Everything-you-always-wanted-to-know-about-European-Union-health-policies-but-were-afraid-to-ask

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EU action for health 55 leave career grades, recruiting more junior doctors and sharing the workload with other facilities, including in the private sector. Accordingly, in 1998 the Commission proposed extending the directive to cover excluded sectors including doctors in training. The updated directive agreed on this basis in 2000 60 did extend the original directive to cover doctors in training but provided a specific further transitional period of up to eight years with higher limits on working time for doctors in training (an average of 58 hours a week, progressively falling to 52 hours a week). This again was in order to take account of the specific difficulties of health system organization, in particular put forward by the United Kingdom. These directives were then further amended and consolidated in 2003, with broadly the same provisions although with a cap on weekly working hours of 48 hours. The directive included similar derogations for longer working hours for doctors in training as the 2000 directive; it also allowed Member States to provide for exceptions allowing employees to choose to work longer hours if they wished, and for managers to be exempted from the cap. Given the size of changes brought by the directive in comparison with the historical practice of doctors working well over 100 hours a week, it is perhaps not surprising that some doctors and managers were critical of the provisions to reduce working hours, arguing that these would reduce the scope for clinical training, and discounting the benefits to patients from fewer fatigue-related errors and to the long-term health of doctors themselves. 61 Indeed, it has taken considerable time and debate to arrive at models of care organization that reconcile these different objectives, and the issue is still debated. However, the criticisms that the EU working time legislation had been developed without taking account of its impact on health systems is more difficult to understand, given that this had been a central part of the European debate since the original directive in 1993, as is the general absence of engagement of health professionals from this debate until the stage of implementation of the 2003 directive in the mid-2000s. This seems to be another example where the wider health community did not understand or engage with the impact of Europe on health – perhaps because the formal basis of the Working Time Directives was health and safety at work, rather than the article on public health, and discussion largely took place in employment-related forums rather than the Health Council, for example. 3.2.6 Consumer protection Injuries and other external causes of death (such as traffic accidents and intentional self-harm) are a major cause of death for younger adults in the EU, particularly 60 European Parliament and Council. Directive 2000/34/EC amending Council Directive 93/104/EC concerning certain aspects of the organisation of working time to cover sectors and activities excluded from that Directive. Official Journal, 2000, L 195:41–44. 61 Mossialos E et al. (eds). Health systems governance in Europe: the role of EU law and policy. Cambridge, UK, Cambridge University Press, 2010.
56 Everything you always wanted to know about European Union health policies men, as shown in Fig. 3.2. This highlights the importance of avoiding injuries in daily life, and this is the area where EU consumer protection actions have their main contribution to health. In particular, the General Product Safety Directive 62 obliges anyone selling consumer products to ensure that they are safe and it provides a range of mechanisms and reference points for doing so, as well as provisions for monitoring and enforcement. 63 One particularly important mechanism is that of European standards, which once developed form key benchmarks against which the safety of products is assessed. Fig. 3.2 Major causes of death by age group in the EU25, 2002 100 Deaths (%) 80 60 40 Other External causes of injury & poisoning Cancer Diseases of the digestive system Diseases of the respiratory system Diseases of the circulatory system 20 0 0 1–4 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 ≥85 Age groups (years) Total Source: Eurostat. Causes of death: annual data. (http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ cd_asdr&lang=en, accessed 4 July 2014). Note: EU25: Member States in 2004. There is also specific legislation on the safety of some specific products, of which the regulation of pharmaceuticals and medical devices is particularly relevant; this is discussed in Chapter 4. There is as yet no similar general European legislation on the safety of services (although the safety of some services is regulated, such as aspects of transport services). 62 European Parliament and Council. Directive 2001/95/EC on general product safety. Official Journal, 2002, L 11/4. The legal base of this directive is actually the internal market article, the first iteration of the directive in 1992 being adopted before the consumer protection article was introduced by the Maastricht Treaty, but it is considered to be part of the EU’s consumer protection legislation and the revised version makes explicit reference to the consumer protection article. 63 Hancher L, Sauter W. EU competition and internal market law in the health care sector. Oxford, Oxford University Press, 2012.
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Everything you always wanted to kno
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The European Observatory on Health
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Keywords DELIVERY OF HEALTH CARE EU
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vi Everything you always wanted to
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List of acronyms and abbreviations
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Summary The idea of “European Uni
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Summary xiii the EU institutions, w
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Chapter 1 Introduction The idea of
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Chapter 2 The EU: institutions, pro
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Fiscal governance and what it means
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Appendix Selected articles relevant
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Appendix 137 protection of national
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Appendix 139 Article 56 (ex Article
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Appendix 141 (f) representation and
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Appendix 143 Union action, which sh
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Appendix 145 - preserving, protecti
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What does the European Union mean f
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