Towards a healthy future? It’s all about working together

Date: 13/01/05

Two MEPs discuss Europe's health prospects and argue for more cross-border partnerships and medical trade

It is time for a new health agenda for the EU and for member states to share their best practice, says John Bowis

The slogan "No Wealth without Health" has never been more relevant to the nations and peoples of the European Union, in relation to both health and development policy. The year has begun with European governments shamefacedly following the lead of millions of their citizens, who immediately understood the urgency of the health and survival needs of the crisis and opened their hearts and their purses to the victims of the Asian Tsunami disaster. Perhaps those same peoples' governments and the EU will now understand that the laudable aims of the Lisbon Strategy to enhance Europe's competitiveness and economic success cannot be achieved without good preparedness against health threats.

In 2004 we welcomed ten new member states to the EU. Each brought its own traditions in health care practice and policy. Each has its own challenges, opportunities and constraints. Yet one of the fundamental abilities of the Union is to find and share best practice and to learn from each other. The EU cannot itself close those gaps in health but it can point the way for individual countries to do so.

EU health policy is at an important stage in its development, as it attempts to manage the many challenges that have emerged over the last few years. SARS, avian flu, the coming flu pandemic and the threat of bio-terrorism have all forced EU states to re-examine their readiness to tackle health threats collectively. The establishment of the European Centre for Disease Prevention and Control in Stockholm has been one answer to this, taken through the Parliament, remarkably, in a single reading. Legislation has also been brought forward on mobility and employment rights, on professional qualifications and on the internal market, which is encouraging greater movement of individuals across the EU, with implications for both healthcare planning and epidemiology.

But patients are demanding more from their national health systems as European Court of Justice (ECJ) rulings and the media promote patient mobility. Then we too address fears of some countries whose health professionals may be tempted abroad and others faced with an increasing burden from health tourism.

The upside of all this will, or should be, new cross-border partnerships, not least on capital investment and skills exchange, where existing health service structures are concerned, but also new techniques of tele-medicine, therapies, communications and patient information.

The issue that has been troubling many officials has been that of patient rights and expectations. The new patient mobility rights are good for patients, who will be able to bypass "undue delay" for treatment in their own country; but not so good for health service managers, who will have to cope with unplanned bills. So how do we develop a consistent approach to the issue, without treading on domestic toes?

The Commission Communication on patient mobility is now being considered by the Parliament. The High Level Reflection Process had identified a number of key themes to improve cross- border healthcare. The Commission's response suggests the process has been little more than a starting point, a drawing of breath before any plunge into the deep waters of reform. No timetables are set; no firm targets for action included; instead we are offered more investigation and more evaluation.

Much of what we expect on health from the new Commission, however, is neither legislative nor costly. Europe is often at its best when it shares best practice. On diabetes for example the Irish presidency put the ball into play. We look to the Commission to run with this, as they did to good effect with cancer screening. Obesity and heart diseases are at excessive levels throughout the EU; likewise mental health problems; likewise HIV/AIDS, so ably assessed by Commissioner Pavel Telicka before his untimely removal as the Czech nominee. All of these should be high on the agenda of our new and welcome Health Commissioner Markos Kyprianou - and no less so for his development colleague Louis Michel.

• British Conservative MEP John Bowis is EPP-ED co-ordinator on the European Parliament's environment, public health and food committee.

There is no reason to close the borders for life-saving remedies while flower bulbs can be traded freely, argues Jules Maaten

Although the European Union does not have exclusive authority over public health, there is much that can and should be done on a European level. The best way to face the problems in healthcare in Europe is to open up the market to have better healthcare and more choice for the patient, to create a better understanding of health-threatening factors relating to lifestyle and to have a European mechanism to react quickly on serious health threats such as SARS, AIDS/HIV and avian flu.

To open up the European healthcare market, the notion of an internal market should be widened. In the year 2005 most products and services, from financial services to flower bulbs, can be traded freely within the Union. So why should the borders remain shut for life-saving remedies and services? One European market for pharmaceuticals, medical care and information could solve a lot of problems for current and future patients. Medicines are essential products, but in the end they are still products on a market of suppliers and consumers; products that are traded. Competition on the market will stimulate companies to innovate and to offer better quality. It will also lead to lower medicine prices for the patient.

The goal must always be to give more choice and better opportunities to the patient. This does not necessarily mean that a completely free market will solve all problems, such as medicines for rare diseases and medicines for children. Access to these kinds of medicines should be guaranteed at all times.

Healthcare could be improved by enlarging the possibilities to visit a physician abroad. The right to visit a physician outside one's own country has already been recognized by the European Court. In my opinion it would be useful to put this right into EU legislation. The principle should be that in a modern society, with generally well educated, mobile and eloquent citizens, people should be able to choose for themselves where they want to be treated and how.

In order to make a considered choice, it is important to be well informed. This can be realised by making it possible for patients to obtain direct information from pharmaceutical companies about medicines and to dispose freely of information on treatment possibilities, independent of the physician.

Better information is also the key to create a better understanding of health threatening factors related to lifestyle. For example, smoking was the number one cause of preventable death in Europe and still there was more information available on the contents of a jar of jam than on the contents of a cigarette. Fortunately manufacturers are now obliged to provide full information on the ingredients of cigarettes. Smoking is an individual choice, but the consumer has the right to full information. So it should be with alcohol or diseases related to lifestyle, such as diabetes. Of course anyone can choose to drink and eat what they want, but they should be aware of possible risks. Only then can they make a balanced choice.

The Union should take the responsibility for protecting the citizens against contagious diseases and bio-terrorist threats. It was pure luck that SARS largely passed Europe by and afflicted other parts of the world. Next time we may not be so fortunate. Given the current threat of a pandemic of SARS or avian flu for example, an information centre is not enough. Concrete action is necessary. There needs to be a European centre that can take action within 24 hours if a pandemic is threatening the health of European citizens.

The open market of pharmaceutical products and medical services, the effective protection against epidemics on a European level and the awareness of life-threatening lifestyles cannot be realised from one day to the next, but in the interest of the patient, the new health commissioner should pursue these goals.

• Jules Maaten is a Dutch Liberal MEP and a member of the Parliament's environment, public health and food committee.

Two MEPs discuss Europe's health prospects and argue for more cross-border partnerships and medical trade.

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