WRITTEN QUESTION E-3245/03 by Erik Meijer (GUE/NGL) to the Commission. Increased costs of hospital treatment and waste-disposal arising from restrictions on cost-saving re-use of surgical instruments.
Date: 2003-11-03
Institutions: European Parliament, Provisional data
Subjects: health costs, health policy, medical device, public health, waste management, waste recycling

C 70 E/244

Official Journal of the European Union

EN

20.3.2004

Answer given by M. Bolkestein on behalf of the Commission

(9 December 2003)

The Italian citizen referred to by the Honourable Member has addressed two letters to the Commission.
The information so far provided to the Commission does not show any clear breach of Community law in
her case. The following analysis was communicated to her in August 2003. Procedures for academic
recognition are governed by national law, since according to Article 149 of the EC Treaty Member States
are responsible for the content of teaching and the organisation of their education systems. Only the
prohibition of any discrimination on grounds of nationality applies. There is no evidence that such
discrimination has occurred in the case of the citizen concerned. On the other hand, the different
treatment of the person concerned compared with Spanish graduates in Filologia Romanica does not
appear discriminatory, since her degree has not been recognised as equivalent to this degree but to the
degree in Filologia Hispanica. As far as the knowledge of the Basque language is concerned, if Basque is an
official language, the Spanish authorities are entitled to require a knowledge of this language, sufficient for
the exercise of the teaching profession, in accordance with the principles established by the Court of
justice of the European Communities in cases ‘Groener’ (C-379/87) and ‘Angonese’ (C-281/98).

As regards recognition of professional experience, the position of the Commission is that migrant workers’
previous periods of comparable employment acquired in another Member State must be taken into
account by Member States’ administrations for the purposes of access to the public sector in the same way
as applies to experience acquired in their own system. The Commission has asked the complainant to
specify whether her professional experience is not recognised in general
terms or only due to the
translation problems.

Finally, concerning the taking into account of her Italian degree as a second degree, more information on
the conditions of admission to the list of temporary teachers is needed in order to evaluate the situation of
the complainant. She has been asked to provide such information.

(2004/C 70 E/264)

WRITTEN QUESTION E-3245/03

by Erik Meijer (GUE/NGL) to the Commission

(3 November 2003)

Subject: Increased costs of hospital treatment and waste-disposal arising from restrictions on cost-saving

re-use of surgical instruments

1.
Can the Commission confirm that the way in which the distinction has been made in the EU since
1993 between ‘single-use’ and ‘multiple-use’ surgical instruments that are placed temporarily in the human
body during surgery prevents certain expensive instruments from being re-used after an operation, so that,
for example, a catheter pump costing between EUR 8 000 and EUR 13 000 that has been placed in the
heart has to be thrown away after use?

2.
Is the Commission aware that such ‘single-use’ instruments are recovered, cleaned and repaired in
Europe not only for the benefit of the Third World, but also for use in Europe itself, in particular in
Belgium and Germany? Is it further aware that, in Germany, the Vanguard company has recycled one and
a half million instruments from 400 hospitals, resulting in savings in hospital costs of EUR 1-2 billion per
year?

Has the Commission considered the position of the ‘European Association for Medical Device
3.
Reprocessing’ (EAMDR) to the effect that hospitals would save millions of euro every year if more surgical
material was recycled, and that, over the last two years, the association tested some 20 000 single-use
instruments for suitability for re-use?

How does the Commission assess the EAMDR position to the effect

4.
that existing provisions
governing single use now appear in practice to protect the interests of the industry (united under its
Eucomed association) rather than those of patients, and that continuing with this practice results
principally in an adverse impact on the environment and/or waste of money spent on disposing of the
waste created by compulsory discarding?

20.3.2004

EN

Official Journal of the European Union

C 70 E/245

Is the Commission prepared to take the initiative of extending multiple use to the extent that can
5.
now be shown to be responsible practice, thereby helping to reduce the soaring costs of healthcare,
without reducing the quality of service to the patient or over-stretching health-care workers?

Source: ‘De Morgen’ (Belgium), for 17 October 2003.

Answer given by Mr Liikanen on behalf of the Commission

(1 December 2003)

The Commission would like to refer the Honourable Member to the background information contained in
the answer given to written question E-3177/03 of Mrs Corbey (1).

1.
No The Commission would consider that the question whether or not particular devices could be
re-used depends entirely on the question whether health is sufficiently protected. The issue of re-use of
single use devices is not specific to the introduction of the medical devices directive, and is subject of
debate in other countries as well, such as the United States, Australia and Canada.

2.
The Commission is aware that re-use of single use medical devices takes place. Some Member States
have either regulation or guidance on the re-use of single use medical devices. It has no knowledge of
detailed market data.

3. and 4.
The Commission has no knowledge of positions taken by the European Association for
Medical Device Reprocessing (EAMDR). The Commission has been requested, and it has accepted, to meet
EAMDR.

5.
The introduction on the market of particular device categories is determined by various factors, such
as technology, health protection considerations and national reimbursement schemes, consideration of
which belongs mainly to manufacturers, health care institutions and Member States. Consequently, the
Commission sees no reason at this stage to develop an initiative to promote the marketing of reusable
devices.

(1) See page 232.

(2004/C 70 E/265)

WRITTEN QUESTION E-3256/03

by Olivier Dupuis (NI) to the Commission

(3 November 2003)

Subject: New attack by Hanoi on freedom of religion

trial,

The Vietnamese authorities have effectively placed 11 dissident monks belonging to the outlawed United
Buddhist Church of Vietnam (UBCV) under house arrest for two years. Among them is the Patriarch Thich
Huyen Quang, whose arbitrary detention has now lasted over 20 years, and his deputy Thich Quang Do,
who had supposedly been released last June. The spokesman for the Vietnamese Ministry of Foreign Affairs
referred to ‘breaches of the laws on national security’. In flagrant violation of international conventions,
Vietnamese law allows local authorities to place people under ‘administrative detention’ for six months to
two years, without
for breach of national security (decree 31/CP of 1997 on ‘administrative
detention’). The repression of the UBCV followed the election of 41 monks (including the 11 arrested) to
key positions in the UBCV at its assembly on 1 October 2003 at the Nguyen Thieu Pagoda (province of
Binh Dinh), and the departure of the Patriarch Thich Huyen Quang and Thich Quang Do for Ho Chi Minh
City. The Vietnamese security services held up their convoy for over 10 hours, after which they forced the
Venerable Thich Huyen Quang, 86, to return to the Nguyen Thieu Pagoda, and the Venerable Thich
Quang Do, 75, to the Zen Thanh Minh monastery in Ho Chi Minh City. According to the Paris-based
International Buddhist Information Bureau (IBIB), this strong-arm police action came a few days after the
conclusion of the first extraordinary assembly of the UBCV since it was outlawed by the Communist
authorities in 1981.