Opinion of the Committee of the Regions on the Communication from the Commission to the Parliament, the Council, the European Economic and Social Committee and the Committee of the Regions: Healthier, safer, more confident citizens: a health and consumer protection strategy Proposal for a Decision of the European Parliament and of the Council establishing a programme of Community action in the field of health and consumer protection 2007-2013
Date: 2006-02-16
Institutions: European Committee of the Regions
Subjects: EU programme, consumer protection, exchange of information, public awareness campaign, public health

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EN

Official Journal of the European Union

16.8.2006

Opinion of the Committee of the Regions on the Communication from the Commission to the
Parliament, the Council, the European Economic and Social Committee and the Committee of the
Regions: Healthier, safer, more confident citizens: a health and consumer protection strategy
Proposal for a Decision of the European Parliament and of the Council establishing a programme
of Community action in the field of health and consumer protection 2007-2013

(2006/C 192/02)

THE COMMITTEE OF THE REGIONS,

Having regard to the Communication from the Commission: Healthier, safer, more confident citizens: a health
and consumer protection strategy and the Proposal for a Decision of the European Parliament and of the
Council establishing a programme of Community action in the field of health and consumer protection 2007-
2013, COM(2005) 115 final — 2005/0042 (COD);

Having regard to the Council's decision of 2 June 2005 to consult it on this subject, under the first para-
graph of Articles 265 and 152 of the Treaty establishing the European Community;

Having regard to its Bureau's decision of 12 April 2005 to instruct its Commission for Economic and
Social Policy to draw up an opinion on this subject;

Having regard to its opinion on the Communication from the Commission: Follow-up to the high level
reflection process on patient mobility and healthcare developments in the European Union and the Communication
from the Commission: Modernising social protection for the development of high-quality, accessible and sustainable
health care and long-term care: support
the national strategies using the ‘open method of coordination’
COM(2004) 301 final and COM(2004) 304 final (CdR 153/2004 fin) (1);

for

Having regard to its opinion on the Communication from the Commission on the health strategy of the
European Community and the Commission's Proposal for a Decision of the European Parliament and of the
Council adopting a programme of Community action in the field of public health (2001-2006) COM(2000) 285
final (CdR 236/2000 fin) (2);

Having regard to its opinion on the Communication from the Commission: Strengthening the social dimen-
sion of the Lisbon strategy: Streamlining open coordination in the field of social protection COM(2003) 261 final
(CdR 224/2003 fin) (3);

Having regard to its opinion on the Commission's Proposal for a Directive of the European Parliament and of
the Council on services in the internal market COM(2004) 2 final (CdR 153/2004) (4);

Having regard to the draft opinion CdR 149/2005 rev. 2 adopted on 28 November 2005 by its Commis-
sion for Economic and Social Policy (rapporteur: Ms Bente Nielsen, member of Århus County Council
(DK-PES);

adopted the following opinion at its 63rd plenary session, held on 15 and 16 February 2006
(meeting of 16 February)

The Committee of the Regions

1.1
notes that the Commission's communication Healthier,
safer, more confident citizens: a health and consumer protection
strategy, advocates bringing together health and consumer
policy; this can generate a synergistic effect on knowledge-
sharing, working methods and the more effective use of admin-
istrative resources;

1.2 welcomes the Commission's efforts to ensure that
people have greater scope to make healthy choices and acquire
healthier consumer habits. The Commission communication
highlights the tremendous importance of health both for indivi-
dual well-being and for achieving the Lisbon strategy objectives,
as better health makes for a more productive Europe and helps

(1) OJ C 43, 18.2.2005, p. 22.
(2) OJ C 144, 16.5.2001, p. 43.
(3) OJ C 73, 23.3.2004, p. 51.
(4) OJ C 43, 18.2.2005, p. 13.

increase labour force participation and promote sustainable
growth. An internal market
is
responsive to consumer needs and wishes will further improve
EU competitiveness;

in goods and services that

1.3
stresses that health and consumer issues should also be
taken into account in other areas of EU policy. To achieve the
overall objectives in the fields of health and consumer protec-
tion, there must be more coordination of political processes in
for
other areas, such as employment and agriculture.
instance,
inappropriate that the EU should be continuing to
subsidise the consumption of unhealthy foods as for example
high-fat dairy products or, in the 2005 Community budget to

It is,

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Official Journal of the European Union

C 192/9

support the tobacco industry to the tune of EUR 916 million,
substantially more than the EUR 14.4 million it is spending on
support for tobacco control. The CoR is therefore pleased that
aid for the tobacco industry is to be phased out completely by
2010;

supports the call for the establishment of a minimum
1.4
set of rights, on a horizontal basis, that all consumers will have
when using services of general interest (e.g. gas and electricity,
postal services, telecommunications, water) whether at national
or cross-border level, based on the principle of universal service
provision (i.e. universal access for services of general interest
that are essential for participation in modern society). This is
an area in which the universal service principle should remain
supreme, and which must meet consumer expectations with
regard to access, security, reliability, price, quality, and choice;

trends towards better health and healthier products and prevent
consumer disinformation;

are

stresses that

1.10
the legal bases of Community public
health and consumer protection policies
completely
in the
different. According to Article 152 of the EC Treaty,
field of public health ‘Community action (…) shall complement
national policies’. However, consumer policy, as set out in
Article 153 of the EC Treaty,
is largely subject to common
approach, with a view to promoting consumers' rights and
protecting their interests, in particular when this concerns the
completion of the internal market. Invoking a shared legal basis
for the two policies is therefore in contradiction with the subsi-
diarity principle.

1.5
considers that there is a need to continue to observe
the impact of the internal market on the health service and
consumer habits in the Member States. The interplay between
Community rules and national health and consumer protection
policies should be examined when implementing the Treaty
objectives of a high level of health and consumer protection
through Community initiatives;

EU consumer law must not be a conduit for specific rules or
laws in the field of health, that interfere with the organisation
and orientation of the health service in the individual Member
States. However, bringing consumer protection policy into line
with the strict complementarity and subsidiarity criteria that
underpin public health policy could have an adverse effect on
EU's own consumer protection powers;

1.6
pleads for a stronger consideration of consumer inter-
ests in the EU's competition policy taking into consideration
the relationship between consumer protection and competition
policy set out in Articles 81 and 82 of the EC Treaty, which
state that the aim of the competition rules applying to under-
takings is to protect competition on the market as a means of
enhancing consumer welfare;

considers therefore that,

instead of talking about a
1.11
strategy for ‘health and consumer protection’, it would be more
accurate of the Commission to refer only to ‘public health and
consumer protection’ throughout its communication as this
would be in accordance with the EU competences laid down in
Article 152;

believes that Community initiatives should be assessed
1.7
for their impact on public health. Such assessments should
examine how decisions taken affect the health of the popula-
tion and not only look at how the various measures affect the
organisation and orientation of the health service. They should
also consider the impact of EU measures on the underlying
values of the health service in the individual Member States. It
is important to bear in mind that the impact of a Community
initiative may vary from one Member State to another;

1.8
feels that steps should be taken to ensure democratic
and transparent decision-taking and responsibility in the field
of consumer affairs. It is particularly important to ensure that
the foodstuffs industry takes environmental and public health
issues on board and provides fresh and nutritious food for
everyone, irrespective of their social and economic background;

takes the view that any linking of health and consumer
1.9
policy must not result
in food producers marketing their
products directly as ‘healthy’ or ‘recommended by doctors.’
Producers cannot be allowed to use the fear of disease either as
a means to sell their goods or mislead consumers into thinking
that certain foods can replace a healthy and balanced diet. It is
therefore important for any European consumer policy to steer

stresses that linking health and consumer policy must
1.12
not result in patients in the healthcare system being placed on
the same footing as consumers on the market. The health
service market differs in a number of substantive ways from
the general consumer market, as is apparent in the uncertain-
ties about healthcare requirements and the costs involved, the
external impact of healthcare use and the information imbal-
ance between providers and consumers/patients. At the same
time, the desired objective is that people should enjoy equal
access to health services — and equal opportunities — irrespec-
tive of social and economic background. It is essential that
Member States retain scope to set priorities, act and intervene
as appropriate;

1.13
recommends that the specific needs of health and
consumer protection should continue to be catered for, despite
their being brought together under a single, joint programme.
That can be done by earmarking budgetary resources specifi-
cally for one policy area or the other. The Commission's
programme details the precise breakdown of resources to be
allocated for the 2007-2013 period. As far as possible, priori-
ties should be adaptable to change as the programme develops,
perhaps in conjunction with the planned evaluation after three
years. That is in keeping with the programme's intention to
draw on flexible action plans;

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acknowledges that

the health
in certain areas of
1.14
service greater
coordination between the Member States
through the open method of coordination appears desirable.
This applies, for example, to patient mobility and the training
and recruitment of health service staff;

observe here that these resources can only be used in the initial
phase of public health-related projects, and not in their day-to-
day management;

1.15
takes the view that the prerequisites for good health
are created right on people's doorsteps. The health service orga-
nisation is only one of many players. In a number of Member
States, it is the regional and local authorities that are respon-
sible for health services and the public health of their commu-
nities. The Committee of the Regions, and the regions and local
authorities responsible in these areas, must therefore be given
influence over the Community's global health strategy. Particu-
lar attention should be paid to the Committee of the Regions'
views on decisions and initiatives that touch on local and
regional authorities' healthcare remit and public health respon-
sibilities. Regional and local authorities must, for instance, be
involved in and have a say in implementing the initiatives to
establish health indicators and benchmarking and public health
strategies in areas such as involvement and influence, mental
health, diet and nutrition and alcohol;

1.16
stresses that civil society must be called upon to take
part in and contribute to the development work. Grassroots
citizens must be guaranteed a say in Community policy on
both health and consumer affairs. It is important to support
specialist health and consumer protection networks, and give
them an opportunity to make their views known at Com-
munity level. This applies, for example, to consumer organisa-
tions, patients' associations and other networks of professional
relevance;

stresses that the Commission must ensure that staff in
1.17
the executive agency have the necessary skills to be able to
implement and apply the Commission's programme, not only
in the fields of health and consumer protection but at a cross-
sectoral level as well;

1.18
feels that to meet the shared and prospective chal-
lenges of health and consumer protection, it is vitally important
that particular attention be paid to the new Member States.
Clear priority should be given to supporting the new Member
States in promoting their healthcare and consumer interests in
order to reduce the discrepancies and imbalances that exist on
the health front within the Union and thus, gradually, to come
within range of the top EU benchmark. For instance, it is unac-
ceptable that average life expectancy, according to Eurostat, is
significantly lower in the new Member States than in the old
Member States;

1.20
feels that to meet the shared and prospective chal-
lenges of health and consumer protection, it is vitally important
that particular attention also be paid to the EU's neighbouring
countries. Clear priority should be given to supporting these
countries in promoting their healthcare and consumer interests
in order to reduce the discrepancies and imbalances that exist
on the health front across Europe and at its fringes;

1.21
stresses that bringing consumer protection and health
care together under one roof can also help promote more
equality within Member States, especially since social and
economic differences often result in differences in health and
consumer protection. Particular attention must be paid not
only to inequalities between Member States, but within them as
well. An increased focus on marginalised groups, such as those
on low incomes, those suffering from obesity, and ethnic mino-
rities,
is of prime importance in achieving the overarching
objective of equal opportunities for all. It is also important to
underline the importance of the individual's own responsibility
for his or her health. A health and consumer policy that
encourages people to make healthy choices is a useful tool in
efforts to stamp out lifestyle-related diseases. Research shows,
that marginalised groups more often suffer from ill health and
lifestyle-related diseases. Helping marginalised groups make
healthy choices can alleviate social and economic inequalities;

1.22
is of the view that the information to be provided by
the Commission must be of use to recipients. Ways must be
found to skew awareness-raising campaigns to the desired
target group. The plan is therefore to conduct interactive infor-
mation and awareness-raising campaigns rather than merely
distribute the same information across
the board. When
spreading information on health and consumer protection, it
could be particularly appropriate to target children and young
people so as to counteract at an early stage bad consumer
habits that may lead to bad health in the long term. Pre-
schools, schools and voluntary organisations can have an
important role to play in this regard;

considers

conducting

that when

information
1.23
campaigns, the Commission must give due regard to the prero-
gative of individual Member States to lay down the rules for
rights and obligations relating to health care within their own
social security systems and in line with the arrangements in
place for the various different services and consumer rights;

acknowledges that, under the proposed Commission
1.19
programme concerning the European Regional Development
Fund for 2007-2013, money from the Structural Funds can be
used for the improvement of public health. The CoR would

recommends that information be provided wherever
1.24
the public requests it, and that it should be followed up by
competent advice and guidance in the individual Member
States. Providing information to marginalised groups is a local

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and regional responsibility. Care must be taken to ensure that
more vulnerable patient groups also have an opportunity to
acquire information on health and consumer protection. Stan-
dardised documentation for all EU citizens would simply aggra-
vate the inequalities between the different social and economic
groups within the Member States, since investigations show
that the better-off groups in society are more responsive to
information campaigns than disadvantaged groups. It is impor-
tant for the success of such campaigns that the local and
regional level be involved in this work;

1.25
urges the Commission to keep abreast of develop-
ments in technology and communications when collecting data
and planning awareness-raising campaigns. These are areas that
are changing rapidly. It is essential to keep up to date in order
to stay visible;

1.26
notes that, given that the agrifood market is to a large
extent subject to imports from third countries, in which health
and authenticity guarantees may be lower than those provided
by European safety standards, consumers must be given clear,
comprehensive
these
products so that they can make an informed choice;

information on the

traceability of

1.27
is pleased that the Commission is to focus on fewer,
bigger and more visible awareness-raising campaigns. This also
makes for more cost-effective operations. It is important that
the joint secretariat is not assessed merely on the number of
completed projects but also on the quality and ultimate impact
of the projects pursued;

1.28
urges the Commission to support the development of
networking for the exchange of experiences and dissemination
of best practice. This is a key part of the open method of coor-
dination.
it is important to involve the
Committee of the Regions and to ensure that the regions and
local authorities responsible for health services are given influ-
ence over the Community's global health strategy;

In that connection,

Brussels, 16 February 2006.

1.29
stresses that the Commission should maintain close
contacts with the research community so as to maintain the
reliability and impartiality of its information and prevention
campaigns. Member States may benefit considerably from
structured, coordinated European-level cooperation geared to
exchanging experience,
sharing knowledge and promoting
research into health and consumer-related developments, as the
Committee also notes in its opinion on the seventh R&D
framework programme (CdR 155/2005 fin). That must be
done in close conjunction with the European framework
programme for research;

is of the view that if Member States are to adopt best
1.30
practice and compare standards — and thus also put in place
the conditions needed to implement many of the proposed
initiatives in the field of health and consumer protection —
then it is of vital importance that they have access to reliable
data and high-quality information. Joint databases and indica-
tors should be established in conjunction with other players in
the field and coordinated with the UN, the OECD, the Council
of Europe and the WHO. It is up to the individual Member
States to take action or launch new initiatives using the
comparative data and information collected;

1.31
is pleased that there is to be a significant increase in
budget resources compared with those for the two existing
programmes. This sends out a clear signal that health and
consumer protection are important both for the quality of life
of individual EU citizens and for the competitiveness of the EU
as a whole;

notes that the negotiations on the financial basis are
1.32
is contingent on the
not yet completed. The final budget
ongoing negotiations on the
EU's 2007-2013 financial
perspective. The Committee of the Regions would like to see
this area receive greater financial priority, as advocated in both
the programme and the strategy.

The President

of the Committee of the Regions

Michel DELEBARRE