(3 May 2021) On the 27 April 2021 the European Economic and Social Committee (EESC), with a large majority of votes (231 in favour, 3 against and 7 abstentions), adopted the opinion on Building a European Health Union. The opinion covers the following documents of the Commission related to the EU Health Union Initiative: (1) Communication on Building a European Health Union: Reinforcing the EU's resilience for cross-border health threats; (2) Proposal for a Regulation on a reinforced role for the European Medicines Agency in crisis preparedness and management for medicinal products and medical devices; (3) Proposal for a Regulation amending Regulation (EC) No 851/2004 establishing a European Centre for disease prevention and control; (4) Proposal for a Regulation on serious cross-border threats to health and repealing Decision No 1082/2013/EU.
Adam Rogalewski, EPSU policy officer responsible for Health and Social Services, was the Worker’s group expert.
The opinion includes reference to ensuring that health is a public good, and to workers both in health and social services by acknowledging the urgent need for addressing adequate staffing levels as a part of preparedness and resilience policies. It also underlines the importance of protecting occupational health and safety based on the EPSU and Amnesty International report on the fatalities among health and care workers.
Here are the most important parts of the opinion covering the EPSU recommendations with the relevant points in the text.
(1.2) It has been observed and felt by the people living in Europe during the pandemic just how ill-prepared the EU was to keep people safe, with its fragmented healthcare architecture and prevention strategy, as well as decades of austerity and under-investment in health and social care services. This had an impact on loss of life, increasing inequality and poverty rates (…).
(1.3) The COVID-19 pandemic has demonstrated how vital health and care services are and that health is a public good. To that end, the EU and Member States should ensure that everyone has equal access to quality, well staffed, well equipped health and social services.
Regarding improving working conditions:
(1.4) During the pandemic, health workers, social workers, health mediators, civil society actors and essential service providers (food, transport) have been at the forefront of the pandemic and demonstrated an outstanding degree of solidarity during the most difficult times. Special attention should be given to healthcare workers and the need to improve working conditions, including pay, recruitment and retention, as well as their health and safety. The pressure of the pandemic has caused many to consider leaving the profession (…).
Linking the package on EU Health with the European Pillar of Social Rights:
(1.10) The new EU health package should be combined with the roll-out of the European Pillar of Social Rights (EPSR), particularly its principles 12, 16, 17 and 18 and the Action Plan on the EPSR which proposes, among other things, an EU Health Data Space. It should also be part of achieving Sustainable Development Goal (SDG)
Linking the cuts and austerity measures with the preparedness of healthcare systems and that health cannot be treated as a commodity:
(2.9) Existing healthcare systems throughout the EU – not least those in MS that have been affected by austerity-driven policies, ongoing underinvestment and extreme cuts to public spending in the previous decade – were unable to respond effectively to the immense pressure that the COVID-19 pandemic caused. This pandemic has highlighted the deficiencies in health systems across Europe and the need to shift how we think about healthcare. Healthcare cannot be treated as a commodity. Equal access to treatment, increased staffing in the health sector and improved conditions for health workers must become a priority.
Recruitment and retention of healthcare workers:
(2.14) The "European Health Union" is an important new development. It must contribute to improving access to healthcare, and the safety and wellbeing of people living in the EU; it will reinforce an appreciation of the Union's commitment to serving its people, and will also protect the MS against the threats of rising nationalism and populism. It should, therefore, be a topic to be included in the Conference on the Future of Europe. To that end, the EESC draws attention to the recommendations in the WHO High Level Commission on Health Employment and Economic Growth report "Working for health and growth: investing in the health workforce" and to the Five-Year Action Plan for Health Employment and Inclusive Economic Growth (2017–2021) which should be implemented as part of improving the EU's preparedness for future health emergencies.
(2.17) The EU should also look more closely at the recruitment, retention and working conditions of health and social care workers. Safety of health and social care workers should also be made a priority, given the number of fatalities seen during the pandemic. Additionally, the EU should collect relevant and transparent data on the impact of COVID on health and social care workers. This will allow the EU and Member States to better assess the long-term consequences of COVID and develop measures to ensure that healthcare systems are better prepared for future health emergencies.
Recommendations regarding the Regulation on serious cross-border threats to health:
(3.3.2) (…) Preparedness for protecting high-risk groups should begin immediately, particularly with regard to those in grouped living conditions and institutions where it has been shown to be very difficult to sufficiently protect residents and respect their rights, as well as to ensure health and safety in terms of working conditions and an adequate level of personnel both in the health and care sectors. This Regulation should also foresee improved monitoring of the shortages of health and care workers in order to assist Member States, the European Commission and the national and European social partners to consider solutions to make work in the sector more attractive and so improve recruitment and retention.
On the role of the social partners in the Health and Security Committee established by this regulation:
(3.3.4) Enabling the EU's Health Security Committee (HSC) to deliver guidance in the adoption of common measures at EU level to face a future cross-border health threat. The European social partners in the health sector (such as in the European Social Dialogue Committee for the Health Sector) should be consulted and included in the governance of the committee.
In the same regulation on the data collection for the management on the cross- border health threats, including data on adequate, needs- oriented staffing levels:
(3.3.5) (…) The data should take into account gender, age, ethnicity, migration background, disability and chronic diseases. It should also cover data on the supply of health professionals and social care, stock of medicines, medical devices and personal protection equipment, intensive care and acute care bed capacity and beds in use, ventilators and ventilators in use, testing capacity and tests performed, and data on the resourcing of public health departments to ensure adequate, needs-oriented staffing levels, in particular per capita staffing levels for community medicine. It also important to gather information on inclusiveness of the national healthcare systems to ensure more equal access. This data should be used to adopt recommendations on ratios for resources per population unit, including the number of healthcare and social services personnel, developed on the basis of good practice and policy assessments.
Finally, the opinion calls for Waiver on COVID-19 vaccination, one of the demands of EPSU:
(5.5) (…) The vaccine should be treated as a public good, and as such it is crucial to ensure that the timely administering of vaccines to the population is not overly hindered by restraints linked to things such as intellectual property rights. The saving of lives must always be the top priority for the EU. It is therefore vital that we ensure Europe remains the leading continent when it comes to vaccine development.
EPSU would like to thank the Workers’ Group of the EESC for their support in including EPSU recommendations.
Here is the link to the opinion on the EESC’s website: