Lost in translation? Reflections on EU health policy

Abstract

There are two common reactions if you say that your work involves looking at EU health policy. For some, the EU is of little importance — a set of distant and irrelevant institutions that barely impact at all on the reality of national health systems. For many others, Brussels and its policy processes are acknowledged to be influential, but are impenetrable; as arcane as they are complex. Both reactions are worth considering. First, can EU health policy claim to be of interest and importance to health professionals and policy makers working beyond the narrow confines of Brussels? Secondly, if it is relevant, is it possible to understand and influence it? Overall, the EU is responsible for a significant proportion of member states’ primary legislation. A recent article puts the figure at 75–80 per cent in the UK, and cites a German candidate in the 2009 European Parliamentary elections as stating that 83 per cent of German legislation originated in the EU.1 Within these overall figures, some policy domains fall more under EU legislative control and command a greater share of the EU budget than others. Primary legislation in the employment, agriculture and environmental protection areas all fall under the EU’s law-making remit, for example. So too does legislation relating to trade and the single market, including industry standards and consumer protection. In this context, health policy and legislation concerning health is a relatively ‘young’ area, where the EU has traditionally had fewer direct, specific, policy initiatives. To understand the extent and constraints on EU health policy, the first step is to consider the legal basis for the European Communities’ (EC’s) competence in health. The key treaty article setting out the EC competence in health policy is Article 152 of the Treaty of Amsterdam (signed in 1997), often referred to simply as Article 152. The text states that: