Conference on the Future of Europe : Proposition 8

The climate change and the European energy dependence are a real concern to European citizens. Foto: Philippe STIRNWEISS / © European Union 2022 / Source: EP

(Elsa Woeffler) – The Covid-19 pandemic that has been a major catastrophe for the past two years and has demonstrated some of the flaws and weaknesses in the European healthcare systems. Even though the European Union would like to standardize its healthcare systems, each member state was not necessarily equal in managing the pandemic. Hospitals in Italy, France and even Germany were overloaded with patients, without any prior cooperation between the countries and the European institutions. This is a shame for the twenty-seven member states, some of which found themselves alone in the face of the wave of patients. This was noted by the panel of European citizens participating in the Future of Europe Conference. Thus, proposal number 8 of the final report of the conference, wishes to strengthen this system, which has shown its limits lately. Defining health as one of the competences shared between the European Union and the Member States is one of the objectives of the request. In the long run, this would allow for better coordination and put an end to the dependence on third countries in order to broaden the scope of the European Union’s competences.

For several years, budgets allocated to hospitals and health care systems have been drastically reduced, leading to a precariousness, not only of the public hospital, but also of the staff attached to it, preventing a good resilience and a good functioning of the latter. Indeed, expenditure on health systems varies greatly from one Member State to another. Before the pandemic, in 2017, France, Germany and Sweden were among the countries that spent the most on health, in contrast to the Baltic countries, which have the lowest rate of health spending, according to touteleurope.eu. Also, despite being a union of twenty-seven countries, the European Union is still very dependent, especially when it comes to medicines and vaccines. To date, the field of public health is primarily a matter for the Member States and not of the European Union. The latter can only complement the actions, which corresponds to a very limited room for taking action.

The European Union, on the basis of Article 168 of the Treaty on the Functioning of the European Union, can intervene in very broad areas such as the improvement of public health, health information and education or the fight against major scourges. However, public health policy is an internal competence of the Member States. Better cooperation between states may seem like a good thing, but not every member state has the same health care system or the same budgets for public health. A possible divide between countries. However, there are several European agencies and bodies that serve public health and allow a start to be made on collaboration between Member States, including the European Commission’s Directorate-General for Health and Food Safety, the CHAFEA Executive Agency, the European Monitoring Centre for Drugs and Drug Addiction, and the European Medicines Agency. Other agencies and bodies have been set up to enable the collaboration that European citizens expect within the European Union.

In order to achieve this goal of strengthening the resilience and quality of our health systems, the European citizens’ panel proposes six measures:

1. The creation of a “European Health Data Space”, which would facilitate the exchange of health data; individual health records could be made available – on a voluntary basis – through an individual EU electronic health passport, in compliance with data protection rules.

2. Adequate working conditions, in particular through a strong social dialogue, including on pay and working arrangements, and harmonization of training and certification standards for health professionals; networking and exchange programs should be developed, such as an Erasmus for medical schools, which would contribute significantly to skills development. In order to retain talent in Europe and allow young professionals to broaden their knowledge and gain professional experience, EU exchange programs should be developed to ensure that our best brains in the life sciences are not attracted to third countries.

3. Ensure strategic autonomy at EU level to avoid dependence on third countries for medicines (in particular active ingredients) and medical devices (including raw materials); in particular, a list of essential and priority medicines and treatments, but also innovative medicines and treatments (such as biotechnology solutions), should be established at EU level, building on existing European agencies and HERA, to ensure their availability to citizens Consider organizing coordinated strategic stockpiling across the EU. In order to achieve the necessary coordinated and long-term action at EU level, include health and healthcare as a shared competence between the EU and its Member States by amending Article 4TFEU.

4. Further develop, coordinate and fund existing health research and innovation programs without compromising other health-related programs, in particular for European reference networks, as the basis for the development of medical care networks for highly specialized and complex treatments.

5. Invest in health systems, in particular in the public and non-profit sector, infrastructure and digital health and ensure that health care providers respect the principles of full accessibility, affordability and quality of services, thus ensuring that resources are not drained by health professionals with little or no regard for the public interest.

6. Make strong recommendations to Member States to invest in effective, accessible, affordable, quality and resilient health systems, including in the context of the European Semester. The impact of the war in Ukraine on public health demonstrates the need to further develop resilient health systems and solidarity mechanisms.