Czech EU Presidency
challenge facing the Czech government during its European presidency over the
next six months will be to secure agreement on new legislation to update
existing European working time rules. Prague, with the help of the European
Commission, has just three months to end the stand off between national
governments and the European Parliament which emerged shortly before Christmas
over the terms and conditions of the new rules.
If it succeeds, the new legislation could be implemented within two to three years. If it fails, the existing legislation will remain in place. This would allow national authorities, 15 of whom already do so, to continue using the opt out from the 48 hour maximum working week if they wish, but would cause almost every country problems with on call time for medical and emergency staff at their place of work.
The European Court of Justice (ECJ) has repeatedly ruled that on call time should be counted as working time – an interpretation that would cause huge costs for health services. Some have even predicted this could mean hospitals in some countries being closed between midnight and 6am.
The Commission has investigated existing practices throughout Europe and concluded that all 27 EU members are breaking the existing rules, as interpreted by the ECJ, in one way or other. A raft of embarrassing court cases against national capitals is not expected immediately, but their prospect is definitely in the wings.
The Czechs have wasted no time in trying to find a way through the current deadlock. They organised a meeting of senior national officials in Prague in mid-January and followed this up a week later with further informal ministerial discussions. The stance being taken by most governments was clear, according to officials close to the issue.
There is strong support among many governments to give health and emergency services flexibility by retaining the opt out indefinitely – a stance that sets member states against the European Parliament which voted in December to phase it out.
However, there are suggestions that a compromise might be possible over the definition of on call time at the place of work. If so, this would need to bridge the government view that inactive time does not count towards the working week and the parliamentary position that all such time should be considered as work.
As if reconciling these different views was not enough, any agreement must be reached and approved by EU governments and MEPs by the time of the last European Parliament plenary session at the beginning of May, before the European elections in June. If that deadline is missed, the proposal for reforming the existing legislation falls and the existing measures remain in place.
Despite this high profile legislative challenge they face, the Czechs are looking to move the public health agenda forward on many fronts in the coming months. In line with one of the wider political objectives of its presidency – advancing a Europe without borders – they will address some of the obstacles in the way of cross-border medical care.
They will also be taking up the Commission’s proposal to improve the quality and safety of organ donations by setting Europe-wide standards and encouraging greater cooperation between national health services so that supply and demand are more aligned.
Currently, some 56,000 people in the 27 EU countries are waiting for an organ transplant and a dozen are expected to die every day because of an absence of suitable donors. While donor numbers and transplants are increasing across Europe, rates vary considerably from 34.6 donors per million people in Spain, to 13.8 in the UK and just 0.5 in Romania.
Another issue that the Czechs will be focusing on will be moves to tackle antibiotic resistance. As Dr Panova Stanislova, a director in the country’s health ministry, told a Brussels conference last November, the country has a long tradition of work in this area and the subject will be examined at a conference on antimicrobial resistance and patient safety.
The digitalisation of healthcare services and the development of e-health will also be on the agenda with a two-day conference in mid- February, as will the financial sustainability of healthcare systems, which will be the subject of a two-day conference in early May.
Finally, the Czech Presidency will be organising early national reaction to the Commission’s proposal towards the end of last year to update pharmaceutical legislation. This is designed to boost innovation and research and to make the industry more competitive, but at the same time contains the controversial suggestion that drug companies should be able to give information on certain medicines direct to patients.