10.11.2017 | Brussels Background The Future of Europe – The end of EU Health Policies?

Ever since the Brexit became tangible and inevitable with negotiation rounds ongoing, the European Union had to start thinking about its future as the so-called EU 27. With Great Britain leaving the European Union the European Union loses a strong member state and –of course- budget. A lot has been discussed about the economic consequences to follow but what about the EU health policies?

Shortly before the festivities for the sixtieth jubilee of the Treaties of Rome in March, the President of the European Union – in an impressive move - played the ball to the Member States and presented the “White Paper on the Future of the European Union”. The Commission’s white paper outlines five scenarios for the future of the European Union, from closer collaboration to simply focusing on the single market as a core competence. One scenario however, left the health care community dumbfounded: The fourth scenario “Doing less more efficiently” paints a future where member states only concentrate on a reduced number of areas such as trade, security, migration, the management of borders and defence. Therefore other areas that always have been difficult to tackle as a union will be excluded from joint policies. In other words: EU health care policy will be a nice memory of the past in this scenario. 
This scenario however, isn’t as farfetched as some might think, considering that the success of health policies and DG SANTE has always been in doubt. Although 2017 marks the 25th anniversary of Article 168 TFEU which paved the way for a closer collaboration in health care policies at EU level, President Juncker does not seem to see a future for European health policies. Despite the fact that in some areas a close cooperation between the member states is definitely needed and if you consider the cross-border health care, the EU initiatives against tobacco advertisement or the European Reference Networks which were already quite a success, some say that DG SANTE is very close to being obsolete. This feeling is even more enhanced with plenty of other DGs taking over “health” projects within the scope of the “Health in all policies” concept. 
According to the latest Eurobarometer survey, most of European citizens apparently want the European Union to step up its game with regards to health care; it is rather questionable if this is also the desire of the member states of the European Union. Some of them will not stop pointing out that health care is the sole responsibility of the member states. Take Germany as an example: Although Germany adopted the Council conclusions on Encouraging Member States-driven Voluntary Cooperation between Health Systems, it had to put its objection in an additional annex. This statement repetitively and strongly emphasised that Germany only endorses voluntary cooperation at Member States level which has absolutely no room for any kind of Commission coordination activities. In fact Germany is of course right in pointing out the existing competences with regards to health. However, solidarity within the European Union is needed and demands also a close cooperation within the area of health care. One example of good cooperation is the sharing of information in relation to cross-border health threads such as resistant bacteria since some issues can’t simply be overcome by one member state alone. 
It is also questionable if a future without DG SANTE would be desirable for the German pharmaceutical industry, since the respective industrial counterpart DG GRWOTH hasn´t put many industrial policies forward either. A strong European health care policy that respects all parties involved is necessary for the pharmaceutical industry to set high quality standards and promote innovation as well as  innovative ideas. 
In the long run, a European Union without EU health policies does not seem preferable to any of the stakeholders in health care. Yes, including health into all policies seems like a good idea, but you also need a supervisory authority for effective coordination – which DG SANTE has done over the past decades.  As health system challenges are present in all European Member States, cross border threats reign the present and health becomes an ever more important part of our daily lives, European health policies cannot be obsolete.