Education And Debate

Health policy in the European Union: how it's made and how toinfluence it

BMJ 2002; 324 doi: (Published 27 April 2002) Cite this as: BMJ 2002;324:1027
  1. Ben Duncan (, European liaison officer
  1. BMA, 31 Rue Montoyer, B-1000 Brussels, Belgium

    The European Union doesn't usually intend to make health policy but in practice other policies— often to do with the union's origins as a free market—affect health care. Ben Duncan explains how the union and its institutions work and how they can be influenced

    European Union law has a profound impact on health service delivery in Britain and other EU countries.1 Yet repeated reassurances to the contrary and attempts to define an EU health policy that does not impinge on national governments' rights to control their healthcare systems have disguised this fact. The result has been that some major changes have taken health ministries and doctors by surprise. A greater willingness to acknowledge the union's role in health care may be expected as it prepares to launch an ambitious new health action programme and member states face up to the consequences of recent European Court of Justice rulings on patients' rights to go abroad for operations.2

    This paper gives an overview of current EU policies relevant to medicine and public health and an insight into how these policies are made—and how they can be influenced.

    Summary points

    European Union law has a major impact on health service provision

    Most of this impact comes from laws not specifically designed as health policy interventions

    Overt acknowledgement of the union's role in health care may be preferable to its current, rather random, interventions

    Information is readily obtainable from online EU information sources, health interest groups, and specialist publications

    Health policy can be influenced by judicious lobbying

    What is EU health policy?

    Official health policy

    Official EU health policy has been built on something of a paradox. Union leaders have for years wanted the union to be seen to be “doing something” about issues, like health, that citizens care about. Yet health policy is so high on national political agendas that most …

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