Nicola While on health care and Europe

Nicola While The run up to the Christmas recess is a traditionally busy time for the European institutions. Last year proved to be no different with a rash of new legislative proposals being released in the pre-festive period. The publication of initiatives on a number of key issues for the medical community encompassing issues as diverse as information for patients on pharmaceutical products, the safety of organ donation and an assessment of the challenges facing the European health workforce will keep MEPs busy for the next six months.

However, the prospect of the summer European Parliament elections when MEPs will return to their constituencies to canvas and when the parliamentary process will grind to a halt casts a long shadow over all policy discussions. Any dossier that is not completed by the summer, when the five-year term of current MEPs comes to a close, runs the risk of being re-started from scratch once the new cohort of 734 MEPs take their seats in the autumn.

Thus controversial dossiers such as the long awaited pharmaceutical package may not complete their tortuous journey through the parliamentary process before the summer deadline. This is a prospect that many health stakeholders may welcome as, whilst the package contains laudable proposals on pharmacovigilence, and measures to prevent drug counterfeiting, it also contains a controversial proposal to relax the rules on the provision of information on prescription only medicines.

Following months of heated debate and intense lobbying, the European Commission is proposing to maintain the ban on direct to consumer advertising whilst allowing pharmaceutical companies to increase the non-promotional information that they can provide to the general public.

Despite assurances from the pharmaceutical industry that this will not lead to advertising, many stakeholders are concerned that the distinction between information and advertising will be blurred and that patients will be at risk from potentially damaging misinformation.

A more welcome move is the proposal for a Council recommendation on patient safety which includes the prevention and control of healthcare related infections. Whilst the EU has no jurisdiction to enforce European-wide quality standards, it can work to encourage member states to raise healthcare standards at the national level and to share best practice in the face of tricky problems such as the prevalence of healthcare related infections in hospitals.

The European Centre for Disease Prevention and Control estimates that such infections affect one in twenty hospital patients throughout the EU. The proposal calls for member states to implement national strategies to combat the problem and suggests ways in which they can work together to monitor pathogens and rates of infection. Widely welcomed by healthcare organisations, this focus on patient safety is part of an overarching strategy by the European Commission to promote patient rights and issues of safety across the EU.

Another key initiative is the Green Paper on the European health workforce which proposes a number of ideas to enable member states to respond to changing patterns of mobility, to the growth of new technologies such as the increased use of telemedicine and to issues around capacity and workforce planning. Initiatives such as investing in the training and recruitment of health personnel and fostering bilateral relations to take advantage of any surpluses of doctors and nurses across the EU should help member states to tackle the challenges facing the health workforce. Meanwhile, global migration is addressed by the proposal to develop an EU-wide set of principles for the ethical recruitment of health professionals from developing countries.

Concrete legislative proposals are unlikely to be published before autumn 2009 but the ball is now rolling and EU member states have recognised the need to work together in order to manage the supply and demand of healthcare workers.

One thing is for sure is that the first half of 2009 will see a flurry of European activity in the healthcare sector and the increasing prominence of health in EU policy making is not set to wane just yet.

Nicola While is EU liaison Liaison Officer at the British Medical Association.