Memorandum by the Department of Health
The evidence is presented after consideration
of the questions outlined on page 2 of the call for evidence (indicated
in italics below).
Do you have any comments on the factual summary
set out in the Annex of the Treaty changes affecting policy areas
within the remit EU Sub-Committee G?
The Department does not have any comments on
the factual summary of the changes to the Treaty which relate
to public health as set out in the Annex of the call for evidence.
What are your views about the impact that
these Treaty changes might have on the evolution of the policy
development process at the EU level for example, the extent to
which the roles in the formulation of EU policy—of the EU
Institutions, the UK Government and of interested stakeholders
within the UK—might be affected by the changes?
The changes to Article 152 ("Public Health")
of the Treaty clarify, in summary, that:
— Measures may be brought forward,
under co-decision procedures, with the aim of setting "high
standards of quality and safety for medicinal products and devices
for medical use" (Article 152(4)(c)). This will enable the
EU to seek to harmonise standards of quality and safety in relation
to medicinal products and devices.
— Proposals may be brought forward,
under co-decision procedures, in relation to cross-border health
threats and the protection of public health regarding tobacco
and alcohol. Such proposals would be "incentive measures"
to protect and improve human health, but would not involve harmonisation
of Member State laws in relation to these areas of public health
policy (Article 154(5)).
New proposals in relation to the above areas
of public health will therefore be brought forward in accordance
with existing EU policy-making procedures. As such, the Department
of Health view is that the changes to Article 152 will not change
the role of the EU institutions, the UK Government or interested
stakeholders in relation to the formation of policy with regard
to those areas of public health outlined above.
Article 152(7) notes that it is for Member States
to define their health policy and to organise and deliver health
services and medical care. It further notes that the responsibilities
of Member States shall include the management of health services
and the allocation of resources to them. Whilst this statement
provides clarity with regard to the role and responsibilities
of Member States, harmonised requirements which affect the provision
of health services may be generated under other articles of the
Treaty. For example, in recent years, the European Court of Justice
has been active in relation to patient mobility. In the light
of this, the Commission intends to bring forward proposals, under
co-decision procedures, which aim to achieve a more general application
of the principles developed by the Court with respect to the provision
of cross-border health services. These proposals will be subject
to scrutiny by the House of Lords European Union Select Committee
and the House of Commons European Scrutiny Committee.
Are there any other ways in which the changes
made in the Reform Treaty, specifically relating to the policy
areas within the remit of EU Sub-Committee G, might have a significant
impact in the EU and in particular in the UK and, if so, what
are these?
The UK is responsible for covering healthcare
costs for UK state pensioners, tourists and "posted"
workers living in other EU Member States. The entitlements and
rules for access to healthcare in other EU Member States derive
from social security legislation (Regulation 1408/71, as amended
by Regulation 883/04).
As a result, the changes made to the social
security provisions of the Treaty may have implications for the
rules of access to healthcare of UK citizens in other EU Member
States. These changes, which are discussed in the submission from
the Department for Work and Pensions to the House of Lords Select
Committee, will provide for Article 42 measures on social security
(and associated healthcare provisions) to move from unanimity
to qualified majority voting in the Treaty. However, a special
mechanism (a strengthened "brake" provision) has been
secured under the Treaty to make sure that the UK can maintain
control over any changes which would affect important aspects
of our social security system, such as entitlements and rules
of access to healthcare in other EU Member States. Experience
of the emergency brake will be required to gain a full appreciation
of how it will operate in practice.
14 December 2007
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