European
Community Health Indicators list that will serve as a basis for the European health monitoring
system. Moreover, the programme will support the elaboration of regular European health
status reports such as mental health or nutritional health. Pillar B was covered by the IDA-
HIEMS system1.

1

Interchange of Data between Administrations (IDA) and Health Indicator Exchange and Monitoring
System (HIEMS)

4

4.

CONSISTENCY AND COMPLEMENTARITY

The Commission sought consistency and complementarity between its public health and other
Community policies, programmes and initiatives by a multitude of efforts on different
operational levels, in particular:

• The implementation of

technological
development and demonstration (1994-1998) which was closely followed by means of the
inter-service consultations on publications of calls for proposals and on adoption of
financing decisions ;

framework programme for

research,

the 4th

The 4th framework programme contained in particular chapters on Public Health and on major
illnesses. However, the co-ordination with this programme remained insufficient resulting in
the absence of synergy between the two programmes.

• The Community’s framework programme for statistical information ;

EUROSTAT was involved in all phases of the implementation e.g. selection and follow-up of
projects, elaboration of the annual work programme, participation in all meetings. Close links
were maintained through the Community Statistical Programme with the work of the national
statistical offices and a high level of synergy was achieved.

• The Community’s projects in the field of

telematic interchange of data between

administrations (IDA) ;

The good co-ordination with the IDA programme led to the developmental work achieved
under pillar B of the programme being entirely financed by the IDA programme

• The other Public Health programmes that have a health monitoring component;

In order to avoid duplication with the other Public health programmes, the Health monitoring
programme did not touch upon the issues covered by those in a more specific manner, such as
in the Cancer, Drugs or Pollution Related Diseases Programmes, for example.

5.

EFFECTIVENESS AND ACHIEVEMENT OF OBJECTIVES

The external evaluation states that the objectives as described in the Decision 1400/97/EC are
already covered to the level of 60% by the actions supported so far through the Programme.
The annual work programmes for 1998 and 1999 have allowed projects to be developed
where more action was needed to meet the objectives. The transparency towards the European
Parliament was ensured by the prior transmission to that Institution of reports and documents
intended for the programme committee as well of the annual work programme and of an
annual list of projects financed.

To ensure the highest possible standards for the quality of the actions selected, the programme
committee gave a favourable opinion on the annual work plans and was consulted on the
preparation of calls for proposals,
the selection of projects and the follow-up of their
implementation. The Commission made the final decision regarding the selection of projects
to be financed taking these opinions into account.

5

6.

MONITORING

Monitoring of the specific actions has been performed mainly through a continuous follow-up
by the Commission Services of the contractual obligations of the projects financed. Apart
from the exchange of e-mails and missions on the spot, co-ordinators meetings were
organised twice a year with all project leaders to ensure a proper co-ordination between
projects and to avoid as much as possible any overlaps. Member States representatives as well
as other Commission Services were invited to participate.

7.

ADJUSTMENTS

To improve the Community added value and increase the number of countries involved, the
Commission urged applicants to enhance networking with the other projects. To cover areas
of Community interest which were not covered by specific actions selected to date, the
Commission adapted the annual work plans based upon an analysis of the active portfolio of
is
the programme. To further ensure the fulfilment of the objectives of the Decision, it
necessary to adjust the implementation of the health-monitoring programme taking into
account the recommendations resulting from the external evaluation report. This is taken into
consideration in drafting the work programmes for the period following that covered by this
report. In addition, several of the points identified by the external evaluation report will be
addressed in implementing the future framework programme for public health. In particular,
this new programme will strive to build on the outputs of the Health Monitoring Programme
by using networks already developed, and taking forward the outcomes of projects supported
on developing health indicators.

8.

EXCERPT FROM THE EXPERT’S REPORT ON THE HEALTH MONITORING

2
PROGRAMME

Finally, excerpts from the findings of an independent expert group which, under contract to
the Commission, analysed the health monitoring programme, are presented below:

• The annual Work programmes for 1998 and 1999 effectively covers nearly all

the

objectives as given in the Decision ;

• Existing networks of experts have been substantially developed throughout the course of
the Programme bringing together all Member States and other non-member countries ;

• Those organisations and networks that depend on third party funding have developed

professionalism in submitting proposals to the Commission ;

• A lot of expertise and professionals are available among the different European Member
States and can be approached for support regarding specific problems and tasks within
public health and health monitoring ;

• The establishing of a Community-wide health monitoring system is still

incomplete
although the numbers of indicators are very high. There is a need to limit the number of
indicators for practical use in policy making ;

2

« Mid-term evaluation of public health monitoring programme », tender No.SANCO/2000/C0/002

6

• Dissemination of the results follows ordinary patterns through the scientific society in the

Community. More information should be made public on the Internet ;

• Priority has been given to the collection of data whereas the development of methods for

analysing and make the data comparable remains limited ;

• Some of the beneficiaries involved need management expertise to cope with the different

administrative and budgetary regulations set by the Commission ;

• More staff also needed in the Commission for co-ordinating the huge amounts of projects

in the programme.

To improve the execution of the programme the external experts recommend the following
actions to be considered:

8.1.

Regarding health monitoring:

• The Commission shall agree about the definition, features and limits of a Community-wide

health monitoring system and deliver its opinion to the policy makers ;

• Define the information needs of policy makers on both a national and a Community level ;

• Limit and specify the objectives and indicators desired to establish a health monitoring

system ;

• For the time remaining for the Programme, two things should be done regarding the
objective of comparability: A small, precise set of indicators for policy making needs to be
decided politically, and then the information collected should include data about the data
source, the comparability with other related information and the instruments used for
generating the data ;

8.2.

Regarding the administration and management process:

• Enhance Commission management capacity by increasing responsibilities, decision

making and setting of goals ;

• A discussion is needed to decide whether the expertise needed for establishing a health
monitoring system by the Commission shall be organised by means of calls for proposals,
calls for tenders or no public call at all ;

• In order to implement a Programme of this size in terms of network and issues involved,

more staff is needed for the content and counselling of the projects.

The Commission considers that many of these points are justified. It has therefore taken
action as specified under "Adjustments" to make improvements in the areas concerned.
However, it is clear that resource limitations still exist and that these can influence greatly the
implementation of this programme.

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9.

FINANCED PROJECTS AND BUDGET

The annual lists of financed projects are available on the Internet site of the Commission since
the beginning of the programme. These lists include in particular details in relation to
objectives, budget allocated, information on the project
leader and number of countries
involved. Following the comitology rules, this information is transmitted as well to the
Programme committee and the Parliament.

All final reports of financed projects are uploaded on the programme's specific CIRCA site
(Communication and Information Resource Centre Administrator) accessible with password
provided on request. The Commission is working on the improvement of the diffusion of the
in particular intents to upload these final reports on the Commission's
projects' results,
Internet site.

An overview of the budget allocation for the years 1997, 1998 and 1999 for the Programme is
presented as follows:

Budget allocation for Health Monitoring programme:

1997

1998

1999

Number of
projects

Budget

MECU

Number of
projects

Budget

MECU

Number of
projects

0

0

10

2.335

9

Budget

MECU

2.191

8