UNCORRECTED TRANSCRIPT OF ORAL EVIDENCE To be
published as HC 373-i
House of COMMONS
MINUTES OF EVIDENCE
TAKEN BEFORE
european scrutiny committee
open method of coordination
Wednesday 23 February 2005
RT HON JOHN HUTTON MP, MR NICK BOYD and MS HANNA
NICHOLAS
Evidence heard in Public Questions 1 -
19
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Oral Evidence
Taken before the European Scrutiny Committee
on Wednesday 23 February 2005
Members present
Mr Jimmy Hood, in the Chair
Mr Liam Byrne
Mr William Cash
Mr Michael Connarty
Jim Dobbin
Nick Harvey
Sandra Osborne
Anne Picking
John Robertson
Mr Anthony Steen
________________
Witnesses: Rt Hon John
Hutton, a Member of the House, Minister of State for Health, Mr Nick Boyd, Head of International
Affairs, Department of Health and Ms Hanna
Nicholas, Team Leader, EU Social Policy Team, Department for Work and
Pensions; examined.
Q1 Chairman:
Minister, welcome to the European Scrutiny Committee. It is delightful to have you here. I know there were some difficulties and we had to rearrange it,
but you are here and I am sure we will have a fruitful discussion. Would you like to introduce your colleagues,
Minister?
Mr Hutton: Yes, Chairman. Thank you very much for that. On my right is Nick Boyd, who is the Head of
International Affairs in the Department of Health, and on my left is Hanna
Nicholas, who is the Head of EU Social Policy in the Department for Work and
Pensions.
Q2 Chairman:
Thank you. Minister, what value added,
if any, do you think the UK might obtain from the application of the open
method of coordination to the health and long-term care objectives?
Mr Hutton: I think that is down
to the Member States to make this process one that adds value. What it is not about, Chairman, is ceding
competence or sovereignty over healthcare policy to the European Commission or
the European Union. The OMC, as you
know, has no treaty basis, it is a collaborative approach to discussing issues
of concern between Member States in a sensible, rational way in areas where we
have a very strong mutual interest.
Health in the European Union is roughly about ten per cent of our
European GDP, and in the context of mobility of labour within the European
Union it is very important that all of the Member States of the European Union
have a forum and an opportunity to discuss together issues which affect all of
our citizens, because we all travel around and across and through the European
Union. I think the open method of coordination
of policy in this area has the opportunity to give all of the Member States of
the European Union an opportunity to discuss these issues of common
concern. It is not about ceding
competence and it is certainly not about agreeing in advance, because we have
not agreed in advance, to set up a whole range of new EU indicators and EU
targets on healthcare policy. There are
in total six areas of policy which currently are subject to the open method of coordination,
of which health is one, and in only one of the other areas, in relation to
employment, has there been any approach towards setting targets and that was
done at the Lisbon Council. The other
five areas are not about setting targets, are not about new EU indicators, and
so on. It is up to the Member States
themselves to fashion this process in the way that they think is going to add
value. In relation to healthcare, we
are at the very, very early stages of deliberations, so we have the opportunity
to mould and shape this discussion in the way that, yes, suits the UK's
national interests, which I have to say as well is a set of interests that are
widely shared across the European Union.
There is not another Member State of the European Union that wants to
give to the Commission competence over national healthcare policy, not a single
Member State wants to do that, and certainly we do not. Sometimes it is sensible to talk, is it
not? I would have thought that for both
Euro-sceptics and Euro-enthusiasts alike the open method of coordination is
actually quite a sensible vehicle to take forward those issues of common
concern that we have clearly between us as members of the European Union.
Q3 Jim Dobbin:
I think probably you have almost answered the question that I was just about to
ask. Could you maybe enlarge on that,
and you have justified to a certain extent why the Commission should be
involved in this, as you said, which is the prime responsibility of Member
States, but could you add some meat to that?
Mr Hutton: The Commission
basically are involved in the open method of coordination to the extent that
they provide a lot of the support services, the back-office function, to allow
the process to go forward. The Social
Protection Committee, where the open method of coordination is being taken
forward in relation to healthcare, is actually chaired by a nominee of a Member
State. Hanna is the UK's representative
on the Social Protection Committee. It
is very much a process led by the Member States. The Commission are there to support the work of the Social
Protection Committee and to help it function, but it is very much a process
which is led by the Ministers, ultimately, who have responsibility for health
and social care. As I said in my
opening remarks, there is a world of difference between the open method of coordination,
which is outside of the treaty, it is a non-law-making process, and the
functioning and work, for example, of the European Council, which is all about
law-making, ultimately. There is no
law-making function that attaches to the open method of coordination, it is not
about EU legislation and that is why I believe also that it is a very important
avenue for us in the UK and other Member States to explore as an alternative to
the approach that always envisages that there will be legislation which comes
out of discussions and collaboration between EU members. It does not always have to be based on
legislation.
Q4 Sandra Osborne:
In your letter of 23 November, you say that the Government supports the
open method of coordination because "this will allow us to share information on
a number of important areas for health" and you have reiterated that
today. Why cannot the information be
shared by other means, why do we need this specific mechanism?
Mr Hutton: I think because it is
probably a very effective method of doing what we want to do. It involves all of the Member States of the
European Union. It does allow us to
look at some of the more general issues around healthcare policy. There is a Commission-led group looking at
patient mobility, there is a Council-level group looking at the same territory
as well but they are looking at very specific issues, issues which have arisen
primarily in the context of some recent decisions of the European Court of
Justice around the rights of patients to receive healthcare when they cross
borders in the European Union, but they are very specific issues. The open method of coordination allows us to
take a more general look and to initiate a discussion between us, as Member
States, about areas of concern that we all have together. The three basic principles that are guiding
the open method of coordination, that were agreed in the Barcelona Council, I
think have given definition and shape to the work of the open method of coordination. I think you have to ask yourself this one
question, Chairman, really, do you think it is a good idea for there to be a
non-legislative basis whereby Member States of the European Union can take
forward discussions in this way which will not result in legislation? I would have thought the answer to that
question would be an emphatic 'yes' because it reflects the principle of
subsidiarity, it is flexibility, I think, built into the process as well and, as
I keep saying, I think it is a good idea for us to talk together across the
European Union about issues of concern in this very important area of
healthcare policy.
Q5 Anne Picking:
The penultimate paragraph in your September letter talks about the light touch
approach. What exactly do you mean by
'light touch', how light a touch and what would it mean in practice?
Mr Hutton: As light a touch as
we can possibly engineer, is what we mean in the UK by that. There is, I think, a broad consensus in the
Member States of the European Union that that is the right way to take forward
the open method of coordination in relation to healthcare. I do not detect any desire in the Member
States of the European Union, certainly in the Council of Ministers in which I
represent the UK, that we should use this process as a mechanism for devising
either new legislation or new targets or new EU indicators. We want this to be a process where we can
discuss these three key principles - accessibility, quality of healthcare and
financial sustainability - in a collaborative context without the threat of
legislation. The European Union has no
competence in these areas and is not going to get any, and that is clear I
think in the draft Treaty which has been negotiated, yet to be ratified,
obviously, so when we talk about a light touch, we are talking about an
opportunity to discuss these principles.
Member States are preparing for later this spring, I think probably in
April, and Nick might have more detail on this, a preliminary statement of our
views about how this process should go forward, which will be also a summation
of where we have got to in terms of healthcare reform and policy initiatives in
the UK. That is likely to inform the
deliberations within the Social Protection Committee, leading to a report, I
think, sometime in 2006. I can
certainly assure the Committee that we will keep you fully informed of how this
process is unfolding within the Social Protection Committee and everything that
I have, in terms of documentation, I will make sure that you have as well.
Q6 Anne Picking:
In the second paragraph you indicate that you have got allies with your view on
the light touch approach. Does that
indicate there are some that are against this approach?
Mr Hutton: No. I think there is overwhelming support for
this light touch approach that I have been indicating. I think that is particularly true amongst
the new Member States of the European Union, that it is felt very strongly by
many key allies of the United Kingdom within the Social Protection Committee,
so I am very confident that there will be a view. It is reflected, I think, to a very large extent in the original
opinion of the SPC that, in relation to the Commission Communication, that is
the view of the SPC as well, that is how we would like it to proceed.
Q7 Mr Cash:
Minister, you said just now, and I hope I have it correctly, that there is no
competence under the constitution, or indeed under the existing treaties, with
respect to long-term and short-term healthcare. Did I understand correctly what you said?
Mr Hutton: The European Union
has no competence over the organisation and delivery of healthcare systems in
the European Union, yes, that is true, and that is reflected in
Article 3.278 of the new Treaty.
Q8 Mr Cash:
Yes; but, at the same time, cutting through all the verbiage of open method of coordination,
the plain fact is that there is an intrusion into the manner, through setting
of targets and the whole paraphernalia, which is the subject of this
discussion, so I do not really think that you are right. After all, we are actually involved in a
process which is allowing ourselves to be absorbed into the manner in which the
European Union functions with regard to long-term and short-term
healthcare. What you have just said
simply does not make sense. You cannot
say, on the one hand, that it is not within the Treaty's competence, so, on the
one hand, there is no legal base, nor will there be under the constitution, and
then say but, on the other hand, "We're going to organise our activities in
line with what it is that they prescribe under Lisbon, and so forth." I am afraid I just simply do not understand
it. Can you just clarify that because
it really is important?
Mr Hutton: It is important, I
agree with you on that, and you missed my initial remarks to the Committee, but
we need to be clear about a couple of things in relation to this whole
process. The open method of coordination
does not have a legal treaty basis, so it is not a process that can give rise
to legal, enforceable obligations attached to how, here in the United Kingdom,
we organise our healthcare system. The
Treaty, of course it is subject to ratification, the referendum, and so on, by
this House, does make it explicitly clear, and we have been insistent on this
in the negotiation process around the new Treaty, that the new Treaty respects
the competences of Member States to organise and finance and deliver their own
national healthcare systems. I think
that is the context in which we are taking this discussion forward through the
open method of coordination, which has a long lineage, going back to 1999, the
deliberations of the Council then, and through various Council Resolutions, and
so on. Your concern, Mr Cash, I
think focuses largely down to this issue about targets. If it has no legal treaty basis, which it
does not have, and therefore no enforceable legal obligations can arise through
the OMC process, why are we exploring the issue of targets? I did make it clear that the United Kingdom
is not supporting the introduction of new targets through the open method of
coordination process and there is no reason why OMC, as it applies to
healthcare, should result in any new targets in that sense. In the five other areas where the open
method of coordination has been applied, in one of them, in employment, there
is a set of targets but they were agreed at the Council as part of the Lisbon
process for economic reform and sustainable employment within the European
Union. In none of the other areas where
the OMC is being deployed is there any set of targets emerging in the way that
you have described and then, as it were, being foisted upon the UK or any other
Member State of the European Union with a requirement that they must deliver on
those targets. Essentially, this is a
political process and it is about discussion, it is not about enforcement, it
is not about law‑making, it is about discussing ideas and concerns. Euro-sceptic or Euro-enthusiast, wherever
you are on that side of the argument, I would have thought that, given this is
not about law-making, given that it has got no treaty basis, it is much more
about the consensual discussions between Member States of the European Union,
yes, with Commission support through the Secretariat, and so on, but
essentially a politically-led process, sceptics and enthusiasts alike would think
this a sensible way to proceed with these discussions, given that all Member
States of the European Union have mutual concerns in this area, given the
economic significance of healthcare systems and the fact that our citizens
travel widely across the European Union.
We have got a vested interest in having these discussions but doing so
in a way that respects different sorts of subsidiarity and flexibility.
Mr Cash: Would you agree,
therefore, that it would be better to use the word 'cooperation' rather than
'coordination'? You know as well as I
do that the word 'coordination' was introduced in order to lock us, for
example, into the whole business of monetary union and that was preceded by
cooperation. You see what I am driving
at. This is a step-by-step approach and
I am sure you accept my point.
Chairman: As a conspiracy, I see
one as well, and Mr Cash seems to see more conspiracies than co-operation.
Mr Cash: Mr Chairman, you are
not supposed to be taking sides in this.
Chairman: I am just being drawn
into the flow of the way the debate is going.
Q9 Nick Harvey:
Minister, you say that neither the UK Government nor, you tell us, the other
Member States are interested in getting into a situation of targets, or you
talk about a light touch, but the Commission proposes, in 2006, to develop reform
strategies for healthcare and long-term care for 2006-2009. What is the point of having a European
reform strategy, exactly, what is the benefit of it? I think, in a sense, I am perhaps touching back on Mr Cash's
distinction between cooperation and coordination. That seems to me to go a step beyond discussion and sharing of
best practice and into the realms of some sort of concerted action?
Mr Hutton: I think it is a good
general principle for all of us who have an interest in the outcome of these
debates across the European Union to have a forum whereby we can express our
concerns and voice our opinions. The UK
has, along with many other Member States of the European Union, a very clear
set of views about how we think we can sustain publicly-funded, free at the
point of use, universally accessible, high quality healthcare systems for all
citizens in our country and abroad. I
think there is a general principle that it is sensible to have an opportunity
and a forum to discuss those sorts of ideas, and essentially that is how I see
it and how in the UK we see the open method of coordination. We do not envisage that, coming out of the
work on healthcare, there will be a set of mandatory requirements imposed on
either us or any other Member State of the European Union to do certain things,
because there is no competence within the European Union, at any level, to
require the UK to do certain things in relation to the financing, organisation
and delivery of our National Health Service.
The future of the National Health Service is, I am glad to say, a matter
for the British people, it is not a matter for the European Commission or the
European Council. If you are asking me
how I see the end product emerging, I would say simply what I said at the
beginning of this, that it is an opportunity for us to discuss reform, ideas
and principles which I think are very important at this moment in time, not
least around the principle of financial sustainability, which I think is
crucial, and to have an opportunity in a forum within the European Union for
Ministers to express their opinions and their views. That is what I think is the product of the deliberation and we
will have to wait and see, and the Committee will be kept fully informed about
any specific outcome or product from the deliberations of the Social Protection
Committee. Then perhaps we can meet
again to discuss them and you can hold me to my word about what I said we
wanted to achieve here.
Q10 Nick Harvey:
Presuming that other Member States have rather different views for models of
delivery, what is a European reform strategy, or set of reform strategies,
running from 2006 to 2009 supposed to be?
Mr Hutton: It is true there are
differences of views, because we are talking about healthcare and healthcare is
a political issue and people do have a different set of views about all of
that. What I think is very important
from our point of view, and I can speak only from the UK's perspective, is that
whatever emerges from the open method of coordination we have to be respectful
of other countries' national domestic policies in relation to healthcare and
not view the open method of coordination as a way of bypassing the sovereignty
of Member States of the European Union to organise their healthcare systems in
the way that they want. Whatever the
specific outcome of OMC might be in these areas, that is one thing it is not
going to do. In that regard, despite
the various political differences that there are between Member States in the
European Union on healthcare reform and healthcare issues, one thing which
certainly I have not detected, and I think it is reflected very clearly, Nick,
in the new draft Treaty, is that there is not any enthusiasm in the European
Union from any Member State to cede sovereignty and therefore legal
jurisdiction to the Commission to tell Member States of the European Union how
they should organise their healthcare systems.
Q11 Nick Harvey:
Of course, but are you confident that other Member States will be equally
respectful, as you put it, of our desire to do things differently?
Mr Hutton: Yes.
Q12 Jim Dobbin:
Minister, as I understand it, other Member States share the Government's doubts
about how the open method of coordination is to be applied. Why has not the Council rejected it in this
instance?
Mr Hutton: The original
initiative to establish the OMC process in relation to healthcare was a
decision of the Council, and a unanimous decision of the Council, it was the
Gothenburg Council. It was a decision
of heads of government in the European Union to establish this process in
relation to healthcare. I think, in
relation to the Commission's Communication to the Social Protection Committee,
yes, there was clearly a debate, and Hanna was there, I was not there. Emerging from the Commission Communication
there was a very clearly expressed view within the Social Protection Committee
that we favoured a lighter touch approach.
From the UK's perspective, that means clearly no new national targets -
we are not having targets foisted upon us by anyone, that is a democratic
process which involves the British people alone and no‑one else - and no
new EU indicators here. We are very
much in favour of developing our own national indicators showing the progress,
hopefully, of healthcare reform in this country, and maybe using that as a
basis for an international database across the European Union. It is not our view, Chairman, that we are
going into the open method of coordination process having conceded, in the way
that perhaps Mr Cash was suggesting, that it is all about setting new
targets and requiring the UK to meet them.
That is absolutely not our view of this process at all and, in terms of
the precedent, which I know Mr Cash will be interested in because he is a
lawyer, no‑one will be able to point to a set of precedents which
indicates that is what comes out of the open method of coordination.
Mr Steen: I do apologise for
missing the best part, probably, of your evidence. My constituency is the eighth oldest constituency in Britain by
age, I happen to be one of the younger people there. Like other constituencies probably on the South Coast and in the
South West, we have a great number of residential and nursing homes, full of
retired elderly people, and mostly they are private homes. There is a constant battle between the local
authorities, social services and health authorities over who is going to pay
for nursing care and residential care, and private homes come and go because
they say the rates are too low. I have
a very deep unease that this country and a lot of Europe are facing an
ever-growing percentage of their populations being aged and they just have not
got the resources or are not prepared to spend those resources on paying for
nursing and residential care and the costs of it. Am I alarmist or is that an anxiety you share?
Anne Picking: In relation to the
European Union.
Q13 Mr Steen:
That is right. In relation to the
European Union. Thank you very much.
Mr Hutton: It is not the
business of the European Union to involve itself in the substantive policies
that you have just been describing. The
organising and funding of long-term care, for example, is a matter for the UK
Government. What the open method of coordination
will allow us to do is talk across the European Union with each other about
precisely those problems. I think,
essentially, one of the three key areas that OMC on healthcare is going to
focus on is financial sustainability and I think this is an issue affecting
every Member State of the European Union, whatever level of expenditure currently
they are committed to. We know that the
European population is an ageing population and it is going to cause pressures
on all publicly-funded healthcare systems to resource the appropriate level of
healthcare. Without being doctrinaire
about it, because actually I am not doctrinaire on these issues at all, simply
from a practical perspective, it is in the United Kingdom's national
self-interest to have discussions with our colleagues in the European Union
about these issues because they are similar concerns. It always strikes me, Chairman, when I go round Europe and talk
to healthcare ministers, and so on, just what a common set of concerns we do
actually have. We may be approaching
and trying to solve those problems in slightly different ways but the problems
are pretty much the same and I think the UK and your constituents,
Mr Steen, would benefit from these discussions, I am sure, and not be
compromised by them. Ultimately, as I
said at the beginning of my remarks, and I have a very strong sense there is
going to be a sense of déja vu for
the third time around the Committee on this, nothing that is going to happen in
the Social Protection Committee, nothing that is going to emerge from our
deliberations through the open method of coordination is going to lead to any
UK Government in the future being required to do certain things in relation to
the funding of long-term healthcare.
That is simply not a possibility.
The OMC has no legal treaty basis, it is not able to issue decisions
that have a binding legal effect and the Health Council, the Council of
Ministers in this regard, will keep a very strong political oversight of the
processes that are underway in the SPC.
Q14 John Robertson:
Minister, just for the record, as the person who has the highest number of
elderly people of any constituency in Scotland and I think the second highest
in Britain, I can tell you that Scotland, of course, has a slightly different
way of looking at its elderly these days.
What kinds of discussions are you having with the Health Minister in
Scotland in relation to Europe?
Mr Hutton: Clearly, as the
Social Protection Committee gets into its work on healthcare and long-term
care, there will be discussions between the devolved administrations in the
United Kingdom about precisely what our presentation is going to be and what
our collective view will be. Hanna
works in the Department for Work and Pensions and it is the Department which
has the lead responsibility for making that coordination and making sure it
works effectively. I do not know
whether it might be helpful, Chairman, for Hanna to say something about the
degree of collaboration between the devolved administrations.
Q15 Chairman:
Yes. Hanna?
Ms Nicholas: Within the Social
Protection Committee business there are two main areas where my colleagues in
Scotland, in the Scottish Executive, have a particular interest, one is
healthcare and one is social exclusion, and we keep in regular touch at
official level so they can keep their Ministers informed. They are copied into papers and they are
copied into the note of our report back from the meetings, and any documents to
this Committee, obviously, they are involved in the preparation of the
explanatory memorandum. In addition,
within the UK, as the Department of Health prepares the next stage, which will
be to do the report, obviously they will be discussing with their colleagues in
the devolved administrations.
Q16 John Robertson:
When you have your meetings abroad, do you have representation from the
Scottish Executive or do you just report back and tell them what is happening?
Ms Nicholas: So far, there have
been I think two occasions, or certainly one occasion that I can recall, I was
not there at the meeting, when the UK was taking part in the peer review on
social exclusion, yes, there was somebody from Scotland accompanying the
official from the Department for Work and Pensions. Generally, because the Committee covers such a broad area, I tend
to go, sometimes supported by other colleagues from other departments but
generally I clear lines across the interested departments ahead of going out
and I am there to present those views, because otherwise there would be too
many officials there at the meeting.
Mr Hutton: Early this week,
Chairman, the Department for Work and Pensions did announce, I think, in a
written ministerial statement in the Commons, that we were taking forward now a
review of the open method of coordination as a mechanism within the context of
our membership of the European Union.
The Commission are overseeing this process. All Member States currently are being asked to express their
views and opinions about OMC as a process and that review internally within the
UK certainly will be based upon and largely informed by discussions with the
devolved administrations as well.
Q17 Mr Connarty:
In the replies you have been giving, Minister, you seem to be, if you like,
showing the reluctance, the Government's reservations about using the open
method of coordination on the basis that somehow it may impose upon the UK
targets and standards that we think should be dealt with within country. Is it not the case that since we signed up
to the Single European Act, which of course was signed up to by the last
Conservative Government, there are certain rights which should apply to all
members of the European Union, regardless of where they travel and where they
find themselves within the European Union?
One of those surely must be the ambition you state in your letter, a high
standard of healthcare in all of the countries in which those citizens find
themselves, because we are really citizens of one Europe. Do you not worry also that the open method
of coordination would mean that in certain parts of the EU we would not be able
to encourage or bring about those high standards of healthcare for all citizens
in all parts of the EU, in fact, that it is a less than effective method for
persuading other countries to spend on healthcare so that all of our citizens
in the EU should find themselves treated properly, in healthcare terms,
wherever they find themselves within the EU?
Mr Hutton: I want to correct just
one thing, Chairman. I am not a
reluctant enthusiast for the open method of coordination. I think it is a health process to have to
run alongside the more formal, legally-based activities that we normally
associate with membership of the European Community, with law-making powers
coming from the Council of Ministers, and so on, involving this Committee and
its scrutiny function. What I was
trying to say was that I think there is a very strong benefit, if you believe
in the principles of subsidiarity, flexibility and respect for the sovereignty
of national parliaments, to have an informal, open, flexible process, like OMC,
to exist as an alternative to the more traditional and, some would say, more
heavy-handed route that ends up with legislation. I am not defensive about OMC. I think it is a useful thing to have to reflect those wider
principles of subsidiarity and respect for national sovereignty. Your wider point about healthcare systems
across Europe is a very, very important one, but I think all I can do probably
in answer to your question is just go back to the Treaty. The European Union itself has no legal
competence in those areas that you have been talking about. It is a Member State responsibility and it
is true, obviously, too, more so now maybe than two years ago, that the
variation between healthcare systems in Europe is actually more visible now
perhaps than it was. That has to be a
process, I think, if you are interested in making sure that your constituents,
or anyone else's, who are travelling across Europe have access to a similar
level of healthcare. We have to apply
ourselves to this fundamental question, what is the best political process
which might produce that result?
Clearly, it is not going to be, in our view, through EU law-making,
because we do not accept the principle here, that this is an issue where we
should see competence and sovereignty, so that it has to be done in an alternative
way. I think the political process is
probably the better way here than the legal, law-making process. I think probably that is all I can say in
relation to those particular points.
Q18 Mr Connarty:
If the open method of coordination is not resulting in that ambition being
realised and that healthcare standard being available to all the people of the
EU throughout the EU regardless of where they work or move, how do we get the
resources to follow the ambitions of those discussions in the OMC, if it is a
loose arrangement, a talking shop?
Mr Hutton: I think the benefit
of OMC is that it does provide an opportunity for the old 15 and the new ten to
come together and talk about healthcare reform in the 21st century
and to learn from each other's various experiences. We have got a lot of experience here in the UK, as other Member
States in the European Union have, about how you modernise, how you improve,
how you get value for money, how you can guarantee universality in healthcare
to our populations, so I think it has got benefit to that extent and I think
that should not be ignored. In relation
to, again, your point about how we get the resources there to ensure that there
is a universal standard of healthcare across the European Union, ultimately
those are political decisions that individual Member States will be making. It is not a process where, in the UK or in
the Council of Ministers or in the EU as a whole, I think, we can safely
envisage that we should go down the route of requiring a certain dedicated
amount of resource to be used in healthcare or requiring healthcare systems as
a matter of law, EU law, to correspond to a certain set of standards. That would breach fundamentally the
principle of competence which resides at the Member State level, and our view
in the UK is that we are not going to compromise on that principle because it
is an important issue. It is not in any
way to diminish the significance of healthcare systems in the European Union,
in fact, everything I have been saying today, I think, has been to emphasise
the importance of this issue to the European Union. I think the question for all of us is how do we get to that
destination point? My basic argument
today is that you do not do it through EU law-making, because (a) that would be
wrong and (b) it would be contrary to the new Treaty. The Commission and the Council could not approach resolving the
issues, those issues which you have identified, in that way.
Q19 Chairman:
Minister, thank you very much. It has
been a short session but it has been very interesting and I would like to
compliment you on the way that you have answered our questions because it seems
to be you are either in a win-win situation or, if you go to the other extreme,
you are in a "damned if you do or damned if you don't" situation. I am sure, from our exchanges today, that
you have convinced a lot of us, if we needed any convincing, that it certainly
looks like a win-win situation. Thank
you very much for coming to the Committee.
Mr Hutton: Chairman, I will keep
the Committee fully informed about what is happening on the OMC admission to
healthcare.
Chairman: Thank you.
