News

HOSPEEMNews
Consultations Hospeem

HOSPEEM Position Statement on the Proposal for a Directive of the European Parliament and of the Council on the application of patients’ rights in cross-border healthcare

On the 2nd July 2008, the European Commission published its proposal for a Directive of the European Parliament and of the Council on the application of patients’ rights in cross-border healthcare. This follows the open consultation that the Commission ran between September 2006 and January 2007 which came in response to a series of European Court of Justice (ECJ) Judgments on health services in the European Union.  The ECJ-Judgements stated that, under certain conditions, EU citizens were entitled to access healthcare in another Member State and be reimbursed for this treatment by their national health systems. The judgments have created uncertainty surrounding the interpretation of case law at European level for patients and for the national healthcare systems.

HOSPEEM supports the desire to establish legal certainty regarding patients’ rights in relation to healthcare treatment in other EU Member States, thus avoiding the situation whereby the ECJ exercises political authority in the field by virtue of its rulings in individual cases. However, the Directive goes beyond the rulings of the ECJ, both in relation to the scope and the content of the Directive, most notably in relation to prior authorisation systems.

HOSPEEM questions that Article 95 of the EC Treaty, relating to internal market harmonisation, is the proper legal basis for a Directive on the application of patients’ rights in cross-border healthcare.  In contrast to the view of the European Commission, HOSPEEM sees a fundamental conflict between Article 95 and the principles enshrined in Article 152 of the EC Treaty which outline the responsibilities of the Member States to fund, organise and deliver health services.

FULL TEXT: HOSPEEM Position Statement

News, Social Dialogue Hospeem

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.
-ends-

For further information, please contact:

HOSPEEM: Gin Ngan +32 2 229 21 58, hospeem@hospeem.eu
EPSU: Tamara Goosens +32 2 250 10 80, tgoosens@epsu.org

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

Social Dialogue Hospeem

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

Projects Hospeem

“Strengthening Social Dialogue in the hospital sector in the new Member States and candidate countries”

Project funded under budget heading 04.03.03.01 (Industrial Relations and Social Dialogue)

FULL TEXT: National Reports Overview | National reports

Introduction

After several years of pre-social dialogue process led by the Joint Representative Taskforce[1], the Committee on social dialogue in the hospital sector (henceforward: the Committee) will soon be established. The Committee aims to improve the quality of employment and quality of services in the hospital sector by means of constructive social dialogue.

Adequate representativity of EPSU and HOSPEEM is an important condition for success. However, social partners from new Member States are not yet very well represented in the European Social Dialogue. Moreover, the situation and status of Social Dialogue within some of these Member States leaves much to be desired. A strong national dialogue is a conditio sine qua non for adequate representativity in Europe. In turn, a high level of representativity will make the sectoral dialogue more effective at the EU level. Hence, capacity-building in the new Member States is a major priority in the work programme of the Committee.

In this project HOSPEEM, EPSU and national social partners from Czech Republic, Slovakia and the Netherlands have joined forces to strengthen the Sectoral Social Dialogue in the EU 27 and to increase representativity in the Social Dialogue Committee. They wish to remove some of the main obstacles for constructive dialogue on national and EU level. They will combine theoretical and practical methods to tackle problems of a different character, thus optimising the final project result.

Link to the objectives and priorities of the budget heading

This project is the first major initiative of the Social Dialogue Committee for Hospitals after the formalisation in September 2006. This project will support the implementation of a major issue of the work programme of the Committee, i.e. strengthening Social Dialogue in the new Member States and candidate countries. It will also help to increase the representativity of social partners in the EU Social Dialogue, especially from the employers’ side. Finally, the pilot activities will contribute to the development of the three major topics defined in the EPSU-HOSPEEM work programme 2006-2007(ageing, recruitment and retention, skill needs).


[1] The Joint representative task force in the hospital sector was founded in 2002 by members of EPSU and CEEP involved in an informal social dialogue since 1999.

Social Dialogue Hospeem

Social Partners’ work programme 2008-2010

Work Programme 2008-2010

EPSU and HOSPEEM agreed in the Social Dialogue Committee for the Hospital Sector on 7 December 2007 to continue their work and their joint partnership approach as developed during the period of their first work programme in 2006-2007. This work will serve as basis for further activities in the Hospital Sector Social Dialogue as presented in this work programme. The work programme will cover a period starting from the date of signature until 31 December 2010. This timing gives the Social Dialogue Committee better opportunities for planning, complete and follow up on the priorities for the period. Halfway in the period the Committee will take stock on the work in order to make eventual changes in the planned activities and priorities where appropriate.

The main priority for HOSPEEM and EPSU in the coming years is to strengthen the social dialogue in the hospital sector at European, national and local level and take up our responsibilities as the recognized social partner European organizations for employers and workers in the hospital sector.

Social Dialogue Hospeem

Future skill needs in health care

Thessaloniki, 22-23 May 2008

Cedefop in cooperation with the European Social Dialog Committee in the Hospital sector in the European Union (HOSPEEM and EPSU) organised a workshop aimed to identify the key trends and future skill needs in the health care sector.

It paid particular attention to the interaction between technology, ICT and skill needs, management of health care and education and training needs in the sector.

Workshop presentations and papers are available on the CEDEFOP website

Activities, Social Dialogue Hospeem

Cross-border recruitment and retention: HOSPEEM-EPSU code of conduct

The European Federation of Public Service Unions (EPSU) and the European Hospital and Healthcare Employers’ Association (HOSPEEM) have jointly signed a code of conduct on ethical cross-border recruitment and retention.

Through the code of conduct the European social partners in the hospital sector want to address inequalities and unnecessary burdens on healthcare caused by unethical recruitment practices. With this agreement they establish in the European hospital sector social dialogue a full commitment to promote ethical recruitment practices at European, national, regional and local level.

The choice of the world health day 2008 as the date for the official signature of the agreement is not casual. The cross-border movement of healthcare professional is indeed an increasingly expanding phenomenon that clearly goes beyond European borders. With that global scope in mind, the European social partners wish that the code becomes a source of inspiration inside and outside Europe’s borders and remind that, in addition to European and national legislation and collective agreements, the already existing ILO-conventions in this field should be taken into account, when looking for an appropriate framework to support ethical recruitment and retention practices.

The Secretary General of EPSU, Carola Fischbach-Pyttel, added that, “Healthcare services are an essential part of the European Social model, therefore all relevant actors must be committed to their fair and effective functioning. The contribution of health care workers to good quality healthcare is essential. Social Partners therefore need to address the various challenges different countries are experiencing in terms of health workers shortages and the reasons why healthcare workers decide to migrate. Strategies which promote adequate workforce supply in all countries should be supported. EPSU and HOSPEEM want to encourage, and as far as possible contribute to, the development and implementation of policies at local, national and European level with the purpose to enhance work force retention”.

The Secretary General of HOSPEEM, Godfrey Perera stated that, “The promotion of ethical recruitment practices all over Europe clearly calls for a multifaceted strategy, including not only social partners but also governments, regulatory and professional bodies and other relevant stakeholders at local, regional national and European level. However, with the present agreement European social partners also want to firmly commit to their own responsibilities. For instance, when using the services of external agencies only those with demonstrated ethical recruitment practices should be used for cross-border recruitment. In case exploitative practices occur, these agencies should be removed from agreed lists”.

The code of conduct is based upon 12 key principles and commitments:

  1. High quality health care, accessible for all people in the EU
  2. Registration and data collection
  3. Workforce planning
  4. Equal access to training and career development
  5. Open and transparent information about hospital vacancies across the EU
  6. Fair and transparent contracting
  7. Registration, permits and recognition of qualifications
  8. Proper Induction, Housing and standards of living
  9. Equal rights and non-discrimination
  10. Promoting ethical recruitment practices
  11. Freedom of association
  12. Implementation, Monitoring and Follow-up

Background

The launch of the European Social Dialogue in the Hospital Sector in September 2006 was a crucial step in the development of industrial relations in Europe, as it gave the recognized social partners EPSU and HOSPEEM the possibility to take joint actions in the field of human resources, employment and social policies by using the social dialogue instruments. It also gave employers and workers both jointly and individually the possibility to give direct formal input on EU polices affecting the hospital sector and its workers. As employers’ and workers’ representatives we (the social partners) also want to take up our responsibilities as European social partners according to the provisions of article 138 of the European Treaty. Policy initiatives on the field of cross-border health care have many social aspects and will affect management and labour. FULL TEXT: HOSPEEM-EPSU Code of conduct – EN

The document will be soon available in 13 languages  :
HOSPEEM-EPSU Code of conduct – FR
HOSPEEM-EPSU Code of conduct – DE
HOSPEEM-EPSU Code of conduct – BG
HOSPEEM-EPSU Code of conduct – CZ
HOSPEEM-EPSU Code of conduct – ES
HOSPEEM-EPSU Code of conduct – FIN
HOSPEEM-EPSU Code of conduct – HU
HOSPEEM-EPSU Code of conduct – NL
HOSPEEM-EPSU Code of conduct – PL
HOSPEEM-EPSU Code of conduct – ROM
HOSPEEM-EPSU Code of conduct – RU
HOSPEEM-EPSU Code of conduct – SV

Example for the use and implementation of the EPSU-HOSPEEM Code of Conduct on Ethical Cross-border Recruitment and Retention from The Netherlands:

This table has been elaborated by NVZ (employers), ABVAKABO FNV, NU 91, CNV Publieke Zaak and FBZ (employees) to promote the implementation in The Netherlands : Table Dutch State of Play – EN , Table Dutch State of Play – NL

This presentation by Dutch social partners in the hospital sector describes the transposition of EPSU-HOSPEEM Code of Conduct on Ethical Cross-border Recruitment and Retention (2008) in The Netherlands: Slides by Elise Merlijn, ABVAKABO FNV, Rolf de Wilde, NU’91 and Tjitte Alkema, NVZ, 1 July 2011 – EN

Report on use and implementation of the EPSU-HOSPEEM Code of Conduct on Ethical Cross-border Recruitment and Retention (2008)

The document was adopted in the meeting of the Sectoral Social Dialogue Committee for the Hospital Sector working group 3/2012 on 5 September 2012 by EPSU and HOSPEEM. Final Report Use and Implementation – EN

Other related documents – WHO Code of Practice on the International Recruitment of Health Personnel:

The World Health Organisation Code of Practice was unanimously adopted by the 63rd World Health Assembly in May 2010: WHO Code of Practice (2010) and User’s Guide (2011)

Documents on the implementation of the WHO Global Code of Practice on the International Recruitment of Health Personnel :

 

 

Consultations, Social Dialogue Hospeem

Joint statement on EU and healthcare

The European Federation of Public Service Unions (EPSU) and the European Hospital and Healthcare Employers Association (HOSPEEM) have jointly signed a declaration on health services in the EU.

EPSU-HOSPEEM Joint declaration – December 2007

  HOSPEEM General Secretary Godfrey Perera, and EPSU head of Health, Karen Jennings sign joint declaration on Health Services

The declaration, which marks the first formal joint position between the EU social partners for the hospital sector, sets out clear principles upon which the management, financing and delivery of healthcare in the EU should be based.

The declaration is particularly timely as the European Commission is scheduled to publish a draft directive on cross-border healthcare in the coming weeks. The Commission draft has already caused some controversy on the way cross-border mobility of patients (a phenomenon that currently involves 1% of EU patients) should be regulated.

The Secretary General of HOSPEEM, Godfrey Perera stated that, “this declaration sends a clear signal that healthcare employers and workers have the interests of patients at the heart of our work. For that reason, we call for decisions on health services to be based on what is best for the patient, not on political theories or on the expansion of internal market rules.”

The EPSU Secretary General, Carola Fischbach-Pyttel, added that, “As the recognised social partners in the hospital sector, we hope that this declaration allows the European Commission to realise that the foundation of quality healthcare in the EU is equal access for all, based on medical need, and not an open market based on cost and ability to pay.”

Key passages in the declaration:

• It is not for the European Institutions to impose market and/or competition mechanisms in the health care sector, which could have as consequence the lowering of standards and increasing costs of health care systems and thus diminishing the accessibility to care.

• Health care should therefore be organised on the basis of common European social values including solidarity, social justice and social cohesion.

• They should also follow the principles of general interest, like equality, accessibility and quality.

• It is essential that EU-internal market or competition rules do not limit the EU Member states’ autonomy in the implementation of these national responsibilities.

Background
The launch of the European Social Dialogue in the Hospital Sector in September 2006 is a crucial step in the development of industrial relations in Europe, as it gives the recognized social partners EPSU and HOSPEEM the possibility to take joint actions on the field of human resources, employment and social policies by using the social dialogue instruments. It also gives employers and workers both jointly and individually the possibility to give direct formal input on EU polices affecting the hospital sector and its workers. As employers’ and workers’ representatives we (the social partners) also want to take up our responsibilities as European social partners according to the provisions of article 138 of the European Treaty. Policy initiatives on the field of cross-border health care have many social aspects and will affect management and labour.

Consultations Hospeem

HOSPEEM response to the Commission questionnaire on the practical implementation of Directive 2003/88/EC concerning certain aspects of the organisation of working time

Introductory comments

This paper summarises the responses received from HOSPEEM members to the Commission’s questionnaire. As a general remark, HOSPEEM members believe that patients should not be treated by tired staff and that staff are entitled to fair working conditions. While the Working Time Directive has been fully implemented by HOSPEEM members, the Directive and the subsequent rulings of the European Court of Justice (ECJ) have caused the hospital and healthcare sector problems and have imposed significant and unnecessary costs on hospital and healthcare employers.

The main problems emerging from the SiMAP and Jaeger judgments are around the interpretation of the term working time for on-call duties and the requirement for immediate compensatory rest. These rulings have caused serious problems in the operation of health systems and have led to Members States recruiting extra staff to prevent gaps in patient services at a large cost without improving productivity.  HOSPEEM members have been both gainers and losers.  In order to resolve the problems caused by the SiMAP and Jaeger judgments, some HOSPEEM members recruited staff from outside Europe as well as healthcare staff from the new Member States.  Losing staff in this way has had a large adverse impact on those health systems.

FULL TEXT: HOSPEEM Answer WTD questionnaire

Consultations Hospeem

HOSPEEM response to the first stage of consultation of the social partners on protecting European healthcare workers from blood-borne infections due to needlestick injuries

The Issue

The European Commission has launched a first stage consultation of the European Social Partners (according to article 138 of the EC Treaty) on protecting European healthcare workers from blood-borne infections due to needlestick injuries. The consultation follows the adoption on 6th of July by the European Parliament of a resolution (hereby “the EP Resolution”) that calls the Commission to bring forward a legislative proposal for a Directive amending Directive 2005/54/EC.

The questions that the Commission is asking are:

  1. Do you consider it useful to take an initiative to strengthen the protection of European healthcare workers from blood-borne infections due to needlestick injuries?
  2. Do you think that a joint initiative by the European Social Partners under Article 139 of the Treaty establishing the European Community would be appropriate?

Position Statement

Needlestick injuries, whilst stressful and with the potential for transmission of a blood-borne infections to staff, are not a major cause of incidents in the healthcare sector in Europe. HOSPEEM members believe that there is sufficient legislation, at European and, consequently, national level, to manage and control the incidence of needlestick injuries, provided that legislation is followed.

Effective management of needlestick injuries requires proper risk assessment, effective and regular training and updates and the provision, in those areas identified by risk assessment as being the most at risk, of safer devices that, if properly used, will reduce the transmission of blood-borne infections. It is not necessary, in areas identified as having little or no risk of transmitting bloodborne infection, to introduce more expensive safer devices.

HOSPEEM supports the principle of subsidiarity in this field. It is the responsibility of Member States to determine the details of regulations the framework of which has been set at European level. This is the approach, for instance, taken by Directive 200/54/EC. HOSPEEM would like this approach to be respected.

FULL TEXT: Response to the first stage of consultation of the social partners on protecting European healthcare workers from blood-borne infections due to needlestick injuries

MENU