Tag Archives: Quality

The CAP towards 2020

The CAP towards 2020

Outline of the Community (European Union) legislation about The CAP towards 2020

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Agriculture > General framework

The CAP towards 2020

Document or Iniciative

Communication from the Commission of 18 November 2010 – The CAP towards 2020: Meeting the food, natural resources and territorial challenges of the future [COM(2010) 672 – Not published in the Official Journal].

Summary

This Communication identifies the challenges facing agriculture and the Common Agricultural Policy (CAP) in the coming years. These challenges have been identified based on past experience, the current economic situation and an extensive public debate organised in 2010.

Through this Communication, the Commission is launching themes for consideration, relating to the future of the CAP. It proposes to adapt the current CAP objectives to the new challenges which have been identified. In particular, the emphasis should be on strong, quality agricultural production, on protecting natural resources and on maintaining the agricultural sector in all EU territories.

Lastly, the Commission explains which instruments would enable the fixed objectives to be met. These instruments should enable the CAP to be greener, fairer, more efficient and more effective.

OBJECTIVES

Food security

Global demand will continue to increase in the coming decades. The EU must be in a position to respond. It is essential that the EU maintains and increases its production capacity.

European citizens want high quality and a wide choice of food products, reflecting high safety, quality and animal welfare standards. A strong agricultural sector is vital for the highly competitive food industry to remain an important part of the EU economy and trade (the EU is the leading world exporter of mostly processed and high value added agricultural products).

Natural resources

Agriculture can put pressure on the environment (water pollution, soil depletion, water shortages and loss of wildlife habitats), but it can also have positive effects (climate stability, biodiversity, landscapes and resilience to flooding).

The EU shall endeavour to limit the negative effects of agriculture and to encourage its positive contributions. The future CAP shall promote energy efficiency, carbon sequestration, biomass and renewable energy production and, more generally, innovation.

Balanced territorial development

Agriculture remains an essential driver of the rural economy in the majority of EU countries. It is necessary to maintain a competitive and dynamic agricultural sector which attracts young farmers in order to preserve the vitality and potential of rural Europe.

INSTRUMENTS

Direct payments

In order to achieve the objectives stated above, the Commission plans to adapt the direct payments system to ensure that payments are better distributed and targeted.

It is proposed that future direct payments should support farmers’ basic income through the granting of a basic decoupled direct payment, with an upper ceiling, targeting of ‘active farmers’, a simple support system for small farmers and the consideration of areas with specific natural constraints.

The Commission proposes to improve the grant criteria relating to the environment through a mandatory ‘greening’ component of direct payments targeted at agricultural practices which address climate change and environmental objectives (permanent pasture, green cover, crop rotation, ecological set-aside, etc.).

Market measures

The Commission specifies that the CAP should keep the overall market orientation of agriculture while also maintaining the management tools which have demonstrated the important role they play in times of crisis or disruption. In the coming years, certain agricultural markets must evolve, in particular the regime currently in place in the sugar sector which is due to expire in 2014/2015.

The Commission believes that more general measures must be taken in order to improve the functioning of the food supply chain, which should be more transparent and within which bargaining power should be more balanced.

Rural development policy

Lastly, the Commission highlights the importance of the rural development policy which the EU carries out through the CAP. It proposes to strengthen the environmental element and to improve coordination of this policy with other European policies.

The Commission proposes to focus on the competitiveness of agriculture by encouraging innovation, promoting good management of natural resources and supporting balanced territorial development balance by encouraging local initiatives.

As well as enhancing the promotion and quality optimisation tools, the Commission believes that a risk management toolkit should be included to deal more effectively with income uncertainties and market volatility.

Action plan on Organ Donation and Transplantation

Action plan on Organ Donation and Transplantation

Outline of the Community (European Union) legislation about Action plan on Organ Donation and Transplantation

Topics

These categories group together and put in context the legislative and non-legislative initiatives which deal with the same topic.

Public health > Threats to health

Action plan on Organ Donation and Transplantation

Document or Iniciative

Communication from the Commission of 8 December 2008 – Action plan on Organ Donation and Transplantation (2009-2015): Strengthened Cooperation between Member States [COM(2008) 819 – Not published in the Official Journal].

Summary

The European Commission is presenting an Action Plan with the aim of strengthening cooperation between Member States in terms of organ donation and transplantation. This plan is also accompanied by a Proposal for a Directive on standards of quality and safety of human organs intended for transplantation.

This Action Plan lays down ten priority actions grouped under three challenges:

  • increasing organ availability;
  • enhancing the efficiency and accessibility of transplantation systems;
  • improving quality and safety.

Priority Actions for increasing organ availability

It is essential to increase the number of organ donors. To this end, the Plan advocates the appointing of transplant donor coordinators in all hospitals practising organ donation.

Hospitals must also promote Quality Improvement Programmes for organ donation, through a specific methodology. Existing methods are to be compared and those giving most results will be promoted.

Exchange of good practice is also strongly encouraged in the field of organ donation from living donors (concerning deceased donors, it is recommended that the potential of donations be maximised). In this regard, altruistic donation programmes should be set up, whilst storing personal data on donors in line with Directive 95/46/EC.

Good communication within families can have positive consequences on willingness to donate organs by family members. This is why health professionals and patient support groups are to strengthen communication and organise training in this field with families in order to increase organ donation potential.

Mobility of patients and donors should also be prioritised as part of cooperation between Member States. It should be possible to identify all donors in the Union. Tools are to be made available by the Commission to this end.

Priority Actions for enhancing the efficiency and accessibility of transplantation systems

Each Member State should prepare a national programme of priority actions to enhance the efficiency of transplantation systems. In particular, a series of common indicators shall be established to monitor organ donation policy.

The Action Plan strongly supports the drawing up of Community agreements on various aspects of transplant medicine. Cooperation is the best framework to generate joint solutions and monitoring mechanisms.

The Action Plan also invites Member States to establish Community agreements on the monitoring of the extent of organ trafficking in Europe. This trafficking is indeed a scourge in that it is one of the causes of the lack of available organs.

Member States are also invited to introduce a system or structure for the exchange of organs in particular for urgent cases and difficult to treat patients (such as children or patients requiring specific treatment).

Priority actions for improving quality and safety

Information concerning organ donations and transplantation should be compiled in registers to facilitate the evaluation of post-transplantation results. This information will be used in particular to develop good medical practices and to prepare a method to compare performance for the monitoring of organ recipients.

An accreditation system for organ donation, procurement and transplantation programmes should be established as part of a common methodology.

Context

As the Communication Organ donation and transplantation: Policy actions at European Union level had already pointed out, demand for organs outweighs supply all over the European territory. There are currently more than 56 000 patients waiting for an organ from a suitable donor. These shortages generate organ trafficking which is a violation of human dignity and fundamental rights. It is for this reason that Member States should strengthen cooperation in order to preserve organ quality and safety.

Related Acts

Proposal for a Directive of the European Parliament and of the Council of 8 December 2008 on standards of quality and safety of human organs intended for transplantation [ – Not published in the Official Journal].

This Proposal for a Directive on quality and safety standards for human organs intended for transplantation establishes a legal framework in this field.

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Standards of quality and safety of organs intended for transplantation

Standards of quality and safety of organs intended for transplantation

Outline of the Community (European Union) legislation about Standards of quality and safety of organs intended for transplantation

Topics

These categories group together and put in context the legislative and non-legislative initiatives which deal with the same topic.

Public health > Threats to health

Standards of quality and safety of organs intended for transplantation

Document or Iniciative

Directive 2010/53/EU of the European Parliament and of the Council of 7 July 2010 on standards of quality and safety of human organs intended for transplantation.

Summary

This Directive sets out a common framework on quality and safety standards for organs * of human origin intended for transplantation into the human body. It also aims to protect donors * and optimise exchanges between Member States and third countries.

Scope

This Directive covers only those organs to be transplanted into the human body, and not the use of organs for the purposes of research.

It applies to:

  • donation *;
  • procurement *;
  • testing;
  • characterisation *;
  • transport;
  • transplantation of organs.

It does not apply to:

  • blood;
  • blood components;
  • human tissues and cells;
  • organs, tissues and cells of animal origin.

Quality and safety of organs

Member States shall implement a quality and safety framework which defines the parameters of all stages of the chain from donation to transplantation *.

These quality and safety frameworks are to fix all of the parameters of the process continuously, from donation to transplantation. They have the following functions in particular:

  • to define traceability * procedures from donation to transplantation or disposal of the organ;
  • to implement standard operating procedures *;
  • to establish the qualifications of personnel.

The procurement of an organ (that has previously been subject to a characterisation) is to be performed in dedicated facilities and under the supervision of a medical doctor as defined in Directive 2005/36/EC.

All procured organs must be characterised before transplantation. The minimum information required includes:

  • le type of donor;
  • the blood group;
  • the cause and date of death of the donor;
  • the clinical history of the donor, including aspects such as neoplasia, hepatisis, HIV or IV drug abuse.

Other complimentary information may be requested, such as the medical history of the donor or, for example, physical and clinical data.

The transport of organs shall be carried out according to clearly defined criteria. The shipping containers used by organisations or companies must contain information such as contact details for the procurement and transplantation organisations, be marked ‘handle with care’ and contain safety instructions and method of cooling.

All organs procured, allocated and transplanted on the territory must be traceable from the donor to the recipient and vice versa in order to safeguard the health of donors and recipients.

If a serious adverse event should occur following organ transplantation, a reporting system, put in place by Member States, should allow relevant information to be reported and transmitted.

Donor and recipient protection

Organ donation must be voluntary and unpaid. However, compensation may be granted to make good the expenses and loss of income related to the donation, while avoiding any financial incentive.

Member States shall be prohibited from advertising the need for, or availability of, organs.

Living donors are to be provided with comprehensive information as to the purpose and nature of the donation, and the consequences and risks involved.

Qualified medical personnel are to select donors on the basis of their health and medical history including a psychological evaluation. These provisions guarantee the quality and safety of organs.

The personal data of the donor shall be protected in line with Directive 95/46/EC. Anonymity is guaranteed.

Competent authorities

Member States shall designate the competent authorities to implement the Directive. They will, in particular, supervise the implementation of the quality and safety framework and exchanges with Member States or third countries;

Context

Over the last 20 years, the use of human organs for transplantation has increased considerably. This technique makes it possible to compensate for the failure of organs such as the liver, lungs or heart. However, this medical practice is associated with risks which this Directive aims to reduce by introducing strict standards concerning the quality and safety of organs.

Key terms used in the act
  • Organ: a differentiated and vital part of the human body, formed by different tissues, that maintains its structure, vascularisation, and capacity to develop physiological functions with an important level of autonomy;
  • Donor: every human source of organs, whether living or deceased;
  • Donation: donating human organs for transplantation;
  • Transplantation: the process of restoring certain functions of the human body by transferring equivalent organs to a recipient;
  • Traceability: the ability for a competent authority to locate and identify the organ at each stage in the chain from donation to transplantation or disposal, this authority, under specified circumstances set out in this Directive being authorised to: identify the donor and the procurement organisation, identify the recipient(s) at the transplantation centre(s), locate and identify all relevant non-personal information relating to products and materials coming into contact with that organ;
  • Standard operating procedures: written instructions describing the steps in a specific process, including the materials and methods to be used and the expected end product;
  • Procurement: a process by which the donated organs become available;
  • Donor characterisation: the collection of the relevant information on the characteristics of the donor needed to undertake a proper risk assessment in order to minimise the risks for the recipient and to optimise organ allocation.

Reference

Act Entry into force Deadline for transposition in the Member States Official Journal

Directive 2010/53/EU

26.8.2010

27.8.2012

OJ L 207 of 6.8.2010

Related Acts

Communication from the Commission of 8 December 2008 – Action plan on Organ Donation and Transplantation (2009-2015): Strengthened Cooperation between Member States” [COM (2008) 819 final – Not published in the Official Journal].
The Action Plan on Organ Donation and Transplantation (2009-2015) sets out 10 priority actions in this area.

Compensation in cases of non-compliance with contractual quality requirements for rail freight services

Compensation in cases of non-compliance with contractual quality requirements for rail freight services

Outline of the Community (European Union) legislation about Compensation in cases of non-compliance with contractual quality requirements for rail freight services

Topics

These categories group together and put in context the legislative and non-legislative initiatives which deal with the same topic.

Transport > Rail transport

Compensation in cases of non-compliance with contractual quality requirements for rail freight services

Proposal

Proposal for a Regulation of the European Parliament and of the Council on compensation in cases of non-compliance with contractual quality requirements for rail freight services.

Summary

Compensation schemes – context

The White Paper of 2001 and the Commission Communication “Towards an integrated European railway area ” of 2002 underline the overriding importance of improving the performance of rail freight services in Europe in order to foster the development of rail freight and contribute to more balanced modal shares.

The current compensation scheme for rail freight customers is defined in the CIM appendix to the 1980 Berne Convention concerning International Carriage by Rail (COTIF).

In this context, the proposed Regulation will introduce minimum quality clauses in contracts between railway undertakings and their customers in connection with all national and international rail freight services in the Community.

Contractual quality requirements

Quality requirements for rail freight services must be based on an agreement between the parties, resulting in rights and obligations and taking into account the specific circumstances of the transport contract. The contract must define the following quality requirements:

  • agreed hand-over times for goods, wagons or trains between the railway undertaking and the rail freight customer;
  • arrival time and compensation for delays;
  • compensation in the event of goods being lost or damaged;
  • compensation in the event of a train being cancelled by the railway undertaking;
  • compensation in the event of a train being cancelled by the rail freight customer;
  • a quality monitoring system defined by the parties.

Principles of compensation in cases of non-compliance with contractual quality requirements by the railway undertaking and/or the rail freight customer

If the railway undertaking does not meet the contractual quality requirements according to the quality monitoring system defined in the transport contract, it must pay compensation to the rail freight customer. The railway undertaking is therefore responsible for:

  • loss of or damage to the goods transported;
  • failure to comply with the agreed times of arrival;
  • cancellation of trains by the railway undertaking;
  • any other failure to comply with contractual quality requirements defined by mutual agreement between the parties to the transport contract.

If the rail freight customer does not meet the contractual quality requirements according to the quality monitoring system defined in the transport contract, the rail freight customer must pay compensation to the railway undertaking. The rail freight customer is therefore responsible for:

  • failure to comply with the agreed hand-over times;
  • cancellation of trains by the rail freight customer.

Compensation in the event of losses of or damage to the goods transported

The amount of compensation for loss of or damage to the goods transported is EURO 75 per kilogram of gross mass short or damaged.

Compensation for delays

The amount of compensation for delays can be adapted according to the severity of the delay and the type of rail freight. For block trains (where the customer buys from the railway undertaking the traction for at least one train made up by the client and specifically scheduled and invoiced), the amount of the compensation must be not lower than 5% nor higher than 25% of the transport price.

For wagonloads (where the client buys from the railway undertaking the transport of at least one wagon within a train made up and scheduled by the railway undertaking and open to several clients), the amount of the compensation must be determined by mutual agreement between the parties to the transport contract, taking into account the specific nature of wagonload transport.

Compensation for lack of information about delays

If the railway undertaking does not make appropriate efforts to inform the rail freight customer about possible delays, the railway undertaking must pay the compensation specified in the transport contract that must be not lower than 5% of the transport price.

Compensation for consequential damages

If loss or damages occur as a result of the arrival time agreed in the transport contract being exceeded, the railway undertaking must pay compensation not exceeding four times the transport price, based on evidence of such losses or damages.

Compensation for cancellation of trains by the undertaking or by the rail freight customer

The parties must define in the transport contract, by mutual agreement, the amount of compensation payable in the event of the cancellation of a train by the railway undertaking or by the rail freight customer.

Exclusions of liability

Under the following conditions the compensation scheme does not apply:

  • fault of the rail freight customer or the railway undertaking,
  • fault of or any other act by a third person,
  • force majeure,
  • circumstances that the railway undertaking or the rail freight customer could not avoid.

Responsibility of the railway undertakings

The contracting railway undertaking, which has accepted goods for transport, is responsible for the transport over the entire route up to arrival, including handling and/or transhipments of the wagons or the trains. The railway undertaking is also liable for its servants and other persons, including infrastructure managers.

References

Proposal Official Journal Procedure
COM(2004) 144 Codecision COD/2004/0050

Related Acts

Convention concerning International Carriage by Rail (COTIF) of 9 May 1980 [not published in the Official Journal].

Vilnius Protocol of 3 June 1999 for the modification of the Convention concerning International Carriage by Rail (COTIF) of 9 May 1980 [not published in the Official Journal].

Recommendation for a Council Decision authorising the Commission to negotiate the conditions for Community accession to the Convention concerning International Carriage by Rail (COTIF) of 9 May 1980, as amended by the Vilnius Protocol of 3 June 1999 [COM(2002) 24 final – not published in the Official Journal].

Communication from the Commission – Further integration of the European rail system: third railway package. [COM(2004) 140 final – not published in the Official Journal].

Proposal for a Directive of the European Parliament and of the Council amending Council Directive 91/440/EEC on the development of the Community’s railways [COM(2004) 139 final – not published in the Official Journal].

Proposal for a Directive of the European Parliament and of the Council on the certification of train crews operating locomotives and trains on the Community’s rail network [COM(2004) 142 final – not published in the Official Journal].

Proposal for a Regulation of the European Parliament and of the Council on international rail passengers’ rights and obligations [COM(2004) 143 final – not published in the Official Journal].

Further integration of the European rail system: third railway package

Further integration of the European rail system: third railway package

Outline of the Community (European Union) legislation about Further integration of the European rail system: third railway package

Topics

These categories group together and put in context the legislative and non-legislative initiatives which deal with the same topic.

Transport > Rail transport

Further integration of the European rail system: third railway package

Document or Iniciative

Communication from the Commission of 3 March 2004 entitled “Further integration of the European rail system: the third railway package [COM(2004) 140 final – not published in the Official Journal].

Summary

In 2001 the Commission set out its objectives for the reform of rail transport in the White Paper ” European transport policy for 2010: time to decide “.The present communication announces the third railway package. The Commission proposes the opening-up of services to competition by 2010 and puts forward proposals concerning the certification of drivers and strengthening of passengers’ rights.

This third railway package comprises two directives and two regulations (of which one was rejected by the Parliament):

Proposal for a Directive [COM(2004) 142 final] on the certification of drivers

In its communication the Commission stresses the impact of driver training on safety. It considers that driver skills fall into two categories:

  • general skills relating to the job of driver;
  • more specific skills relating to line knowledge, the rolling stock and the operating procedures of the railway undertaking for which the driver works.

With the opening-up of the rail freight markets, a growing number of drivers will find themselves operating on the network of another Member State. The Commission therefore wishes to establish:

  • a certification system attesting that the driver has sufficient general knowledge, authenticated by a licence issued to the individual driver that is recognised and valid throughout the Community;
  • a series of certificates attesting to specific knowledge (relating to a specific route, rolling stock and railway undertaking) and allowing the driver to operate.

Proposal for a Regulation [COM(2004) 143 final] on passengers’ rights

In order to make the railways more attractive, the Commission also wishes passengers’ rights to be better protected – particularly with regard to reimbursement for train delays. The situation of passengers on international journeys is often less secure. The Commission therefore considers that the current international arrangements, based on the Convention concerning International Carriage by Rail (COTIF), are inadequate and do not directly create passengers’ rights.

Access to information and fares, and the option of buying international rail tickets easily, are in the Commission’s view the very least that is needed to make rail services attractive. In addition, the Commission wishes liability to be clearly defined in the event of accidents, incidents or train delays. On this last point, compensation thresholds should be set and the various channels for passengers’ appeals clearly identified. Lastly, the Commission considers that greater account should be taken of the needs of people with reduced mobility.

In the Commission’s view, these arrangements to protect passengers’ rights will be all the more vital once the market is opened up for certain services.

Proposal for a Directive [COM(2004) 139 final] on opening up the passenger transport market

The Commission stresses the contrasts between regional, national and international rail traffic and wishes to take these diverse segments into account by combining two models for opening up to competition:

  • under the first, a competitive procedure can be used to award a public service contract. In the Commission’s view this model would work well for suburban and regional services, which transport the vast majority of passengers. It forms the basis of the Commission’s proposal to modernise Regulation No 1191/69 on public service obligations;
  • the other model consists in opening up access to the infrastructure for operators wishing to provide international services. This model would be better suited to long-distance services and to specific services where commercial innovation is likely to attract new customers.

The competitors will need to have:

  • rolling stock and drivers authorised for service in the Member States in which they plan to operate;
  • a railway undertaking licence in a Member State;
  • a safety certificate issued by the national safety authority of each of the Member States they plan to cross;
  • infrastructure capacity, in order to provide a regular service.

The Commission therefore wishes all international services to be opened up to competition on 1 January 2010. This opening-up also includes cabotage on international services (carriage of passengers between two places within the same Member State).

Interoperability requirements

The Commission also points out that integrating Europe’s railway systems requires technical harmonisation in order to ensure the interoperability of rolling stock and equipment.

A fourth proposal rejected by the Parliament

The Commission had also made a proposal for a regulation aiming to improve the quality of rail services. It was rejected first time round by the Parliament. In particular the text proposed establishing mandatory minimum clauses in transport contracts, among which there was a proposal for a compensation system in case of freight being delayed or damaged. It would have encouraged railway undertakings and their clients to regulate quality management contractually.

Report on equality between women and men – 2008

Report on equality between women and men – 2008

Outline of the Community (European Union) legislation about Report on equality between women and men – 2008

Topics

These categories group together and put in context the legislative and non-legislative initiatives which deal with the same topic.

Employment and social policy > Equality between men and women

Report on equality between women and men – 2008

Document or Iniciative

Report from the Commission to the Council, the European Parliament, the European Economic and Social Committee and the Committee of the Regions of 23 January 2008, Equality between women and men – 2008 [COM(2008) 10 – Not published in the Official Journal].

Summary

This year, the European Commission is publishing its fifth report on equality between women and men, the first to cover the enlarged European Union (EU) of 27 Member States.

Gender gap: main developments

The figures for recent years show that the situation of women on the labour market in Europe is subject to two-tier development:

  • major progress in terms of quantity, on the one hand;
  • quality of employment remaining unfavourable in many respects on the other hand.

Female employment is still the driving force behind growth in employment within the European Union (EU):

  • 7.5 of the 12 million new jobs created since 2000 are held by women;
  • the female employment rate is currently 57.2% (+ 3.5 points in comparison to 2000, in contrast to the increase by less than one point for men);
  • the employment rate for women over 55 years has increased more rapidly than that for men in the same age range (it is currently 34.8%, i.e. an increase of 7.4 points in comparison to 2000);
  • a significant narrowing of the employment rate gap between men and women, falling from 17.1 points in 2000 to 14.4 points in 2006.

This point, given the fact that women have better success rates at school and university (59%), generally raises the question of the quality of work for women:

  • the pay gap has stabilised at 15% since 2003 (it was 16% in 2000);
  • sectoral and occupational segregation by gender is not diminishing and is even increasing in some countries;
  • the proportion of female managers in businesses has stagnated at 33% and there is very little progression in the numbers of female politicians;
  • the balance between professional and private life remains precarious (the employment rate for mothers with young children is only 62.4% compared with 91.4% for fathers);
  • 76.5% of part-time workers are women;
  • recourse to temporary work is also more common among women (15.1% compared with approximately 14% for men).

This occupational imbalance is not without effect on the social situation of women:

  • long-term unemployment is still more common among women (4.5% compared with 3.5% for men);
  • the risk of poverty, particularly among women over the age of 65 (21%, i.e. 5% more than for men), is reinforced by shorter, slower and less well-paid careers.

Policy and legislative developments

The Roadmap for Equality between Women and Men, launched in 2006, has given fresh impetus to Community policy in this area. An annual work programme allows the Commission to ensure follow-up action.

In 2007, the Commission launched the second phase of formal consultation of the social partners at European level on the possible approach of Community action for the reconciliation of professional, private and family life with a view to improving or supplementing the existing framework.

The Commission has also given its support to the European .

Infringement proceedings for failure to transpose Directive 2002/73/EC on equal treatment have practically been wound up. Analysis of the conformity of national implementing measures started in 2007 and will be continued in 2008.

Furthermore, the Commission has demonstrated its full commitment to tackling the pay gap between women and men in its Communication of 18 July 2007.

Progress has also been achieved with the establishment of the European Institute for Gender Equality.

Challenges and policy guidelines

The report stresses the need to significantly improve the quality of employment for women, while confirming the progress achieved in terms of quantity.

With this in mind, and in particular through the new cycle of the European Strategy for Growth and Jobs, it advocates concentrating structural, legislative and financial efforts on:

  • reducing differences in pay;
  • in-serve training;
  • health and welfare at work;
  • the reconciliation of professional and private life (accessibility of childcare services, the quality of services of general interest, etc.);
  • action to combat stereotypes linked to gender and cultural origin;
  • support for the implementation and follow-up of political commitments.

Background

In addition to the implementation of measures defined in the Roadmap for Equality between Women and Men, 2007 saw a number of major landmarks in connection with:

  • the contribution of the Commission to the establishment of common flexicurity principles;
  • the celebration of the 50th anniversary of European gender equality policy;
  • the launch of the European Year of Equal Opportunities for All;
  • the 10th anniversary of the signing of the Amsterdam Treaty, the basis for the European Employment Strategy and for gender mainstreaming in Community policies.

The future of health care and care for the elderly: guaranteeing accessibility, quality and financial viability

The future of health care and care for the elderly: guaranteeing accessibility, quality and financial viability

Outline of the Community (European Union) legislation about The future of health care and care for the elderly: guaranteeing accessibility, quality and financial viability

Topics

These categories group together and put in context the legislative and non-legislative initiatives which deal with the same topic.

Public health > Health determinants: environment

The future of health care and care for the elderly: guaranteeing accessibility, quality and financial viability

Document or Iniciative

Communication from the Commission of 5 December 2001 – The future of health care and care for the elderly: guaranteeing accessibility, quality and financial viability [COM(2001) 723 final – Not published in the Official Journal].

Summary

The EU’s overall health situation and health care systems are among the best in the world, thanks to the widespread extension of cover against sickness and invalidity, the rise in the standard of living, improved living conditions and better health education.
Total health care spending rose from around 5 % of GDP in 1970 to over 8 % in 1998. Public health care spending followed the same trend of growing faster than GDP in most countries.

ISSUES COMMON TO ALL EU HEALTH CARE SYSTEMS

The impact of demographic ageing on health care systems and expenditure

The ageing of the population in Europe involves two aspects:

  • since 1970, life expectancy at birth has risen by 5.5 years for women and almost 5 years for men. This trend also means higher life expectancy in “good health” and in the absence of disability;
  • there are more elderly people. The proportion of the total European population older than 65 is set to increase from 16.1 % in 2000 to 27.5 % by 2050, while the proportion of the population aged over 80 years (3.6 % in 2000) is expected to reach 10 % by 2050.

If Eurostat’s basic scenarios are confirmed, public expenditure on health care could increase by between 0.7 and 2.3 GDP points in the period 2000-2050.
The increase in the numbers of elderly people will thus increase the pressure on the public sector for long-term care.
In light of these needs, health care structures, methods of financing and the organisation of services will have to evolve. It will be particularly important to deal with the increased need for skilled manpower, as smaller and more unstable family structures make it increasingly difficult to rely on the support of family networks.

The growth of new technologies and treatments

Developments in medical technology (gene therapies, growing replacement organs, new medicinal substances, etc.) provide benefits for patients, for example by reducing the risks of serious illness by means of preventive treatment. However, these innovations come at a cost, and financing is an issue that must be considered. In the context of prudent budget management, clear, transparent and effective evaluation mechanisms must be developed, as this is the only way to guarantee greater accessibility to these new products and treatments.

The increase in patients’ demands

It has been observed for half a century that the demand for health care tends to increase more than proportionally to the per capita income. Demand is determined by standard of living and level of education. This has three main consequences:

  • patients are better educated and are able to adopt healthier lifestyles and a prevention-based attitude which in the long run makes it possible to avoid the need for costly care. This is why health care systems are focusing increasingly on education and prevention;
  • patients expect ever better quality and efficiency from health care systems. The spread of information technologies gives patients access to more information on services available at European level and allows them to make an increasingly well-informed choice;
  • health care consumers feel that they need to be considered as partners and players in health care systems, not only by health professionals but also by the public authorities. They also expect greater transparency on the performance and quality of care services.

THREE LONG-TERM OBJECTIVES: ACCESSIBLITY, QUALITY, VIABILITY

While the organisation of health care systems, their funding (ratio of public/private funding) and planning as a function of the needs of the population are a matter for the Member States, this responsibility is exercised increasingly within a general framework on which many Community policies have a bearing (research, public health policy, free movement of persons and services, viability of public funds). This is an argument for strengthening European cooperation.

The Communication identifies three long-term objectives for national systems, which should be pursued in parallel.

Accessibility

Access to health care is a right enshrined in the Charter of Fundamental Rights of the European Union. However, it is often affected by an individual’s social status. It is therefore particularly important to ensure that access to health care for disadvantaged groups and for the poorest members of society is guaranteed.
The joint report to evaluate the national action plans for social inclusion proposes three categories of measures:

  • measures to develop disease prevention and promote health education (mother and child care, medical care at school and medical care at work);
  • providing less expensive and even free care for those in low-income brackets;
  • measures aimed at disadvantaged groups, e.g. the mentally ill, migrants, the homeless, alcoholics and drug addicts.

Quality

In order to provide quality health care, national governments are required to achieve an optimum balance between the health benefits and the cost of medication and treatment. Ascertaining quality in this way is made complex by:

  • the diversity of the structures and levels of health care, which often influence demand for health care and consequently the level of expenditure;
  • the different approaches to medical treatment.

Comparative analysis of health care systems and medical treatment should make it possible to identify “best practice” and thus to help improve the quality of health care systems.

Financial viability

A certain level of financing is required to ensure the availability of high-quality health care that is accessible to the population. There is upward pressure on these health care costs, irrespective of the way in which Member States’ health care systems are organised. Member States have been undertaking reforms since the early 1990s, based mainly on two methods:

  • regulation of demand, by increasing contributions or by ensuring that the final consumer bears an increasingly large share of the costs;
  • regulation of supply, by determining budgets or resource envelopes for health care providers, creating a contractual relationship between “buyers” and “providers” of health care.

It is often difficult, however, to distinguish the short-term effects from the more structural effects of these reforms, which allow spending to develop at a sustainable pace. This Communication recommends more exchanges of experience, which would help to keep track of the policies introduced and would be a useful way of comparing health care systems and encouraging progress.

In order to achieve these objectives it is essential that all parties concerned (local authorities, health care professionals, social protection bodies, supplementary insurance companies, consumers) work together to build strong partnerships.

Background

This Communication is a response to the conclusions of the Lisbon European Council of March 2000, which stressed that social protection systems needed to be reformed in order to be able to provide high-quality health care services. It also takes up the request made by the Gothenburg summit (June 2001) to prepare a progress report for the Spring 2002 European Council suggesting guidelines in the field of health and care for the elderly.

Key figures
  • life expectancy in 2000: 74.7 for men and 81.1 for women
  • life expectancy in 2050 (Eurostat forecast): 79.7 for men and 85.1 for women
  • percentage of people aged over 65 in Europe in 2000: 16.1 %
  • percentage of people aged over 65 in Europe in 2050: 27.5 %
  • percentage of people aged over 80 in Europe in 2000: 3.6 %
  • percentage of people aged over 80 in Europe in 2050: 10 %

Related Acts

Communication from the Commission of 20 April 2004 – Modernising social protection for the development of high-quality, accessible and sustainable health care and long-term care: support for the national strategies using the “open method of coordination” [COM(2004) 304 final – Not published in the Official Journal].
This Communication proposes that the “open method of coordination” be extended to the health and long-term care sector. This will allow a framework to be established to promote exchanges of experience and best practices and support the Member States in the reform of health care and long-term care.

Joint report from the Commission and the Council on health care and care for the elderly: Supporting national strategies for ensuring a high level of social protection .
The Barcelona European Council (2002) invited the Commission and the Council to examine more thoroughly the questions of access, quality and financial sustainability. A questionnaire was sent to the Member States in 2002 in order to collect information on their approaches to these three objectives. The joint report is based on the responses received.
This joint report was adopted by the “Employment, Social Affairs, Health and Consumer Affairs” Council on 6 March and by the “Economic and Financial Affairs” Council on 7 March as a contribution to the March 2003 European Council.