1 Europe André Meijer Universiteit Maastricht Programme director European Public Health

2 European Community role on health (main source: Lecture dr. Merkel, dg sanco, in Maastricht)

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5 Europe  The Treaty of Rome (25 March 1957) created our European family  The Maastricht Treaty (1992) created a specific public health role, still developing  But health has always been an important part of the Community policies

6 Health in Community policies - but in which ones?  Free movement of goods  Agriculture  Free movement of persons, services and capital  Visas, asylum and immigration  Transport  Competition and taxation  Economic and monetary policy  Employment  Commercial policy  Customs  Social policy  Culture  Public health  Consumer protection  Trans-European networks  Industry  Economic and social cohesion  Research and technological development  Environment  Development cooperation  International cooperation (source: lecture dr. Merkel, dg sanco, in Maastricht)

7 Health in Community policies - all of them! Free movement of goods Free movement of goods Agriculture Agriculture Free movement of persons, services and capital Free movement of persons, services and capital Visas, asylum and immigration Visas, asylum and immigration Transport Transport Competition and taxation Competition and taxation Economic and monetary policy Economic and monetary policy Employment Employment Commercial policy Commercial policy Customs Customs Social policy Social policy Culture Culture Public health Public health Consumer protection Consumer protection Trans-European networks Trans-European networks Industry Industry Economic and social cohesion Economic and social cohesion Research and technological development Research and technological development Environment Environment Development cooperation Development cooperation International cooperation International cooperation (source: lecture dr. Merkel, dg sanco, in Maastricht)

8 Public health actions  Legislation to set European rules and standards  Open coordination  Policy actions (of Commission and Sanco)  Support to Member States and society (through networks and projects)

9 Policy actions In 2005 Commission introduced a process which includes policy development on :  ‘health’ and  ‘health systems’

10 Future Health Strategy

11 Health Strategy: Consultation 2004  Results: Mainstreaming cross-policy approach Mainstreaming cross-policy approach Focus (further) on promotion Focus (further) on promotion Bridge health inequalities Bridge health inequalities Tackle global health issues Tackle global health issues Address other key issues: ageing, technology, cross border issues Address other key issues: ageing, technology, cross border issues (source: lecture dr. Merkel, dg sanco, in Maastricht)

12 Pharmaceutical Forum EU In Tech E-Health HTA Healthy Life Years Health information Health Portal European Centre of Disease prevention He S ec Com Health services Initiative Patient Safety - Health Profs Health investments in Structural Funds Regions for Econ Change White paper on Nutrition Communication on Alcohol Tobacco control strategy WHO, ENP Third Countries Current and Future Challenges (source: lecture dr. Merkel, dg sanco, in Maastricht)

13 The EU Health Strategy Why an EU Health Strategy now?  No coherent strategic approach to current and future challenges, no overarching aims and objectives  There is a need to: Set out a strategic overall framework (10 years with a mid term review), including cross-sectoral work and partnership with Member States Set out a strategic overall framework (10 years with a mid term review), including cross-sectoral work and partnership with Member States Set out aims and objectives Set out aims and objectives Trigger change - deliver concrete results through an effective implementation process Trigger change - deliver concrete results through an effective implementation process (source: lecture dr. Merkel, dg sanco, in Maastricht)

14 Framing the Strategy Core Issues to improve the health of EU citizens - promotion and prevention, inequalities, ageing, cross-border issues; health services… 2. Health in all Policies - Regional development, structural funds, environment, economic policy, social policy, research etc. 3. Global Health - EU work at the global level communicable diseases, pandemics, trade, health and development aid Global Issues Health in all Policies Core Issues (source: lecture dr. Merkel, dg sanco, in Maastricht)

15 Consultation process  Sanco started with note  ASPHER participated and reacted formally (among 150 others)  Impact Assessment includes data on administrative burden and administrative costs for the MS   White Paper on EU Health Strategy in mid/end 2007  See Commission website: _strategy_en.htm

16 Health services initiative

17 Free movement but…  Basic principle: Court has ruled that health services are provided for remuneration thus fall within scope of the Treaty  But barriers to free movement may still be justified, in particular: to protect public health; to protect public health; to ensure financial sustainability of health systems. to ensure financial sustainability of health systems.

18 Health Services Initiative  Bring legal clarification and certainty  Help national health systems to better address common challenges  Reduce inequalities between Member States and regions

19 Health Services Initiative: the Consultation  Consultation closed 31/01/2007  Over 270 replies received  Individual replies already available in the Internet  Report of the consultation will be presented to the Informal Council in Aachen April 2007  After the Council, report will be available in the Internet  Based on the consultation, the Impact Assessment will be launched  Proposal expected November 2007  operation/mobility/community_framework_ en.htm

20 EU 2008 and future plans

21 Main topics  Free movement  Patient safety  Sufficient and good health workforce

22 Patient safety  Key concern of citizens – 78% of EU citizens see patient safety as an important problem  Estimate of 10% of adverse events  Mainly Member State responsibility, but enormous potential for added value

23 Patient safety  Main objectives Reduce avoidable harm Reduce avoidable harm Ensure citizens have confidence in healthcare throughout the EU Ensure citizens have confidence in healthcare throughout the EU Blame-free culture for professionals Blame-free culture for professionals When mistakes happen, have mechanisms for learning from them and providing redress When mistakes happen, have mechanisms for learning from them and providing redress Sharing best practice to ensure high standards for all EU health services Sharing best practice to ensure high standards for all EU health services  Proposals in 2008

24 Health workforce for Europe  Shortages of health professionals for some regions and specialisms Migration Migration Ageing of the health workforce Ageing of the health workforce Impact in developing countries as well Impact in developing countries as well  Variations between countries Initial training content, recognition of specialisms, continuing professional development Initial training content, recognition of specialisms, continuing professional development  Need collective action to address

25 Health workforce for Europe  Establish a European Health Workforce Forum Building on the work of the High Level Group Building on the work of the High Level Group Bringing together all relevant stakeholders Bringing together all relevant stakeholders Develop shared ideas for next steps Develop shared ideas for next steps  Opportunity to rethink the health workforce we need in Europe

26 So what ?

27 Draft proposals  More focus in curricula for cross border, European and global developments in PH  Cooperation and alliances with other European PH associations  Common projects  Support by members through Pool of experts Pool of experts Thematic committees Thematic committees  An office in Brussels with an active and supportive staff

and further There is definitely a big role for ASPHER to play in Brussels, elsewhere in Europe and the world