Euro Brief
November 2006. No: 11/2006
For further information on any of these news items, please contact: nwhile@bma.org.uk
- Consultation: Health care services
- No agreement on Working Time
- EU strategy to reduce alcohol related harm
- European Qualification Framework
- Ageing European population and health care impacts
- Diet and nutrition
- Consultation: Ethics in clinical trials on children
Following the exclusion of healthcare services from the Directive on Services in the Internal Market earlier this year and following the recent rulings by the European Court of Justice advocating cross-border healthcare, the European Commission is proposing to establish a European Community framework for safe, high quality and efficient health services.
The overall objective of this framework is to provide Member States with more legal certainty and increased support for cooperation between national health systems. Before the European Commission makes proposals for future action in this area, which are expected later in 2007, it has launched a public consultation.
The consultation contains nine key questions and is open for consultation until 31 January 2007. Any interested party can submit a response and the BMA’s final response will be featured in a later issue of euro brief. Meanwhile the consultation will be discussed at a meeting of the European Forum on 13 December.
No agreement on Working Time
EU Ministers have once more failed to reach agreement on the revision of the Working Time Directive. The Directive is currently under review with the aim of abolishing or greatly reducing the use of the opt-out in order to achieve a European-wide 48 hour working week.
The Finnish EU Presidency submitted a compromise proposal at the end of October which aimed to forge a middle way between the two opposing sides to the debate. The compromise proposal would have allowed the UK to keep its opt-out whilst imposing slightly stricter conditions on its use. It would also have reduced the overall ceiling for all workers (including those who have signed the opt-out) to 60 hours a week - down from the current 78 hours.
Another significant aspect of the compromise proposal was the inclusion of a new category called 'on-call time'. Under this new proposal, the inactive part of on-call time would not have constituted working time. This went against recent European Court of Justice rulings which had declared that time spent by hospital doctors asleep but on-call should count as working time.
The proposal was discussed by Ministers but they were unable to reach agreement. The UK and most of the new EU Member States insisted on keeping the opt-out whilst other Member States (such as France, Spain, Italy, Greece and Cyprus) demanded its abolition. Agreement on on-call time can only be reached in conjunction with agreement on the opt-out. So pending further progress the Court of Justice rulings on on-call time will continue to stand.
The European Commission has now stated that it is likely to launch legal action against those Member States failing to incorporate the Court of Justice ruling regarding on-call time for the medical profession. The UK would be one of 23 States under scrutiny. In principle, EU Ministers have agreed that in order to avoid excessive costs for most Member States' health systems the rules must be changed. This may be attempted through a separate proposal specifically for the medical sector, although it is looking increasingly unlikely.
EU strategy to reduced alcohol related harm
Following its recent public consultation, the European Commission has published its new EU strategy on alcohol related harm. The strategy contains five priority themes:
- To protect young people, children and the unborn child
- To reduce injuries and death from alcohol related road deaths
- To prevent alcohol related harm among adults and to reduce the impact on the workplace
- To inform, educate and raise awareness on the impact of hazardous consumption
- To develop and maintain a common evidence base at EU level
European Qualification Framework
The European Commission has released a proposal for a new European Qualification Framework. The Framework will provide a common language to describe qualifications which will help Member States, employers and individuals compare qualifications across the EU’. The core element of the EQF is a set of eight reference levels describing what a learner knows, understands and is able to do — their ‘learning outcomes’ — regardless of the system in which a particular qualification was acquired.
If adopted, the proposal would mean that qualifications earned during time spent abroad by doctors in training would be more easily recognised by their home institution. The proposal will now be examined by the Council and the European Parliament, with adoption expected before the end of 2007.
Ageing European population and health care impacts
The European Commission has published a policy paper on the demographic future of Europe and the impacts that an ageing population will have on issues such as health care. The paper first analyses the impact of ageing on public expenditure, focusing on the predicted sharp rises in public spending on health and long term care. It calls for better adapted health care systems and a preventive approach to chronic diseases through the use of new technologies.
The paper then stresses the need to to improve public health by increasing the active population. Effective preventive measures will be necessary to tackle obesity, smoking, alcoholism and mental illnesses. It also raises questions about the new types of care that will be needed in order to deal with an increase in the illnesses commonly suffered by an older population.
The Commission will review progress made in 2008.
Diet and nutrition
In the framework of the EU Platform for Action on Diet, Physical Activity and Health, the European Health Commissioner Markos Kyprianou last week invited a range of journalists to attend an event where he publicly “named and praised” several CEOs of major food, drink and retail industries for their commitments to tackling obesity. The aim was to highlight effort made by industry in four particular areas: nutrition claims, food labelling, reformulation and advertising. Companies that received special praise included Pepsi, McDonald’s and Unilever. Unsurprisingly the reaction to this announcement was hostile with journalists questioning the corporate driven nature of the press conference.
Launched in 2005 the EU Platform brings together a broad range of EU-level representatives of the food, retail, catering, advertising industries and the health sector. The Commission will publish a Communication on Nutrition and Healthy Diets in 2007.
Consultation: Ethics in clinical trials on children
The European Commission has published a stakeholder consultation on ethical considerations when performing clinical trials involving children. The consultation contains a number of questions designed to provide an overview of practice in the different EU Member States. Responses can be submitted until 31 January 2007.