Nicola While: The EU impact on UK healthcare

The May 2010 coalition agreement in the UK promised to examine the balance of competences between Britain and the European Union (EU) with a view to assessing how the UK’s national interests interact with the EU.

The UK Foreign and Commonwealth Office (FCO) duly launched this review in July 2012. It will be broken down into a number of individual reports covering specific areas of EU competence, and will run until autumn 2014.

This month the Department of Health (DH) published its call for evidence with a deadline of 28 February 2013. It hopes to produce its report on the EU impact on UK healthcare in summer 2013, which will feed into the conclusions of the wider review.

The DH call for evidence asks a number of questions which focus on overarching issues regarding the impact of EU legislation on the provision of healthcare and the extent to which EU policies are effective in promoting and improving public health.

Responses to this call for evidence may welcome the priority given to public health and patient safety at EU level and recognise that some issues are best addressed at the supranational level due to the free movement of patients, doctors, and medical products across borders, and the prevalence of public health threats which do not respect European internal borders.

However, they may also insist that it is essential that EU legislation fully respects the principle of subsidiarity and the right, enshrined in the EU Treaties, of member states to organise and finance their healthcare systems as they see fit. This is particularly important given the nature of the UK’s publicly funded NHS.

The FCO review covers a wide range of policies where the EU has competence and which affect the health sector. These range from the relatively uncontroversial (pharmaceuticals, medical devices, and public health) to other policy areas which are not dealt with directly by the Department of Health, but which often have unintended consequences on the health sector (employment policy, internal market policy, enlargement).

Responses to these aspects of the review will be most interesting and may potentially have the biggest impact on the UK government’s future relationship with the EU. This is especially true for employment policy where the coalition government has already voiced its intention to “limit the application of the European Working Time Directive in the UK.”

Examining wider EU policies, such as future enlargement, will also have a bearing on the UK health sector. If large countries such as Turkey are to join to the EU in the coming decade as planned, the impact on policies such as the free movement of doctors and patients may be substantial.

The final conclusions of the review should be published just in time for the next UK general election which is due to take place in May 2015. Its impact on the outcome of that vote may be crucial.

Nicola While is an EU policy specialist.