13 Seasonal influenza vaccination
| (30797)
11970/1/09
COM(09) 353
| Draft Council Recommendation on seasonal influenza vaccination
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| Legal base | Article 152(4) EC; — ; QMV
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| Department | Health |
| Basis of consideration | Minister's letter of 2 December 2009
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| Previous Committee Report | HC 19-xxvi (2008-09), chapter 5 (10 September 2009)
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| To be discussed in Council | December
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| Committee's assessment | Politically important
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| Committee's decision | Cleared
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Previous scrutiny of the document
13.1 When we considered the Commission's draft of the Recommendation
in September,[38] we
noted that, in 2003, the World Health Organisation (WHO) recommended
targets for the vaccination of elderly people: 50% by 2006 and
75% by 2010. Although some countries have already achieved the
latter target, most have not.
13.2 We also noted that recital 11 of the draft Recommendation
said that:
"Seasonal influenza can lead to a pandemic
and cannot be confined to a geographical region or Member State.
Coordinated action at Community level can therefore help Member
States achieve their national targets."
13.3 Paragraph 1 of the Commission's draft of the
Recommendation provided that each Member State "should"
prepare and implement a national plan in order to achieve as soon
as possible and no later than the winter of 2014-2015 a vaccination
coverage of 75% in all "at risk groups". The plan "should"
allocate the necessary resources to enable the target to be reached.
13.4 Paragraph 2 of the Commission's draft said that
Member States "should" use the definitions of at risk
groups specified in that paragraph. It also said that Member States
"should" organise annual surveys of the take-up of the
vaccination by the at risks groups. The surveys "should"
use the guidelines to be issued by the European Centre for Disease
Prevention and Control. Member States "should" also
foster education, training and information for healthcare workers
and people at risk and their families.
13.5 Paragraph 3 of the Commission's draft provided
that Member States "should" send the Commission a report
on their implementation of the Recommendation by the end of May
every year.
13.6 In her Explanatory Memorandum on the draft Recommendation,
the Parliamentary Under-Secretary of State at the Department of
Health (Ann Keen) told us that the UK Government recognised the
importance of increasing vaccination rates among the groups most
at risk from the effects of seasonal influenza. Scotland and Northern
Ireland had already attained the WHO 75% target for people aged
65 or more. In 2008/09, the rate in England for those aged 65
or over was 74.1% and for those under 65 with clinical risk conditions
the proportion was 47.1%. The UK already had a well-established
seasonal influenza vaccination programme; detailed uptake surveys
were done; and information about vaccination was available to
the public and healthcare workers. The UK was, therefore, among
the best placed of Member States to implement the Recommendation.
13.7 But the Government had reservations about the
Commission's draft because:
- Recommendations are not legally
binding but this draft Recommendation said that Member States
"should" do this or that, as if the Recommendation could
impose mandatory duties.
- Member States are responsible for deciding policies
on public health and, in the Government's view, the Commission
had not provided a sufficient reason why EC legislation was necessary.
The UK doubted that the proposal was consistent with the principle
of subsidiarity.[39]
- The list of chronic medical conditions in paragraph
2 of the Commission's draft was different from the list used in
the UK, which is based on the advice of the UK's Joint Committee
on Vaccination and Immunisation.
13.8 We shared the Minister's concerns about the
Commission's draft of the Recommendation and decided to keep it
under scrutiny pending progress reports from the Minister on the
negotiations.
The Minister of State's letter of 2 December
13.9 In her letter of 2 December, the Minister of
State at the Department of Health (Gillian Merron) tells us that
the draft Directive was discussed by representatives of the Member
States and the Commission in September and October. All the amendments
proposed by the UK were accepted. The Minister encloses the revised
draft of the Recommendation. The main changes are as follows:
- wherever the Commission's draft
said "Member States should", the words have been deleted
from the revised version and replaced by "Member States are
encouraged";
- the revised text recognises that health services
in some Member States are devolved;
- the list of "at risk groups" has been
deleted from paragraph 2, leaving Member States free to decide
their own lists;
- the vaccination coverage rates are not presented
as mandatory targets but as desirable aims; and
- the requirement for Member States to make an
annual report to the Commission on the implementation of the Recommendation
has been deleted.
13.10 The Minister tells us that in the course of
the discussions, the Commission and the Presidency of the Council
made it clear that the purpose of the Recommendation was to bring
other Member States up to the same level on flu immunisation as
countries such as the UK and Netherlands which currently have
the highest uptake rates.
13.11 Finally, the Minister says that the Swedish
Presidency hopes that the Council will be able to adopt the revised
Recommendation before the end of this month.
Conclusion
13.12 We welcome the Government's success in negotiating
a revised text which omits the objectionable features of the Commission's
draft. We understand that the UK was alone in questioning whether
the proposal was consistent with the principle of subsidiarity.
We recognise that an arguable case for its compliance with the
principle can be made for the reason given in recital 11 (see
paragraph 13.2 above).
13.13 We have no further questions to put to the
Minister and we are now content to clear the draft Recommendation
from scrutiny.
38 See headnote. Back
39
Article 5 of the EC Treaty provides that, in matters which do
not fall within its exclusive competence:
"The Community shall take action,
in accordance with the principle of subsidiarity, only if and
in so far as the objectives of the proposed action cannot be sufficiently
achieved by the Member States and can therefore, by reason of
the scale or effects of the proposed action, be better achieved
by the Community." Back
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