High time for enhanced European coordination and competence on health
Date
28 May 2020
Sections
Health & Consumers
The COVID-19 crisis has exposed the gaps and weaknesses in health systems that the patient community has long been aware of. It has also brought home once again the importance of a strong European public health policy designed to meet the needs of Europeans. While the emergency is still not over, attention must now be turned towards enhanced European collaboration and competence to ensure our health systems emerge from it stronger, more prepared and more people-centred. Health is not only a national matter – it is an urgent European and global health policy priority.
EPF represents the interests of over 150 million patients with chronic conditions across the EU who expect and rely on European cooperation to improve healthcare delivery and quality for all. In concert with its 75 members, EPF ensures the patient perspective in European health debates and has significantly contributed to, among other things, understanding of the various barriers patients across the Union face in accessing healthcare whether in their own countries or across borders; recognition of the unique value that patients’ insights bring into assessments of healthcare quality; and the importance of tackling discrimination and stigma experienced by patients in employment.
The time is now right for a coordinated Europe to protect our health
Health and access to healthcare are fundamental rights, but also critical determinants of social cohesion and economic growth. In addition to the current COVID-19 crisis, Europe faces several important health threats which must be of top priority for the EU. These range from anti-microbial resistance, increasing prevalence of chronic diseases and persistence of infectious diseases, to the impact of emerging technologies and inequities in access to healthcare. These threats also do not respect borders and they can be far more effectively tackled together than by single Member States alone.
Under the Treaty, “common safety concerns in public health matters” is a competence shared between the European Union and EU countries (Art. 4 TFEU). Moreover, Article 168 TFEU enables the EU to take several different types of measures to support, complement or supplement national actions and policies in fighting major health scourges, inter alia by promoting research, monitoring, information and education, and by supporting cooperation between Member States.
EPF believes now is the time to end the debate on whether health is an EU competence. Citizens and patients have clearly voiced their expectations for the EU to do more on health. , In many cases, the EU already can do more: it simply needs a united political will and the necessary resources. We urge EU decision-makers to ensure that the Union exercises the full extent of its powers and instruments in the field of public health to do more now, while evaluating whether the health competences contained in the Treaties will be sufficient to ensure it has the capacity to not only cope with future pandemics but to deliver a healthy and cohesive future for its people.
Several actions can be taken forthwith: implementing existing EU legislation effectively, agreeing new legislation and guidance where needed, investing more resources in health, reinforcing the coordination role of the EU, and upgrading the Union’s health agencies. Civil society organisations play an important role and should be welcomed as partners in shaping Europe’s new health agenda.
Getting the best use out of the tools that we have
Several instruments and frameworks already exist at EU level to support more equitable access to high-quality healthcare. These include better implementation of Directive 24/2011 on patients’ rights in cross-border healthcare as well as the social security Regulations, to ensure those patients who need treatment across borders can get it without financial hardship.
We believe developing a transparent and reliable European joint procurement mechanism for medicines, vaccines and devices is needed to ensure their availability and affordability while contributing towards equity and solidarity. To complement this, we call for the proposed Regulation on health technology assessment to be agreed and implemented as soon as possible. Horizon-scanning and combining efforts on assessing new technologies can do much to reduce fragmentation, lead to more effective and efficient use of scarce national resources and contribute to fair access to effective new technologies across the Union.
In addition, the speedy implementation of the new Regulations on clinical trials and medical devices – both of them postponed – should remain an absolute priority in the EU agenda.
More investment in health coordinated by a stronger EU health programme
EPF strongly supports the decision to revert to a single dedicated Health Programme announced by Commission President Ursula Von der Leyen. This is an important recognition of the need to invest in Europe’s health. While we had welcomed the closer connection between health and social policy implicit in the European Social Fund Plus, we had also raised concerns about the positioning of health and the reduced budget allocated to the programme.
Europe needs a robust, forward-looking health programme which addresses not only cross-border health threats, but the above-mentioned formidable challenges posed by chronic diseases and persisting health inequalities that risk to be exacerbated by the current economic crisis. The Health Programme should support the introduction of innovative solutions for better quality, more accessible and people-centred healthcare. Innovation should not only be about new products and technology for patients, but also about supporting research into and exchange of knowledge in social and systems innovation, such as participatory healthcare practices and health literacy initiatives. The Health Programme should be closely linked to the health pillar of the research framework under Horizon Europe, the successor to the Innovative Medicines Initiative, digital policies such as the European Health Data Space, and relevant non-health activities to ensure a Health in All Policies approach. Designed effectively, the Health Programme can be the engine to identify health research needs, but also translate health research into workable evidence-based policy.
Stronger mandate and resources for the Commission and the health agencies
The mandate and resources of the EU’s two main health agencies, the EMA and the ECDC, should be extended and upgraded to ensure the expertise and capacity to deliver effective monitoring, information systems and regulatory activities. Equally, the new EU budget under the Multiannual Financial Framework should ensure that the Commission’s services are adequately resourced to undertake their necessary coordination role to drive Health in All Policies and synergies between sectors and DGs. A civil society engagement strategy encompassing but not limited to communication, should be implemented for the ECDC, adapting learnings from the long experience of the EMA where such engagement has proven invaluable.
Civil society plays a vital role
Meaningful patient involvement is an underused resource with real potential for improving the effectiveness, efficiency and long-term sustainability of healthcare systems. Patients’ organisations, together with other civil society health organisations, are an essential resource in shaping health policy at national and European levels. Patient organisations channel the voice of patients by representing their interests coherently, helping policymakers understand the lived experience and enhancing the relevance of policymaking. They also provide services, education, information and capacity-building. Patient organisations and the wider civil society must be fully involved in shaping the future of EU health policy and research. To enable them to play this role effectively and independently, co-production should be built into all EU-level health-related initiatives, along with sustainable resources for financial support to NGOs.
For further information or inquiries, please contact Katie Gallagher, Senior Policy Advisor katie.gallagher@eu-patient.eu