Call to inject impetus into decision-making

Date: 27/06/1996

By Michael Mann

HEALTH Commissioner Pádraig Flynn is generally content with developments in EU public health policy since the Commission was granted new powers under the Maastricht Treaty.

But he admits that the eight specific health programmes identified by the Commission have not progressed as quickly as he had hoped.

“Article 129 really does give us quite a lot of competence and we are still seeking to define a full interpretation of what it offers us,” says Flynn of the chapter on public health written into the EU treaty for the first time in 1993.

The Commissioner says there is no need to extend Community competence in the health field, arguing the most important thing is to develop a good understanding with the member states and a better appreciation of the issues “in house”.

He believes the advent of Article 129 has enabled the Commission to make its health promotion efforts highly visible and says initiatives such as the European weeks on cancer and drugs have been a considerable success.

But he is hopeful that treaty changes following the Intergovernmental Conference will streamline decision-making procedures.

Commission programmes on health monitoring and drug prevention now look unlikely to be agreed before the annual summer break, while those on pollution-related diseases, health data indicators and a communicable diseases surveillance system have yet to find their way through the Commission.

Perhaps something needs to be done during the IGC treaty revision. The co-decision procedure is good, but the process could be speeded up, suggests the Commissioner.

In the meantime, DGV, the Directorate-General responsible for health policy, is looking to improve understanding in other Commission departments of the health aspects of EU policies.

“We need a better link with research on health-related activities and on the health impact of other policies,” Flynn stresses, adding: “It is not often referred to, but of serious consequence is the relationship as far as agriculture is concerned.”

However, he points out that the Commission works as a college and that all interested directors-general already meet regularly in the inter-service group on health. “We ensure that health matters are taken into account in all proposals. They don't just appear willy-nilly on the Commission's agenda,” he says.

Another potential problem is the comparatively small sums of money available to finance EU-wide action. “We are developing a better public health strategy, but there are limitations on the resources available to us. For the cancer programme, we have 64 million ecu over five years, which is not a lot of money,” he says, admitting this is a drop in the ocean compared to the vast sums invested by the major tobacco companies.

The Commissioner is also very aware of the evident contradiction between efforts to reduce health risks from smoking and subsidies of around 1 billion ecu which are still paid to tobacco growers in the south of the Union.

“I would like to see that situation changed as quickly as possible. We would obviously have to look at alternatives for those who would be seriously affected commercially. Some of the savings we have made already go into research,” says Flynn.

Despite general belt-tightening within the Union's institutions, Flynn is convinced that health programmes will not suffer.

“Our funds for preventative programmes are well spent. It's hard to quantify, but every time you keep someone away from the doctor, you save money for health systems which are under considerable pressure,” he says.

The question of how to maintain efficient healthcare systems despite the ever-growing demands placed upon them will occupy much of the Commision's attention in the months ahead.

Flynn aims to draw up a new policy document by the end of this year based on comments on his recent discussion paper on social security systems.

Commission estimates suggest that by 2025, over one-third of EU citizens will be pensioners, further increasing the strain on public services.

As to the near future, Flynn is optimistic about plans for improved trans-Atlantic cooperation in the area of health. Apart from a new attempt to forge a compromise on tobacco advertising, he hopes the Irish presidency will also launch new initiatives on drugs and international crime as well as blood safety.

It remains his target to attain a common position on three of the health programmes over the next six months, and to manoeuvre the last three through the Commission's services.