The Irish health Presidency programme takes forward the work on addressing health threats, co-ordinating public health actions and supporting health systems, which has been done to-date under previous Presidencies, and seeks to advance the principles and objectives in the Community's public health programme, 2003-2008.
An overall objective of the Irish Presidency is to enrich our shared knowledge and experience in the protection and improvement of public health, together with mapping out the course of how we best address future needs. The Irish health programme provides clear insight into the enormous depth and breadth of the challenges we face in this area. It ranges across regulatory measures in areas such as food and pharmaceuticals, through serious health threats such as tobacco, to the orientation of health systems in relation to greater patient mobility. The health Presidency programme focuses on a number of key themes and I have set out the work done in these areas for the Deputy's information.
The Presidency offers a special opportunity to demonstrate our commitment and determination to advancing public health throughout the Union. I believe that we developed a very focused Presidency programme.
The theme of the promotion of cardiovascular health has attracted a considerable focus of attention under the Presidency programme. The aim is to reach European agreement on best practice for the population and to develop strategies for the prevention of cardiovascular disease.
An evidence-based expert conference took place in Cork on 24-26 February. This consensus conference on cardiovascular health was based on extensive preparatory work by experts. The aim of the conference was to reach European agreement on best practice for the prevention of cardiovascular disease in the population. The conference has produced conclusions which have undergone consideration in the Council's health working group and were discussed at the ministerial consultative meeting on 12 May with a view to presenting draft Council conclusions on cardiovascular health for adoption by EU Health Ministers at our June meeting.
A second cardiology conference took place on 10-11 May aimed at reaching agreement of cardiology data standards. The aim of the cardiology audit and registration data standards, CARDS, project is to develop expert consensus on European data standards for three priority modules of a cardiovascular health information system. The data standards will set out the variables to be collected, precise definitions for each variable and the purpose for which each data item is being collected.
Priority will be given to information needs for clinical audit, as well as for epidemiological analysis and health service planning. It is estimated that a set of one hundred data items will be identified, prioritised and defined for each topic. The agreed data standards will be disseminated to European cardiologists and health care agencies, as well as vendors of hospital and cardiology information systems, to encourage them to implement the data standards.
On patient mobility issues judgements of the European Court of Justice involving payment for health services and access by individuals on a cross border basis have given rise to a number of significant challenges in the health care systems of EU member states. This has led to these issues being examined in a "high level process of reflection", HLPR, established on the initiative of the European Commission. This informal process, which involved Ministers from all member states and other stakeholders, was completed in December 2003.
The outcome of the process was a series of recommendations, which may provide the basis for clearer understandings around patient mobility at an EU level. There is a need for a framework to be put around the facilitation of patient mobility in a manner that takes account of the responsibilities of member states to organise and deliver health services that are equitable and sustainable.
As there is potential for significant impact on national health systems, Health Ministers are determined that they should set the course for greater patient mobility. A Commission communication dated 20 April 2004 arising from this HLPR process has been received on which the Irish Presidency plans to carry out further work. This has been identified as a priority matter on which to advance deliberations between Health Ministers — it was discussed on 12 May at the ministerial consultative meeting — during the period of the Irish Presidency with a view to the adoption of Council conclusions.
The Irish Presidency will be contributing in relation to the public health aspects of the Commission's environment and health action plan. The action plan will focus on the four priority effects on health to be addressed in the first cycle, 2004-10. These include childhood respiratory diseases and asthma allergies. The action plan is intended to be the Commission's contribution to the forthcoming WHO Ministerial Conference on Environment and Health which will take place in Budapest in June 2004 and, in particular, to the preparation of the children's environment and health action plan for Europe, CEHAPE. The Irish Presidency will also be contributing to the conference ministerial declaration.
An expert workshop led by the Joint Research Centre of the European Commission considered childhood asthma from a genetic and environmental perspective. This workshop took place on 22-23 April. Its work will inform Presidency draft conclusions on childhood asthma which will be presented to the Council of Health Ministers for consideration.
An e-health conference, with related exhibition and awards, and associated closely with the e-Europe action plan of the community took place on 5-6 May. This theme focused on citizen friendly applications of information and technology in health. Amongst the areas discussed were health cards; integrated care records; evidence based decisions; health portals; quality of health websites and telemedicine.
Work has been proceeding in the area of information technology and health, at national, EU, Council of Europe and WHO level and considerable added value can be obtained from taking stock of existing achievements and planned developments, in order to map out the future direction to be taken. The conference conclusions have informed draft Council conclusions on e-health. A separate Commission communication on e-health dated 30 April 2004 and titled "e-Health — making healthcare better for European Citizens: an action plan for a European e-Health area" has been received and is being considered. An informal meeting of Health Ministers, which was held on 12 May, is an integral part of achieving the maximum progress across the range of topics above.
At this informal meeting Health Ministers held a wide ranging discussion on cardiovascular disease which supported the recommendations from the February conference on promoting heart health in the European Union. Mr. Tommy Thompson, secretary of Health and Human Services in the USA, made a presentation to the Ministers on the US approach to prevention of cardiovascular diseases and obesity, particularly in young children. It was clear from the discussions that the outcome of the February heart health conference and of the CARDS conference on development of data standards for collection of comparable data in cardiology databases and registries will make a practical and valuable contribution to development of cardiology strategies at European level. There was also scope for further co-operation between the European Union and the USA in relation to tackling the challenges of cardiovascular disease and obesity. On the basis of the positive experiences of working together in the context of the EU Presidency, Ireland and the USA are committed to exploring further collaborative opportunities in the area of public health, going forward.
Health Ministers had a very worthwhile discussion on patient mobility. As reflected by the views of Ministers, the Community is seen to be at a crossroads in the future development of health policy at a European level. The Ministers agreed the Commission communications on patient mobility and on sustainable health care/open method of co-ordination are interlinked and form part of an overall coherent strategy for health care systems at European level.
There appeared to be universal acceptance of the need for the early establishment of what is termed a permanent mechanism to support European co-operation in the field of health care and to monitor the impact of the EU on health systems and to co-ordinate and manage the various discussions on health policy which are taking place in a wide variety of different fora in Brussels. The need for overall coherence and for legal certainty were emphasised.
The Commission decision on the establishment of a new high level group on health services and medical care was welcomed as an interim step towards the early establishment of a permanent health mechanism. There was universal agreement on the need to introduce greater legal certainty into this area and to develop health policy at European level following the series of European Court of Justice judgments.
On European centres of reference, there was general agreement on the need for mapping of centres of reference for highly specialised or rare diseases on a systematic and structured basis according to agreed clear criteria with regard to their designation and use.
On pandemic preparedness and response planning, Ministers followed up on discussions held at a special meeting on 12 February 2004 on improving Community preparedness for dealing with communicable disease threats including biological events. Ministers considered a number of questions and were generally agreeable to an extension of the health security committee's mandate until the centre for disease prevention and control is established in Sweden in 2005. The mandate should be reviewed at that time. Minister's also agreed on the need for member states and the Commission to work together for early agreement on adoption of a co-ordinated approach to the purchase of anti-virals and vaccines to deal with outbreaks of communicable diseases.
The Swedish Minister for Public Health, Mr. Morgan Johansson, made a presentation on issues surrounding alcohol and public health. Commissioner David Byrne informed Ministers that the Commission was preparing a draft strategy in relation to alcohol. Ministers welcomed the Commissioner's information in this regard and looked forward to seeing the communication. I reported briefly on the outcome of the e-health conference held on 5-6 May. Ministers and the Commissioner welcomed and supported the Irish Presidency initiative in this area.
A conference will be held on 17/18 June to review tobacco control policies in the European Union. The conference will focus on achievements to date, and, in light of enlargement of the European Union, will provide an opportunity to stimulate debate on the course of future action to further protect human health in this area.
An international food safety conference on the issue of the harmonisation of official food controls took place on 11/12 March. The aim of the conference was to provide a forum to explore the requirements and impact of the proposal for a regulation on official feed and food controls.
A meeting of governmental chief nurses took place on 16 April, which facilitated an exchange of views among the participants regarding recent developments and challenges in nursing and midwifery and in healthcare systems. Representatives of 21 member states attended.
A conference on promoting workplace health, "Networking Workplace Health in Europe", will take place in June. This conference aims to establish a platform for the exchange of experiences between national forums on workplace health, to provide an overview of the different priorities for action across Europe and to identify the cross cutting challenges for future workplace health improvement.
On 17-18 June the final meeting and conference to launch the outcome of the EU Commission funded project to draw up a European blueprint for action on breast feeding will take place. This blueprint is based on a comprehensive review of research evidence for the effectiveness of intervention taken globally to improve breast feeding rates.
Whilst the Irish Presidency has contributed significantly in regard to the themes and events which we identified as priorities, progress has also been made on a number of dossiers at EU level from the ongoing legislative work programme. I have set out the work achieved by the Presidency below.
Agreement has been achieved under the Irish Presidency on the proposal for a European centre for disease prevention and control. The centre will concentrate primarily on communicable diseases. Outbreaks of unknown disease may be dealt with by the centre and will handed over to appropriate agencies once identified. It has been agreed that it will be located in Stockholm, Sweden. This means that the timetable for having the centre up and running in 2005 will be achieved.
As the Presidency, Ireland has achieved agreement on a Council decision to allow the Community and its member states to ratify the WHO Convention on Tobacco Control and the Community and member states can now to proceed to ratification.
The discussion at the avian influenza special Council meeting of 12 February meeting was followed up by the Irish Presidency which focused on how best member states could co-ordinate with the Commission in engaging with the pharmaceutical industry to consider the preparation of protocols in relation to the manufacture, availability and distribution of vaccines and anti-virals, as part of pandemic planning preparedness. Follow up work on this topic has continued in the Council and Council conclusions will be presented to the Health Council on 2 June 2004.
Commissioner Anna Diamantopoulou originally announced a proposal for a European health insurance card at the Employment and Social Affairs Council meeting on 19 January 2002. It was seen as an essential part of a package of measures, outlined in the action plan for mobility designed to reduce the obstacles faced by workers when moving around the EU. It was confirmed at the spring European Council on 25-26 March that the card will be introduced on 1 June 2004, during the Irish Presidency.
The card will replace all temporary stay forms from 1 June 2004, that is, the E111 — temporary visit, E128 — students and posted workers, E119 — unemployed persons going to seek work in another member state and E110 — persons working in international transport. Previously, E111 holders were entitled to immediately necessary care, while holders of other temporary stay forms were entitled to necessary care. However, the amendments which have been introduced in order to allow the introduction of the health card ensure that all insured persons will be entitled to all health care benefits in kind that become medically necessary, taking account of the nature of the benefits and the expected length of stay.
Consideration of important dossiers on international health regulations of the World Health Organisation and food and nutrition matters, for example, health claims and food fortification, will be progressed to the fullest extent possible during the Irish Presidency.
For the Employment, Social Policy, Health and Consumer Affairs Council on 1-2 June 2004 Health Ministers will convene in Luxembourg on 2 June 2004. The draft agenda is as follows: promoting heart health — adoption of Council conclusions; e-health — presentation of Commission communication, adoption of Council conclusions; pandemic preparedness plan — information from the Commission, adoption of Council conclusions; health care developments in the European Union — (a) patient mobility: adoption of Council conclusions, presentation of Commission communication and exchange of views; (b) sustainable health care: presentation of Commission communication; (c) European health insurance card: information by the Commission; international health regulations — adaptation of negotiating directive, progress report; European centre for disease prevention and control — briefing by the Commission; WHO framework convention on tobacco control — briefing by the Presidency and the Commission; European health strategy — briefing by the Commission; childhood asthma — adoption of Council conclusions; environment and health — information from the Commission; food claims — progress report; fortified foods — progress report; alcohol harm reduction among young people — information from the Presidency; other business — diabetes, written information from the Presidency; osteoporosis, written information from the Presidency; proposal for a services directive — information from the Presidency.
