1. 09/05/2015© The University of Sheffield 1 The impacts of European Union Law on the healthcare sector: Paper I – Institutional overview Tamara Hervey, Jean Monnet Professor of European Union Law, University of Sheffield (t.hervey@shef.ac.uk)

2. 09/05/2015© The University of Sheffield 2 Overview Introduction EU Law EU law making and the competence of the EU The structure of EU law Supremacy of EU law Enforceability of EU law Policy responses/EU added value Conclusions

3. 09/05/2015© The University of Sheffield 3 Three key questions: What is special about EU law? What challenges and opportunities for those in the healthcare sector therefore arise? What kinds of questions should those involved in managing the healthcare sector therefore be asking themselves?

4. 09/05/2015© The University of Sheffield 4 EU law making and competence

5. 09/05/2015© The University of Sheffield 5 EU law making and competence 736 MEPs 20 Parliamentary Committees 25 Directorates General

6. The structure of EU law 09/05/2015© The University of Sheffield 6

7. The structure of EU law Free movement law Prohibits restrictions on movement of goods, services, persons Exceptions where justified Competition law Prohibits cartels and monopolies Exceptions for public services 09/05/2015© The University of Sheffield 7

8. The structure of EU law Law and policy that softens internal market/competition law Employment law Consumer protection law Environmental law Public health law … 09/05/2015© The University of Sheffield 8

9. 09/05/2015© The University of Sheffield 9 Supremacy of EU Law national law that contradicts EU law must be ‘disapplied’

10. The enforceability of EU law Individual rights in EU law Enforceable before (ordinary) national courts ‘Direct effect’ Applies to enforce EU law against ‘public’ bodies 09/05/2015© The University of Sheffield 10

11. The enforceability of EU law 09/05/2015© The University of Sheffield 11

12. Policy responses ‘Framework Programmes’ Public health programme Best practice 09/05/2015© The University of Sheffield 12

13. EU PUBLIC HEALTH PROGRAMMES Now Operated by Executive Agency for Public Health and Consumers http://ec.europa.eu/phea/index_en.html Objectives: Improve citizens' health security Promote health for prosperity and solidarity Generate and disseminate health knowledge Budget: c € 300 million

14. Opportunities Life expectancy at birth (years) for males ranges from 65 (Latvia, Lithuania) to 79 (Sweden), a gap of 14 years Life expectancy at birth (years) for females ranges from 76 (Bulgaria, Latvia, Romania) to 84 (France, Italy, Spain), a gap of 8 years Source: Rosling H. Gapminder, registered as a Foundation at Stockholm County Administration Board Health status varies widely in EU

15. 09/05/2015© The University of Sheffield 15 Solidarity, redistribution, territorially based – closed-ness vs Remove national barriers, access to wider markets, efficiencies and economies of scale – open-ness

16. 09/05/2015© The University of Sheffield 16 Summary Logic and structures of EU law ≠logic and structures of healthcare EU law-making institutions may be unaware of healthcare concerns The special nature of EU law Can have challenging effects for national healthcare systems Benefits and opportunities