Health as an EU competence – the way forward?

Good afternoon, health colleagues, and welcome to the European Alliance for Personalised Medicine (EAPM) update, which today focuses on the crucial issue of health care as an EU competence, writes EAPM Executive Director Dr. Denis Horgan.

Should health be an EU competence?

A screenshot of a draft document from the European Parliament, appears to show that the European Parliament’s Committee on Constitutional Affairs is working on a resolution calling for a number of treaty changes, including a change to Article 4 to make health a shared EU and member state competence. 

This follows the conclusions of the  Conference on the Future of Europe, which called for more EU powers in health care which spoke along the following lines: “The pandemic shows the importance of co-ordination among European countries to protect people’s health, both during a crisis and in normal times when we can tackle underlying health conditions, invest in strong health systems and train the healthcare workforce,” the commission said. “The European Health Union will improve EU-level protection, prevention, preparedness and response against human health hazards.” 

The actual powers of the European Parliament are limited — it can in no way reopen the treaties itself. That is a laborious undertaking that would require the agreement of the 27 member countries. But it would be one more voice joining in to ask for fundamental changes to the EU’s present constitution. 

EU health competence and EU solidarity 

One of the European Union’s bids to improve health care was the directive on patients’ rights in cross border care from 2013.  This provides a graphic demonstration of just how far Europe remains from any real coherence on health policy and on innovation.

Under EU rules, citizens are guaranteed the right to access health care services in any country within the bloc through the cross-border health care directive. In practice though, they’re subject to a number of limitations and bureaucratic obstacles. In all but seven member countries, patients need pre-authorization from their home country before being able to access health services abroad.

The new rules were designed to clarify and reinforce citizens’ rights to choose where to seek medical treatment, and in what circumstances. 

The directive’s effectiveness depends on collaboration by member states at EU level.

However, EU citizens rarely take advantage of their right to receive treatment in hospitals in other countries inside the bloc, reveals a report on the topic published by the European Commission.

The legislation could have enabled a shift away from national isolationism in health. The new rules are intended to make the EU’s famed internal market work for health for the first time, by strengthening the freedoms relating to movement of goods, people, and services. The vision is that patients could move around Europe to access safe and high quality cross border healthcare, accompanied by the free flow of their health data from one country to another.

If only, but we live in hope!

It is nearly 50 years since the EU adopted its first legislation on drugs, but despite dozens of subsequent directives, regulations, and decisions, covering many thousands of pages, EU law remains a patchwork quilt of distinct policies on the conditions that underpin innovation and access. 

The blame lies not only with the current economic challenges facing member states but also with national insistence on retaining national methods.

To realise the promise of personalised medicine, a treaty change could be crucial to progress. Freer movement of patients and data around Europe; closer collaboration on reference networks and data banks; wider access to information; institutionalised cross fertilisation between providers, payers, and regulators; and enhanced common understanding on health technology assessment are all preconditions for the successful evolution of personalised medicine.  

The EU has worked on these issues to various degrees over the last years as evidenced by the recent proposal of the EU Health Data Space. 

A  new level of coherence on EU policy is necessary. 

The success, or failure, of the delivery of the promise of personalised medicine is a test case for Europe’s ability to seize opportunity, as well as a crucial determinant of how far and how fast Europe can develop valuable new therapeutic  and diagnostic approaches.

But if the opportunity is missed—or mishandled—the damage will be felt not only by today’s patients, but by tomorrow’s patients too.

Estonia Event - Leading the way in personalised medicine

The University of Tartu and the Estonian Research Council are organizing a networking seminar for 15-17 June, entitled ‘Leading the way in personalised medicine: Solutions for Europe'. 

The EU’s key initiatives like the 1M Genomes project/MEGA and Beating Cancer Plan lead the way to enable personalised and early prevention & treatment. Estonia, with its advanced electronic health records and large population-based genomic databases, is ideally positioned to demonstrate the scalability of integrating genomics with a nation-wide health-care system. 

The seminar highlights the European Commission and leading organisations’ strategic approaches in personalized medicine, which have the potential to transform the EU's healthcare sector. For more information and to register, by 26 May, click here.

COVID-19 committee

The first meeting of the European Parliament’s new COVID-19 committee (COVI) on Thursday (12 May) did not bring about any concrete results but revealed the broad range of topics MEPs wish to address in the quest to collect lessons learnt from the pandemic.

At the first COVID meeting, Chairwoman Kathleen van Brempt welcomed Health Commissioner Stella Kyriakides, reassuring her that this would be just one of many invitations for her to debate with committee members. “We are still very close to the crisis, so policymakers and experts who were there during the crisis, such as you Mrs Commissioner, are still in office. 

"Today there are only seven health ministers in our member states who were in office at the beginning of the crisis. We will need all that expertise.”

Brempt said during her opening statement. The Parliament greenlighted the new special committee in March 2022 tasked with overseeing lessons learned from the COVID-19 pandemic and making recommendations for the future. As with other special committees, the COVID-19 committee has been granted an initial mandate of 12 months, which can be prolonged if MEPs find it necessary.

EU institutions publish final text for Digital Markets Act

The Committee of the Permanent Representatives of the Governments of the member states to the European Union approved and published the final text of the provisional agreement for the Digital Markets Act. The COREPER's approval came with no further changes compared to the last amended version of the DMA text from 18 April. The DMA regulates competition in the EU digital marketplace, but carries similar obligations and references to the EU General Data Protection Regulation

EU global health funding

The EU’s funding for global health initiatives like COVAX was the topic of discussion at Tuesday’s (17 May) joint public hearing of the European Parliament’s budget and development committees. The EU has made clear its support for increasing regional manufacturing capacity, particularly in Africa. In fact, this was a central outcome of the EU-AU summit in February. However, things aren’t looking good as the first facility to produce  vaccine for Africa has yet to receive a single order. 

The World Health Organization has reviewed all seven studies globally on administering a second COVID-19 vaccine booster and concluded  that there is some short-term benefit in an mRNA booster in highest risk groups. This includes health workers, those aged over 60 and immunocompromised people. 

Supporting mental health

Mental health is an integral and essential component of health. It is critical to individual well-being, as well as to social and economic participation. Prior to the COVID-19 pandemic, the total costs arising from mental health problems accounted for more than 4% of GDP across the member states (Health at a Glance: Europe 2018). The heavy individual, economic and social burdens of mental illness are not inevitable. 

Although many member states have policies and programmes to address mental illness at different ages, the distribution of these actions is uneven throughout the life course. Furthermore, the COVID-19 pandemic has immediate and long-term consequences, including on mental health, which require action that focuses on vulnerable groups, including children, and refugees and migrant populations. Hence, there is an acute need to increase awareness, knowledge sharing and capacity building in the area of mental health.

The Commission supports member states to reduce the burden of non-communicable diseases in order to reach the UN SDGs. The Commission is working on a new Initiative, ‘Healthier Together’, which includes five strands: cardiovascular diseases, diabetes, chronic respiratory diseases, mental health and neurological disorders, and a horizontal strand on health determinants. In each of these strands, the reduction of health inequalities will be tackled. 

And that is everything from EAPM for now. Stay safe and well, and enjoy your day.

Share this article: