Euro Brief
16 - 28 February 2005. No: 4/2005
- Pressure grows on commission over services directive - go to section
- No single market yet in medical technology, says Eucomed - go to section
- EU action plan on drugs - go to section
The influential European Economic and Social Affairs Committee (EESC) has said that the feasibility of applying the Country of Origin Principle to health and social services should be reviewed. The Country of Origin Principle would allow a service provider to practice in a country, observing on the rules and standards of the country where s/he is established – regardless of the fact that the sector may not be harmonised in the EU.
There should be a transitional period of harmonisation in the field of healthcare and in regulated professions – including medics, says the Committee’s Opinion Report. The Institution, which takes part in the legislative process by producing non-binding reports, says that an “immediate application of the country of origin principle could lead to a watering down of standards”
The EESC Opinion was adopted at the EESC Plenary session on the 10th February. The EESC is an institutional consultative body dating back to the 1957 foundation of the European Community. The Committee has 317 members appointed by the Council, representing various economic and social interests.
The German Chancellor Gerhard Schroeder has called for special protection to be given to workers in the healthcare sector. In a meeting with Commission President Jose Manuel Barroso on 15th February, Schroeder made the case for more safeguards against “social and wage dumping”.
The Directive is also being discussed by EU Finance Ministers, including Gordon Brown, on 17th February. Vice President of the Commission Guenter Verheugen admitted, “it won’t fly politically as it
stands”. The Commissioner responsible for the directive, Charlie McCreevy said, “We’ll see what clarifications or adjustments can be made. I hope to narrow the gap over the coming weeks”.
However, Trade Commissioner Peter Mandelson sounded a note of caution when he said amendments to the directive should “not throw the baby out with the bathwater”. The Chairman of the European Parliament’s powerful Internal Market Committee, Philip Whitehead hinted this week that he had doubts about the country of origin principle. He told the EU Reporter, “I believe that one approach that might work could be to explore the potential of a model that worked on the basis of mutual recognition rather than the country of origin principle”. He also said that the Parliament will need to take into account concerns some member states have about including sensitive areas like health in the Internal Market Directive.
Regardless, Centre-Right members of the Internal Market Committee are expected to favour inclusion of health in an internal strategy meeting on the health sector and the services directive on 28th February. The Vice Chair of the Committee, Mrs Charlotte Cederschiold MEP, who favours inclusion of health, has said that the deregulation that the directive would bring to the health sector would create a genuine competitive internal market. Even though the Commission has dismissed fears that this directive would lead to competition in health services, Thomas Mayer, Deutsche Bank’s Chief European economist, said recently, “EU institutions should concentrate on trade liberalisation and the deregulation of goods and services markets. Through this, competitive pressure rises, which in turn creates pressure on national lobby groups defending vested interests to accept structural change”.
One such national lobby group defending vested interests is the General Osteopathic Council which came out with its position paper calling for health to be carved out of the directive. It says that this directive may in fact complicate rather than simplify administrative procedures, creating more red tape. It wants clear assurance that authorisation schemes can be permitted for patient safety and not just the general “reasons of public interest”.
The paper also asks if osteopathy is not regulated in his/her country, what is the competent authority to take action?
Another risk to patients is that there may not be any competent authorities to “mutually assist” with – or receive assistance from, in other member states for the purposes of practice supervision.
While they welcome the proposed European Codes of Conduct, there are currently no formalised common standards in training and practice of osteopathy.
At a two-day hearing in the European Parliament organised by the Socialist Group on 15th and 16th February, Professor Beaumont of Aberdeen University said the whole basis for the directive, namely the Country of Origin Principle, was wrong since it goes against the Rome Convention on contractual obligations. He said it would mean that someone in Portugal which has a no-fault system could do business in the UK with a fault system with no consequences for the service provider.
There were calls for an impact study on the professions. Anne Van Lancker MEP said while the directive refers the Country of Origin Principle to areas where there some co-ordination between member states already exists, it lists “behaviour of professions” as a co-ordinated area – yet this is not in any significant way, co-ordinated.
Socialist MEPs said that this would not create a level playing field in Europe. Instead there would be 25 different legal systems operating in EACH country – increasing economic costs and red-tape.
The Rapporteur for the Directive, Evelyn Gebhardt MEP said that given the Centre-Right majority in Parliament, it would be impossible to reject the legislation. However she was confident that some sectors may be removed from the scope of the directive. One alternative, she suggested is a separate directive for Services of General Interest (those predominantly funded by the State) have a separate directive once SGIs have been properly defined.
Centre Right MEPs could be split over whether health should remain or not. Irish MEP Avril Doyle has said she wants health to be taken out of the directive. The EPP Group position will not be clear until after their internal meeting on 28th February.
No single market yet in medical technology, says Eucomed
The medical industries lobby in Europe; Eucomed told a London conference this month that there was no genuine internal market for medical devices.
Director General Maurice Wagner said that not all patients can be guaranteed the latest equipment. He said, “Pricing and reimbursement procedures at Member State level delay the introduction of innovative medical technology and may vary from country to country. As such, some products may be available in one country and not another”.
He also pointed to “insufficient training or knowledge of medical professionals in the use of new treatments”.
Medical technology comprises a wide range of products – syringes, bandages, wheelchairs, cardiac implants, dialysis machines, diagnostic devices and imagery equipment. While there is no internal EU market for healthcare services – at present – medical goods are supposed to form part of the single market.
EU action plan on drugs
The Commission adopted an action plan on drugs for 2005-2008, which outlines how to implement to drugs strategy agreed by EU leaders in December 2004.
Member States will make drug treatment and rehabilitation programmes, covering psychosocial and pharmacological aspects, more available. The Commission will also propose EU minimum standards on drug treatment by 2007.