Opinion of the Committee of the Regions on The white paper — Together for health: A strategic approach for the EU 2008-2013
Date: 2008-04-09
Institutions: European Committee of the Regions
Subjects: cooperation policy, equal treatment, health care, health policy, local authority, public health, regional authority

5.7.2008

EN

Official Journal of the European Union

C 172/41

Opinion of the Committee of the Regions on ‘The white paper — Together for health: A strategic
approach for the EU 2008-2013’

(2008/C 172/08)

THE COMMITTEE OF THE REGIONS

— believes that a common approach to health matters should not result in any moves towards harmoni-

sation or to any infringement of the subsidiarity principle;

— asks the Commission to make reducing inequalities in health a priority objective;

— notes that the strategy does not address the issue of pharmaceuticals and calls therefore for a closer

examination of this issue;

— believes that cancer screening is an example of specific healthcare treatment and thus a matter for the
national level; it should not therefore be included in the health strategy. However, cooperation and
sharing of best practice amongst EU countries is welcomed;

— believes that

local and regional authority input

into the new EU-level structured cooperation
mechanism could be achieved by having some seats on the new health-related committees filled by
regional and local representatives, but demands that such a structured cooperation mechanism be
discussed further and that it must be done in an open and transparent way;

— believes that the Commission should compile a digest of relevant health-related cooperation networks
and organisations and that steps should be taken to bring together the stakeholders concerned to
develop appropriate and effective types of cooperation.

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Official Journal of the European Union

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Rapporteur: Mr Karsten UNO PETERSEN, Member of South Denmark Regional Council (DK/PES)

Reference document

White Paper — Together for Health: A Strategic Approach for the EU 2008-2013

COM(2007) 630 final

Political recommendations

THE COMMITTEE OF THE REGIONS

1.
welcomes the Commission white paper setting out a Com-
munity health policy strategy until 2013, subject to compliance
both with Treaty Article 152, which stipulates that public health
is basically a matter for national policy, and with the subsidiarity
principle;

2.
agrees that health is central in people's lives and needs to
be supported by effective policies in all areas, including action
taken in Member States and at EU and global
level. The
Commission should continue to give priority to public health as
an area of EU competence in which major health gains can be
achieved;

3.
notes and applauds the growing interest in health matters
at EU level, as was reaffirmed in the Reform Treaty agreed in
Lisbon on 19 October 2007, which proposes reinforcing the
political importance of health. However, the Committee of the
Regions would point out that a common approach to health
matters should not result in any moves towards harmonisation
or to any infringement of the subsidiarity principle;

recognises the new requirements underlying the framing
4.
of a more strategic Community-level approach,
including the
ageing population, new health threats (pandemics, biological
incidents, bioterrorism and climate change challenges) and new
technologies, but underlines that care should be taken to ensure
that the EU does not overstep the limited health-policy related
powers assigned to it under Art. 152 of the EC Treaty;

including solidarity, grassroots involvement

supports the values and principles set out in the white
5.
paper,
in policy-
making, the reduction of inequalities in health, the promotion
of investment in this area, the integration of health concerns
into all policies, and the strengthening of the EU's voice in
global health;

6.
backs the white paper's three overriding objectives —
fostering good health in an ageing Europe, protecting citizens
from health threats, and supporting dynamic health systems and
new technologies — and endorses the proposals for specific
action on them;

7.
ences of regional and local partners is a vital element

notes that openness vis-à-vis the role, interests and experi-
in

ensuring that the values, principles and objectives of the white
paper can also be translated into practice;

8.
asks the Commission to make reducing inequalities in
health a priority objective and to focus on the health-related
discrepancies between different social groups; Priority should
thereby be given to supporting Member States that are lagging
behind in developing public health measures and improving
people's state of health, so as to reduce the discrepancies and
imbalances that exist on the health front within the EU;

welcomes a system of health indicators, provided there is

9.
no infringement of national responsibility for healthcare;

10.
notes that the strategy does not address the issue of phar-
maceuticals despite the far-reaching impact on patients and the
public if the provisions in place in this area are considered
solely as a facet of industrial policy and not in connection with
health; calls therefore for a closer examination of the pharma-
ceuticals question, taking as its point of departure the fact that,
in many EU countries, this area comes within the ambit of
health and health insurance;

11.
believes that cancer screening is a healthcare issue and
thus a matter for the national level; it should not therefore be
included in the health strategy;

Implementation of the strategy

12.
also notes that local and regional authorities are directly
affected by the EU's new health strategy since, in many Member
States,
it is they who are responsible for the health and/or
healthcare sectors;

13.
draws attention to the fact that regions and local health
players are often responsible for the planning, management,
operation and development of the health sector — and also
frequently bear financial responsibility for this area too; they are
close to grassroots concerns and thus have a profound under-
standing and knowledge of the health field;

is pleased that

14.
the white paper recognises local and
regional authorities as key actors in delivering healthcare and
thus expects that, given their responsibility in this area, they will
be fully involved in implementing the strategy. The strategy will
be most effective of it is backed up by regional and local input
at as early a stage as possible, thereby also boosting scope for
the regional or local level to take ownership of the strategy;

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welcomes the scope afforded by the white paper for
15.
regional and local
involvement in a new EU-level structured
cooperation mechanism, and is pleased that the Commission is
to work on a cross-sectoral basis and that it is to ensure consis-
tency with other bodies that deal with health-related issues, but
demands that such a structured cooperation mechanism be
discussed further and that it must be open and transparent and
by no means go beyond the coordination referred to in the
second sentence of Article 152 (2) of the EC Treaty;

16.
notes in that connection the importance of involving
bodies and networks representing local and regional authorities
on health matters at an early stage in the deliberations of future
EU health initiatives;

17.
backs the Commission proposal for a new EU-level struc-
tured cooperation mechanism to advise the Commission and to
promote coordination between the Member States, provided
that, as the Commission itself is proposing, this new mechanism
secures adequate regional and local input and involvement at an
early stage. This also applies to local and regional authority
input and involvement in the planned new structure, under
which Member States are to replace some existing committees;

that,

terms,

in practical

18. makes the point
local and
regional authority input into the new EU-level structured coop-
eration mechanism could be achieved by having some seats on
the new health-related committees filled not only by national-
level members but by regional and local representatives as well,
thereby yielding the broadest possible consultation on health
issues and giving greater scope for generating a sense of owner-
ship, at regional level, for EU health initiatives;

that

proposes

regional and local

19.
representatives be
appointed from within the Committee of the Regions for a fixed
period. The regional and local representatives on the new EU
health-related committees could then report back to the
Committee of the Regions;

20.
agrees that value can be added to Member States' action
through the Commission's proposal to foster cooperation with
stakeholders at Community level and feels it
that
Commission efforts to secure the continued development of
partnerships with these players and to build on — or possibly
set up new — health forums or networks should also bring in
local and regional representatives much more fully than is the
case today;

is vital

21.
in that context, calls for cooperation first and foremost
with the Committee of the Regions as the only advisory body
under the Treaties representing local and regional authorities,
but also with various networks and organisations that pool local
and regional authority expertise in the health arena at EU level.
It
the
Commission ensures that they are have broad regional and local
coverage, that they are equally accessible for all regional and
local authorities to take part, and that no barriers, such as high
membership fees, are erected to participation;

that, when selecting these networks,

important

is

formal

recommends that the Commission draw up a digest of
22.
relevant
cooperation
networks and organisations that meet the above criteria, and
the stakeholders concerned to
also that
develop appropriate and effective types of cooperation;

informal health-related

it bring together

and

23.
drawing on the Commission's transparency initiative,
recommends transparent working methods, i.e. the Commission
should publicly announce the health stakeholders with whom it
is working and the players that are to be involved at an early
stage in the forums, committees and bodies it is proposing be
set up;

24.
would also ask the Member States to lay down proce-
dures for the timely involvement of their own regions or local
authorities in health-related issues at EU level;

Financial instruments

that

agrees

the actions

25.
strategy should be
supported by existing financial instruments until the end of the
current
additional
budgetary consequences, not least in the light of the regions'
and local partners' commitments;

(2013), without

framework

financial

in this

26.
is pleased that the Commission has drawn attention to
the link between a healthy population and the Lisbon objectives
for growth and jobs and, in that context, asks that, in future,
cohesion policy and the common agricultural policy should
focus more strongly on public health aspects;

Recommendations to the EU presidency

would ask the EU presidency to incorporate the substan-
27.
tive elements of points 7, 8, 15, 16, 19, 20 and 22-24 of this
opinion into the Council conclusions on the EU health strategy,
viz:

27.1
openness vis-à-vis the role of regional and local part-
ners is a vital element in ensuring that the values, principles and
objectives of the white paper can be translated into practice
(point 7);

27.2
reducing inequalities in health must become a priority
objective; the focus should be on the health-related discrepancies
between different social groups and priority should be given to
supporting Member States that are lagging behind in developing
public health measures (point 8);

the Commission proposal for a new EU-level structured
27.3
cooperation mechanism should secure adequate regional and
local input and involvement at an early stage. This also applies
to local and regional authority input and involvement in the
planned new structure, but demands that such a structured
cooperation mechanism be discussed further and that it must be
open and transparent and by no means go beyond the coordina-
tion referred to in the second sentence of Article 152 (2) of the
EC Treaty (point 15);

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in practical terms,

27.4
local and regional authority input
into the new EU-level structured cooperation mechanism could
be achieved by having some seats on the new health-related
committees filled by regional and local representatives (point
16);

27.5
cooperation should focus first and foremost on the
Committee of the Regions as the only advisory body under the
Treaties representing local and regional authorities, but should
also be conducted with a number of other networks and organi-
sation that pool
local and regional authority expertise in the
health arena at EU level (point 19);

a digest should be complied of relevant health-related
27.6
cooperation networks and organisations and that steps should
the stakeholders concerned to
be taken to bring together

develop appropriate and effective types of cooperation (point
20);

the Member States should lay down procedures for the
27.7
timely involvement of their own regions or local authorities in
health-related issues at EU level (point 22);

the actions in this strategy should be supported by
27.8
existing financial instruments until the end of the current finan-
cial
framework (2013), without additional budgetary conse-
quences, not least in the light of the regions' and local partners'
commitments (point 23);

27.9
in future, cohesion policy and the common agricultural
policy should focus more strongly on health aspects (point 24).

Brussels, 9 April 2008.

The President

of the Committee of the Regions

Luc VAN DEN BRANDE