The Standing Committee of European Doctors (CPME) aims to promote the highest standards of medical training and medical practice in order to achieve the highest quality of health care for all patients in Europe. CPME is also concerned with the promotion of public health, the relationship between patients and doctors and the free movement of doctors within the European Union. CPME’s members are the most representative National Medical Associations of 27 countries in Europe and works closely with the National Medical Associations of countries that have applied for EU membership as well as specialized European medical associations.

CPME welcomes the opportunity to respond to the European Commission’s new strategy document for the European Union. We have read this document with great interest and hope. Unfortunately, it became very quickly apparent to us that the issue of health is not addressed in this document. In fact, health is only mentioned twice, in passing1 1 Page 6: we should look ahead and match future skills better to future needs, particularly for new types of jobs such as “green” jobs and other growth areas, such as in the health sector. Page 10: The emergence of new services (e.g. on-line services, such as e-health shows huge potential).

We sincerely regret that a document, which purports to “shape the next generation of public policies”, does not recognize the pivotal role of health. Although health issues come under the principle of subsidiarity, the EU’s added value in this field is undeniable.

In addition, we would argue that many of the societal and economic challenges identified in the Commission’s document have significant consequences in the health sector, which should be recognized and integrated in the Commission’s vision for 2020. Health is a cross cutting issue and should therefore be an integral part of the Commission’s new generation of policies and could be achieved namely by highlighting:

- the link between the economic crisis and the implications on health, e.g. mental health, poorer health outcomes (namely due to stress, poor diet, etc).

- the relationship between an exit strategy out of the crisis and the role of the health sector as one of the biggest, most innovative and dynamic sectors of the economy. The health and social care sector have been a pivotal in the expansion of the services sector since 2000 and should therefore be supported to be a driving force in the context of an economic recovery policy.

- the importance of tackling health inequities (between and within the Member States), which have been further exacerbated in the current economic crisis. The more health issues are streamlined in policies, the better health and economic outcomes will be. This is recognized in Art. 168 of the Treaty on EU on health mainstreaming which asserts that European Commission proposals should always take into account their possible adverse effects on health and that these should be changed if found problematic.

- the link between health and climate change both in terms of new health threats due to climate change and also the environmental footprint of the health sector (e.g. hospitals and the pharmaceutical sector) should be reflected in the strategy. The impact of the health sector must be taken into account in the creation of a smarter, more efficient and greener economy.

- the impact that the rising cost of healthcare, demographic challenges, and ageing population (burden chronic diseases, etc) will have on the health sector. The Commission has recently highlighted the strain under which the health sector is increasingly under (e.g. Green Paper on European Workforce for health) and that will affect all Europeans and yet none of these concerns are highlighted in the Commission’s 2020 strategy. The economic and healthcare benefits of new technologies, such as e-health, should also be clearly reflected in the EU 2020 strategy. As the European Commission highlighted in its report “e-health is worth it”, e-health services may well provide better quality services for less money.

- the impact of cross border care given that it is not only the diseases that cross the borders but increasingly EU-citizens, both as citizens and as patients. In this respect the Cross Border Health Care Directive is key.

- while the Commission stresses the interdependence between Member States in the economic sphere this is also true in the health sector. For instance, new/emerging health threats (e.g. H1N1 pandemic, tobacco and alcohol and global shortage of health professionals) can best be tackled through EU-wide cooperation. CPME agrees with the Commission’s statement that “Our social, economic and environmental objectives must go hand in hand if we are to deliver on our thematic priorities for 2020.” We believe that the suggestions set out above support this position and give concrete examples of how this can be best achieved in the interest of Europeans’ well-being

– which is now a new objective of the EU (as enshrined in Art. 3, Treaty on EU). In his strategy for the next Commission, President Manuel Barroso called to put “People at the heart of the agenda”. Yet health, which is of the highest importance to EU citizens, was overlooked. In the Future “EU 2020” Strategy paper, the Commission states that “delivering this sustainable growth requires agreement to an agenda that puts people and responsibility first” yet health has again been overlooked. The EU’s added-value has been to help make European citizens healthier, safer and more confident. We, European doctors, therefore urge you to ensure that health is put back at the heart of all of the Commission’s policies.

Rue Guimard 15 (4th Floor) - 1040 Brussels - Belgium Tel. : +32 (0)2 732 72 02 - Fax : +32 (0)2 732 73 44 - E-mail : secretariat@cpme.eu - Web : http://www.cpme.eu