1. EPHA Presentation Healthcare and social services treated equally as estate agents or advertising companies excluded from the Directive or Healthcare and social services, how are they regulated in the EU. BudapestPim de Graaf, MD May 3, 2007

2. EPHA Presentation European Public Health Alliance Ngo’s and institutions from all over Europe to promote health policy and support member organisations www.epha.org Institutions and organisations in Europe, to strengthen Primary Care www.euprimarycare.org

3. EPHA Presentation Challenges Large inequalities in the health status of people and in access to health care, within and between countries. New health risks, amongst others by life style and environmental factors. Rising costs of health care, due to several reasons, amongst them ageing of the population. Demand for better quality of care. Need for much greater involvement in the development of the EU of citizens and their organisations.

4. EPHA Presentation Our vision People in Europe should benefit from EU, individually and collectively Civil organisations need to become actors in shaping the EU EU health policies can support member states Care and health care should be delivered in the community as much as possible – cheaper and better quality

5. EPHA Presentation Rome Treaty1957 …… Maastricht Treaty1992 Amsterdam Treaty1997 Nice Treaty2000

6. EPHA Presentation Health in the Amsterdam treaty Article 3 par 1 30 39 par 3 46 par 1 95 par 3 95 par 6 95 par 8 137 140 152 153 174 par 1 186 Contribution to the attainment of high level of health protection Restriction of free movement of goods in regard to health protection Restriction of the free movement of workers in regard to public health Restriction of the right of establishment in regard to public health Attainment of a high level of health protection in regard to the approximation of laws Restriction of approximation of law in regard to public health Obligation to inform Commission in case of public health problems in a field which has been a subject to prior harmonisation Health protection in the working environment Prevention of occupational accident and diseases Public health Health protection as part of consumer protection Health protection as part of environmental protection Restriction of free movement of workers of overseas countries or territories in regard to health protection

7. EPHA Presentation Article 152 1. A high level of human health protection shall be ensured in the definition and implementation of all Community policies and activities. Community action, which shall complement national policies, shall be directed towards improving public health, preventing human illness and diseases, and obviating sources of danger to human health. Such action shall cover the fight against the major health scourges, by promoting research into their causes, their transmission and their prevention, as well as health information and education. The Community shall complement the Member States' action in reducing drugs-related health damage, including information and prevention. 2. The Community shall encourage cooperation between the Member States in the areas referred to in this Article and, if necessary, lend support to their action. Member States shall, in liaison with the Commission, coordinate among themselves their policies and programmes in the areas referred to in paragraph 1. The Commission may, in close contact with the Member States, take any useful initiative to promote such coordination. 3. The Community and the Member States shall foster cooperation with third countries and the competent international organisations in the sphere of public health.

8. EPHA Presentation Article 152 4. The Council, acting in accordance with the procedure referred to in Article 251 and after consulting the Economic and Social Committee and the Committee of the Regions, shall contribute to the achievement of the objectives referred to in this Article through adopting: (a) measures setting high standards of quality and safety of organs and substances of human origin, blood and blood derivatives; these measures shall not prevent any Member State from maintaining or introducing more stringent protective measures; (b) by way of derogation from Article 37, measures in the veterinary and phytosanitary fields which have as their direct objective the protection of public health; (c) incentive measures designed to protect and improve human health, excluding any harmonisation of the laws and regulations of the Member States. The Council, acting by a qualified majority on a proposal from the Commission, may also adopt recommendations for the purposes set out in this Article. 5. Community action in the field of public health shall fully respect the responsibilities of the Member States for the organisation and delivery of health services and medical care. In particular, measures referred to in paragraph 4(a) shall not affect national provisions on the donation or medical use of organs and blood.

9. EPHA Presentation Health and consumer affairs Health strategy Public Health Action Programme KP7 Pharmaceutical products Smoking and alcohol related policies

10. EPHA Presentation Legislation blood and blood products Directive of 30 September 2005 as regards Community standards and specifications relating to a quality system for blood establishments.

11. EPHA Presentation

13. Open Co-ordination Method High Level Process of Reflection

14. EPHA Presentation Services Directive European Parliament takes health and social services out Requests separate proposals April and September 2006: communications on social and health services

15. EPHA Presentation Where are we now? The Commission does the splits European citizens wait for clarity – and quality and affordability.

16. EPHA Presentation

17. Thank you