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40 <strong>EDI</strong> European Law Green Paper lists future challenges Europe to Promote Healthcare Professions With its “Green Paper on the EU Workforce for Health”, the European Commission is making another attempt to expand its competences in the healthcare sector. That despite the fact that the EC Treaty states that the principal responsibility for organizing and delivering healthcare services lies with the member states. A striking point is that the Commission seems to base its deliberations on a healthcare concept with a focus on employees rather than self-employed persons. It does not differentiate between healthcare professions. Those who want to look more closely at the hypothesis of the Green Paper will also have to read the White Paper “Together for health” published in autumn 2007. In this work, the Commission explains its strategic approach to Community healthcare policy and makes concrete suggestions. The strategy is based on common values and principles for the healthcare systems of the EU member states that are not defined by European law but by a series of decisions by the ministers of health. As the European Council stated in June 2006, these values and principles include universality, access to high quality care, distribution fairness/equality and solidarity. A common healthcare policy wants to “take the rights of citizens and patients as its starting point”. Demographic changes and the healthcare system In July 2008, therefore, the Commission presented a draft “Directive on the application of patient's rights in cross-border healthcare“ intended to increase patient mobility. It is currently being discussed by the European Parliament. Unlike this specific legislative act, the Green Paper on the EU healthcare workforce addresses the question how healthcare services can be provided for an aging European society. After all, the number of people over 65 years will grow by almost 67 million by 2060. In addition to demographics, the heterogeneity of the workforce – different levels of knowledge and expertise – and the low popularity of the healthcare professions with the younger generation constitute special challenges. This is compounded by the problems related to the migration to and from the EU, especially immigration from poorer countries. Seen in this light, the demand for a “high-quality workforce” is a quite ambitious goal. Green Paper calls for a “high-quality workforce” Whether a sufficient number of healthcare workers can be attracted in the future will depend on how successfully young workers can be recruited and held and how much is invested in existing healthcare staff. According to the Commission, this includes both a capacity increase in healthcare education facilities and intensive continuing education. But Brussels would not be Brussels if it did not immediately suggest the formation of a new authority: A “Monitoring Centre for the healthcare workforce” is to support the member states in planning the future development of the healthcare workforce. In addition, the flow of data is to be improved in order to obtain reliable indicators for the future demand for healthcare workers. Whether this will ultimately create as much as a single job remains to be seen. Despite the increasing demand for qualified personnel within the EU, the Commission is set to do everything to avoid a “brain drain” from developing countries to Europe. Two years ago, Brussels suggested applying ethical standards to the hiring of highly qualified healthcare workers from third countries in order to limit the negative influence of migration on precarious healthcare systems in developing countries. Relieving the burden on the self-employed Not until the very end does the Green Paper address the entrepreneurs for the creation of jobs in healthcare. Small and medium enterprises are the driving forces of growth and employment – this is as true in the healthcare sector as elsewhere. Improving the conditions for entrepreneurs in healthcare is therefore an important contribution toward increasing the healthcare workforce. Unfortunately, the Commission’s suggestions in this area are limited to “promoting entrepreneurship” and “examining the barriers to entrepreneurial activity in the health sector”. That is far too little to master the immense challenges facing the member states in the healthcare sector. Peter Knüpper, solicitor Joint practice of Dr Rehborn Munich, Germany
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