Development of high-quality, accessible and sustainable health care and long-term care
This Communication proposes to extend the "open method of coordination" to health care and long-term care. This will help to establish a framework to promote the sharing of experience and best practice, thus supporting Member States in their efforts to reform health care and long-term care.
Communication from the Commission of 20 April 2004 - 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" [COM(2004) 304 final - Not published in the Official Journal].
Social protection is 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 even those on a low income have access to care. The social protection systems in the Member States have considerably reduced the risk of poverty and helped to improve the state of health of the people of Europe. They are therefore an important part of the European social model.
Following the Lisbon and Gothenburg European Councils, which highlighted the need to reform social protection systems, the Commission identified three principles, set out in the Communication of 2001, on the future of health care and care for the elderly, that could serve as a basis for this reform: accessibility of care for all, based on fairness and solidarity; high-quality care for the population; and measures to ensure the financial sustainability of this care.
The Commission therefore calls for the coordination of national policies to be stepped up in order to support the modernisation and development efforts in the healthcare sector and calls for a global strategy which would include the other three main areas of social protection: pensions, social inclusion and pay. These areas have been coordinated more closely since 2000.
As set out in the Commission's Communication on streamlining coordination in the field of social protection, the social protection systems need to be reformed in an integrated and coordinated way in order to make social protection more coherent and to ensure closer coordination with other political processes such as the European Employment Strategy, in particular the challenges of the ageing workforce, and the broad economic policy guidelines (BEPG).
In this context, the "open method of coordination" will be a vital tool, as it respects the diversity of the national healthcare situations, helps to involve the many actors in this sector and favours a comprehensive, integrated approach to the problems encountered today in the different systems, by establishing a close link with the instruments and policies associated with the field.
On the basis of these guidelines, the Commission is proposing objectives to support the development of the systems in the EU:
- ensuring access to care: universal access, fairness and solidarity;
- promoting high-quality care;
- guaranteeing the financial sustainability of accessible, high-quality care.
Ensuring access to care: universal access, fairness and solidarity
With a view to providing a safety net against poverty or social exclusion associated with ill health, accident, disability or old age, Member States propose to:
- ensure access to healthcare based on the principles of universal access, fairness and solidarity, and to ensure the financial and physical accessibility of care systems for disabled persons;
- offer specific care for elderly people;
- promote palliative and end-of-life care;
- reduce regional inequalities in the provision of care;
- develop infrastructure, particularly hospitals, with the support of the ERDF and the Cohesion Fund.
Promoting high-quality care
The quality of European healthcare systems must remain a fundamental objective. This calls for a preventive approach and effective management of the care system, on the basis of closer coordination between all the players.
In order to improve people's state of health and quality of life, the Commission feels that Member States should:
- promote practices and treatments providing real benefits for health and quality of life;.
- evaluate the costs and benefits of drugs, equipment and treatments;
- ensure a high level of training;
- develop health and safety at work policies based on risk prevention.
Guaranteeing the financial sustainability of accessible, high-quality care
Member States are always faced with the need to ensure proper funding for their care system. In this context, they have long been implementing measures designed to ensure the financial equilibrium of the systems, such as reimbursement rates (in order to encourage responsibility or guide demand in a particular direction), prices and volumes of treatments (in order to control certain products or prescriptions) or the fixing of budgets, particularly in the hospital sector.
The quest for financial sustainability should therefore be based on the development of prevention and guidance policies so as to reduce the need for expensive treatments, on a sustainable rate of expenditure development and on improving the effectiveness of the system by means of decentralisation and involvement of the various players.
The Barcelona European Council (2002) called on the Commission and the Council to examine in detail the issues of access, quality and financial viability with regard to healthcare and long-term care. A questionnaire has been sent to Member States in order to obtain information concerning their approach to these three objectives. The Commission and the Council drew up a joint report on the basis of this questionnaire. Based on this work, the Spring 2003 European Council highlighted the need to step up exchanges and collaboration in this area and, in April 2004, the Commission proposed, in this Communication, to extend the "open method of coordination" to the healthcare and long-term care sector.
For further information on healthcare and long-term care, visit the website of the Directorate-General for Employment and Social Affairs.