European auditors question the value of EU funded public health programmes

The beneficial impact of the European Union’s increasing involvement in public health programmes has been challenged by the authority that audits the EU’s annual accounts.

The Luxembourg based European Court of Auditors, in its first major assessment of European funding of health programmes and projects, identified weaknesses in strategic planning and an absence of priority setting in its investigation into the EU’s 2003-2007 public health programme. In particular, it pointed to goals it considered too broad, the absence of specific quantifiable success criteria, and inadequate funding.

“Objectives should be set. You need specific targets for each policy area, so that awareness of nutrition should increase by a certain percentage within a certain number of years. They have this in the US and it works well,” said an official involved in the assessment.

The conclusions to the 68 page report state, “The Court finds that the PHP [public health programme] (2003-2007) did not make a major contribution to health promotion in the European Union.”

The five year programme was financed by €232m (£200; $325m) from the annual EU budget. It focused on three areas—health information, rapid reaction to health threats, and tackling health determinants. In all, some 352 projects were funded, 36 which the auditors examined.

Henri Grethen, the European auditor who authored the report, maintained that the investigation raised questions about the worth of certain elements of European public health programmes.

“The Court found that the right conditions for the projects financed by the EU budget were not in place to protect and improve public health. Under these circumstances, it was difficult for such projects to have any major impact on citizens’ health,” he said.

The Luxembourg member of the European Court of Auditors also warned the European Commission, which has considerably increased its involvement in, and financing of, health issues across the 27 member bloc in recent years, not to stray beyond its legal remit and to recognise that public health is largely a national responsibility.

The European Commission accepts the criticism. It points out that it has already begun to streamline programme management and implementation by creating an outside agency to manage these responsibilities.

In its defence it makes clear that the contents and financing of the programme are determined by EU governments and the European Parliament. It notes that an internal commission evaluation had already pinpointed areas for improvement. These are being implemented in the current public health programme, which runs to 2013.

The commission accepts that a larger budget would have made a greater impact, but insists that given the time it takes health promotion measures to influence individuals’ behaviour, it would be better to wait until the evaluation of the 2003-2007 public health programme is available next year before making a definitive judgment.