Towards an integrated European health approach for better and equal patient care

Before the devastating COVID-19 pandemic, it was heresy to talk about a unified European health policy. The member states – despite the inherited differences and intolerable health inequalities – jealously took care to keep health care under national competence. At most, coordination and the issuing of recommendations could have been considered, while in a very few areas, such as blood safety, shared powers were approved.

It took a real public health crisis claiming many lives, as well as the initiative and advocacy of the Group of the Progressive Alliance of Socialists and Democrats, for the European Parliament to recognize the need for joint action. This is how the landmark public health resolution, with the concept of the European Health Union (EHU), was born in July 2020.

This resolution called for cooperation, which included the elaboration of quality standards for healthcare in all member states. This objective would be possible as a result of stress tests in the EU countries to assess the resilience of national health systems as a matter of urgency, to identify weaknesses, and to check whether health services could cope with possible further outbreaks of epidemics.

An important aspect of the document was how to address health inequalities, for example through equal access to medicines and medical devices.

The last 3 years brought considerable progress in the implementation of the EHU. Among others ECDC’s powers were broadened and important projects such as the European Health Data Space and the Europe’s Beating Cancer Plan were launched. A promising development has been achieved with the EU budget 2021-2027, which has 13 times more funds than the previous envelope, with around €5.3 billion for health programmes (EU4Health).

Currently, the new European pharmaceutical strategy and the draft of the related regulations are in the crossfire of debates. The key pillars of the concept would enable patients to receive affordable and transparent medicines throughout the EU. There is a lot to be done, because while in France or Germany, for example, 80 percent of total drug budget are covered by the state or social insurance, in Hungary, Romania and the Baltic countries, patients pay more than 50 percent at the pharmacy (including prescribed and over-the-counter products). Many people do not get access to innovative drugs at all or late.

In the integrating Europe, it cannot be allowed that there should be a shortage of medicine in any member state or that low-income families should not have access to expensive antibiotics. The acceptance processes that determine the subsidies should be simplified and unified, and web-based patient registers should be built for accurate and common monitoring of the therapies.

I truly believe that the Commission’s idea which puts the patient in the middle of the proposal is a great idea and good direction, on the other hand I think we have to find the right balance in order to create something timeless.

In May 2023, welcoming the WHO’s announcement that COVID-19 is no longer an emergency of international concern, Commission President Ursula von der Leyen said: “The pandemic…has taught us that the EU’s strength lies in its unity, including when confronted with major health crises…changed the face of the EU, which has become a true European Health Union.”

Although this optimistic vision of the future can be achieved in long run, progressives have a moral obligation to stand up for EHU’s values and integrated approaches. One of the next steps in the series should be aimed at formulating and adopting the uniform minimum quality criteria for healthcare. The content of these demands must be discussed with a multitude of professional and civil society organizations; however, the criteria should include minimum requirements in terms of primary care, health workforce density, share of health expenditures in government budget and more.

Sooner or later, it is inevitable to amend the basic EU treaties, including the introduction of shared health competences in a couple of issues as it has been raised at the recently concluded large-scale civil consultation on the Future of Europe.

A specialized council configuration for health should also be created to strengthen the voice of national health representation at EU level.

It is a legitimate suggestion that common EU-level decisions are needed in a public health emergency, e.g., when WHO declares a pandemic. All the more so, because the experiences of the COVID-19 have confirmed that isolation and separate solutions represent a dead end.

Finally, it is an encouraging sign that in January 2023 the European Parliament established its public health subcommittee (SANT) within the Committee on Environment, Public Health and Food Safety (ENVI). This is certainly a message that the issue of health is becoming higher on the agenda of the EP members and foreshadows the possibility that the area will receive an independent main committee in the next term.