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The impacts of European Union Law on the healthcare sector:

Paper I – Institutional overview

Tamara Hervey, Jean Monnet Professor of European Union Law, University of Sheffield (t.hervey@shef.ac.uk)

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Overview• Introduction

• EU Law• EU law making and the competence of the EU

• The structure of EU law

• Supremacy of EU law

• Enforceability of EU law

• Policy responses/EU added value

• Conclusions

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Three key questions:

• What is special about EU law?

• What challenges and opportunities for those in the healthcare sector therefore arise?

• What kinds of questions should those involved in managing the healthcare sector therefore be asking themselves?

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EU law making and competence

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EU law making and competence

736 MEPs20 Parliamentary Committees

25 Directorates General

The structure of EU law

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The structure of EU law

• Free movement law• Prohibits restrictions on movement of

goods, services, persons

• Exceptions where justified

• Competition law• Prohibits cartels and monopolies

• Exceptions for public services

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The structure of EU law

• Law and policy that softens internal market/competition law• Employment law

• Consumer protection law

• Environmental law

• Public health law …

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Supremacy of EU Law

national law that contradicts EU law must be ‘disapplied’

The enforceability of EU law

• Individual rights in EU law

• Enforceable before (ordinary) national courts

• ‘Direct effect’

• Applies to enforce EU law against ‘public’ bodies

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The enforceability of EU law

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Policy responses

• ‘Framework Programmes’

• Public health programme

• Best practice

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EU PUBLIC HEALTH PROGRAMMES EU PUBLIC HEALTH PROGRAMMES Now Operated by Executive Agency for Public Now Operated by Executive Agency for Public

Health and ConsumersHealth and Consumers

http://ec.europa.eu/phea/index_en.html

Objectives:• Improve citizens' health security• Promote health for prosperity and solidarity • Generate and disseminate health knowledge

Budget: c € 300 million

OpportunitiesOpportunities

• Life expectancy at birth (years) for males ranges from 65 (Latvia, Lithuania) to 79 (Sweden), a gap of 14 years

• Life expectancy at birth (years) for females ranges from 76 (Bulgaria, Latvia, Romania) to 84 (France, Italy, Spain), a gap of 8 years

Source: Rosling H. Gapminder, registered as a Foundation at Stockholm County Administration Board

Health status varies widely in EU

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Solidarity, redistribution, territorially based – closed-ness

vs

Remove national barriers, access to wider markets, efficiencies and economies of scale – open-ness

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• Logic and structures of EU law ≠logic and structures of healthcare

• EU law-making institutions may be unaware of healthcare concerns

• The special nature of EU law

• Can have challenging effects for national healthcare systems

• Benefits and opportunities