Reading the Runes on Future Health Policy

What can be gleaned about the direction that health policy will take for the next five years under the new European Commission, scheduled to take office at the beginning of November? As the candidates prepare for their grilling by the European Parliament over the coming weeks, they are mulling over the answers they will give to MEPs keen to check on their credentials. This face-off between the European Parliament and the political figures that the member states have designated as European commissioners is now an established practice, but is not guaranteed to shed much light on the future of health policy. It does, however, say a little about the preoccupations and predilections of the parliament.

So far, the parliament has sent a series of written questions to the candidates. It has asked Vytenis Povilas Andriukaitis, the Lithuanian health minister who is slated to become commissioner for health (and food safety), what aspects of his personal qualifications and experience "are particularly relevant for becoming commissioner and promoting the European general interest," and "what motivates you?"

More particularly, MEPs want to know "What will be the commissioner's top priorities in the field of public health and food safety?" and "How will you personally ensure the good quality of legislative proposals, full transparency of lobbying activities directed at you and your services, consistent and balanced consultation of all stakeholders, and efficient cooperation among all relevant commission services?" They also ask, "How does the commissioner plan to maintain and contribute to further improving the quality of health systems?"

Carlos Moedas, the putative research commissioner, is being asked about his priorities, "taking into account the emphasis on jobs, growth, competitiveness and sustainable development," and about how he will "personally ensure full transparency of lobbying activities directed at you."

Jyrki Katainen, who is likely to get the portfolio for jobs and growth, has been asked "How will you improve the competitive position of Europe in the global economy?" and how he will create "a climate of entrepreneurship that is a precondition to job creation within the European Union?"

And to Elżbieta Bieńkowska, who is expected to take over the new and expanded portfolio for industry affairs, the parliament has asked "What measures will you take to help improve growth, competitiveness and job creation in the single market?" and "What steps will you take to enable businesses, in particular smaller firms, to have access and reap the benefits of the single market?"

The parliament's interest in boosting competitiveness is felt across the political spectrum, largely because it is seen as a step towards job-creation. But it is accompanied by a strong desire among MEPs to influence commission policy, and to limit the power of what are seen in many parts of the parliament as excessively interventionist business interests. But so far, there are no answers, and elucidation may have to wait until Andriukaitis and the others appear before the parliament next week.

Some clues can also be found in the letters that commission president Jean-Claude Juncker has sent to each of his appointees. Notably, he has asked Andriukaitis to focus on developing performance assessments of health systems: "The EU can clearly help member states address the challenge of increased calls on health services and more complex technological choices at a time of intense pressure on public finances," said Juncker. He has told Bieńkowska to focus on Europe's need for "a high-performing industrial base" to ensure it keeps global leadership in strategic sectors with high-value jobs "such as the automotive, aeronautics, engineering, chemicals, and pharmaceutical industries.” And Moedas is instructed to promote “the international excellence of the EU’s research and science” and to strengthen research capacities and innovation strategies. He also wants more attention to applied research, “with a greater participation of the private sector."

Whether this means a more active, more innovation-oriented policy on health remains to be seen. First the commission needs to win full European Parliament backing, and only then can it take up office on November 1. Only then will EU policy emerge as a reality, rather than as a series of expressions of good intentions.