Europe - Health equals wealth

Citation

(2010), "Europe - Health equals wealth", International Journal of Health Care Quality Assurance, Vol. 23 No. 2. https://doi.org/10.1108/ijhcqa.2010.06223bab.008

Europe - Health equals wealth

Article Type: News and views From: International Journal of Health Care Quality Assurance, Volume 23, Issue 2

Keywords: Public healthcare, European health policy, Public health projects

The European Commission has spent years arguing that public health is good for the economy. But when will it be entrenched in the EU’s economic and social policy?

If the Lisbon treaty ever comes into force, the European Union will take on a new aim: to promote the well being of its citizens. But will this have any substance, or will it remain just warm words?

Supporters claim that this provision will be another milestone in the EU’s health and social policy, which has been gathering force over the past 15 years.

When the European project began, competence for health was limited to health and safety in the workplace. These days the EU takes an interest in well being, health inequalities patients’ rights, pandemics and how to get people to eat better, exercise more and quit smoking. It is all a far cry from the days when men gathered in smoke-filled rooms to forge the Economic Coal and Steel Community.

But EU policymakers still see a long road ahead before public health becomes entrenched in economic and social policy. The European Commission’s department for health and consumers has spent the last few years arguing that public health is not a “nice” extra, but good for the economy.

“Health is not a cost on the economy. It is part of the growth and jobs agenda”, says Robert Madelin, the director-general of the department. But he adds that “too few economic policymakers understand the links between population health and sustainable economic competitiveness”.

This is not just a problem for policymakers, but also for industry. “Many factory owners, whether it is big companies or small and medium-sized companies, don’t yet realise that it’s not just paternalism; it’s strategic good sense to worry about the health of their workforce”, says Madelin.

In 2005 the Commission won a small victory when it managed to get a “healthy life years” measure included in the Lisbon Agenda for growth and jobs, which sets out to transform the EU into “the most dynamic and competitive knowledge economy in the world” by 2010. “Healthy life years” is a measure of time lived free from disability, and its incorporation into the Lisbon Agenda marked a shift into broader territory than the earlier focus on merely cutting red tape. But the Lisbon Agenda has not lived up to its hyperbolic aims.

For Madelin, one of the big questions for the next Commission is how to update the EU’s strategy on growth and jobs. “What does it mean to renew the Lisbon Agenda in a way that shows citizens that their social concerns, such as jobs, education and so on, are part of globalisation and a market-driven Europe?” he asks. According to Madelin, health is not the only social indicator that needs to be taken into account. Education and social capital, he says, are also important “flanking measures” that contribute to “a vibrant knowledge-based society”.

José Manuel Barroso used the prospect of a more ‘social’ Lisbon Agenda to entice MEPs to vote for his second term as Commission president. It will need to advance a “people’s Europe”, Barroso declared, while avoiding the details of what this means. But the Commission is constrained by the reluctance of national governments to cede new powers to the EU, especially on health and welfare. Unlike competition or internal market policy, discussions on health always provoke the unresolved existential question: what should the EU do in this area?

Madelin sees the EU’s role as setting the agenda, rather than executing it. Policy instruments will vary, he says, pointing to “hard measures” such as food labelling laws and research grants, as well as “softer” measures, such as encouraging food producers to take voluntary steps to cut sugar, salt and fat content (a reference to the group of food manufacturers and health campaigners that make up the EU’s “nutrition platform”). The EU also has a small budget to fund public health projects.

Soft measures, such as sharing best practice and encouraging voluntary action, are likely to multiply in future. The test for the EU will be how far these measures deliver on big talk of promoting wellbeing and a people’s Europe.

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