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

Appendix 2
 

Appendix 1: Tips for successful research and sources of information

Research tips

(1) Make use of specialist publications about EU policy. These provide context and analysis on the issues, and are usually written in a more digestible style than official EU documents.

(2) Pick the brains of an EU policy expert, if you have access to one. If it is a medical issue then someone in your medical association or professional body may be able to brief you about it. If you are interested in the EU’s research programme the chances are that there are staff or academics at your local university who know how to apply for funding.

(3) Consider subscribing to the information service of one of the European health policy networks. The cost may vary depending on the network but will generally be in the region of a few hundred Euros. Some networks may consider lowering, or even waiving, this fee for organisations and individuals from developing countries.

Selected health interest groups

European Health Management Association www.ehma.org

European Health Telematics Association www.ehtel.org

European Heart Network www.ehnheart.org

European Network of Health Promotion Agencies www.enhpa.org

European Network for Smoking Prevention www.ensp.org

European Federation of Pharmaceutical Industries and Associations www.efpia.org

European Public Health Alliance www.epha.org

Health Action International www.haiweb.org

Mental Health Europe www.mhe-sme.org/mhe-sme

Oxfam/MSF Cut the Cost Campaign (access to essential medicines) www.oxfam.org.uk/cutthecost

Medical

Standing Committee of European Doctors www.cpme.org

Links to other EU and national medical associations www.cpme.be/en/links.htm

EU Online information sources

Home pages of the EU Institutions

European Commission europa.eu.int/comm

(for a full listing of commissioners see http://europa.eu.int/comm/commissioners/index_en.htm)

European Parliament www.europarl.eu.int

(for a listing of MEPs by state and party see http://wwwdb.europarl.eu.int/ep5/owa/p_meps2.repartition?ilg=EN&iorig=home)

Council of Ministers http://ue.eu.int

European Court of Justice www.curia.eu.int

EU Public Databases

Europa

Contains general background information and briefing notes about the EU and its policies, as well as links to the Web sites of all EU Institutions, bodies and agencies. www.europa.eu.int

EU-Lex

This is a database of EU legal texts. It gives free on-line access to the texts of the EU and the Treaties, EU legislation in force (searchable by topic), and recent European Court of Justice judgments. http://europa.eu.int/eur-lex

European Legislative Observatory

This database allows you to search for proposals that are in the policy pipeline. It identifies the key people involved in the parliament and commission, gives a brief description of proposal and the debate thus far, and forecast the dates of upcoming votes. wwwdb.europarl.eu.int/dors/oeil/en/default.htm

Official websites of other international organisations

WHO Europe www.euro.who.int

WHO Geneva www.who.int

Organisation for Economic Co-operation and Development (OECD) www.oecd.int

Council of Europe www.coe.int

Information about EU healthcare systems

WHO Europe country reports www.euro.who.int/countryinformation

OECD health data www.oecd.int/els/health

European Observatory on healthcare systems www.euro.who.int/eprise/main/WHO/progs/OBS/TopPage

Specialist publications on EU policy

European Voice

Weekly newspaper reporting on and analysing EU policy developments. For subscription details and on-line access to latest edition see: www.european-voice.com

Eurohealth

Quarterly magazine on EU health policy published by LSE Health. For more details see: www.lse.ac.uk/Depts/lsehsc/eurohealth.htm

Newsletter and bulletins of the European Health Management Association

For information see: www.ehma.org

Update

Published every two months by the European Public Health Alliance. For subscription details and access to some back copies go to www.epha.org and click on "publications".
 
 

Appendix 2: Overview of EU policy impacts on medicine and public health

(1) Internal market (free movement of goods, services, persons and capital), within which:

(i) Pharmaceutical policy

(ii) Medical devices

(iii) Food safety, food labelling

(iv) Product safety and product labelling in general

(b) Mutual recognition of medical qualifications

(c) Free movement of patients (2 ) Health and safety at work / labour law

(3) Environment

(4) Agriculture

(5) Regional policy

(6) Research / technology policy

(7) Development aid and trade policy

(8) Health policy based on Article 152 of the EC Treaty (public health policy)

Internal market, health and safety, labour law, environment

The EU has significant law making powers. These laws, and indeed the EU treaty articles that underpin them, can give rise to rights enforceable by citizens in front of national courts. For example, a Greek doctor coming to the UK could go to court compel the UK regulatory authorities to recognise his or her Greek medical diplomas. Doctors in Spain have used the courts to enforce their right under the EU Working Time Directive to work a 48 hour week, while patients from several EU countries have used the courts to define a right to have treatment abroad reimbursed by their healthcare system. Areas 1-3 then, can have a direct and easily identifiable effect on the lives of healthcare professionals and citizens in the EU.

Agriculture, regional policy, research and technology policy, development aid and trade policy

The EU’s law making powers in these areas are limited. In agriculture the EU does have extensive powers to legislate on animal and plant health - though this is now classified by the EU as consumer health protection—as well as to regulate prices and production. In the area of technology policy the EU has power to legislate on patent rights,[1] though again this could be classified as an internal market power.[2] In the area of trade policy it is the EU that negotiates trade agreements with third countries or in the World Trade Organisation on behalf of its member states (article 133). With a view to a potential new round of negotiations in the WTO the European commission’s directorate-general for trade and the directorate-general for development are negotiating with the pharmaceutical industry on the issue of patent rights and drug pricing in the developing world.[3] In general, however, the major impact that the EU has in these areas is by the large amounts of money it distributes under them. Between now and 2006 the EU is committed to spend around 40bn Euros each year supporting agriculture, some 30bn Euros each year financing regional development and job creation schemes within the EU and some 7.6bn Euros each year on aid to developing countries and eastern Europe.[4] In the field of research the European Commission has proposed that the EU spend about 4.4bn Euros a year between 2002 and 2006, with about 500m Euros annually being spent on "genomics" and health related biotechnology applications.[5] Expenditure on this scale can clearly have a significant impact.

Public health policy

Under the last heading - health policy based on the Article 152 (public health) of the EU Treaty, the EU has very limited legislative powers and very limited financial means at is disposal. Article 152 allows the EU to pass laws on quality standards for blood products and organs, animal and plant health measures aimed at protecting human health, and spending programmes to finance EU level health projects. On other health issues Article 152 exhorts "co-operation between the member states" and EU actions that "complement national policies." In practice this means that, on most issues, the basis of EU policy is resolutions and recommendations adopted by the member state health ministers in the health council. These may carry some political force, but they are not legally binding. It is therefore difficult to quantify their practical impact on the lives of ordinary citizens and doctors in the EU. It is similarly difficult to quantify the impact that the relatively small amount of money spent each year on EU health projects has. The annual budget for these EU level health policy projects between 2002 and 2006 is likely to be in the region of 50m Euros a year.[6] Health projects already funding by the EU have helped foster the creation of a number of European health policy networks - in particular the European Public Health Alliance, the European Network of Health Promotion Agencies, the European Network for Smoking Prevention, and the Tobacco Control Resource Centre (see appendix 1 for their web addresses). These networks have done much valuable work, but it would be fair to say that the constituency they reach is small.[7] The EU "health information system" proposed for creation under the new funding package[8] will reach a larger constituency over the years, but it is likely still to be of more interest to health policy makers than to ordinary doctors and patients.

1. Legal protection of biotechnological inventions. http://europa.eu.int/scadplus/leg/en/lvb/l26026.htm.
2. European Commission Communication COM 2000 (6), section 3.2. http://europa.eu.int/comm/research/area/com2000-6-en.pdf
3. http://europa.eu.int/comm/trade/csc/med.htm
4. European Commission. The new financial framework: new interinstitutional agreement and financial perspective (2000-2006) http://europa.eu.int/scadplus/leg/en/lvb/l34003.htm
5. European Commission. Budget breakdown for the Research Framework Programme (2002-2006) as proposed by the European Commission. Brussels, EC, 2002.
6. COM COM (2000) 285 http://europa.eu.int/comm/health/ph/general/phpolicy_new.htm
7. Interview with Fernand Sauer, director of public health. Eurohealth 2001;7(2).
8. See COM COM (2000) 285 http://europa.eu.int/comm/health/ph/general/phpolicy_new.htm