DG Health and Consumers
Alpeuregio Summer School
Brussels - 9 July 2012
Marco Valletta
Assistant to Director General Paola Testori Coggi
DG Health and Consumers
Health and
Consumers
SANCO Goals
• To make Europe a healthier, safer place, where consumers
can be confident that their interests are protected.
• A zero-risk society may not be possible but we are doing as
much as we can to reduce and manage risks for consumers.
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These goals are spelled out in three pillars:
- Food safety (food / animals / plant)
- Consumer empowerment and protection
- Public Health
Health and
Consumers
WHO WE ARE
 DG Health and Consumers has around 960 staff.
 About 660 of us are in Brussels;
 About 120 work in Luxembourg and another 180
in Grange, near Dublin
Health and
Consumers
Food safety
Making sure our food is safe and
wholesome from farm to fork
Health and
Consumers
A unique integrated approach
The mad cows disease and the various food scandals of the ninety
convinced on the need to act at European level and to define
an integrated approach
This means:
•
•
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protect the health of crops and forests
protect the health and welfare of farm animals
ensure Europe's food is safe and wholesome
through coherent farm-to-table measures and adequate
monitoring, while ensuring the effective functioning
of the internal market.
Health and
Consumers
5
Making sure our decisions are science based
•
Risk assessment (RA) and management (RM) as
separate steps
• Risk assessment: European Food Safety
Authority
• Risk management: European Commission
through a regulatory committee procedure
• - Transparent process open to 27 MS of the EU and to
more than half a billion EU citizens
• - Individual analysis and authorisations for various
dossiers (GMOs, pesticides, additives…..)
Health and
Consumers
6
1 - Health of crops and forest
•
•
•
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By ensuring that the seeds used in the EU
respect minimum quality standards
By authorising effective and safe plant
protection products
By monitoring via EUROPHYT (a notification and
rapid alert system) the increasing number of
interceptions of pests and diseases
By fighting the spread of these diseases when
they appear on the EU territory (red palm wevil,
pinewood nematode).
Health and
Consumers
7
2 - Health and welfare of farm animal
•
•
Animal Health Strategy (2007-2013): provides
the framework for animal health measures
It is based on the principle that “prevention is
better than cure”:
- precautionary measures
- disease surveillance
- controls and research
- minimization of impact.
Health and
Consumers
8
2 - Health of farm animals – 9 areas of action
1. Harmonisation of intra-community trade of live
animals, semen, ova and embryos and placing on the
market of products of animal origin (AH certificate and vet
checks)
2. Preventive measures on imports – (legislation,
inspection and certification of Third Countries on the basis
of OIE standards, vet controls at the EU Borders and
possible corrective measures if needed). TRACES (TRAde
Control and Expert System) is a trans-European network for
veterinary health which notifies, certifies and monitors
imports, exports and trade in animals and animal products
3. Animal disease control eradication and monitoring –
of specific animal diseases and zoonoses in EU areas
(brucellososis, tubercolosis, rabies….)
4. Traceability - identification and registration, depending on
the characteristics of the different species (identifiers,
registers or passports).
Health and
Consumers
9
2 - Health of farm animals – 9 areas of action
5. Animal nutrition, feed additives – A register of
authorised feed additives + new feed additives, an
authorisation procedure
6. Veterinary medicinal products – well defined procedures
(centralised / mutual recognition / national)
7. Research - The EU has supported research on animal
health in successive multiannual Framework Programmes
(FP) since 1984
8. Science – 3 EFSA panels (additives, AH and biological
hazards) and national reference labs
9. Financial aspects - Community financial contribution
to the Member States and farmers in case of diseases
Health and
Consumers
10
3 – Animal welfare
The European Commission's activities in this area start with the
recognition that animals are sentient beings.
The general aim is to ensure that animals need not endure
avoidable pain or suffering. Requirements  5 freedoms
•
•
•
•
•
Freedom from hunger and thirst - access to fresh water and a
diet for full health and vigour.
Freedom from discomfort - an appropriate environment with
shelter and comfortable rest area,
Freedom from pain, injury and disease - prevention or rapid
treatment,
Freedom to express normal behaviour - adequate space and
facilities, company of the animal's own kind,
Freedom from fear and distress - conditions and treatment
which avoid mental sufferings.
Health and
Consumers
11
3 – Animal welfare
- Community action plan (2006 – 2010)
- The new animal welfare strategy (2012 – 2015)
- Specific sartor legislation aiming at protecting animals:
•
•
•
on the farm and in particular laying hens, calves and
pigs
during transport
at time of slaughter or killing
Health and
Consumers
12
4 – Ensuring the safety of our food
•
•
Reg. 178/2002 (European food law) - defines the
basic principles.
Our actions move around four pillars:
1. Authorisations of those substances which might
create safety concerns (GMOs, pesticides, additives…)
2. Controls carried out by MS but co-ordinated by the
Commission and supervised by the FVO.
3. Rapid Alert System for Food and Feed (RASFF)
info exchange and quick reaction to serious risks in
the food/feed chain
4. Information to consumers – Reg 1169/2011
Health and
Consumers
13
EU Consumer Policy
Empowering and protecting
Health and
Consumers
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Lisbon Treaty Article 169
Current Consumer Policy Strategy, replaced by 2012 - 2020
Consumer Agenda
The 2007-2013 Consumer programme, replaced by the
2014-2020 Consumer programme - €197m (i.e. around
€25m per year)
Facts/Evidence about EU Consumer Markets
Financial Instruments
The “acquis” on consumer protection
Health and
Consumers
15
Consumers =
Driving the economy
Final consumption expenditure of private
households = 56% of EU GDP
Health and
Consumers
A taste of consumer policy: a story of rights
and opportunities
You expect:
•
•
•
Products you buy to be safe
Not to be cheated or misled
Repair, replacement or refund of faulty goods
Health and
Consumers
17
A taste of consumer policy: a story of rights
and opportunities
You can also expect:
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•
•
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To get the best deal
To have the same rights wherever you go
To be able to get help when things go wrong
To Policy makers to listen to your concerns
Health and
Consumers
18
Key aspects of Consumer Policy
•
- Quality of life - directly relevant for EU citizens
•
- Competitiveness – more competition/better deal for
consumers (in eurospeak = ensures that consumers
benefit fully from the Internal Market)
•
- Consumers can buy – what they want, wherever
they want - without thinking about borders
•
 Scope: Economic interests of consumers + non-food
product safety issues + integration into other relevant
policies, such as food safety, energy, transport, etc.
•
Complement to national consumer policy
Health and
Consumers
•
•
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Article 169
To promote the interests of consumers and to ensure a
high level of consumer protection:
• Health
• Safety
• Economic interests
To promote the right to information, education and the
right to organise in order to safeguard consumer
interests
Integration in other Community policies and activities
(article 12)
Contribution to the completion of the internal market
(article 114)
Health and
Consumers
2012 – 2020 Consumer Agenda
Three main challenges stemming from Europe 2020
• The digital revolution
• Sustainable consumption
• Social exclusion, vulnerable consumers and accessibility
Four pillars
• Reinforce consumer safety
• Enhance knowledge
• Improve application, step up enforcement and secure redress
• Align rights and key policies to economic and societal change
Health and
Consumers
Key Actions
•
Consumer market monitoring (Scoreboard and studies)
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Product Safety
•
Common Sales Law (DG JUST)
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Package Travel Directive
•
Individual (ADR/ODR) and Collective Redress
•
Enforcement
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Support to Consumer Organisations
•
Education
Health and
Consumers
Consumer Scoreboards
= The alarm system informing policymakers of problems in
the market
Two editions:
• 1. Consumer Conditions Scoreboard (CCS) in spring
• to track the integration of the retail internal
market and the development of cross-border ecommerce
• to benchmark national consumer policies
• 2. Consumer Markets Scoreboard (CMS) in autumn
• to detect potentially malfunctioning markets, for
in-depth analysis
Health and
Consumers
Consumer Conditions Scoreboard
Part 1: Integration of the Internal Market
Objective = to detect fragmentation and assess crossborder experiences
• - Cross-border trade
• - E-commerce
• - Cross-border complaints, disputes and information
requests
• - Consumers’ and retailers’ attitudes towards cross-border
purchases and sales
Health and
Consumers
Consumer Conditions Scoreboard
Part 2: Consumer conditions in the MS
Objective = to benchmark and measure progress of
consumer environment in the Member States
• - Consumer Conditions Index
• - Enforcement in Member States
• - Consumer Affordability
• - Country Consumer Statistics
Health and
Consumers
5th Consumer Conditions Scoreboard
Main findings
• Despite the sustained growth of domestic e-commerce,
growth of cross-border e-commerce is modest at best
- In 2010: 36% domestic, 9% cross-border
• Consumers face very different conditions across the EU.
- Existing consumer measures are considered
adequate by 4 out of 5 consumers in countries
like UK and Ireland while in countries like
Bulgaria and Greece less than a third of
consumers share this view.
Health and
Consumers
Consumer Markets Scoreboard
 -Annual market monitoring survey of 50 markets
looking at comparability, trust, problems,
complaints, satisfaction, switching and choice
• -Prices – differences of prices of comparable
products (groceries, consumer electronics, cars,
energy, bank fees)
• -Complaints – harmonised national complaints
data as from 2012
Health and
Consumers
Main findings:
- Services markets continue to under perform,
with banking services and telecom services all
below average.
- Goods markets perform considerably better.
- Exceptions: second-hand cars and vehicle fuels
- Compared with 2010, the electricity and fuels
markets have deteriorated most
Health and
Consumers
Market Studies and Behavioural Studies
• Prices of current accounts study, published 2009
- showed that opacity is linked to higher prices
- prices of accounts with average usage range from
253€ in Italy to 27€ in Bulgaria.
 the banking industry will voluntarily develop a code
to make bank fees more transparent.
• Behavioural study on retail investments, published 2010
- less than 2 in 100 consumers made all investment
choices optimally
- almost 3 in 5 consumers rely on advice
Health and
Consumers
Market Studies and Behavioural
Studies
• Retail Electricity study: published in November 2010
• Mystery shoppers could save on average 100€ by switching to the
cheapest electricity provider
• but very few consumers compare offers or switch
 the regulators will develop guidelines in the areas of price
comparison and switching procedures.
• E-commerce studies published in Oct 2009 and Jan 2012:
• Great potential for savings and choice goes unfulfilled: retailers
refuse 6 in 10 cross-border online orders
• If e-commerce were to grow to 15% of the total retail sector and
Single Market barriers were eliminated, total consumer welfare
gains are estimated to be around €204 billion, an amount
equivalent with 1.7% of EU GDP.
 Commission communication with recommendations to remove
barriers to online trade
Health and
Consumers
Market Studies and Behavioural Studies
• Electrical and electronic goods study: published in
March 2012
• Consumers in some countries could save up to 35%
of the price when buying some electrical or
electronic goods in another EU country
continuing monitoring of competition and for
improved consumer information in these markets.
Planned behavioural studies on CO2/Car labelling, food
information, tobacco, package travel, bank accounts,
bank card fees, Common sales law, …
Health and
Consumers
Consumer empowerment – why?
• - Need for empirical data on consumer
empowerment
• - Better design of regulation, information and
education – at EU and national level
• - 55 000 consumers surveyed in EU27+IS+NO
in March 2010
Health and
Consumers
Consumer empowerment – what?
-
Perceived confidence
Consumer skills
Consumer awareness
Consumer behaviour
Willingness to take action and detriment
Health and
Consumers
Consumer empowerment – awareness
- 28% know the cooling-off period in distance
selling of financial products (e.g., car
insurance) – 14 days
- 39% know the length of the guarantee rights –
2 months  2 years
- 44% know the cooling-off period in doorstep
selling (e.g., when buying a vacuum cleaner) –
7 days
Health and
Consumers
Consumer Empowerment Index
Health and
Consumers
Consumer Safety
- Only “safe” products may be placed on the EU market - General
Product Safety Directive (non food)
- EU Member States responsible for market surveillance and
enforcement
- European Rapid Alert System for dangerous consumer products
(non food) - RAPEX
- International cooperation – Trilateral EU-US-China
- On-going review of the GPSD to ensure greater coherence,
facilitate compliance by manufacturers and clarify obligations for
all economic operators in the value chain
Health and
Consumers
RAPEX
Exchange of information between Member States and the
Commission on measures taken to prevent or restrict the
marketing or use of products posing a serious risk to the health
and safety of consumers.
In 2010, there were 2.244 notifications
Health and
Consumers
RAPEX
In 2011, the five most frequently notified products were:
•
Clothing, textiles and fashion items – 32%
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Toys – 25%
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Motor vehicles – 9%
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Electrical appliances – 8%
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Childcare articles – 4%
Health and
Consumers
RAPEX
In 2011, the five most frequently notified risks were:
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Injuries – 24%
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Chemical – 19%
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Strangulation – 16%
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Choking – 14%
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Electric shock – 9%
Health and
Consumers
RAPEX
Country of origin of the notified products in 2011:
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China – 58%
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EU-27 and EEA countries – 17%
•
Other – 15%
•
Unknown – 10%
Health and
Consumers
Products standards: RIP cigarettes
• Introduction of reduced ignition propensity (RIP) cigarettes
which rapidly self-extinguish when left unattended
• As of 17 November 2011 all cigarettes must comply with
the new standards
• They reduce the risk of fire and injuries and are expected to
save hundreds of lives every year
Health and
Consumers
Emergency measures
If necessary, the Commission can impose
EU-wide measures to ban the marketing of
specific unsafe products.
Health and
Consumers
Novelty lighters (example of emergency measures)
A Commission Decision requires since 2008 that all
“novelty” lighters are banned and other lighters must be
child resistant.
Health and
Consumers
DMF (example of emergency measures)
Dimethylfumarate (DMF) – a biocide used to protect furniture
and footwear against mould – is strongly skin sensitising.
As of 1 May 2009, all consumer products containing DMF are
banned by Commission Decision 2009/251/EC.
Health and
Consumers
A type of consumer goods
Cosmetics
• Make-up, perfumes, sunscreens and products for personal
hygiene, tooth-care products, shampoos, soaps…
• Europe is the world leader. Over 145,000 people are
employed in the cosmetics industry in Europe.
Health and
Consumers
New Cosmetics Regulation 1223/2009
• Introduction of new definitions
• Simplified notification system at EU
• Cosmetics Products Safety Assessment
• New rules on certain types of substances: CMR and
nanomaterials
• Enhancement of in-market control (MS in charge)
Health and
Consumers
Scientific Assessment
Functioning of SCCS Scientific Committee for Consumer Safety
Member
States
Cosmetics
Industry
concern
DG SANCO
Cosmetics Unit
Update of
Cosmetics Directive
evaluation
request
scientific opinion
mandate
for evaluation
DG SANCO
SCCS
Risk Assessment
Unit
Health and
Consumers
Unfair Commercial Practices Directive
(Directive 2005/29/EC)
■ New law to stop unfair treatment of consumers
■ Protecting Consumer’s economic interests
■ Misleading and aggressive practices
■“Black list” of practices banned upfront
Health and
Consumers
Alternative Dispute Resolution (ADR)
 Efficient and effective redress for EU consumers and businesses is
a fundamental pillar of EU consumer policy. ADR offers a quick,
inexpensive and simple way to obtain redress out-of-court.
 Commission proposal of a Directive on ADR (November 2011)
 Boosting growth and contributing to re-launch the Single Market.
 ADR proposal aims at ensuring that: i) all EU citizens have access
to quality ADR for any consumer dispute in the Single Market; ii)
ADR respects binding quality principles; iii) consumers are
informed by traders about ADR; iv) ADR are monitored and
controlled by national competent authorities.
 Together with the ODR proposal, it forms part of the EU priority
initiatives with growth potential to be adopted in the course of
2012.
Health and
Consumers
Online Dispute Resolution (ODR)
 Online access to effective and efficient dispute resolution will help
to resolve problems arising from online consumer transactions.
 Commission proposed a Regulation on ODR (November 2011)
 The ODR proposal establishes a web-based platform accessible
directly online by all EU citizens. The ODR platform will offer to
consumers and traders a single point of entry for the out of court
resolution of disputes related to the cross-border online sale of
goods or provision of services.
 Together with the ADR proposal, it forms part of the EU priority
initiatives with growth potential to be adopted in the course of
2012.
Health and
Consumers
Collective Redress
 Mass markets are expanding in size – large numbers of
consumers can be harmed by the same practice of a
single trader.
 Judicial collective redress procedures exist in 15 Member
States. National systems do not deal with cross-border
issues effectively.
 An EU framework for Collective Redress (in the
Commission Work Programme for 2012) will follow up on
the full range of previous Commission work on Collective
Redress.
Health and
Consumers
FINANCIAL SERVICES FOR CONSUMERS
 We are currently preparing (with DG MARKT) a legislative
proposal in the area of bank accounts that will cover
the issue of transparency and comparability of fees and
bank account switching.
 We carry out various integration activities for promoting
consumers’ interests in the field of financial services:
- active cooperation in the definition of other legislation on
financial services which has a direct impact on consumers,
- contribution to improve the transparency
efficiency of the payment systems.
Health and
Consumers
and
the
PROTECTION OF BORROWERS
 Contracting consumer credit is a major decision difficulty and may
provoke serious indebtedness.
 Consumer Credit Directive is the major tool for the protection
of borrowers.
 It provides for:
– Harmonised information in advertisement, pre-contractual
information and contract;
– Possibility to withdraw from signed contract within 14 days;
– Early repayment of the loan.
 Consumer Credit Directive is now transposed by all Member
States and guidelines for its implementation are finalised.
 A study on the performance of the Consumer Credit Directive
is now carried out for the Commission.
Health and
Consumers
Legislation needs enforcement
A network of public consumer authorities
responsible for the protection of collective consumer
economic interests in EU in cross-border transactions
An obligation to co-operate at EU level
Mutual assistance arrangements: mechanisms to
exchange relevant information and list of minimum
powers for authorities to ensure effective enforcement
cooperation
EU-coordinated enforcement actions: Sweeps
Health and
Consumers
Sweeps
In a sweep national authorities:
check selected websites (sector) for compliance with legal
information requirements from consumer laws
follow-up on detected irregularities to ensure sites comply to law at
the end of enforcement phase
Annual exercise since 2007; sectors targeted so far:
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Airlines
Ring tones for mobile phones
Electronic equipment
Ticket for cultural and sport events
Consumer credit (ongoing)
Regularly 20- 30% of sites with irregularities in first phase, 8090% compliant at the end of the exercise.
Health and
Consumers
European Consumer Centres
Network (ECC Net):
the European Consumer Advisor
29 ECCs in 27 MS + NO and IS
provide information before shopping cross-border (goods or
services)
assist consumers facing problems with cross- border
transactions via amicable solution
advise on redress - an appropriate Alternative Dispute
Resolution (ADR) scheme, NEB, European Small Claims
procedure, etc.
71,000 contacts 2011
Health and
Consumers
Involvement of consumer organisations
in EU policies
ECCG (European Consumer Consultative Group)
Capacity-building projects
Information campaigns
Education of consumers via various tools
Health and
Consumers
Community health action – past and future
Paola TESTORI COGGI
DIRECTOR GENERAL FOR HEALTH AND CONSUMER
Health and
Consumers
58 of
Health is Wealth
Spending on health is over 9% of EU GDP (over €1000
billion)
Share of public health spending is 7.4% of GDP - the
remaining being private
Italy7.0% (2.1% private); Poland 5.1% (1.9%
private) and USA 7.3% (8.7% private)
Spending on health as a share of public budgets: 15.8%,
14.8% in Italy, 16.9% in Germany, 11.9% in Poland and
6.7% in Cyprus.
Share of healthcare spending by function:
• - Curative care : almost 45%
• - Long-term and rehabilitative care : almost 12%
• - Prevention : only 3% (1,4% in Italy)
Health and
Consumers
source:
The ageing population
The over 80’s is the fastest growing sector of the population
(Increase of 50% over the last 18 years. Likely to rise over
160% by 2060)
In 1990: for every person over 65 there were 5 people of
working age. Today there are only 4; in 2060 there will be
just 2
By 2060, public health spending may have increased by over
4% points of GDP
Improving the health of older people can limit growth in
health spending to below 0.7% points of GDP
Health and
Consumers
source:
Health determinants
Health is a result of a number of factors,
individual and social
Need for action at many levels
Tackle the root causes of health inequalities
Advocate "health in other policies"
Age, sex and
genetic factors
Healthcare
system
Health
Environment and
socio-economic
factors
Lifestyle
Health and
Consumers
Health Means Wealth
Healthier citizens  reduced strain on healthcare system, but also:
Healthy Adults:
•
are more likely to be in the workforce – in ageing Europe healthy
active workforce will be a key determinant of sustainable productivity
•
are more productive
•
work and live longer and save more for retirement
Healthy Children
•
have better schooling outcomes and education  less school
absenteeism and early drop-out  indirectly contribute to future
productivity.
•
lead to lower child mortality  increased future labour supply and
less strain on pension systems

a more competitive economy
Health and
Consumers
Case Study – Mental Health
Public health dimension
Mental disorders represent the largest share in the burden of
disease: 23% of disability adjusted life years in the EU. Depression
alone: 8% (WHO 2004)
Mental disordersare the leading reported reason for diability benefits
(early retirement), accounting for 27,5% of them (EU-15 – Dg
EMPL)
During the years 2004-2006, suicide caused on average 59,040
deaths per year (Eurostat)
• Among the 15 countries in the world with the highest male
suicide rate, 7 are EU-Member States
Health and
Consumers
Case Study – Mental Health
Economic dimension
In Sweden, the costs of depression may have doubled between 1997 and
2005, mainly because of increasing indirect costs such as through
productivity losses (Sobocki et al 2007)
18 million work days lost to depression in Germany in 2006 -cost for
employers: € 1.59 billion
In the UK (England, Scotland, Wales), in 2007 more people claimed
disability benefits because of mental disorders than unemployment
benefits(UK DWP 2007)
Health and
Consumers
Inequalities not only among MS but also within MS
(poorer, less educated groups)
Twice the level of chronic illness - heart disease and depression
14-year difference in life expectancy (men) between EU Member States
Twice as many people out of work due to sickness
50% higher infant mortality
Hepatitis
• Migrants = 5 to 90 times more frequently affected by Hepatitis B
• Intravenous drug users = 30 to 60% of all Hepatitis C infections
Tuberculosis
• Migrants ~ 25% of all TB cases in EU. Up to ~ 90% in some MS
• TB rates in Prison 10–100 times higher
Other examples in some MS
• Infectious disease mortality ~ 2.8 times higher in people with
elementary school education
• Higher risk of hospitalisation related to infectious disease in children of
mothers with only basic schooling
Health and
Consumers
The EU Health Strategy
An overarching policy framework
4 principles:
 Shared EU health values (universality, access to good quality
care, equity and solidarity)
 Health as wealth
 Health in all policies
 Strong EU voice in global health
3 objectives:
 Fostering good health in an ageing Europe
 Protecting citizens from health threats
 Supporting dynamic health systems and new technologies
Health and
Consumers
Implementing the EU Health Strategy
An integrated approach
Strategy implemented by:
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EU institutions
Member States
Regional and local authorities
Other stakeholders
Through structures such as:


Council Senior Level Working Party on Public Health (SLWP)
EU Health Policy Forum (stakeholders)
3 instruments:
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

Legislation
Cooperation
Financing
Health and
Consumers
Legislation
Pharmaceuticals and Medical Devices
 Pharmacovigilance (adopted Dec 2010): Regulation and Directive
applies from July 2012 + new rules following Mediator stress test
proposed in 2011
 Falsified Medicines (adopted May 2011, transposed by Jan 2013)
 Information to Patients: Revised proposals (Directive and Regulation )
adopted in October 2011; under discussion)
 Clinical Trials and Medical Devices (proposals planned in 2012)
Health and
Consumers
Legislation
Organs, Blood, Tissues and Cells
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
Implementing legislation to ensure procedures for coordinating vigilance, traceability and
characterisation of organs exchanged between Member States
Build EU-level coordination for vigilance and traceability of tissues and cells (IT platforms
discussed with EMA and ECDC Management Boards)
Health threats

It
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

Health Security Initiative: Commission proposal for a Council and EP Decision on serious cross
border health threats (adopted 7 Dec 2011)
aims at:
reviewing and updating the existing EU legislation on communicable diseases
ensuring adequate prevention, control of and follow-up to all public health threats at EU level
puting the Health Security Committee on a legal footing
Tobacco
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
Tobacco advertising and sponsorship Directive (2003)
Revision of Tobacco Products Directive (2012)
Health and
Consumers
Legislation
Council Recommendations
(Selection)
 Prevention of drinking of alcohol by young people (2001)
 Prevention of health-related harm associated with drug dependence
(2003)
 Cancer screening (2003)
 Prevention of injury and the promotion of safety (2007)
 Patient safety, including the prevention and control of healthcare
associated infections (2009)
 Action in the field of rare diseases (2009)
 Smoke-free environments (2009)
 Seasonal influenza vaccination (2009)
Health and
Consumers
Cooperation
European Innovation Partnership on Active and Healthy Ageing





Strategic Implementation Plan (SIP) (adopted Nov 2011) foresees a first set of
specific actions to be launched in 2012:
Prescription adherence action at regional level
Personal health management starting with falls prevention initiative
Action for prevention/ early diagnosis of functional decline and frailty
Replicating and tutoring integrated care for chronic diseases, including remote
monitoring at regional level
Development of interoperable independent living solutions, including guidelines for
business models
Next steps:


Communication on this EIP and its Strategic Implementation Plan by the EC in February 2012
Commission to Invite for commitment in 2012
Health and
Consumers
Cooperation
Antimicrobial Resistance Action Plan (adopted 17 Nov 2011)
It
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
aims at :
Making sure antimicrobials are used appropriately both in humans and animals
Preventing microbial infections and their spread
Developing new effective antimicrobials or alternatives for treatment
Cooperating with international partners to contain the risks of AMR
Improving monitoring and surveillance in human and animal medicine
Research and Innovation
Communication, Education and Training
Reflection processes together with Member States
 Chronic diseases: Council conclusions (2010)
 Sustainable Health Systems: Council conclusions (2011)
Health and
Consumers
Cooperation
Health Promotion and Disease Prevention
Nutrition
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Strategy on Nutrition, Overweight, and Obesity-related health issues (2007)
High-level group on Nutrition and Physical Activity (Member States’ authorities)
EU Platform for Action on Diet, Physical Activity and Health (stakeholders)
Council conclusions on salt intake reduction (2010)
… in addition to the well developed regulatory framework on food products (food labelling and nutrition
claims)
Tobacco
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Council recommendation for a “Smoke-free Europe” by 2012
«Ex smokers are unstoppable» campaign (launched in June 2011)
… in addition to the legislation on tobacco products
Alcohol
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Council recommendation on prevention of drinking of alcohol by young people (2001)
EU Strategy on reducing alcohol related harm (2006)
Council conclusions on alcohol and health (2009)
Committee for national alcohol policy and action (Member States’ authorities)
European Alcohol and Health Forum (stakeholders)
Health and
Consumers
Cooperation
EU areas of cooperation (examples):
•
•
•
•
•
•
Cancer: Screening guidelines, European Partnership for Action Against
Cancer
Mental Health: European Pact for Mental Health and Well being
Rare diseases: Joint Action to share expertise and information
HIV/AIDS: Think Tank (Member States) and Civil Society Forum
(stakeholders)
Health Workforce: Member States Working Group on Health Workforce
Health Inequalities: Joint Action
International Cooperation
e.g. World Health Organization/Framework Convention on Tobacco Control
Health and
Consumers
Financial instruments
Health Programme 2008 - 2013
Budget of € 321.5 million
 Improve health security
 Promote health and reduce health inequalities
 Generate and disseminate health information and knowledge
Health for Growth Programme 2014 - 2020
(Commission proposal Nov 2011)
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Budget of € 446 million
Develop innovative, efficient and sustainable health systems
Increase access to better and safer healthcare
Promote health and prevent diseases
Protect people from cross-border health threats
Health and
Consumers
Other Financial instruments
Research
 €6 billion for health research in 7th Framework Programme:
- Biotechnology, general tools and medical technologies for human health
- Translating research for human health
- Optimising the delivery of health care to European citizens
 Horizon 2020 (2014-2020) : Research and innovation funding
Proposal due end 2011: Health and ageing as one of the major societal challenges
Structural Funds
 European Regional Development Fund (ERDF)
 European Social Fund (ESF)
2007-2013: Over €5 billion on direct health investment
Post-2013 proposals (presented Oct 2011): Invest in health infrastructure, innovation, cross- border
cooperation, health workforce training, health equity, healthy and active ageing
Health and
Consumers
Let me conclude with the 2011 major step
towards a Europe for Health
Directive on Patients’ rights in cross-border
healthcare
Health and
Consumers
77
The 3 Aims of this Directive
1. Help patients to exercise their rights to
reimbursement for health treatment in any EU
country (cross-border healthcare)
2.
2. Provide assurance about safety and quality of cross-border
care
3.
3. Establish formal cooperation
between health systems
Health and
Consumers
78
1. Helping patients
Information to patients
•
Patients will access all relevant information via their
National contact points
Rules of reimbursement
•
Patients will know: 1) when they need a prior
autorisation; 2) when it can be refused to them; 3)
the level of reimbursement they can get; 4) if they
need to pay upfront
Procedural guarantees
•
Patients will benefit from: clarification of
responsabilities; clear rules if something goes
wrong; right to a review of administrative decisions;
and right to judicial proceedings
Health and
Consumers
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Safeguards for health systems
•
•
Levels of reimbursement
National health authorities pay out NO MORE than for the treatment that
corresponds to benefits provided for in its legislation
They pay out ONLY for treatment they would pay for at home
•
Gatekeeper mechanism
Conditions and formalities for treatments required in a Member State can
also be imposed for treatments abroad (ex : obligation to consult a family
doctor before visiting a specialist)
•
System of prior authorisation
In case of serious risks for health system, Member States can introduce a
system of prior authorisation for hospital care or highly specialised and
cost-intensive care.
Health and
Consumers
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2. Quality and safety
Transparency and accountability
Information on healthcare providers and
on standards applied
Member States responsibility
Refusal of prior authorisation if doubts
over quality and safety of a healthcare
provider
Cooperation of Member States
On standards and guidelines on quality
and safety
Health and
Consumers
3. Cooperation between health systems
Recognition of prescriptions
A prescription issued in another EU country will be recognised in a
patient's country of residence and vice versa
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eHealth
European Reference Networks
It will bring together specialised centres accross Europe helping health
experts to disseminate information and expertise
Health Technology Assessment
A permanent EU structure of cooperation to help decision-makers to
make the right decisions on health investment and spending
eHealth
A first step towards "interoperability" of ICT for health at EU level
for safety and quality of care, continuity of care, and health research
Health and
Consumers
Conclusion:…..we keep
working for you
Thank you!!
Health and
Consumers