Policy responses and statements

Name of organisation:

Department of Health

Name of policy document:

UK consultation on European Commission proposal for a programme of community action in the field of health and consumer protection 2007-13

Deadline for response:

6 January 2006

Background: This consultation sought views on a proposal from the European Commission for a for a programme of community action in the field of health and consumer protection for the years 2007 to 2013. The three core objectives for health and consumer policies in the proposed programme are:

- Protect citizens from risks and threats which are beyond the control of individuals and that cannot be effectively tackled by individual Member States alone (eg health threats, unsafe products, unfair commercial practices).

- Increase the ability of citizens to take better decisions about their health and consumer interests.

- Mainstream health and consumer policy objectives across all Community policies in order to put health and consumer issues at the centre of policy-making.

The actions that are foreseen to meet these objectives fall under the following headings:

- Improving communication with EU citizens on health and consumer issues;
- Increased civil society and stakeholder participation in policy-making related to health and consumer protection;
- Development of a common approach for integrating health and consumer concerns into other Community policies;
- Improvement of early detection, evaluation and communication of risk;
- Promotion of safety of products and substances of human origin;
- Promotion of international co-operation.

The strategy states that the two policy areas also have distinct and specific individual objectives. In the area of health, the following objectives are proposed:

To protect citizens against health threats;
To promote policies that lead to a healthier way of life;
To contribute to reducing the incidence of major diseases in the EU;
To contribute to the development of more effective and efficient health systems; and
To support the objectives above by providing health information and analysis.

COMMENTS ON
DEPARTMENT OF HEALTH UK CONSULTATION
ON EUROPEAN COMMISSION PROPOSAL FOR
A PROGRAMME OF COMMUNITY ACTION IN THE FIELD OF HEALTH AND CONSUMER PROTECTION 2007-13

Summary of Key Points

1 The College gives a cautious welcome to the proposals, remaining concerned that the driver may be administrative efficiency rather than significant policy synergy.

2 The College supports a robust defence of the health budgets, given the essential programme of work listed within the proposals and the threat to the overall EC budget. It would be important to ring fence health funds within a joint programme.

3 The College supports strongly the focus on public health and the intention to share best practice across Europe. It is important that this programme interfaces with other Directives with policies that directly or indirectly impact on health (eg DG Agriculture and DG Employment).

4 The College endorses the focus and links with the R and D Framework proposals given the gaps in knowledge and evidence, particularly in public health.

5 The College encourages wider dissemination of the UK role in EC activity on health and acknowledgement of the value of work completed to date.

General Comments

The College is pleased to respond to the above consultation and supports the combination of health and consumer protection in one programme, provided that this does not in any way hazard the focus on public health or allow the future of health care to be driven slavishly by economic output and competitiveness.

Although not so labelled within the European Commission (EC), much of the “consumer protection” agenda includes policy areas which outwith the EC would be thought of as “public health” (eg food safety), and others which also contribute to improved community health and avoidance of injuries (eg safety of toys etc.). Indeed, a combined programme may result in increased administrative efficiency, thereby releasing additional funds for investment in projects etc.

The College supports the stated objectives of the EC:

• to protect citizens against health threats
• to promote policies that lead to a healthier way of life
• to contribute to reducing the incidence of major diseases in the EU
• to contribute to the development of more effective and efficient health systems, and
• to support the objectives above by providing health information and analysis

The current public health programme includes three elements: development of health and health service information systems, control of health threats, and promotion of health by tackling health determinants. The new proposed programme includes the following (health) strands:

• “Enhance surveillance and control of health threats”; acknowledging the importance of ensuring robust systems for health protection at EU level. The College is encouraged by the recent creation of the European Centre for Disease Prevention and Control (ECDC) in Stockholm.

• “Deliver response to health threats”: this is a new strand. The College supports EU activity (such as development of infrastructure, capacity development etc) which enhances the effectiveness of arrangements at national level, provided there is at no stage duplication of services, which could be both wasteful and a cause of confusion.

• “Promote health by tackling determinants”: the College supports the EC’s intention to tackle both lifestyle factors (such as tobacco, alcohol, and unhealthy diets) and the broader socio-economic and environmental health determinants. These are core public health activities, and can enhance considerably actions taken at member state level.

• “Prevent diseases and injuries”: this is another new strand. The College supports as both reasonable and sensible the proposals for development of secondary prevention (coupled by enhanced research in this area) and for campaigns for injury prevention targeted at specific risk groups.

• “Achieve synergies between national health systems”: this is another new strand, and, in the view of the College, one forced upon member states and the EU by decisions of the European Court of Justice (ECJ). It is clear that, in the absence of any EU competence to legislate in the field of health services owing to rights acquired by both individuals and organisations through Single Market legislation, the ECJ has been obliged to fill the void with case law. The College is concerned about this and would prefer the implications of the Single Market for health services to be clarified by transparent legislation. However, in the absence of such a possibility, the College acknowledges that the EC’s proposals for facilitating cross-border health care, information exchange, promotion of patient safety, setting up an EU system of reference centres of excellence etc do attempt to clarify the relationship between nation health services in the light of ECJ decisions concerning health services.

• “Generate and disseminate more and better health information to citizens, health experts and policy-makers”. There are a dearth of effective and reliable information systems concerning health and healthcare in Europe, especially if compared to the situation in the USA. The development of effective systems in this area must be a high priority for both the EC and all member states, if more effective services are to be planned, delivered and evaluated properly in the future and citizens of Europe are to engage in the debate.

The College notes, however, that the EC defines “public health” and “health” very narrowly, and that many very important determinants of health are the responsibility of other DGs, such DG Agriculture (in the area of food production and nutrition), DG Employment, DG Transport, DG Research, and DG Region (with its substantial regional development and cohesion funds). While the first paragraph of Article 152 of the Treaty of Rome (as currently amended) states that: “A high level of human health protection shall be ensured in the definition and implementation of all Community policies and activities”, there appears to be a general tendency to deprioritise this requirement in several DGs. In particular, the College is aware of the importance of improving the nutrition of diets across Europe, and of the contribution towards this which could be achieved if the Common Agricultural Policy (CAP) could be reformed so as to promote health. Accordingly, the College would welcome a statement of intent to observe and apply the requirements of this important statement within the Treaty.

The College welcomes the intention in the EC’s proposals for a considerable increase in the budget allocated to health-related activities, whilst noting the current problems between member states regarding agreement over the overall budget for 2007- 2013. The College hopes that, within whatever overall budget package is finally agreed, the planned increase in spending in the health budget is preserved.

The College has less expertise in the consumer protection field, but in general supports the proposed four strands of action in this area: “better understanding of consumers and markets”, “better consumer protection regulation”, “better enforcement, monitoring and redress”, and “better informed and educated consumers”.

Consultation Questions

Considering the specific questions posed by the Department of Health in its consultation, the College offers the following responses:

1 Do you agree with the public health objectives of the proposal?