7 Action Plan for a European eHealth
Area
| (25646)
9185/04
COM(04) 356
+ ADD 1
| Commission Communication : eHealth — making healthcare better for European citizens: An Action Plan for a European eHealth Area
Commission staff working paper — preliminary impact assessment
|
| Legal base | — |
| Department | Health |
| Basis of consideration | Minister's letter of 4 July 2004
|
| Previous Committee Report | HC 42-xxiii (2003-04), para 3 (16 June 2004)
|
| Discussed in Council | 1/2 June 2004
|
| Committee's assessment | Legally and politically important
|
| Committee's decision | Cleared
|
Background
7.1 On 16 June, we considered this Communication which:
- describes the benefits of eHealth systems and services
for consumers, the health professions and health service managers;
- summarises what the Commission sees as the challenges
facing Health Ministers, health service providers and managers,
and the eIndustry; and
- sets out an eHealth Action Plan for Member
States and the Commission.
7.2 In the introduction to the Communication, the
Commission says:
"Member States have shown that they are keen
to take an eHealth agenda forward, drawing on best practices
and experience from across the Union. This should enable a move
towards a 'European eHealth Area'; a framework built on
a wide range of European policies and initiatives…
"eHealth plays a clear role in the European
Union's eEurope strategy, and is key to achieving stronger
growth and creating highly qualified jobs in a dynamic, knowledge-based
economy … To move ahead, action will be required within several
important policy areas that range from research and the roll-out
of broadband networks in telecommunications, to action in public
health, and work in Member States that promotes mobility and assesses
the implications of European ageing on healthcare systems."[14]
7.3 The Annex to the Communication sets out the Action
Plan. It includes, for example:
- By the end of 2005, each Member
State is to develop a national or regional roadmap for eHealth.
This should focus on deploying eHealth systems, setting
targets for interoperability and the use of electronic health
records, and address issues such as the reimbursement of eHealth
services.
- By the end of 2006, Member States, in collaboration
with the European Commission, should identify a common approach
to patient identifiers. This should take account of best practices
and developments in areas such as the European Health Insurance
Card and identity management for European citizens.
- By the end of 2006, Member States, in collaboration
with the European Commission, should identify and outline interoperability
standards for health data messages and electronic health records,
taking into account best practices and relevant standardisation
efforts.
- By the end of 2007, Member States should adopt
conformity testing and accreditation schemes following successful
best practices.
- By the end of 2008, the majority of European
health organisations and health regions (communities, counties,
districts) should be able to provide online services, such as
teleconsultation (second medical opinion), eprescription,
ereferral, telemonitoring and telecare.
- By the start of 2005, Member States, in collaboration
with the European Commission, should agree on an overall approach
to benchmarking in order to assess the quantitative, including
economic, and qualitative impacts of eHealth."
7.4 The staff working paper (ADD 1) attached to the
Communication contains no estimate of the cost of any of the proposed
actions. It says that all the activities included in the Action
Plan are consistent with the principle of subsidiarity and are
proportionate. No extended impact assessment of the proposals
is recommended.
7.5 The Minister of State for Health at the Department
of Health (Mr John Hutton) told us that most of the actions ascribed
to Member States in the Action Plan are already being taken forward
in the United Kingdom through the National Programme for IT in
the NHS. The Minister added that the Communication had no immediate
implications for subsidiarity. His Explanatory Memorandum of
7 June said that the Communication "will be discussed at
the Health Council 1-2 June".
7.6 In our view, the status of the Action Plan is
not clear. Nor is it clear if the Plan is put forward for approval
or as a statement of what Member States are, in some way, obliged
to do. We asked the Minister to tell us the items in the Action
Plan to which the Government is already committed and any to which
it has not yet made a commitment.
7.7 Since neither the Communication nor the Minister's
Explanatory Memorandum contains an estimate of the cost of implementing
the Action Plan, we asked the Minister to estimate the costs and
benefits to the UK of implementing the Action Plan; and for his
comments on the view that an extended assessment is not required.
7.8 We noted that the Action Plan sets dates by which
Member States are to complete specified activities. It seemed
to us that the Action Plan might not be compatible with the principle
of subsidiarity because the Plan — for which no legal base
is cited — appears to dictate the priorities Member States
should adopt for the organisation and delivery of health services,
which Article 152 of the EC Treaty recognises as the responsibility
of Member States. We asked the Minister to enlarge on his comment
that the Communication has "no immediate implications for
subsidiarity".
7.9 We also noted that the Minster's Explanatory
Memorandum of 7 June said that the Communication was to be discussed
by the Health Council on 1 and 2 June. We were surprised that
the Explanatory Memorandum did not tell us about the discussion.
We asked the Minister to tell us about it.
7.10 Finally, we noted that the Communication envisages
a "European eHealth Area". It was not apparent
whether this is a would-be piece of slick presentation or if the
words had some real meaning. We asked the Minister to comment
on the point.
The Minister's letter
7.11 In reply to our question about the status of
the Action Plan, the Minister says that the Plan:
"contains a large number of actions that are
either the responsibility of the Commission or Member States.
The actions do not have any legal status and no legislation is
required or envisaged at this stage. The UK will not face court
action over any failure to implement the action plan."
7.12 In answer to our question about the items in
the Plan to which the Government is committed, the Minister tells
us:
"the National Programme for IT (NFfIT) is as
part of its overall work programme developing an infrastructure
that is capable of supporting the targets contained within the
action plan. These targets specifically include the key areas
of:
- addressing common challenges such as developing
targets for interoperability and their standards, patient identifiers,
investment in ehealth, health information networks;
- pilot actions to accelerate implementation including
the use of cards, telemedicine, eprescription, ereferral
and telemonitoring; and
- working together and monitoring practices setting
benchmarking [sic], evaluation and dissemination of best
practices."
7.13 The Minister has not provided the estimates
of the costs and benefits to the UK of implementing the Action
Plan for which we asked. He says, however, that the Plan will
be implemented as part of the National Programme for IT and that
"the funding for these initiatives are [sic] in line
with the spending plans to implement Delivering 21st
century IT support for the NHS: national strategic programme."
7.14 The Minister adds that:
"No formal extended assessment [of the Action
Plan] is necessary at EU level nor is one necessary at UK level.
The actions proposed do not have any direct economic impact and
do not create any additional regulation."
7.15 In reply to our request that he enlarge on his
comment that the Communication had no immediate implications for
subsidiarity, the Minister says:
"the targets contained within the documentation
have no legal basis and are aspirations. The NPfIT has published
through its work programme a detailed implementation plan that
will allow the action plan to be implemented. A number of these
targets have already been met as England remains considerably
ahead of its European partners. Therefore the Government believes
that this Communication is compatible with the principle of subsidiarity.
The Government also believes the actions proposed are proportionate."
7.16 Finally, the Minister tells us that, on 2 June,
the Council noted that the Commission aimed to establish a European
eHealth Area through a programme of activities to address
common challenges; he also says that the Council's conclusions
on eHealth were adopted without debate.
Conclusion
7.17 It appears from the Minister's letter that
the Commission's Action Plan is a mere list of "aspirations".
It is not binding on Member States and, so it seems, it is not
worth assessing the Plan's costs and benefits. In our view, this
raises the question whether the cost of producing the Plan represents
good value for the taxpayers' money and whether the expenditure
could have been put to better use on investment in services for
patients. We ask the Minister, therefore, to challenge the value
of any proposals to produce similar Plans in future.
7.18 We see no benefit in examining the document
further and so, with the reservations made in the previous paragraph,
we now clear it from scrutiny.
14 Pages 4 and 5 of the Commission's Communication. Back
|
