The EUs Role in Healthcare

Healthcare is a competency of Member sSates. However, the European Union institutions also have a shared competence on public health safety concerns (Article 4, TFEU) and the power to support and align national actions for the protection and improvement of human health (Article 6, TFEU). Thus, the EU has adopted a cross-sectoral “health-in-all-policies” approach which aims to turn the EU into a smart, sustainable and inclusive economy.

In the past, the main instrument of the European Commission to implement EU health policy has been the third EU health programme. It sets the priority areas and criteria for funding actions on health for the period 2014-2020. 

Proposed Multi-Annual Financial Framework integrates public health funding in wider areas 

According to the proposal for the new Multi-Annual Financial Framework for 2021-2027, the European Social Fund Plus (ESF+) Programme will become the cornerstone of public health funding. This programme merges existing funds and programmes including the Health Programme, the European Social Fund, and the Employment and Social Innovation. 

Funding for health policies is also provided through other key financial instruments such as Horizon, the European Regional Development Fund, and the InvestEU Fund.

Latest EU health policy developments 

Cross-Border Healthcare

In 2011 the European Commission presented its landmark Cross-Border Healthcare Directive (2011/24/EU), aiming at strengthening cooperation among Member States and improving access of patients to healthcare services abroad. It facilitates reimbursements, improves access to information at home, and enhances quality and safety. The advancement of cooperation in electronic health (e-Health) is a further central point of the Directive. 

Although a step in the right direction for patients’ rights, the Directive has faced several challenges regarding its implementation since it entered into force in October 2013. Notably, it has not managed to make direct cross-border care payments mandatory, rather letting the issue remain at the discretion of each Member State. 

EU Cooperation in Health Technology Assessment

The Cross-Border Healthcare Directive involved among other things  a voluntary Health Technology Assessment network of EU Member States, which was finally established in 2013. However, in response to the increasing calls for more sustainability and less duplication of work on HTA beyond 2020, the Commission presented a proposal for a stand-alone HTA Regulation in January 2018. 

The proposal calls for mandatory joint EU-level clinical assessments of medicines and medical devices. It further foresees a structure comprised of a Member-State-driven Coordination Group, a wide Stakeholder Network, and the Commission Secretariat in supervisory role. 

Within the HTA Network, EFA is a member of the HTAStakeholder Pool representing patients and consumers together with eight other organisations. EFA emphasizes that patients should be involved in every step of the HTA process, to ensure higher quality in the assessments and better access to health technologies. Although in principle recognised, patients’ involvement in the new processes is not given a clear structure, an uncertainty reflected both in the proposed legislation and in the Parliament position.