6 Health care and long-term care
| (25576)
8131/04
COM(04) 304
| Commission Communication: Modernising social protection for the development of high quality, accessible and sustainable health care and long-term care: support for the national strategies using the "open method of coordination"
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| Legal base | — |
| Document originated | 20 April 2004
|
| Deposited in Parliament | 28 April 2004
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| Department | Health |
| Basis of consideration | EM of 11 May 2004
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| Previous Committee Report | None
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| To be discussed in Council | 1 and 2 June 2004
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| Committee's assessment | Politically important
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| Committee's decision | Not cleared; further information requested
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Background
6.1 Health care and long-term care are the fourth limb of the
European Community's approach to social protection (the other
three limbs are employment, pensions and social inclusion). The
Commission describes "social protection" as "a
way of distributing, at the level of an entire society, costs
which often exceed the means of an individual or his/her family,
ensuring that paying for healthcare does not lead to impoverishment
and that even those on a low-income have reasonable access to
care".[10]
6.2 The Lisbon European Council defined the Open
Method of Coordination as follows:
"This method, which is designed to help Member
States to progressively develop their own policies, involves:
- fixing guidelines for the Union
combined with specific timetables for achieving the goals which
they set in the short, medium and long terms;
- establishing, where appropriate, quantitative
and qualitative indicators and benchmarks against the best in
the world and tailored to the needs of different Member States
and sectors as a means of comparing best practice;
- translating these European guidelines into national
and regional policies by setting specific targets and adopting
measures, taking into account national and regional differences;
and
- periodic monitoring, evaluation and peer review
organised as mutual learning processes".[11]
The document
6.3 The Commission says that the provision and funding
of health care and long-term care need reform to meet three challenges.
First, these sectors have an important contribution to make to
the achievement of the Lisbon goal for social inclusion and making
the best of the potential of the European workforce. Second, in
2002 the health care and social services sectors accounted for
10% of total employment in the then Member States. In the same
year, about 38% of the people employed in those sectors were aged
over 45. So the health and social services sectors will face stiff
demands to recruit replacements. Improving both the
quality of jobs in these sectors and the productivity of care
providers will, therefore, be essential. Third, the increase in
the proportion of people in the enlarged Community aged over 65,
and the growth in the proportion of old people who live on their
own, will increase the demands for health care and long-term care.
6.4 Accordingly, the Commission proposes the following
high-level objectives for the Community:
- ensure fair and universal access
to care;
- promote the provision of care
of high quality; and
- ensure that high-quality, universally accessible
care is financially sustainable in the long-term.
6.5 The Commission proposes specific measures to
give effect to each of these objectives. For example, the Commission
calls on Member States to ensure close coordination between social
services, hospitals and health services based in the local community
to provide high-quality, easily accessible and sustainable care
for elderly people; to adopt measures to recruit and train care
staff and remove disparities between regions in the provision
of services; to evaluate drugs, equipment and treatments in order
to identify best value; to reduce risks of accidents and ill-health
through health and safety at work policies; and to improve the
management of resources.
6.6 The Commission says that:
"responsibility for the organisation and funding
of the health care and elderly care sector rests primarily with
the Member States, which are bound, when exercising this responsibility,
to respect the freedoms defined and the rules laid down in the
Treaty. The added value of the 'open method of coordination' is
therefore in the identification of challenges common to all and
in support for the Member States' reforms".[12]
6.7 The Commission sees the next steps as including:
- agreement of the objectives
before the end of this year;
- meanwhile, the Commission starts work on identifying
possible indicators for the objectives;
- By March 2005, Member States send the Commission
reports "covering the challenges facing their systems at
national level, current reforms and medium-term policy objectives";
- the Commission then analyses the reports; and
- this would lead, in 2006, to "an initial
series of 'development and reform strategies' in health care and
long-term care for the period 2006-2009".
The Government's view
6.8 The Minister of State for Health at the Department
of Health (Mr John Hutton) tells us that:
"We are considering further how the open method
of coordination in this area should best relate to the other strands
of activity for the EU affecting health care … Our initial
view is that whilst the opportunity to exchange and share information
with member states, facilitated by the Commission, on health systems
could be helpful, it should not be heavy handed and dominated
with indicators".
Conclusion
6.9 As the Commission recognises, the primary
responsibility for health care and long-term care rests with each
Member State. We agree with the Minister that sharing information
with other Member States about the issues discussed in the Communication
could be helpful. There may be useful lessons and ideas to be
learned from other countries. But the open method of coordination
goes well beyond the exchange of information; it involves detailed
reports, the setting of benchmarks and targets and so on, as we
explain above. It does not appear to us that the Communication
provides a sufficient justification for the application of the
open method of coordination to health care and long-term care.
6.10 We understand that discussion of the Communication
is still at an early stage. We should be interested to know if
others share our doubts about the Commission's proposal. We should
be grateful, therefore if the Minister would keep us informed
of the progress of the discussions in the Council. Meanwhile,
we shall keep the document under scrutiny.
10 See page 2 of the Communication. Back
11
Conclusion 37, Lisbon European Council, 23 and 24 March 2000. Back
12
Page 11 of the Communication. Back
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