EZA workshop on health care in the EU

Contribution to the Conference on the Future of Europe

The Conference on the Future of Europe (CoFoE) is a participative initiative of the European Commission for defining the future of Europe with input from its citizens. The EZA has joined this initiative and is preparing proposals for the conference. Several workshops have been held to develop EZA’s positions and the process is being rounded off with the EZA FORUM on 3 February.

The most recent EZA workshop focused on the current problems associated with how healthcare is organised in the EU, as well as various health issues in the healthcare sector. It began with some very insightful introductions presented by Dr. Sabina Stan and her colleague Roland Erne from Dublin City University, together with Lorenzo Munar, project manager for the healthcare sector of EU-OSHA.

It became clear that a destructive circular process is taking place in the EU which is completely undermining access to quality and affordable healthcare. This destructive circular mobility process consists of medical tourism on the part of Western Europeans to the private healthcare sector in Eastern Europe, accompanied at the same time by the migration of higher skilled healthcare workers from Eastern Europe who take up lower skilled jobs in facilities in Western Europe. It has come about as the result of the very complex design of the EU single market that has resulted in privatisation taking over public services. Only the EU can stop this and has a great responsibility in this respect.

One way of changing this is to use the European Pillar of Social Rights (principles 16 and 18) to alter this destructive circulatory process. Everyone has the right to timely access to affordable, preventive and curative healthcare of good quality (principle 16). Everyone has the right to affordable long-term care (LTC) services of good quality, in particular home care and community-based services (principle 18). The final goal must be to strengthen the public health sector on a cross-border scale and to stop privatisation.

Secondly, a major new report from 2021 shows how the challenging working conditions in the healthcare sector are reflected in the significant share of long-term care workers that face work-related health issues. Trade unions and workers organisations are important partners for EU-OSHA when it comes to using the results of this study and improving working conditions in the future.

Here it is also worth reflecting on the division of competences (EU/member states) regarding health issues. The legalistic approach adopted towards competences for issues such as healthcare and the minimum wage is in fact a deliberate strategy on the part of those member states that oppose social progress. There are examples to show that it can be done otherwise, such as the directive on equal pay. Nor were there any obstructions or discussions of competences in the past when the decision was taken to reduce the number of hospital beds.