EPSU Health Strategy Group - Declaration

Meeting of 25 February 2009

“any European proposal on health services should take, as its departure point, the principles of solidarity, accessibility, affordability and universality. Articulating legal personality for these principles in the context of health services delivery remains one of the greatest challenges of the EU”. EPSU Public Service Pledge for European Elections 2009.


“Universal health care and access to quality health services are fundamental to a social Europe. This should be the guiding principle of the EU health care debate. Unfortunately the European Commission sees health care primarily in market terms. This is wrong", says Karen Jennings, President of the EPSU Health and Social Services Committee.

Wrong legal basis for health directive



The European Commission has based the draft directive on internal market rules (Article 95 of the EU treaty). The Commission has ignored the role of public services in promoting social and territorial cohesion (Article 16) and the responsibility of Member States to guarantee a high level of public health (Article 152). This suggests that the Commission’s primary objective is the liberalisation and marketisation of the healthcare sector.

Healthcare for all - not another market opportunity



EPSU health representatives express their profound concern that universal health care provisions would be put into jeopardy, unless the legal basis is changed to include the above principles of general interest and member state management.

Quality healthcare near you



It is already the case that over 25% of people feel that they are too far from a doctor or a hospital. Only 3 % of Europeans now take the opportunity to travel abroad for care. 97% stay at home and rely on the healthcare facilities in their country. Priority should thus be given to local and accessible care facilities. Especially in this time of economic crisis, investment in qualified health care staff and adequate infrastructures are of prime importance. Now is not the time for another deregulation project by the Commission.


Commission proposals based on health only of your wallet




The current proposals only cater for patients’ with the financial means to pay for cross-border healthcare upfront (as well as related travel and accommodation costs). This raises the possibility of a two-tier national health service. Poorer people are less likely to be able to exercise the right to cross-border care as patients will be required to pay for cross-border treatment themselves and then be reimbursed. No provision has been made for the reimbursement of travel or accommodation costs.

EPSU agrees that it should not be left to the European Court of Justice to shape European health policy on the basis of individual case law. This must be the prerogative of the Commission, the Parliament and the Council. But a directive on patient mobility must respect the fundamental nature of health care provision with a basis in solidarity.

We call on European and National Politicians to ensure healthcare for all



With the discussions of the proposed trans-border health directive having started in the European Parliament as well as the European Council, EPSU urges Members of the European Parliament and National Health Ministers to ensure the following principles form the starting point of the directive:

- confirm the public nature of health care the public interest must take precedence over the application of internal market principles;-

- guarantee accessible, universal and proximity health services ; patient mobility is not an alternative to the local provision of health services

- ensure that patients’ rights are safeguarded across the European Union by developing and applying common principles on quality health care standards

- develop 'prior authorisation' as a tool in the organisation and planning of
health care and as a support to patients searching for the
needed healthcare.

EPSU Health Strategy Group 25 February 2009

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