Green paper on EU health workforce

Green paper on EU health workforce: Commissioner Vassiliou calls for social partners’ contribution

Press Communication

European Hospital and Healthcare Employers’ Association (HOSPEEM)
European Federation of Public Service Unions (EPSU)

On Monday 14 July a joint Hospital Social Partner delegation met Commissioner Vassiliou.

Commissioner Vassiliou explained the rationale for promoting the Cross-border Healthcare Directive. She underlined in particular the need for better collaboration between the Member States as well as the establishment of centres of excellence as one major objective of the directive. Christina Carlsen, while welcoming the intention of bringing legal clarity, expressed HOSPEEM’s concern that the planning capacity at national level might face new challenges. “It will be difficult to foresee what flow of patients we have to expect”, said HOSPEEM Vice Secretary General. According to the Commission services this directive would count for 1 % of the EU population with a perspective to increase to 4 % in the future. The bulk of medical treatment will continue to be delivered at home. Where medical treatment is sought abroad this will be delivered mainly under the provisions of regulation 1408, for example during major sports events. “If this is the case, why not adapt the existing regulations in accordance with EU jurisprudence?” asked Carola Fischbach-Pyttel, EPSU.General Secretary. “We therefore wonder what exactly the added value of the proposed directive will be?”

Importantly, Commissioner Vassiliou agreed on the need to develop structured cooperation with the Hospital Social Partners in the future. DG SANCO intends to publish a Green paper on health workforce, in December 2008.

The European-wide lack of qualified health professionals and the migration of health care professionals within and across the European Union borders require a common policy at European level.

Commissioner Vassiliou invited the social partners to address the questions related to health staff shortages in Europe. The role of employers and workers is a key factor when it comes to successfully developing and implementing these policies”

The starting point for an had hoc input of the social partners to the ongoing Commission work will be the Code of Conduct and follow up on Ethical Cross-Border Recruitment and Retention in the Hospital Sector, signed in April 2007. The text deals with many of the aspects the Commission is intending to tackle, such as strategies to promote ethical cross border recruitment and to prevent acute staff shortages in the so called “donating countries”.

The meeting of the Health Commissioner with the EPSU and HOSPEEM leadership marks a significant step in the relations between the European Commission and European Social Partners in the hospital sector.

For further information, please contact:

HOSPEEM: Gin Ngan +32 2 229 21 58,
EPSU: Tamara Goosens +32 2 250 10 80,

EPSU is the European Federation of Public Service Unions. It is the largest federation of the ETUC. 8 million public service workers and their 213 trade unions are members. They organise workers in health and social services, local and national administration, energy, water, waste.In the health and social services sector EPSU organises 3.5 million members
HOSPEEM is the European Hospital and Healthcare Employers Association. It regroups at European level national employers’ associations operating in the hospital and health care sector and delivering services of general interest, in order to co-ordinate their views and actions with regard to a sector and a market in constant evolution. HOSPEEM is an individual member of CEEP

Patient’s rights directive proposal: Further clarity needed

Godfrey Perera, Secretary General of HOSPEEM, today commented on the European Commission’s proposals in relation to the application of patients’ rights in cross border healthcare

“As hospital and healthcare employers, HOSPEEM welcomes any action that will benefit patients within the constraints of affordability for each Member State and which does not threaten the viability of health systems. Although HOSPEEM has concerns about some of the European Commission’s proposals, it is pleased that the Commission is trying to resolve the current impasse and uncertainty. HOSPEEM believes that healthcare should be guaranteed by a clear legislative framework and not be subject to uncertainty created by court judgements. It is also vital that issues such as patient safety, reimbursement of costs and the right to legal redress are resolved. However, the Directive, as currently drafted seems to go beyond the rulings of the ECJ, by making it very difficult for the Member States to ask for prior authorisation for hospital treatment abroad. This might have serious consequences for the organisation, financing and delivery of healthcare in European Member States.”

While patient’s rights to treatment abroad have been enshrined in European law, HOSPEEM believes that the Commission’s proposals also have the potential to create health inequalities. Although all patients will have rights to access healthcare in other Member States, only the mobile and well informed patients will be able to benefit. What about the patients who are not mobile? According to the Commission’s figures, they represent over 90% whose healthcare needs are met through care provided by their domestic system.

HOSPEEM takes the view that further clarification is needed about the authorisation process. We believe that patients should be required to go through prior authorisation procedures in their home country before seeking hospital care abroad and asking to be reimbursed for this care. Prior authorisation procedures allow healthcare systems to monitor their finances, plan the delivery of services and the management of the healthcare workforce.

HOSPEEM members believe it is important that when patients go abroad for treatment then their home health system, as the financer of the care, is able to decide what treatment is most appropriate. HOSPEEM takes the strong view that Member States should be able to retain the right to plan services and manage resources in order to ensure the financial viability of their health systemsand that the European Commission do not go beyond their competences in this area
HOSPEEM is concerned that the draft directive could also create extra bureaucratic burdens for health systems which could prove expensive and time consuming.

Therefore we want to ensure that all the ramifications of the Commissions’ proposals are properly considered and look forward to working closely with the European Commission, the Council and the European Parliament, so that the views of European hospital and healthcare employers are taken in to account. Moreover, we look forward to see included into the debate the position of the hospital sector social partners as expressed in the joint statement on health services in the European Union.

To conclude, said Godfrey Perera, “We hope that the co-decision procedure will provide answers to the questions we are putting forward today and will give us back a text that will genuinely be helpful to all EU patients and healthcare providers.”

EPSU-HOSPEEM Joint declaration – December 2007