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What the new European parliament might do about health

BMJ 1994; 308 doi: https://doi.org/10.1136/bmj.308.6941.1392a (Published 28 May 1994) Cite this as: BMJ 1994;308:1392
  1. R Watson

    It is a fairly safe bet that European public health will not be one of the central issues in the forthcoming campaign to elect the 567 new members of the European parliament. There may be the occasional sniping at governments as opposition parties point to better working conditions and health records in other European Union countries. But the responsibility for such matters remains essentially in national hands.

    Yet the European Parliament has been taking an increasing interest in health issues, and its successor, which starts its five year term of office in mid July, looks set to continue the trend. The idea has even been mooted of giving public health in Europe a higher political profile by making it the sole responsibility of one of the score or so parliamentary committees on which members of the European parliament sit.

    The suggestion, which also reflects personal jostling for authority among MEPs, is unlikely to be taken up, partly because the European parliament is under financial pressure to cut back the administrative expansion it has enjoyed over the past decade. But, more importantly, there is a strong feeling that health and environmental issues are so linked that it makes sense for the same committee to continue treating both.

    It is certainly the view of Ken Collins, the Scottish Labour MEP who has been chairman of the environment, public health, and consumer protection committee for the past 10 years and is likely to continue in that role in the new parliament. “I do not feel the time is politically ripe to have a separate health committee. It is still a new policy area. And health and environment are so linked that the study of disease is very often environment related,” he argues.

    Even so, his committee has been able to call on a wide range of medical expertise as it carefully enters this new arena. Their ranks include the eminent physician and Socialist MEP, Leon Schwartzenberg, whose support for euthanasia has sparked off controversy in his native France; Adriana Ceci, and Italian Socialist member and professor of paediatrics; Spanich Christian Democrat Jose Valverde Lopez, a professor of pharmacy; Greek Socialist Paraskevas Avgerinos, a former minister of health; and Irish Fine Fail MEP Mary Banotti, a psychiatric nurse. Their presence prevents the parliament soaring on flights of fantasy.

    “They are able to inject a note of practical realism into our debates as they are aware of the limitations of what we might be able to do. When we talk of a European public health policy, there is a great tendency to see a perfect health care system at a European level. Their value is that they say what the Union can do more effectively than individual member states,” effectively than individual member states,” explains Collins.

    For the 70 year old Schwartzenberg, who is standing down as an MEP, raising health issues at a multilateral European level not only enriches the domestic debate but could also break through the polarised argument that often dominates national discussions. He believes it would be far more effective if a single campaign against AIDS could be run throughout the union. His view is shaped by the effectiveness of British policy, particularly on drugs, which has limited the number of drug users among those HIV positive to just 7% . In France the figure is 40% . “In France, we did not take the same decisions on syringes and substitute drugs. It would have been better to have had the same campaign in the whole of Europe,” he maintains.

    As he leaves the European parliament Schwartzenberg offers some areas where the European Union could usefully foster worthwhile transnational cooperation. Doctors, He suggests, have enough international contacts through conferences and publications of their research. But more should be done for nurses and public health administrators to give them access to experience in other countries in the search for the best practice.

    Collins agrees. “It is not just a question of causes of a diseases, but also of recovery rates. This is what you can investigate at a European level,” he points out. There is little doubt that epidemiology will be the main thrust of the European Union's public health activities for the foreseeable future, if Collins and his colleagues have their way.

    Two themes are likely to feature more prominently on the union's future agenda. The first is rare diseases, where populations in individual member states are not sufficiently extensive to provide adequate data. The second, as Europe's population ages, is likely to be Alzheimer's disease and dementia.

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