British Medical Association manifesto for 2004 Euro-elections
• believes that healthcare systems should remain the sole responsibility of member state governments but recognises that the European Union plays an increasingly important role in public health policy.
• wants to see public health explicitly recognised as an objective of the EU in the draft Constitutional Treaty. Commercial interests and internal market measures should not take precedence over public health. There should be more routine use of Health Impact Assessments when drawing up new EU legislation.
• notes that medical staff are constantly having to innovate in order to meet the challenges of a rapidly evolving healthcare market. This shows the commitment of doctors to embrace change for the benefit of patients. Patients' health is our business
• believes the European Parliament has a crucial part to play in safeguarding patients' interests and guaranteeing quality standards of care. MEPs are able to make decisions which can improve their constituents' health. Their health is also your business
Raise standards in Public Health
The fast-tracking of a new European Centre for Disease Control earlier this year and the new recommendations from the Commission on patient mobility shows that we have come a long way in recognising public health as an important issue for the EU in the last five years.
Since the Euro-elections in 1999, Europe has legislated for a welcome ban on tobacco advertising, launched the European Health Action Programme and has improved safety controls over imports of tissues and cells.
Nevertheless, there are still far too many internal market measures being proposed by the Commission that take insufficient account of their effects on people's health. The BMA is calling on election candidates to pledge action on the crucial issues we have highlighted below.
Banning tobacco in the workplace
A ban on smoking in the workplace will save thousands of lives in Europe. The EU should stop paying lip-service to the dangers of passive smoking at work and act now.
Europe should follow Ireland's lead where a successful ban on smoking in the workplace was introduced this year. Pregnant women are particularly vulnerable. A BMA report on smoking and reproductive health found that pregnant non-smokers exposed to second-hand smoke are more likely to have lighter babies and to give birth prematurely.
Pregnant workers should be entitled to leave of absence on full pay if their safety cannot be guaranteed. Directive 92/85/EEC should be amended to provide the necessary protection. The BMA is calling on the UK Government to introduce legislation that bans smoking in places of work.
Making food and alcohol advertising more responsible
The European Commission is reviewing legislation governing broadcasting and TV advertising in the Internal Market. The BMA believes that the Television Without Frontiers Directive should be strengthened to improve monitoring of TV advertising.
Persistent use of images of "social and sexual success" in alcohol advertising, which Article 15 of the directive is supposed to prevent, fuels the phenomenon of binge drinking among the young in the UK. It is hard to reconcile the fact that binge drinking is on the increase and that provisions on alcohol advertising vary so wildly between member states with the Commission's assumption that Article 15 works effectively.
Around 70% of children's advertising is for food and foods high in fat, salt and sugar account for over half of all food advertisements. We would like to see Article 16 to be amended to include a general reference to the protection of the minor's health and a ban on advertising "unhealthy food" during children's TV
Regulating health claims on snacks and junk food
The European Parliament has been set a challenge of putting to an end ambiguous and misleading health claims made by food manufacturers and retailers. The BMA urges MEPs to welcome the Commission's proposals to put in place an authorisation system that will ensure that health claims stand up to scientific scrutiny.
If a chocolate bar claims to be good for bones because of its calcium content, then it has a duty also to warn consumers about sugar levels. The public is entitled to make an informed choice based on accurate and comprehensive information.
Protecting the environment to improve children's health
Health Ministers are meeting in June in Budapest to adopt a strategy to protect the environment to improve public health - in particular children's health. The BMA wants to see issues such as indoor pollution and asthma in the young high on the agenda. We are also working to have our concerns about passive smoking addressed.
Better working conditions for health professionals
The BMA welcomes plans to remove unnecessary obstacles to the mobility of doctors across borders. We also want to make it easier for doctors' qualifications to be recognised in another Member State. However, improving the internal market for the medical profession should not be done at the expense of patient safety.
Since the last election, patients seeking treatment across borders have become increasingly commonplace. EU legislation designed to facilitate this is very much welcomed as long as it doesn't begin to encroach on nationally determined clinical priorities.
The BMA is working with the Commission to streamline recognition of qualifications in an enlarged Europe, while at the same time ensuring there is no compromise to standards of quality care. The EU has an important part to play in making a doctor's working environment safer. As the UK is about to implement the Working Time Directive for junior doctors in August, we welcome the Commission's move to review aspects of working time across the board.
Finding a third way for working time
The Commission is currently reviewing the individual opt-out, which is widely used in the UK. It is also looking at the definition of "working time", since the Jaeger and SIMAP rulings have massive implications for doctors in training, who are often resident at the hospital when on-call.
The BMA believes that brief periods of rest in a hospital on-call should not be classed as equivalent to resting at home and so agree with the judgement that defines time spent compulsorily resident in hospital as working time. However, time spent not working while non-resident on-call should not be classed as working time. That is why we are looking for a third definition of working time. The BMA wants to see opt-outs remain for those who are in a position to determine their own working hours.
Safeguarding training standards and protecting patient safety
The Parliament made some important amendments to Commission plans to merge sectoral and general directives in a new regime for the recognition of qualifications cross borders. The BMA is keen to safeguard these changes to the new Qualifications Directive.
They provide for maintaining automatic recognition rights in as many medical specialities as possible without compromising on minimum training requirements. We also welcome the crucial First Reading vote which rejected the Commission's proposals to allow medics to practise in another member state without having to register with the competent authority for up to 16 weeks. The European Parliament agreed with our argument that this would compromise patient safety.
Recognising the special requirements of health in the internal market
The Commission has recently proposed a framework directive aimed towards completing an internal market for professional services by 2010. This will require Member States to justify national regulations so that an assessment can be made as to whether they constitute a barrier to trade. While doctors are in the scope of the directive, we are keen for derogations to be acknowledged - such as a derogation from the "Country of Origin" principle. It is important that doctors are regulated by the authorities of the host state.
Together with Commission recommendations on patient mobility, this legislation could have far-reaching effects on how Member States organise their healthcare systems. The draft directive spells out cross-border rights of EU patients. We welcome the improved rights and the many freedoms this directive brings, but special care must be taken when health services are included in internal market legislation. Health is not a market service like any other.
Making medical devices safer
In an average hospital, workers incur approximately 12 to 30 needlestick injuries per 100 beds each year. However, it is estimated that between 60% and 80% of incidents go unreported. EU Worker Safety and Health Directives should be strengthened to insist on the use of the best available technologies to avoid needlestick injuries as is the case in the USA.
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British Medical Association 2004 manifest pentru euro-alegeri - British Medical Association manifesto for 2004 Euro-elections - articole medicale engleza - startsanatate