WRITTEN QUESTION E-0908/04 by Paolo Bartolozzi (PPE-DE) to the Commission. Services of general interest.
Date: 2004-03-24
Institutions: European Parliament, Provisional data
Subjects: freedom to provide services, health care system, health service, open method of coordination, public service, right to health, single market, universal service

C 88 E/244

Official Journal of the European Union

EN

8.4.2004

(2004/C 88 E/0247)

WRITTEN QUESTION E-0908/04

by Paolo Bartolozzi (PPE-DE) to the Commission

(24 March 2004)

Subject: Services of general interest

A motion for a resolution was tabled in the European Parliament on 14 January 2004 on the
Commission’s Green Paper on services of general interest (1).

In this document the Commission includes health among non-economic services of general interest, and
defines the difference between economic and non-economic services as fundamental, since the two
categories are not subject to the same Treaty provisions.

It is clear that ‘the future of non-economic services of general interest’, including health or social services,
‘raises issues on a European scale, such as the content of the European model of society’.

It should be borne in mind that:

(cid:1) the health sector is characterised by ethical and social values, because its aim is to safeguard health as
an inalienable subjective right, but this does not mean that the services designed to provide these
safeguards are of a non-economic nature as far as their organisation and management are concerned;

(cid:1) ‘economic and non-economic services can co-exist within the same sector’ not least because ‘the

distinction between economic and non-economic activities has been dynamic and evolving’;

(cid:1) the common objective of the reforms carried out in many Member States has been to safeguard the
principles of welfare as a ‘choice on the part of society’, involving the introduction of mechanisms
creating competition between a number of public and private service providers among which the
public is completely free to choose.

For these reasons the inclusion of health among non-economic services of general interest, which are ‘not
subject to specific Community rules, nor are they covered by the internal market (…) rules of the Treaty’,
seems reductive.

Can the Commission say:

(cid:1) why health is not included among economic services of general interest, since such services are subject
to common obligations which must be ensured for the public, such as universality, continuity, quality,
accessibility and security;

(cid:1) if health is thus excluded from the process of implementing the internal market, will this not mean
abandoning the objective, set by many Member States, of achieving the advantages of market
efficiency without neglecting social justice, guaranteed by State guidance, control and responsibility?

(cid:1) On what basis is health excluded from the general approach outlined in the Commission’s
Communication ‘An internal market strategy for services’? Would not the recognition of health as an
economic service of general interest (cid:1) hence subject to the favourable influence of competition on the
basis of quality (cid:1) promote the successful pursuit of the Community objective of a ‘high level of health
protection’?

(1) COM(2003) 270.

Answer given by Mr Byrne on behalf of the Commission

(30 April 2004)

Health systems meeting public objectives are in principle services of general interest, whether economic or
not. However, it is up to Member States to define the public service obligations concerned, as part of their
overall responsibility for the organisation of health services and medical care. The differences in
organisation of the national health sectors result in different legal positions with regard to Community
law and provisions concerning services of general interest. In this respect it may be relevant to distinguish

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between the provision of health services and the systems put in place for their financing. Health services
provided for remuneration are an economic activity within the meaning of the EC Treaty, regardless of
how they are financed (see C-158/96 Kohll and C-157/99 Smits-Peerbooms). On the other hand,
solidarity-based, non-profit-making social security funds are not undertakings within the meaning of the
competition rules of the EC Treaty (see C-159/91 and C-160/91 Poucet-Pistre and, more recently on
16 March 2004, C-264/01, C-306/01, C-354/01 and C-355/01 AOK Bundesverband). However, exactly
how different national health systems fit into these categories will depend on their precise organisation and
status.

Nevertheless, all health systems throughout the Union share common values of accessibility, quality and
financial sustainability, despite their diversity. Moreover,
the potential advantages of mobility and
cooperation across Europe are open to patients, providers and those responsible for health systems. The
provisions on the coordination of social security systems (currently being simplified) and the forthcoming
European health insurance card provide an effective means for patients to access healthcare throughout the
Union and be reimbursed. The Commission has also proposed a directive on services in the internal
market (1) which will help to facilitate cross-border provision of services, and which includes specific
clarification with regard to the reimbursement of healthcare costs.

Health ministers, together with other health stakeholders, have come together in a high level process of
reflection on patient mobility and healthcare developments in the European Union. The report established
by this reflection group contains nineteen recommendations regarding European cooperation to promote
better use of resources; information for patients, professionals and providers; access to and quality of care;
an appropriate response to enlargement through investment in health; and the reconciliation of national
objectives with European obligations. The Commission has responded to these recommendations by
proposing the extension of the open method of coordination to healthcare and long-term care. Taken
together, all these different initiatives form an integrated strategy to enable patients to exercise their rights
under European law to healthcare in other Member States and to facilitate European cooperation between
health systems whilst respecting the responsibilities of the Member States for the organisation and delivery
of health services and medical care.

(1) COM(2004) 2 final.

(2004/C 88 E/0248)

WRITTEN QUESTION P-0913/04

by Philip Bradbourn (PPE-DE) to the Commission

(19 March 2004)

Subject: Driver attestation checks

Could the Commission inform me what percentage of HGV drivers entering the EU from non-member
States are regularly checked in accordance with driver attestation regulations upon reaching the EU’s
common frontiers, especially Germany and Austria?

What minimum percentages of such checks are the European Commission and Member States proposing
in order to ensure that following enlargement the new frontiers will be fully policed in respect of driver
attestation?

Answer given by Mrs de Palacio on behalf of the Commission

(23 April 2004)

Regulation (EEC) No 881/92 (1) as amended by Regulation (EC) No 484/2002 (2) foresees that a driver
attestation shall be issued by the Member State at
the Community
authorisation for each driver who is a national of a non-member country whom he lawfully employs or
who is lawfully put at his disposal. This entails that only those drivers that are nationals of a non-member

the request of

the holder of