Congress report - European Health Forum Gastein

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European Health Forum Gastein 2001
In this sense, enlargement may trigger the long overdue formulation of a new or extended
role for health at EU level. The newly proposed and already quite progressive EU public
health strategy looks only half-hearted in the light of the possible problems related to
enlargement. There will be important roles for a future European Public Health Coordinating
Centre, a new institution recently mooted by the Commission. Here some US federal
institutions might serve as examples. The US Centre for Disease Control and Prevention
(CDC) and other federal institutes use legal and financial levers to achieve compliance with
federal regulations and support state and local networks with scientific advice and
coordinating capacity.
In conclusion, health accounts for an important share of a country’s economy and is a
substantial public concern. The state must take responsibility for health as a public good and
related externalities such as infectious disease control. It has a pivotal role in health care
systems: regulating financing and provider markets and avoiding market failures, fostering
good health and preventing health threats. In the specific area of EU enlargement a
substantial agenda remains to be tackled. For health and accession issues and the reform
agenda, is there an increased EU “federal” mandate?
6. Workshop Summary: Ms Laura MacLehose, Research Officer, European Observatory on
Health Care Systems, London School of Hygiene and Tropical Medicine
The five papers presented a broad range of issues related to the enlargement of the EU and
provoked a lively discussion. Issues from patient movement to the stewardship role for the
European Commission were touched upon. Views from the current EU member states and
from the accession countries were shared. The wide and varying topics broached throughout
the session reflected the complex process of enlargement, highlighted the far-reaching effects
of the move and pointed to many health issues for which the evidence is still unclear.
The new developments in the enlargement process in relation to health were highlighted by
Bernie Merkel. The Commission has been active in areas including funding, training,
information exchange and coordination. Martin McKee provided a broad overview of the
health situation across the EU and candidate countries. Epidemiological evidence for some of
the main health issues and their underlying causes were presented. In both presentations,
some of the challenges and opportunities for health through the enlargement process were
described. The future movement patterns of patients and health professionals are unknown
but this is a concern in terms of future planning, quality regulation and funding. The issue of
whether a minimum package for health was necessary for patients to move between
countries was raised. Pharmaceutical production, supply, quality and pricing are also issues
that need ongoing review in light of enlargement. Communicable disease control across
borders was also touched upon. The challenge of actually putting in place the Acquis
Communautaire (the complete body of EU law), which is estimated to total around 80,000
pages of text, and implementing and enforcing this new legislation was also considered. The
role of informal payments for health, common in many accession countries, was also
discussed.
The study carried out by the Austrian Federal Ministry of Social Security and Generations in
collaboration with candidate countries provided an interesting insight into quality policy in
the health care systems of the accession countries. The study, which built upon a previous
exercise of current EU countries, looked at the potential and need for cross-national
cooperation for quality issues. The study found that while quality policy issues have been
recently introduced in some of the accession countries, there is much interest in this area
and some laws and regulations in support of improving quality have been put in place.
However, although the importance of a having national health care quality policy was
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