CELEX: 51995PC0138
Language: en
Date: 1995-04-18
Title: Amended proposal for a EUROPEAN PARLIAMENT AND COUNCIL DECISION adopting a programme of Community action on health promotion, information, education and training within the framework for action in the field of public health

COMMISSION OF THE EUROPEAN COMMUNITIES
                                     Brussels, 18.04.1995
                                     COM(95) 138 final
                                     94/0130 (COD)
                  Amended proposal for a
EUROPEAN PARLIAMENT AND COUNCIL DECISION
     adopting a programme of Community action on
 health promotion, information, education and training
            within the framework for action
               in the field of public health
(presented by the Commission pursuant to Article 189 a (2)
                     of the EC-Treaty)
 ---pagebreak---                           EXPLANATORY MEMORANDUM
Amended proposal for a European Parliament and Council Decision adopting a
programme of Community action on health promotion, information, education and
training within the framework for action in the field of public health.
The Commission's initial proposal for a European Parliament and Council Decision
adopting a programme of Community action on health promotion, information, education
and training within the framework for action in the field of public health was adopted by
the Commission on 1 June 1994.
The Commission's initial proposal was accorded a favourable opinion by the Committee
of the Regions1 and the Economic and Social Committee2.
Following the opinion of the European Parliament adopted at first reading on 15 March
1995 the Commission is presenting, pursuant to Article 189a of the EEC Treaty, an
amended proposal for a decision. Two types of amendment are mainly involved, viz:
- a set of amendments adding useful detail and clarifications with respect to the initial
   proposal;
- another set of amendments slightly strengthening the content of the actions involved
   in the programme as regards specific aspects of health promotion.
The Commission's amended proposal retains the same structure and aims as the initial
proposal, but some provisions and programme actions have been clarified or elaborated
on.
Of the 43 European Parliament amendments, 18 have been accepted either as they are (4,
9, 28, 30, 31, 37, 39, 47 and 48) or in substance but with amended wording (2, 6, 8, 14,
16, 18, 19, 21 and 25).
As for the three amendments (10, 12 and 13) concerning committee arrangements and
determination of the appropriations available for each year, the Commission will adopt
the provisions later agreed at inter-institutional level.
For amendments 11, 34, 35, 36 and 38, which include both acceptable and unacceptable
elements, the Commission proposes changes in their wording.
The Commission has not accepted four amendments (1, 5, 23 and 41) dealing with fields
of activity (health and safety at work, medical treatment and care, specific diseases)
outside the scope of the programme or of Article 129.
1
  Plenary session of 15-16 November 1994
2
  Plenary session of 25-26 January 1995
 ---pagebreak--- The Commission was unable to retain amendments 7, 15, 17, 20, 24, 26 and 44. These
refer to general accepted principles or commitments entered into by the Commission but
explicit mention of which is not justified or appropriate in the specific context in which
they are proposed.
Finally, six amendments (22, 27, 29, 33, 40 and 43) were not accepted by the
Commission because they refer to population groups (the elderly, disadvantaged groups)
or activities (information on medicines) already explicitly covered by actions under the
programme.
                                                                                      0^0
 ---pagebreak--- Initial proposal                                          Amended proposal
(COM)94 202 final
THE EUROPEAN PARLIAMENT AND THE
COUNCIL OF THE EUROPEAN UNION,
Having regard to the treaty establishing the European
Community, and in particular Article 129 thereof,
Having regard to the proposal from the Commission,
Having regard to the opinion of the Economic and
Social Committee,
Having regard to the opinion of the Committee of the
Regions,
1. Whereas, with reference to point (o) of Article 3 of
     the Treaty, Community action must include a
     contribution of the Community towards the
     achievement of a high level of health protection;
     Article 129 expressly provides Community
     competence in this field by encouraging the
     cooperation between Member States and, if
     necessary, lending support to their action;
2. Whereas the Commission communication of
     24 November 1993 on public health, states that
     experience acquired by the Commission until now
     from actions in public health, justifies a programme
     of Community actions in the four priority areas of
     health promotion, information, education and
     training;
3. Whereas the resolution of the Council and of the
     Ministers of Education meeting within the Council,
     of 23 November 1988, concerning health education
     in schools, emphasized that certain eating habits,
     the uncontrolled use of some chemical substances
     and medicines, drug abuse, smoking and
     environmental pollution have a harmful effect on
     health, bearing in mind the related problems of
     safety and accident prevention;
                                                                           I I su~
 ---pagebreak--- Initial proposal                                          Amended proposal
(COM)94 202 final
4. Whereas, the resolution of the Council and of the
     Representatives of the Governments of the Member
     States, meeting within the Council, of 3 December
      1990, concerning an action plan on nutrition and
     health has underlined that the promotion of a
     healthy lifestyle related to nutrition is vitally
     important to enable people to make the necessary
     choices for ensuring appropriate nutrition in
     keeping with individual needs;
5. Whereas the conclusions of the Council and the         5. Whereas the conclusions of the Council and the
     Ministers for Health of the Member States, meeting       Ministers for Health of the Member States meeting
     within the Council, of 13 November 1992,                 within the Council, of 13 November 1992,
     concerning health education based on the                 concerning health education based on the
     Commission communication to the Council of               Commission communication to the Council of
      11 May 1992 on school health education, identified      11 May 1992 on school health education, identified
     the school as a vital setting for systematically         the school as a vital setting for systematically
     developing a healthy lifestyle that will enable          developing a healthy lifestyle that will enable
     sickness and accidents to be reduced, considered         sickness and accidents to be reduced, considered
     that there were a variety of other settings such as      that there were a variety of other settings, such as
     homes, local communities, workplaces, hospitals,         homes, local communities, workplaces, hospitals, in
     etc. in which health promotion and health education      which health promotion and health education had a
     had a central role, and invited the Commission to        central role, and invited the Commission to
     strengthen cooperation between Member States in          strengthen cooperation between Member States in
     implementing effective health promotion and health       implementing effective health promotion and health
     education actions in the various settings;               education actions in the various settings;
6. Whereas these actions need to be undertaken within
     the framework for action in the field of public
     health set out by the Commission and take into
     account, as the Council requested in its resolution
     of 27 May 1993, other actions undertaken by the
     Community in the field of public health or which
     have an impact on public health;
7. Whereas in its Resolution concerning public health,
     health promotion and health education the
     European Parliament formulated a series of
     proposals for Community action in the field of
     accident prevention and prevention of
     cardiovascular diseases which are not the subject of
     existing Community programmes;
                                                          7a. Whereas it is desirable to make provision for health
                                                              promotion and health education measures for older
                                                              people:
 ---pagebreak--- Initial proposal                                           Amended proposal
(COM)94 202 final
     Whereas the results of the integrated approach as
     demonstrated in the joint World Health
     Organization - Council of Europe - European
     Community Project 'The European network of
     health promoting schools' are encouraging with
     respect to the different ways of implementing
     health promotion in particular settings;
     Whereas it is recognized that socio-economic
     conditions such as housing, unemployment,
     urbanization, and social exclusion should be taken
     into consideration in the promotion of health,
     particularly for those living in deprived areas;
                                                           9a. Whereas some social policv objectives coincide
                                                               with public health objectives, as a feeling of well-
                                                               being at work is a factor in each human being's
                                                               personal development and psychological balance;
10. Whereas health education and information are
     expressly mentioned in the provisions of the Treaty
     dealing with public health, and constitute a priority
     for Community action in public health;
11. Whereas, in accordance with the principle of
     subsidiarity, action on matters not under the
     exclusive competence of the Community, such as
     those on health promotion, must be undertaken by
     the Community solely where, by reason of their
     scale or effects, the objectives can better be
     achieved at Community level;
 ---pagebreak--- Initial proposal                                           Amended proposal
(COM)94 202 final
12. Whereas cooperation with the competent
     international organizations and with non-member
     countries should be strengthened;
13. Whereas a multiannual programme should be
     launched with clear objectives for Community
     action, and priority action selected to promote the
     health of all the citizens of the Community as well
     as appropriate mechanisms for the evaluation of
     such action;
                                                           13a. Whereas, although maintenance of health
                                                                throughout people's lives is universally desirable,
                                                                the tendency of women to live longer than men
                                                                requires particular attention;
14. Whereas the programme has to contribute to the
     enhancement of awareness of health determinants
     and risk factors, early detection of adverse effects,
     counselling and advice, and health and social
     support;
15. Whereas, from the operational point of view, the
     investment made in the past both in terms of the
     establishment of Community networks of non-
     governmental organizations and of the mobilization
     of all those involved in health promotion and
     education has to be safeguarded and developed;
16. Whereas, however, possible duplication of effort
     has to be avoided by the promotion of the
     exchange of experience and by the joint
     development of basic information modules for the
     public, for health education and for training
     members of the health professions;
                                                           16a. Whereas it is desirable for the various past or
                                                                current actions implemented in Member States to
                                                                be taken into account, by either the relevant
                                                                authorities or other bodies involved in health
                                                                policv;
 ---pagebreak--- Initial proposal                                        Amended proposal
(COM)94 202 final
17. Whereas this programme must be of five-year
      duration in order to allow sufficient time for
      actions to be implemented to achieve the
      objectives set,
HAVE DECIDED AS FOLLOWS:
Article 1
A Community action programme on health promotion,       A Community action programme on health promotion,
information, education and training is adopted for a    information, education and training is adopted for a
five-year period, from 1 January 1995 to 31 December    five-year period, from 1 January 1996 to 31 December
 1999.                                                  2000.
Article 2
The Commission shall ensure implementation of the       The Commission shall ensure implementation of the
actions set out in the Annex in accordance with         actions set out in the Annex in accordance with
Article 5 and in close cooperation with the Member      Article 5 of this decision and in close cooperation with
States and the institutions and organizations active in the Member States. It shall also act in cooperation with
health promotion.                                       the institutions and organizations active in health
                                                        promotion.
Article 3
The budgetary authority shall determine the
appropriations available for each financial year.
Article 4
The Commission shall ensure that there is consistency   The Commission shall ensure that there is consistency
and complementarity between the Community actions       and complementarity between the Community actions
to be implemented under this programme and the other    to be implemented under this programme and the other
relevant Community programmes and initiatives.          Community actions affecting health, especially in the
                                                        areas of education and training, and of health and
                                                        safety at work.
 ---pagebreak--- Initial proposal                                        Amended proposal
(COM)94 202 final
Article 5
1. For the implementation of this programme the
    Commission shall be assisted by a committee of an
    advisory nature, hereinafter referred to as 'the
    Committee', composed of two representatives from
    each Member State and chaired by the
    representative of the Commission.
2. The representative of the Commission shall submit
    to the Committee a draft of the measures to be
    taken. The Committee shall deliver its opinion on
    the draft, within a time limit which the chairman
    may lay down according to the urgency of the
    matter, if necessary by taking a vote.
    The opinion shall be recorded in the minutes, in
    addition, each Member State shall have the right to
    ask to have its position recorded in the minutes.
    The Commission shall take the utmost account of
    the opinion delivered by the Committee. It shall
    inform the Committee of the manner in which its
    opinion has been taken into account.
Article 6
1. The Community shall encourage cooperation with         The Community shall encourage cooperation with
    non-member countries and with international public    non-member countries and with international public
    health organizations, including the World Health      health organizations, including the World Health
    Organization.                                         Organization.
                                                          The programme shall provide support for proposals
                                                          submitted by Member States and for initiatives by
                                                          organizations and agencies active in the health
                                                          promotion field.
2. The EFTA countries, in the framework of the
    Agreement on the European Economic Area and the
    countries from central and eastern Europe with
    whom the Community has concluded association
    agreements may be associated with the activities
    described in the Annex.
 ---pagebreak--- Initial proposal                                         Amended proposal
(COM)94 202 final
Article 7
1. The Commission shall regularly publish information
    on the actions undertaken and the possibilities for
    Community support in the various fields of action.
2. The Commission shall submit to the European
    Parliament, the Council, the Economic and Social
    Committee and the Committee of the Regions a
    mid-term report on the actions undertaken, as well
    as an overall report at the end of the programme.
Annex
Community action programme                               Community action programme
on health promotion (1995 to 1999)                       on health promotion (1996 to 2000)
A. Health information
1.    Efforts to contribute to a better knowledge of the 1. Support and coordination of the work carried out in
      psycho-sociological mechanisms involved and of         the Member States with a view to a better
      health information methods and techniques, as          knowledge of the psycho-sociological mechanisms
      well as fostering the assessment of results.           involved and of health information methods and
                                                             techniques.
                                                             Fostering the assessment and dissemination of
                                                             results.
      Surveys of public opinion on various aspects of
      health promotion (Eurobarometer survey) and
      support for the preparation and assessment of
      specific information campaigns including those
      coordinated at Community level or in several
      Member States.
                                                         2a. Support for work to become better acquainted with
                                                             socio-economic and cultural differences in relation
                                                             to health promotion and health education.
3.    Support for a European infrastructure for          3.  Support for development of a European
      information and documentation on public health         infrastructure, particularly in the form of
      and health promotion for use by professionals,         transnational networks, reference centres for
      administrators and decision-makers in the field of     information and documentation on public health
      public health, and dissemination to interested         and health promotion for use by professionals,
      parties of information on the Community's              administrators and decision-makers in the field of
      activities in this field.                              public health, and dissemination to interested
                                                             parties of information on the Community's
                                                             activities in this field.
 ---pagebreak--- Initial proposal                                          Amended proposal
(COM)94 202 final
B. Health education
4. Promotion, by consultation between the Member              Promotion, in consultation with the Member States,
     States, of the inclusion of health education in          of greater integration of health education in school
     school curricula, and support for the development        curricula, and development of exchanges of
     and distribution of appropriate health education         experience, teaching materials and training staff in
     programmes, teaching materials and modules.              particular by means of pilot projects, in order to
     Support for demonstration projects and innovative        promote healthy lifestyles and behaviour.
     measures with the aim of promoting healthy               Support for the European network of health
     lifestyles and behaviour, including support for the      promoting schools in cooperation with WHO and
     European network of health promoting schools in          the Council of Europe.
     cooperation with WHO and the Council of Europe.
5. Support for health education measures in the
     workplace, particularly in relation to prevention of
     alcohol abuse and tobacco consumption, and
     nutrition.
6. Support for health education projects among young      6. Support, coordination and assessment of health
     persons and adolescents who have left the school         education projects among young persons and
     system in settings such as sport and leisure             adolescents who have left the school system, drawn
     activities and socio-cultural activity centres,          up and implemented by either official bodies or
     including innovative means of providing continuing       private associations and non-governmental
     structured health education.                             organizations in settings such as sport and leisure
                                                              activities and socio-cultural activity centres,
                                                              including innovative means of providing continuing
                                                              structured health education.
                                                          6a. Support for innovative pilot projects with regard to
                                                              continuing structured health education for adults.
 ---pagebreak--- Initial proposal                                            Amended proposal
(COM)94 202 final
C. Vocational training in public health and health
     promotion
7. Review and assessment of existing structures and
     training schemes in public health and health
     promotion and compilation of a European directory.
     Support for cooperation involving schools of public
     health, universities and bodies providing training in
     this area with a view to the development of
     common training courses and exchanges of students
     and teaching staff.
8. Promotion of cooperation between the Member                  Promotion of exchanges of training modules and
     States on the content of training courses and              training experiences in the fields of public health
     training activities in the fields of public health and     and health promotion for professionals,
     health promotion for professionals, administrators,        administrators, managers and decision-makers,
     managers and decision-makers, emphasizing                  emphasizing interdisciplinary approaches.
     interdisciplinary approaches.
9. Support for training activities concerning health            Support for training activities concerning health
     education in schools aimed at teachers, instructors        education in schools aimed at teachers, instructors,
     and other staff concerned including development of         and other staff concerned, including development
     modules, teaching aids and materials. Support for          of modules, teaching aids and materials.
     training for health professionals in the prevention
     of diseases, early detection of alcoholism and
     information for the public on the use of medicines
     and self-medication.
                                                            9a. Support for training and further training for health
                                                                professionals in health promotion, the prevention
                                                                and early detection of diseases and information for
                                                                the public on the rational use of medicines, in
                                                                particular generic medicines and self-medication.
 ---pagebreak--- Initial proposal
(COM)94 202 final
D. Specific prevention and health promotion
     measures
10. Support for integrated health promotion activities       10. Support for integrated health promotion activities
     and projects relating to disadvantaged or vulnerable        and projects relating more particularly to groups
     groups and particular territorial areas, and                disadvantaged due to their vulnerability or social
     incorporating the intersectoral dimension of health         exclusion (such as the elderly), to socio-cultural
     promotion.                                                  differences (migrants) or to their living in
                                                                 disadvantageous areas or situations, incorporating
                                                                 the intersectoral dimension of health promotion.
11. Examination of the role of balanced nutrition as a       11. Examination of the role of nutrition and other
     health protection measure and of nutrition in the           lifestyle factors in the etiology of diseases, and
     etiology of diseases, particularly cardiovascular           information for the public with a view to better
     diseases. Promotion of analysis, evaluation and             understanding the basic principles of nutrition and
     exchange of experience in respect of innovative             new techniques and methods of presentation and
     measures for the prevention of cardiovascular and           preparation of foodstuffs.
     related diseases.
                                                             11a. Promotion of exchanges of experience and
                                                                    information and support for activities aimed at
                                                                    the prevention of cardiovascular and related
                                                                    diseases.
                                                             lib. Promotion of exchanges of experience and
                                                                    information and support for actions concerning
                                                                    alcohol consumption and its medical and social
                                                                    consequences.
                                                             lie. Support for actions to promote regular exercise
                                                                    and the adoption of proper physical and mental
                                                                    health practices.
                                                             lid. Support for studies into the ageing populations of
                                                                    the European Union, promotion of exchanges of
                                                                    experience and information
                                                                    age-related diseases, in coordination with the
                                                                    other specific programmes.
12. Support for activities on medication, including self-    12.    Support for activities on rational use of
     medication, in cooperation with general                        medicines, in particular generic medicines and
     practitioners and pharmacists, as well as efforts to           self-medication, as well as actions to monitor the
     monitor the development of practices and assess                development thereof and the implications, in
     their implications.                                            cooperation with general practitioners and
                                                                    pharmacists.
                                                          10
 ---pagebreak---                                                        23/03/95
Initial proposal                                              Amended proposal
(COM)94 202 final
E.     Health promotion strategies and structures
13.    Surveys and comparative analyses of health
       promotion structures and strategies and
       assessment of these policies, as well as activities
       to encourage and support cooperation between
       Member States on various strategic aspects of
       public health and health promotion.
14.    Support for networks of national or regional
       health promotion bodies, adopting an integrated
       approach (i.e. an approach covering the various
       determinants, contexts and population groups) and
       promotion of joint activities and projects.
                                                           11
 ---pagebreak---                                                                    ISSN 0254-1475
                                                             COM(95) 138 final
                                              DOCUMENTS
EN                                                                            05
                                     Catalogue number : CB-CO-95-150-EN-C
                                                              ISBN 92-77-87758-8
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