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Markos Kyprianou

European Commissioner for Health

Health Services and the Annual Strategy for 2008

ENVI Parliamentary Committee, European Parliament
Brussels, 27 February 2007

President, Honourable Members,

I am pleased to have the opportunity to appear, once again, before this Committee – to discuss with you some important matters of common concern.

Today I will focus on two issues, in accordance with the Committee's request:

  • first – key items from the Commission's Annual Strategy for 2008, which fall under my responsibility and that of this Committee, and
  • second – health services

APS 2008

Today's dialogue serves two purposes:

First, it provides me with an opportunity to set out some key elements of my programme for 2008.

Second, it offers you the opportunity to provide feedback on the various initiatives.

Focus for 2008 remains on the key strategic objectives fixed at the start of this Commission, namely prosperity, solidarity, security and freedom.

Main target remains sustainable growth, to provide more and better jobs – improving the economic perspective. But also delivering policies to meet citizens' expectations of where Europe should act.

In the APS 2008 we are pushing forward with a range of ambitious policies to show citizens how the European dimension is essential to realising their aspirations in today's world.

This is a challenge, especially in my policy areas of public health and food safety.

After the completion of the fifth round of enlargement of the European Union, 2008 will be a year of consolidation and continued implementation of the existing Acquis, together with further action to ensure better regulation.

Four key aspects of the APS 2008:

  • Patient safety and the quality of health services,
  • Ensuring compliance with EU food safety, animal health, animal welfare and plant health standards,
  • Development of a legal framework for the risk assessment by the European Food Safety Authority of genetically modified food and feed, and
  • Developing infrastructure for crisis preparedness in the area of health and safety.

1. Patient safety and the quality of health services

  • 78% of EU citizens classify medical errors as an important problem in their country. (Eurobarometer, Jan 2006)
  • Member States hold primary responsibility for ensuring patient safety as part of their healthcare programmes.

Action at EU level aims at:

  • Reducing the gap between Member States by facilitating the sharing of knowledge and expertise;
  • Ensuring that citizens have confidence in health services; and
  • Ensuring the overall quality of those services.
  • European level cooperation is important in relation to healthcare associated infections (affect about 10% of patients). Impact of healthcare acquired infections includes:
  • Delays in treatment and prolongation of patients' suffering;
  • Increased health care costs;
  • Direct and indirect economic implications, such as loss of productivity and increased disability;
  • Creation of complementary problems to that of antimicrobial resistance.
  • Experience with MRSA (Methicillin Resistant Staphylococcus aureus), Clostridium dificile and SARS shows that infections can spread rapidly between countries.

Specific outputs expected in 2008 include:

  • A Communication on patient safety, including a proposal for a Council recommendation;
  • A proposal for a council recommendation on health-care associated infections;
  • Strengthening collaboration and cooperation at European level on patient safety.

2. Ensuring compliance with EU food safety, animal health, animal welfare and plant health standards
Actions aiming to better ensure compliance with EU standards:

  • Monitoring implementation of EU standards by EU trading partners through intensified verification on the ground;
  • Monitoring implementation in an enlarged EU;
  • More effective enforcement, better monitoring and prioritised handling of enforcement issues.
  • More than 150 countries currently export food, feed, live animals and plants to the EU.
  • Aim to increase inspection frequency by 10% by regularly visiting major third country exporters, follow-up inspections and on-the-ground verifications.
  • Recent trade problems with third countries clearly suggest that some main trading partners lack confidence in the safety of products originating in the EU.
  • We envisage in 2008 the creation of a "special response team" in order to monitor closely and perform on-the-spot verifications of actual progress made towards timely and credible implementation of the acquis in the Member States.
  • Also aim to establish internal criteria and guidance on prioritisation of enforcement issues in relation to risk for public health and to increase the monitoring capabilities of Commission services.

3. Development of a legal framework for risk assessment by the European Food Safety Authority (EFSA) of GM food and feed

  • Increased use of GM crops worldwide, results in a correspondingly higher number of applications for authorisations of GM food and feed.
  • In 2008 the basic regulation will have been in place for 5 years. The expertise gained will allow a legal framework for EFSA risk assessment to be adopted.
  • Implementing measures such as authorisations, control strategies and safeguards will be adopted as needed.

4. Developing infrastructure for crisis preparedness in the area of health and safety

  • Crisis Management - key activity of my services in fulfilling their mission to protect European citizen's health and safety.
  • Despite preventive measures, a major cross-border health crisis will occur at some time (e.g. SARS, influenza Pandemic).
  • The ability of the EU and Member States to respond rapidly in a coordinated manner is essential.
  • Member States and the Commission have already done a lot of work, in 2005 and 2006, including developing crisis preparedness plans, running crisis simulation exercises and establishing better co-ordination mechanisms.
  • Much more needs to be done both inside the Commission and by the Member States.
  • Need not just the development of plans – plans must also be tested, under realistic conditions, to train the personnel involved and to identify any practical or policy issues, (problems with basic infrastructure).
  • My services are currently preparing a call for tender to reinforce our training and exercise capacity in the public health area for the years to come.
  • Crisis simulation exercises have shown that for the Commission to effectively fulfil its co-ordination rule during a major public health crisis, it needs to substantially update its IT and Communication infrastructure. (as an administration not as a body which needs to provide critical public services to its interlocutors)
  • Crisis and rapid alert systems require much higher standards of reliability and speed of recovery than normal administrative systems.
  • Therefore, there is a need for supplementary hardware, higher levels of service (for example at weekends and at night), and greater flexibility to intervene in case of a systems failure.

Health Services

  • Commission launched, in September 2006, a public consultation on the question of possible Community action this area, which ended on 31 January., following the exclusion of health services from the Services Directive.
  • Received 260 contributions from a broad range of interested partners. Analysis of responses to the consultation exercise in process.
  • First assessment of the contributions received broadly confirms the need for Community action to address the range of issues set out in the consultation paper – such as the need for legal certainty and support for cooperation between health systems.
  • There appears to be recognition of the potential added value for patients, professionals and health systems overall from some form of Community action on health services.
  • Stakeholders also emphasised the need to respect social objectives, as well as common values such as universality, access to good quality care, equity and solidarity as set out by Health Ministers in June 2006.
  • Challenge is not to make a choice between either having the benefits of the internal market or respecting social values. Rather it is to put in place a framework that can bring both the benefits of freedom of movement and respect for health objectives and social values.
  • Summary report of contributions will be drawn up within the next two months to provide an overarching picture of the views and ideas contained in the responses.
  • Input from the European Parliament to this process would be most welcome.
  • Commission plans to bring forward concrete proposals on health services later on in 2007.
  • Objective is to find a solution that will provide real added value without creating new bureaucratic barriers whilst respecting the principle of

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