With the new health programme EU4Health, the EU Commission wants to take a step towards a common health policy. However, for a paradigm change in EU health policy to become successful, it is also necessary to consider the improvement of working conditions of healthcare professionals and live-in care workers. The Chamber of Labour has developed relevant proposals for European legislative acts.
Health policy is a policy field, which primarily is Member States’ own responsibility. The EU only assumes an advisory and supporting role. However, the COVID-19 crisis has revealed the weaknesses of the current systems: the lack of coordinated measures – especially at the start of the pandemic – was met with incomprehension by many EU citizens. Deliveries of protective masks, which were held at internal borders or even confiscated by other EU States within the scope of national solo initiatives, left many doubting a European solidarity between Member States. In order to avoid such scenarios in future, EU-Health Commissioner Stella Kyriakides presented the new health programme EU4Health on May 28.
“We need more Europe in the area of public health”, Kyriakides summarized many of the calls, which could be heard during the pandemic. The crisis had shown that the EU’s collective ability to respond had to be improved considerably. The now presented health programme EU4Health shall not only contribute to increasing the ability to respond, but also herald a general paradigm change in European health policy. According to the EU Commission, the programme shall help to make the EU’s population healthier and health systems more resilient as well as to support innovations in the health sector. Recent weeks had shown that more coordination during health crises, more capacities at EU level - to prepare for and tackle such a crisis - as well as more investments in health systems were required. A number of tools shall enable the EU, both in respect of precaution and as a direct response to health crises “to take quick, decisive and coordinated action with Member States in both preparing for and managing crises, as well as improving the functioning and performance of EU health systems overall”. Unfortunately, there is no mention of the poor working conditions, with which health professionals and live-in care workers have been coping with for a long time.
Significant increase of funds
The now presented programme shall be furnished with a budget of EUR 9.4 billion for the period from 2021 to 2027. Compared to the EUR 413 million, which are currently available to the health sector, this would mean a 23-fold increase of funds. Financing shall take place in parts via the EU budget and in parts via the EU recovery plan. This shall enable, among other, the building up of reserves of medical supplies, the training of health professionals for deployment across the EU, as well as the increased monitoring of health risks and the improved resilience of health systems. Even if the new health programmes has been hugely influenced by the developments of the last weeks and months, the Commission also stresses its potential in dealing with non-communicable diseases such as cardiovascular diseases or cancer. Regarding this sector, EU4Health shall support national programmes for prevention and health promotion.
Changing the Treaties?
As Vice-President Margaritis Schinas pointed out, EU4Health was consistent with current primary law competencies. One did not want to change the existing treaty, but fully exploit the possibilities it offers. However, and probably also with a view to the demand of the French President Emmanuel Macron to give the EU more powers in the health sector, Schinas also implied that changing the Treaties would not be off the table. “If the moment is right, it will happen”, said Schinas. If it will be possible to implement the proposed EU4Health programme, now depends whether Member States and EU Parliament agree on the EU budget.
AK proposal for improved conditions for health professionals and live-in care workers
The COVID-19 crisis has not only shed a light on professionals in the public health sector but also on the at times catastrophic working conditions, under which they have to operate. However, regarding the working conditions, the situation had been far from satisfactory even before the crisis and an ambitious European health policy, which even considers changing the EU Treaties, should most definitely also drive forth improvements for people working in the sector. All EU Member States struggle with a lack of personnel both – in elderly and healthcare as well as in the entire health sector. Whilst healthcare professionals are confronted with understaffed jobs, overlong working hours and low pay as well as insufficient rest or leave periods, working conditions of care personnel fall victim to non-transparent agency structures, which enable exploitation or even abuse.
The Chamber of Labour is convinced that it is high time for action at EU level. A "Health Professions Directive", which introduces Europe-wide minimum standards for these sectors, would be an answer to staff shortages, whilst at the same time improving the working conditions for healthcare professionals. In view of the rising need for live-in care workers, a framework directive, which defines the fundamental rights and duties of all actors involved, is urgently needed. It could guarantee the rights of people working in this sector and put a stop to non-transparent practices to the detriment of workers, of people in need of care and their families.