European elections, what are the challenges for healthcare

Health-related issues have not been the focus of the (poor) European election campaign: these are national competencies and there is a struggle to find joint solutions. On Across Europe the main challenges for the next 5 years

European elections are just around the corner: from June 6 to 9, citizens of the 27 Member States will be asked to choose their representatives for the next 5 years.

Not much has been said about health in the election campaign: it is a national competence, and although many problems are similar, there is a struggle to find joint solutions.

In our journey with Across Europe, we saw how some European nations are tackling such issues as health workforce shortages, inequalities in access to health services, and the sustainability of their care systems.

The heterogeneity of experiences tells us that a common solution on these problems is unlikely to be found any time soon. 

One example for all: the vote establishing abortion as a fundamental right. On 11 April, the European Parliament passed a resolution to include termination of pregnancy in the Union’s Charter of Fundamental Rights.

The Europarliament’s okay, which came with 336 votes in favor, 163 against and 39 abstentions, is not binding, however, but has “only” a political value: while this is an important step, it does not affect it at the normative level.

At the same time as passing the resolution, MPs called on Poland and Malta to repeal their national laws restricting this right. 

The one area that has been worked on concretely, especially during the last Belgian-led semester, is the shortage of medicines: on 24 April, the Critical Medicines Alliance was launched, which contains a series of actions to diversify supply chains and support European pharmaceutical production.

The challenges of the coming years

On the table for the European Union tomorrow are some important issues: reform of pharmaceutical legislation, the most important change in 20 years that is facing a number of obstacles from industry. 

The European Commission has drafted a reform proposal that has gone through the scrutiny of the many stakeholders involved. The various experts were able to express their positions and proposed countermeasures. On 10 April, the European Parliament approved a light version of the Commission’s proposal, which also takes into account the concerns and demands of pharmaceutical companies. This package will be rediscussed and finally approved by the new Parliament. 

Pharmaceutical legislation reform, EHDS and antimicrobial resistance are issues that will affect the next legislature

Another important piece was the approval of the European Health Data Space Regulation (EHDS), which is part of the broader European data strategy. The document aims to facilitate the movement of health data between different Member States, so that a European citizen can pick up a medication in one EU nation with a prescription issued in another. Similarly, practitioners taking charge in the territory of the Union of a European citizen will be able to access his health data wherever he is, thus facilitating hospital admissions and scientific research in general. The regulation will be published in the Official Journal in the fall. 

Finally, during the last term, the Commission set some important stakes regarding the fight against antimicrobial resistance (AMR), including a 50% reduction of sales of antimicrobials for farm animals and aquaculture by 2030, a ban of the routine use of antibiotics for prophylactic purposes to groups of animals or as growth promoters in farm animals, and a 20% reduction of antibiotic consumption also by 2030. However, as the Commission’s Director General for Health and Food Safety Sandra Gallina reminded to TrendSanità, «we cannot rest on our laurels».

ECDC estimates that, every day in EU/EEA countries, about 390.000 hospitalized patients are affected by at least one antimicrobial agent, and for about 35,5% of patients this happened in hospitals.

Outgoing ECDC Director Andrea Ammon also highlighted to TrendSanità «the urgent need for further action to mitigate this threat at the European level». 

Common problems

On the other hand, with regard to issues such as health workforce shortages, waiting lists, sustainability of health services and territorial inequalities, the European Union is fragmented among different national policies. 

These problems affect everyone, including those countries that allocate a very high percentage of their gross domestic product to health (such as France and Finland), or nations that have focused heavily on digital health (such as Estonia).

Among the cases recounted in the Across Europe column, Luxembourg and Bulgaria are peculiar. Luxembourg is the first country in Europe, in terms of health spending per capita, but with 5.7 percent in the ratio of health spending to GDP, it ranks last on this parameter. Compared to other member states, Luxembourg enjoys a significant financial advantage from population growth and the contribution of frontier workers, who contribute to the health care system without fully burdening its resources. In contrast, it has a rather limited medical tradition. There are no faculties of medicine or pharmacy, for example.

Bulgaria, unlike most EU countries, has no problems with waiting lists. However, major social inequalities remain, especially between cities and more rural areas, which undermine access to services. Differences related to income and place of residence are more pronounced than the average in other European Union countries. 

Who will be the next health Commissioner?

One of the people who will have the most power to impact the European healthcare of the future will be the next health commissioner. This role has been held for the past five years by Cypriot Stella Kyriakides, who does not seem interested in continuing in the next term. It is also quite rare for an outgoing commissioner to be reappointed to the same role.

A Euronews article recalls that one of the favorites, Malta’s Deputy Prime Minister Chris Fearne, who is also a surgeon and the longest-serving health minister in Europe, is offside because of a national scandal that prompted him to resign and withdraw his European candidacy. 

With Chris Fearne’s exit, the other papal names are Frank Vandenbroucke, Tomislav Sokol or Dubravka Šuica

With Fearne’s exit, many are looking to Belgium’s Frank Vandenbroucke, who successfully led the last European semester.

Another name in the running is that of the Parliament’s current speaker, Croatian Tomislav Sokol, who during the last term was actively involved in some of the most important health dossiers in the mandate and was also a member of the Parliamentary Health Committee and the two special committees on cancer and pandemic.

However, because of the balance of power between the states, two of his compatriots could take the chair away from him: one is the current European Commissioner for Democracy and Demography Dubravka Šuica, who if reappointed, she could also get the health delegation. The other is Prime Minister Andrej Plenković, who it is said could be the EPP’s reserve choice if Ursula von der Leyen is not reappointed. In the latter case, Croatia would be unlikely to get another key role such as health.

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Michela Perrone
Giornalista pubblicista