14 November 2014, Brussels

To the attention of Ministers of Health

RE: Upcoming meeting of the EPSCO Council – Europe 2020 and the AGS

Dear Minister,

In October, the Council endorsed the joint opinion of the Employment and Social Protection Committees, which stated that Europe’s social challenges must be at the forefront of the review. As the implementing mechanism of the Europe 2020 Strategy, the European Semester must be targeted to ensure this necessary rebalancing of social and economic priorities.

Your upcoming meeting of the EPSCO Council will discuss the Review for likely the last time before the Commission publishes its report and will set the tone for the Council’s debates on the 2015 Annual Growth Survey (AGS). We would therefore like to take this opportunity to highlight the importance of ensuring that the value of health is recognised in the Europe 2020 Strategy and to suggest some ways in which the Council might contribute to this goal.


Health in the Europe 2020 Strategy


In our letter of April 2014, EPHA made a number of specific recommendations about the individual headline targets, suggesting ways in which they might be better served. EPHA agrees that these targets, though not yet achieved, should not be changed at this stage. However, the way in which they are pursued and the mechanisms employed require substantial revision. Fundamentally, the balance between social and economic priorities must be restored. This will require: a re-focusing of the main instruments away from indebtedness, towards social investment; more effective use of impact assessments, indicators and targets; better linkage of the Strategy to other policies and; full inclusion of all stakeholders. As such, EPHA offers the following recommendations:

- The social and employment implications of policies undertaken as part of the Strategy should be routinely assessed using social impact assessment, health impact assessment, and the social scoreboard – the Strategy must go beyond GDP if it is to achieve its social aims. The Scoreboard, whilst an important step forward, might be supported by indicators for child poverty levels, access to healthcare and homelessness, as well as a specific health target.

- Policies seeking to address macroeconomic imbalances often conflict with the social goals of the Strategy – reducing expenditure by cutting the salaries of health professionals, for example, has threatened the provision of quality care in many member states. A coherent mechanism for identifying and addressing these kinds of conflicts must be adopted and alternative implementation options should be explored – for instance, the efficiency gains of health promotion, disease prevention programmes and community-based care could be examined in more depth.

- The Strategy should be adjusted to ensure the full and effective participation of all stakeholders. This includes the European Parliament, national parliaments, the EPC and SPC, social partners and civil society, as well as joint leadership between the ECOFIN and EPSCO Councils and full involvement of DG SANCO. A positive first step would be todraft guidelines for working with civil society and establish joint meetings between the EPSCO and ECOFIN Councils.

- The Strategy must be coherently and effectively linked to other policy areas, such as the WHO Global Code of Practice regarding health personnel, the Strategy on Nutrition, Overweight and Obesity, the Alcohol Strategy, the HIV/AIDS Strategy and the overarching Health Strategy. It should also ensure connections between health policies and policy in outside areas which affects health, such as industrial policy, the common agriculture policy and budgetary decisions. Such linkage might be facilitated by the creation of a joint Council configuration and Parliament Committee, and more comprehensive use of the health impact assessment, to monitor coherence with other policy goals.

The coming months will also see discussion within EPSCO of the 2015 AGS. In its October meeting, Ministers endorsed a SPC review of recent social policy reforms, which highlighted the importance of ensuring that the 2015 AGS reflect the long-term social priorities of the Europe 2020 Strategy and the Social Investment Package. In its report on the implementation of the European Semester’s 2014 priorities, the Parliament notes that the AGS is not detailed enough and does not provide the means to achieve its objectives. Similarly, an expert panel has found that the CSRs not transparent and are presented in a vague form, without numerical targets and often in coded language. The Parliament suggests that a review, similar to that underway for the Europe 2020 Strategy, should be conducted for the Semester. We urge the EPSCO Council to take these issues and suggestions into account during its debate.

On behalf of the public health community, I wish you a fruitful discussion and offer you the full support of civil society.

Yours Sincerely,

Peggy Maguire EPHA President


[Letter: EPHA President] Upcoming meeting of the EPSCO Council – Europe 2020 and the AGS


Last modified on November 28 2014.