Dobesedni zapisi razprav

Četrtek, 4. julij 2013 - Strasbourg

9. Vpliv krize na dostop ranljivih skupin do oskrbe (razprava)

  Przewodniczący. − Kolejnym punktem porządku dnia jest sprawozdanie sporządzone przez Jean Lambert w imieniu Komisji Zatrudnienia i Spraw Socjalnych w sprawie wpływu kryzysu na dostęp słabszych grup społecznych do opieki (2013/2044(INI)) (A7-0221/2013)

  Jean Lambert, rapporteur. − Mr President, I want to start by warmly thanking colleagues from the different political groups who have worked on this report with me in an extremely constructive atmosphere. I also want to thank the many individuals and organisations – whether professional associations, non-governmental organisations or voluntary bodies – that have provided their direct experience and evidence about what is happening on the ground at the moment in our Member States to those who are particularly vulnerable. We have tried to reflect their voices in this report and provide some ways forward.

We take as our starting point the declaration that all human beings are born free, with equal dignity and equal rights, and we believe that it is the responsibility of Member States to promote and guarantee those rights.

We are also saying that the fundamental values of the European Union should be respected even in a crisis situation, and access to care, healthcare and social assistance should be seen as a basic right for all within the European Union.

We know that times are hard in many countries, but we have also heard how political choices are making things harder. We have heard much in this Parliament about the dire situation of young people without employment. Yet some Member States stop health insurance after a certain period of time out of work. It is the European Year of Citizens, yet some Member States are making it more difficult for EU nationals to access healthcare to which they are entitled. The EU has a Roma strategy, yet we still have many examples of prejudice affecting access to healthcare despite the existing EU legislation.

The Parliament welcomed the Commission recommendation on children and the recognition of the need to invest in early years to enhance life chances, yet we are seeing an increasing number of children taken into care linked to family poverty, and others going without basic vaccinations. Rising costs, falling income and cuts in services make it difficult to maintain the preventative services to which our governments have signed up, and we are storing up longer-term problems.

We heard about those providing and receiving care: many of them informal carers, many becoming a vulnerable group in themselves. People with disabilities told us that not only are some places going back to old models of institutional care rather than supporting independent living, but the levels of hate crime against people with disabilities are rising as they are increasingly viewed as burdens. They are not the only groups now experiencing harassment or even violence.

So the list of problems is long, but we also try to look at some solutions. Some are straightforward, such as the provision of accurate and understandable information. Tackling discrimination and extending the legal framework at EU level would also be seen as useful. But we have also called for Member States to carry out social impact assessments on austerity measures and to address the shortfalls. The Commission and Member States, in cooperation with all relevant stakeholders, and that means vulnerable people themselves, should monitor and address – that is the active part in national reform plans – which policies run counter to the EU’s 2020 poverty reduction targets.

We want the Commission to include social safeguards protecting care and social services and social protection systems in agreements with countries in receipt of financial assistance. Many of us find it incredible that that has not already been done.

We want to see support for carers and are asking the Commission to bring forward proposals for a carers’ leave directive. A social dialogue for the care sector could also help raise standards for the workforce.

There are many other proposals in our report and I am sure we will hear those in the debate this morning. Once again, I thank colleagues for their very active input and support in this important issue.

  Johannes Hahn, Member of the Commission. − Mr President, I wish to thank the rapporteur, Ms Lambert, and the shadow rapporteurs for developing this report and for having this debate in plenary. It rightly draws the attention of policy makers at all levels – European, national, regional and local levels – to the impact the economic crisis is having on vulnerable groups in society and their access to health and other forms of care.

The Commission shares the view that the social investment approach to health and long-term care is needed. Investing in sustainable health systems and people’s health and reducing inequalities is decisive for economic growth. Investing in prevention and organising early intervention can also prevent much higher costs at a later stage for both the individual and society as a whole.

The Social Investment Package adopted by the Commission in February 2013 outlines concrete measures of how to reorient social policies so they focus on preparing people to confront risks throughout their lives rather than simply repairing the consequences.

The Commission is working together with Member States and stakeholders on the implementation of the Package, including in the areas of health and long-term care. The Package also provides suggestions on how to best use the European Social Fund (ESF) to achieve these goals. In the current situation there are more and more demands on the ESF to support Member States in helping their people and particularly the most vulnerable ones.

Therefore it is important that the ESF receives the appropriate share of cohesion policy resources in each Member State. The Commission further welcomes the agreement that was reached to allow Member States that so wish to increase their allocation to the European programme for the most deprived up to a total of EUR 3.5 billion.

In the framework of the European Semester the Commission highlighted the importance of access to and the quality of services. It called for broad access to affordable and high-quality services, such as social and health services, child care, housing and energy supply. The annual growth survey also called for ensuring the cost effectiveness and sustainability of healthcare services by assessing their performance against the twin aim of a more efficient use of public resources and access to high quality health care.

The Commission welcomes the strong emphasis the report puts on the role of informal carers and the toll care duties often take on their professional and private lives. The Commission is working with Member States on improving the quality of long-term care in the context of the Social Protection Committee. A report on this issue will be available early in 2014.

One further avenue to ensure access to care for vulnerable groups is the completion of the legal framework for protection against discrimination at EU level by adopting the directive based on Article 19 of the Treaty on the Functioning of the European Union and monitoring transposition and application.

Discrimination on grounds of religion, disability, age and sexual orientation is unacceptable in European societies not only in the labour market but also in access to goods and services. It undermines the achievements of the Europe 2020 targets, in particular the attainment of a high level of employment and poverty reduction, and may threaten European values such as social cohesion and solidarity.

To conclude, I will just reiterate the Commission’s commitment to work along many of the lines set out in the report. This is demonstrated by the initiatives we have taken to maintain and improve access to care services for persons in vulnerable situations.

  Inês Cristina Zuber, relatora de parecer da Comissão dos Direitos da Mulher e da Igualdade de Oportunidades. − Senhor Presidente, o parecer da Comissão FEMM referente ao relatório sobre o impacto da crise no acesso dos grupos vulneráveis aos cuidados de saúde, do qual sou relatora, é bastante claro. Todas as pessoas têm o direito à saúde, independentemente da sua condição económica e social, e a responsabilidade de assegurar este direito cabe aos sistemas de saúde públicos.

O parecer diz ainda que os cortes orçamentais na saúde não resultam apenas da crise, mas sobretudo das medidas de austeridade que supostamente seriam a solução para fazer face à crise, que, pelo contrário, têm resultado num retrocesso no direito das mulheres à proteção na saúde.

Assim, a Comissão recomenda vivamente que seja contrariada a tendência dos cortes orçamentais nos sistemas de saúde públicos, recomenda à Comissão FEMM que, em sentido inverso, se invistam nestes sistemas para que, no que se refere às questões das mulheres, se combatam as desigualdades entre homens e mulheres no domínio da saúde, se combatam os principais problemas de saúde pública que as mulheres enfrentam, se garanta o direito à saúde sexual e reprodutiva, se garantam serviços de saúde para as mulheres vítimas de violência e cuidados de saúde para os bebés.

A Comissão FEMM recomenda ainda que se reforcem os serviços de saúde no que diz respeito aos cuidados primários e que seja garantido o direito universal ao acompanhamento médico periódico. Infelizmente, as políticas da União Europeia, nomeadamente as políticas de consolidação orçamental, têm significado totalmente o contrário do que está plasmado neste parecer e neste relatório e essa é a face real da União Europeia.

  Heinz K. Becker, im Namen der PPE-Fraktion. – Herr Präsident, Herr Kommissar Hahn, werte Kolleginnen und Kollegen! Heute beschließen wir im Europäischen Parlament nicht mehr und nicht weniger als einen verbesserten Zugang zu Gesundheit, zu Medizin, zur Fürsorge und Pflegebetreuung schutzbedürftiger Menschen, von denen es in Europa nicht wenige gibt. Zugleich stärken wir aber auch das europäische Sozialmodell, das weltweit führende, mit Abstand beste. Als Schattenberichterstatter danke ich ganz herzlich der Berichterstatterin Lambert für die professionelle Zusammenarbeit. Auch der Kommission ist zu danken, da sie in der Krise erkannt hat, dass Handeln notwendig ist und Initiative ergriffen werden muss. Gerade in dieser Krise haben wir dazu im Parlament eine Fülle wichtiger und wertvoller zusätzlicher Inputs geliefert, Mechanismen eingebaut, von denen ich einzelne, für die Zukunft wichtige hervorheben will.

Das Europäische Semester wird sich in Zukunft dieser Zugänglichkeit und der Qualität der Pflegedienste deutlich widmen müssen. Prävention und lifelong healthy aging – um es auf Deutsch auszudrücken – sind von der Schule über den Arbeitsplatz bis in den Ruhestand fix zu implementieren. Der Leistung Familienangehöriger in der Pflege – wie wir wissen, vorwiegend Frauen, Mütter, Töchter – ist im Familienbereich entsprechender Stellenwert beizumessen, und es müssen ihnen Rahmenbedingungen angeboten werden, die Pflegeurlaub und ähnliche entlastende Methoden umfassen. Ich bin stolz zu sagen, dass gerade heute im österreichischen Parlament eine Neuregelung und ein Ausbau der Pflegekarenz und der Pflegeteilzeit beschlossen werden.

Die Kommission ist aufzufordern, diese Rahmenbedingungen für Pflegeurlaube zu entwickeln. Es ist eine Initiative, die umzusetzen ist. Neue Technologien wie die Telemedizin sind entsprechend wichtig, ebenso wie Qualifikation und beste Ausbildung, die zum Standard werden müssen. Es ist eine riesige Jobchance für die junge Generation.

Ich möchte generell abschließend feststellen, dass das Benchmarking für europäische Mitgliedstaaten verpflichtend werden muss und endlich der Europäische Rat seine Blockierung der Diskriminierungsrichtlinie aufgeben muss. Das sind wir den Menschen schuldig, insbesondere den schutzbedürftigen.

  Birgit Sippel, im Namen der S&D-Fraktion. – Herr Präsident! Vielen Dank vor allem auch an die Berichterstatterin. Ich hoffe wirklich auf eine breite Zustimmung für diesen Bericht, aber im Grunde genommen ist es ein Skandal, dass wir einen solchen Bericht überhaupt vorlegen müssen. Das Bild Europas war lange Zeit sehr positiv: relativer Wohlstand, solide soziale Sicherungssysteme, die allen Bürgerinnen und Bürgern Zugang unter anderem zu Pflege und medizinischer Versorgung sicherten. Doch dieses Bild bekommt deutliche Risse! Und das in besonderer Weise in den Programmländern, aber nicht nur dort!

Die massive Zunahme von Jugendarbeitslosigkeit, Kürzung von Renten und Sozialleistungen einerseits sowie erhöhte Zuzahlungen zu Medikamenten und Zugangsgebühren für die Gesundheitsversorgung andererseits zeigen Folgen. Mitten in Europa steigt die Zahl von Menschen, denen bei Gesundheitsversorgung und Pflege der Zugang zu Leistungen massiv erschwert wird. Besonders betroffen sind ältere Menschen, Kinder aus einkommensschwachen Haushalten, Arbeitslose, Migranten und Menschen mit Behinderungen. Und es ist ein Skandal, dass mitten in Europa Menschen für ihre Medikamente betteln oder aus Armut ganz auf eine medizinische Versorgung verzichten müssen.

Allzu lange haben wir uns infolge der Krise auf fiskalische Fragen konzentriert und die sozialen Auswirkungen, die gesundheitlichen Folgen sowie auch daraus resultierende langfristige Kosten ignoriert. Wir können nicht länger zusehen, wie wir gerade eine ganze Generation junger Menschen verlieren und grundlegende soziale Dienstleistungen wie medizinische Versorgung auf dem Altar einer rigiden Kürzungspolitik geopfert werden. Wir brauchen ganz generell eine verstärkte soziale Folgenabschätzung und eine stärkere Beachtung sozialer Kriterien bei der Evaluierung öffentlicher Haushalte. Wir benötigen ganz konkret dringend Investitionen in Arbeit und Ausbildung – auch im Bereich der Gesundheitsberufe. Wir brauchen hier und in allen anderen Bereichen faire Arbeitsbedingungen und eine Stärkung der sozialen Sicherungssysteme.

Das demokratische und soziale Europa ist die Zukunft – auch für unsere Bürgerinnen und Bürger! Doch wir müssen sie gestalten, und das nicht irgendwann, sondern ganz genau jetzt!

  Marian Harkin, on behalf of the ALDE Group. – Mr President, first of all I want to thank the rapporteur for her important and comprehensive report. I think it is important because, in the middle of all the debate about austerity, about six-packs and two-packs, ESM and EFSF, sometimes we forget about real people, about ordinary people and how they are living with the impact of the current crisis. Some of those people are being asked to pay an unacceptably high price and that unacceptably high price is for them, their children and their elderly parents.

In some countries there is inadequate care provision; sometimes, there is virtually none. That is the reality of people’s lives and while we continue to debate and speak of austerity policies, we often forget, or at least we seem to accept, that some people suffer. The question is: are we prepared to let vulnerable people wait and wait, to be denied access to care. The answer to that is ‘yes’, because it is happening. In some countries, such as Greece, systems have broken down. In other countries, like my own – Ireland – the health system is severely stretched. It is fracturing in places and some people are paying a very high price.

Just last Saturday I spent one hour with the carers’ representative from my own region. She is extremely concerned about the mental and physical health of family carers and she told me that, in the region, not since January has one care package been approved. Not even one. That does not mean that people’s lives are immediately threatened, but it does mean two things. It means, first of all, that those who need care simply do not get it. They lose their dignity, and their quality of life is severely compromised, particularly for those with mobility or disability issues. They lose their independence and they lose any choice or control over their own lives.

Just imagine if that happened to us. How would we deal with that? And then the informal carers that the Commissioner spoke of are under unbearable pressure, stretched beyond limits with little or no assistance, no respite and real evidence of serious impacts on mental and physical health. As Jean said in her report, we need to carry out assessments of the social impact of austerity measures and how they affect people’s lives and we need to stop focusing entirely on fiscal stability and also look at access and quality of care.

  Ana Miranda, em nome do Grupo Verts/ALE. – Senhor Presidente, parabéns à relatora que apresenta um problema sério: salvar os serviços públicos como a saúde e a assistência social. A interferência da troica nos orçamentos nacionais, assim como as medidas antissociais e de austeridade de alguns Estados-Membros, provocam um impacto social direto com consequências de pobreza e de exclusão social. Estes serviços são fundamentais, tendo em conta a demografia e as consequências sociais da crise, o duro impacto da crise no acesso dos grupos vulneráveis aos cuidados de saúde é uma evidência das graves políticas de austeridade e cortes sociais que alguns Estados-Membros têm vindo a seguir.

A Europa era um exemplo de modelo social e, agora, a Europa está na via de reduzir o bem-estar social, o acesso aos serviços públicos e à igualdade de oportunidades. Falamos dos cidadãos mais vulneráveis, dos mais carenciados, dos mais excluídos, dos mais pobres, dos que, por causa da crise, se têm tornado ainda mais pobres. Temos quase, Senhor Comissário, 25 % de pessoas na Europa em exclusão de pobreza. Agora, a cara da pessoa vulnerável já não é a mesma que era há uma década, agora, qualquer um pode ser vulnerável: ao perder o emprego, ao perder a casa, ao ter um salário baixo, ao ser jovem ou ao ser velho, qualquer grupo pode ser cronicamente pobre.

Assistimos, sem qualquer dúvida, à emergência de um novo grupo de mulheres e homens vulneráveis, aos novos necessitados. Os serviços públicos têm, pois, uma grande importância para as nossas vidas e retalhá-los é uma evidência de que a atual construção europeia vai contra os direitos humanos essenciais, preferindo retalhar serviços básicos em vez de os apoiar. Com a desculpa da crise, muitos Estados-Membros consolidaram a privatização da saúde, fomentando dois tipos de saúde, uma para os ricos e outra para os pobres, reduziram serviços, limitaram o acesso público de certos grupos aos cuidados de saúde e ao reembolso de certos tratamentos, de medicamentos, de próteses, de alimentos essenciais, ao reembolso de programas em ambulâncias, e aos serviços sociais, como os da dependência.

Alguns Estados-Membros também criaram barreiras através das regras da segurança social. Tome-se como exemplo os casos em que um seguro de saúde cessa após um período de desemprego ou em que os sistemas recusam o acesso de certos grupos, tais como os imigrantes sem documentos, a cuidados primários urgentes, como sucede em Espanha. Ou ainda os casos em que os sistemas que apenas consideram trabalhadores a tempo inteiro em detrimento dos trabalhadores a tempo parcial ou com atividade ocasional. As mulheres também, sobretudo as mulheres de minorias étnicas e mulheres migrantes, encontram-se particularmente desfavorecidas.

Alguns Estados-Membros estão a modificar ou a reformar os seus sistemas de segurança social, as pessoas sem-abrigo ou em alojamentos a curto prazo estão a crescer em alguns Estados-Membros, o que, em muitos casos, compromete a continuidade dos serviços sociais. O aumento dos custos de cofinanciamento e das receitas estão a impedir estas pessoas de procurarem os cuidados numa fase inicial, levando à incidência de posteriores cuidados de saúde mais caros e urgentes. A vergonha e o estigma na procura de cuidados de certas doenças, como a SIDA ou mesmo o cancro, provocam também a redução de serviços. Também os cortes salariais decorrentes do abandono do apoio que resultaram, por exemplo, no encerramento de hospitais de unidades básicas, como sucedeu na Galiza, o meu país, ou o caso de trabalhadores e trabalhadoras da saúde que emigram, como as enfermeiras espanholas que vão para o Reino Unido ou para a Alemanha. Exemplos de cortes em investimentos como sucedeu no meu país, onde 650 mil galegos e galegas estão em situação de exclusão, onde há 17 mil lares onde não entra um euro e onde se regista 50 % de desemprego juvenil. Por favor, reajam a este problema tão grave.

  Milan Cabrnoch, za skupinu ECR. – Pane předsedající, děkuji paní zpravodajce za vypracování zprávy. Sdílím východiska paní zpravodajky, že obecně se přístup ke zdravotní péči zhoršuje, a to především nebo mimo jiné v oblasti zranitelných skupin: mladých, seniorů, chudých či přistěhovalců. Sdílím také obavy, že situace se nebude zlepšovat. Nesouhlasím však s navrhovaným řešením.

Evropská unie nemá žádnou odpovědnost za zdravotnictví v jednotlivých členských zemích, a proto by měla podporovat členské země v provedení reforem, podporovat je především ve zlepšení hospodářské situace, a nikoli je úkolovat. Pokud prostředky nevytvoříme, tak je také nebudeme moci přerozdělovat, ani ve prospěch zranitelných, ani ve prospěch nikoho jiného.

Příčiny jsou hospodářské, příčiny jsou také ve struktuře poskytování zdravotní péče. Naše populace stárne a členské země na to musí reagovat a v mnoha zemích ještě nebyly provedeny reformy. Řešení není v tom, že vyhlásíme deklaratorně práva občanů, není v tom, že zakážeme zemím škrtat a nutit je do dalšího zadlužování, ani je lépe monitorovat či draftovat doporučení a dávat jim domácí úkoly. Řešení leží v ekonomické prosperitě a v reformách zdravotních systémů.

  Patrick Le Hyaric, au nom du groupe GUE/NGL. – Monsieur le Président, je veux d'abord me féliciter du rapport de Mme Jean Lambert. Elle a raison de montrer à quel point la politique d'austérité dégrade dangereusement l'accès aux soins, particulièrement pour les citoyens les plus fragiles. On ne peut aussi que se féliciter du consensus qu'il va y avoir autour de ce rapport.

Mais dans ces conditions, il nous faudrait pousser la logique jusqu'au bout, et demander ensemble l'arrêt du démantèlement des droits sociaux et humains dans chacun de nos pays, l'arrêt de l'application du two-pack et du traité budgétaire: ils organisent cette austérité, qui constitue un anti-humanisme. Il aurait fallu tenir bon sur le budget européen, et non pas voter sa diminution, comme cela a été fait, afin d'obtenir les sommes indispensables pour le Fonds européen d'aide aux plus démunis.

On ne peut voter des textes qui font mal aux gens et, ensuite, produire ici des rapports ou faire de belles déclarations pour constater le mal. Il faut cesser de considérer la santé comme une marchandise et donc l'exclure du cadre de la concurrence et du débat sur le marché transatlantique. La santé devrait devenir, pour le Parlement européen, un bien commun à défendre plus que jamais.

  Mara Bizzotto, a nome del gruppo EFD. – Signor Presidente, onorevoli colleghi, 27 milioni di disoccupati, soprattutto giovani, 120 milioni di cittadini a rischio povertà, non sto parlando di una situazione di un paese lontano colpito da chissà quale e imprevista catastrofe, ma dell'Europa del 2013.

Colleghi, mi unisco a voi nel chiedere all'Unione nuove misure per favorire l'assistenza sanitaria e sociale ai gruppi vulnerabili. Solo se stabiliamo oggi – senza se e senza ma e senza quel falso buonismo che troppo spesso c'è qui dentro – che a essere vulnerabili in Europa sono prima di tutto gli europei; sono i cittadini dei nostri paesi membri, quelli costretti a emigrare per cercare lavoro, sono le famiglie europee che dopo aver versato per anni i contributi allo Stato sono rimaste senza assistenza e sono costrette, in casi estremi, sempre più spesso purtroppo, a cercare cibo nei rifiuti oppure a rivolgersi alla Caritas per aver cibo o altri aiuti.

Consiglierei a qualche burocrate di Bruxelles o a qualche parlamentare magari di uscire dai propri uffici e andare nelle nostre città e vedrebbe purtroppo anche questo. Sono almeno quattro milioni gli italiani tra i 40 e i 60 anni che pur avendo un lavoro vivono di stenti, senza potersi permettere un pasto decente, un tetto sulla testa.

Davanti a questa emergenza umanitaria smettiamola di perderci nella retorica sulle minoranze, sui rom, sui clandestini e soprattutto smettiamola di chiedere a chi sta male – i nostri cittadini – di stare peggio. Prima di stendere fiumi di parole sull'importanza dell'inclusione, pensiamo alla nostra gente che ha lavorato una vita e che oggi non riesce ad arrivare alla fine del mese.

  Patricia van der Kammen (NI). - Voorzitter, volgens dit verslag over de toegang tot zorg voor kwetsbare groepen moet de EU zich voortaan gaan bemoeien met het gezondheidszorgbeleid van de lidstaten. Zo zou volgens de rapporteur in het Europees semester ook rekening moeten worden gehouden met zaken als toegankelijkheid en kwaliteit van zorgdiensten.

Veel gekker moet het niet worden! Het verslag pleit zelfs voor gratis zorg voor kwetsbare bevolkingsgroepen. Voorzitter, grátis bestaat niet, want iemand moet immers de rekening betalen. Dit verslag is alweer een voorbeeld van de vreselijke eurofiele drang tot alomvattende EU-bemoeienis. In Nederland hebben we prima sociale en medische voorzieningen die voor elke burger toegankelijk zijn. EU-bemoeienis zal er enkel toe leiden dat landen die hun zaken op orde hebben de portemonnee mogen trekken om bij te dragen aan landen die hun zaken niet op orde hebben. Het socialistische EU-beleid beloont keer op keer inefficiency en gebrek aan organisatie.

Voorzitter, laat heel duidelijk zijn dat gezondheidszorgbeleid en socialezekerheidsbeleid nationale aangelegenheden zijn. En laat nog duidelijker zijn dat dat wat de PVV betreft ook zo moet blijven!

  Philippe Boulland (PPE). - Monsieur le Président, chers collègues, je tiens à remercier la rapporteure pour son excellent travail.

Nous avons le devoir, nous politiques, d'enrayer la spirale infernale de la crise. Des concitoyens qui perdent leur emploi, qui vivent au jour le jour l'austérité vont forcément réduire des dépenses jugées non essentielles à leurs yeux, et ceci peut malheureusement concerner les soins de santé.

Notre responsabilité est de penser sur le moyen et le long terme. Nous ne pouvons pas accepter que ces patients potentiels ne puissent accéder à un système de soins adéquat, ni que des chômeurs en fin de droit perdent toute assurance maladie. C'est tout un modèle de société construit sur la solidarité, via nos systèmes de sécurité sociale, qui risquerait de s'effondrer et notre Europe sociale, d'en pâtir.

Moins on fait de préventif, plus on fera de curatif et plus on fera appel aux services d'aide à la personne, qui sont déjà confrontés à une forte demande. Faute de moyens financiers, faute d'allégements administratifs et fiscaux pour les services sociaux d'intérêt généraux, faute de reconnaissance professionnelle, ces services d'aide à la personne ne peuvent pas se développer en nombre suffisant.

Certes, les États membres sont sollicités de toute part pour réaliser des investissements dans les domaines stratégiques: soutenir les PME, relancer la croissance. Mais rappelons-nous que nous évoluons dans un modèle d'économie sociale de marché et que toute mesure économique a un impact social qui doit être mesuré. C'est pourquoi il faut, en matière d'accès aux soins, assurer des formations adaptées et continues pour les professionnels de santé, développer des structures de consultation médico-sociales et accentuer les investissements dans la télémédecine pour pouvoir soigner les personnes situées dans des zones géographiquement éloignées ou pour pallier les déserts médicaux qui se propagent partout en Europe.

Je ne veux pas qu'un jour, on puisse accuser le Parlement de non-assistance à Europe en danger.

  Edite Estrela (S&D). - As crises não têm o mesmo impacto em todas as pessoas. As principais vítimas são os mais desfavorecidos: as crianças, os idosos, as pessoas com deficiência. Os cortes nos serviços sociais e de saúde já se fazem sentir em muitos Estados-Membros. Há doentes, sobretudo idosos, que não têm acesso à medicação.

Por outro lado, alguns Estados-Membros têm complexos procedimentos de acesso à segurança social, o que impede algumas pessoas de receberem aquilo a que têm direito e contribui para o aumento da pobreza e da doença nos grupos mais vulneráveis.

Os cuidados de saúde para pessoas com necessidades específicas encontram-se igualmente ameaçados. As medidas de redução de custos, como a introdução de taxas moderadoras de saúde pagas antecipadamente, o aumento das despesas não reembolsáveis ou a exclusão de grupos vulneráveis, como os migrantes irregulares, do acesso aos cuidados de saúde, não foram totalmente avaliadas quanto às suas consequências. Não se pode cortar no essencial e a saúde é essencial.

  Niccolò Rinaldi (ALDE). - Signor Presidente, onorevoli colleghi, l'Europa non ha, come sappiamo, una competenza diretta nell'assistenza sociale e nell'assistenza medica, però noi non possiamo nasconderci dietro questo "mantra" delle competenze degli Stati membri.

Certamente, c'è un fondamento legale in questo argomento, ma non giustifica l'alterazione di quella che alla fine diventa la stessa identità europea che è un'unione basata sulla solidarietà. Assistenza e assistenza medica vuol dire anche ponte tra chi ha bisogno e tra chi può aiutare e che include, naturalmente, le responsabilità dello Stato. L'Europa avrebbe bisogno di includere forse tra i suoi parametri di convergenza anche un indicatore di qualità dei servizi sociali e dei servizi medici, creando una sorta di porto franco – così nel mio partito lo abbiamo definito – protetto da tagli indiscriminati che garantisca l'accesso ai servizi sanitari.

Ma anche altre cose, la qualità all'educazione, anche attraverso insegnanti di sostegno, aiuto psicologico laddove questo sia necessario, un'attenzione particolare nei confronti della terza età, nei confronti delle popolazioni migranti, la formazione permanente, la prevenzione, la lotta concreta, in particolar modo rispetto a problemi sanitari e sociali per coloro che sono affetti dall'indigenza. Parametri più stringenti a livello europeo che probabilmente potrebbero indurre i governi nazionali a politiche che eliminino i tanti sprechi che ci sono, premiando la qualità.

L'onorevole Jean Lambert come relatrice ha fatto un lavoro, secondo me, eccellente come sempre – sa quello di cui parla, un vademecum di buone pratiche e di cose che si possono fare e non di "wishful thinking", non semplicemente di buoni auspici – che è prezioso tanto per la Commissione quanto per le amministrazioni nazionali. Mi auguro che questa voce possa essere ascoltata per non tagliare in due l'Europa, tra chi ha bisogno e chi non aiuta, perché questa cesura alla fine fa saltare tutto, fa saltare la stessa identità europea.

  Paul Murphy (GUE/NGL). - Mr President, it was Aristotle who said that you can judge a society by the way in which it treats its most vulnerable citizens. What judgment would he pass on Europe today, when you have governments and EU leaders driving austerity policies that condemn the poor, the elderly, minority groups and people with disabilities to poverty and increasing hardship in order to protect the interests of the bankers, the bond holders and big business?

The Irish Government, the star pupil of austerity according to the Commission, has waged war on the most vulnerable people. It has deliberately targeted support and services for people with disabilities and children with learning difficulties. Many here will cry crocodile tears and give out about how unfair all this is, while their parties at home will say there is no alternative: we have to vote for cuts.

We have had enough of this hypocrisy. Austerity is not inevitable. It is not unavoidable. It is a political choice to protect some at the expense of others. I salute those people with disabilities, older people, and other vulnerable groups who have been to the fore in campaigning against austerity right across Europe.

  Jaroslav Paška (EFD). - V každej slušnej civilizovanej spoločnosti je starostlivosť o zraniteľné skupiny obyvateľstva integrálnou súčasťou sociálnej politiky. Väčšina krajín Európskej únie už dlhodobo rozvíja svoje systémy a mechanizmy, ktorými realizuje nevyhnutnú pomoc odkázaným skupinám obyvateľstva.

Zhoršená hospodárska situácia už od roku 2009 generuje väčšiu záťaž na sociálne systémy členských štátov, pretože počet nezamestnaných stále rastie a sústavne narastá aj chudoba obyvateľstva. Preto musíme pohotovo zareagovať na tento nepriaznivý trend a hľadať ďalšie nové možnosti ako pomôcť odkázaným skupinám zabezpečiť si aspoň elementárne potreby pre dôstojný život.

Jednou zo základných potrieb každého človeka je prístup ku každodennému stravovaniu. A myslím si, že práve v oblasti potravinovej politiky máme v Únii také rezervy, ktoré by sme mohli v dnešných ťažkých časoch v záujme zlepšenia pomoci odkázaným skupinám účinne mobilizovať.

Európski poľnohospodári sú schopní vyprodukovať dostatočné množstvo potravín pre všetkých obyvateľov Únie. Naši odkázaní spoluobčania však často nemajú dosť peňazí ani na to, aby si obstarali potrebnú stravu. Európska komisia však poskytuje poľnohospodárom dotácie na to, aby len udržiavali pôdu a negenerovali nadprodukciu potravín.

Možno keby sme miesto týchto dotácií dokázali od poľnohospodárov takúto nadprodukciu potravín vykúpiť a za symbolické ceny ju odovzdať charitatívnym a sociálnym inštitúciám či zdravotníckym zariadeniam, vytvorili by sme mechanizmus, ktorým by sme dokázali eliminovať ohrozenie populácie podvýživou či hladom.

  Regina Bastos (PPE). - Senhor Presidente, Senhor Comissário e Colegas, louvo o trabalho da relatora e dos relatores-sombra, particularmente do meu grupo político. Todos sabemos que a crise económica que vivemos tem graves consequências sociais. O impacto na saúde dos europeus é uma dessas consequências. Temos a responsabilidade de acabar com esta espiral de aumento do desemprego e da pobreza que dificulta o acesso aos serviços de saúde e que leva muitos a não conseguir comprar todos os medicamentos de que precisam e a aceder a cuidados médicos. É preciso evitar que as medidas de austeridade, que reduzem o orçamento destinado aos sistemas públicos de saúde, contribuam também para acentuar as desigualdades no acesso aos cuidados de saúde e que a pessoas mais afetadas sejam as mais carenciadas e frágeis, justamente aquelas que merecem maior e melhor proteção.

Qualquer discriminação em razão da idade, da orientação sexual ou da raça é inaceitável. É imperioso evitar a deterioração dos serviços de saúde nos Estados-Membros e garantir que não se desinvista nos setores sociais e da saúde.

O Fundo Social Europeu, como disse o Senhor Comissário, é um instrumento importante para esse efeito. A proteção e a promoção da saúde devem assim continuar a ser uma prioridade para os Estados-Membros. A qualidade, a longevidade e a dignidade da vida humana assim o exige.

  Emer Costello (S&D). - Mr President, first of all, I want to commend the rapporteur for the excellent work that has been done on this report. There is no doubt that the crisis has had a disproportionate impact on the most vulnerable of our society, the elderly, children living in poverty, people with a disability and migrants. Indeed, the crisis is forcing more and more people into the margins and making them more vulnerable. In that respect, I welcome the increase in the fund for European aid for the most deprived. I will be able to deal with that as rapporteur for that report.

The health and social care sector is also a major employer. We need to remember that there are currently nearly three million jobs in this sector and Cedefop reckon that there will be seven million by 2020. We need to ensure that this is decent work. I welcome very much what the Commissioner has said about social investment, but I believe that we need to go further. President Barroso’s announcement yesterday in relation to the partial thawing of a restrictive approach to Member States’ public investment was welcome, but I would like to have reassurance that this will incorporate care services that are co-funded by the ESF. I think it is important that we implement the recommendations of this report so that we can work towards achieving the EU 2020 targets.

  Kartika Tamara Liotard (GUE/NGL). - Mevrouw Lambert doet heel goede suggesties om de zorg voor kwetsbare groepen veilig te stellen en ik steun haar dan ook. We moeten echter niet voorbijgaan aan de échte oorzaak van het feit dat steeds meer mensen geen geld hebben voor de dokter. De rapporteur noemt ouderen een kwetsbare groep en dat klopt. Ouderen worden kwetsbaar als hun bejaardentehuis wordt wegbezuinigd, als de AOW wordt gekort en als je pensioen in gevaar komt door niet-legitieme maatregelen van de Europese Unie.

Maar ook andere groepen worden kwetsbaar. Verhoog mensen hun huur, neem hen hun vastearbeidscontract af, laat ze lange reizen maken voor zorgbehandelingen, ja dan worden mensen kwetsbaar. Brussel stuurt daar doelbewust op aan. Het is daarom naïef om juist de Europese Commissie om aanbevelingen te vragen om deze kwetsbare groepen te beschermen. De Commissie heeft die gevolgen zelf veroorzaakt. Het is aan de EU om een stapje terug te doen in deze crisis en de lidstaten financiële ruimte te laten, zeker als het gaat om basisbehoeften zoals zorg.

  Claudio Morganti (EFD). - Signor Presidente, onorevoli colleghi, non possiamo negare che l'Europa abbia per fortuna un livello assistenziale medio piuttosto elevato, soprattutto se paragonato agli altri paesi come ad esempio gli Stati Uniti.

Non si può tuttavia rischiare di perdere il livello raggiunto a causa della crisi economica in corso, si può tagliare in molti ambiti, ma salute e assistenza non vanno assolutamente toccate. Nella relazione si fa riferimento al progetto di vita indipendente per persone disabili, è una grande opportunità che può consentire loro di vivere in maniera migliore sentendo meno il peso della loro condizione.

Un paio di settimane fa, diversi disabili toscani hanno occupato la sede della regione Toscana a Firenze per chiedere che non venissero tagliati i fondi a sostegno di questi progetti. La situazione sembra essersi risolta per il meglio, forse con le solite promesse da marinaio, ma non è ammissibile dover costantemente ricorrere a simili iniziative per ottenere quello che dovrebbe essere un diritto naturale. La crisi non può incidere sulla vita delle persone che già soffrono maggiormente, questo sembrerebbe logico ma la realtà è piuttosto diversa.

Nel testo si insiste molto sulla necessità di garantire l'accesso alle cure a particolari categorie, tipo i rom e gli immigrati, io dico che purtroppo anche molti cittadini italiani di quello che una volta si chiamava il ceto medio sono in estrema difficoltà ed è anche e soprattutto a loro che dobbiamo guardare, poiché la crisi sta mettendo in ginocchio un'intera fascia di popolazione che rischia di non poter più ricorrere a determinate prestazioni sanitarie che dovrebbero invece essere loro garantite. Presidente, prima la nostra gente e poi tutti gli altri.

  Sari Essayah (PPE). - Arvoisa puhemies, hyvä komission jäsen, valiokunnan mietintö nostaa esille tärkeän huolen talouskriisin vaikutuksista heikossa asemassa olevien ryhmien hoidon saantiin. Mietinnössä olisi mielestäni voitu ehkä vielä enemmän korostaa sitä, että toimivan sosiaali- ja terveydenhoitojärjestelmän tulee perustua jokaisen kansalaisen yhdenvertaiseen mahdollisuuteen saada hoivaa, eli niin sanottuun universalismin periaatteeseen, joka on muun muassa pohjoismaisten sosiaaliturvajärjestelmien pohjana.

Vakuutuspohjainen järjestelmä, joka perustuu työsuhteeseen ja siitä johdettuihin sosiaaliturvaoikeuksiin, on hyvin hyvin haavoittuvainen järjestelmä talouskriisin oloissa, niin kuin olemme nähneet monissa maissa. Minimietuudet takaava universaali järjestelmä vaatii toimiakseen hyvässä kunnossa olevan julkisen talouden ja myöskin sen tukemiseksi toimivan verotuksen.

Monien maiden tämänhetkisten ongelmien taustalla on se, että verotusjärjestelmä ei toimi, progressio puuttuu, veroaste on liian matala eivätkä monet ihmisryhmät osallistu verojen maksuun. Siksi tarvitaan näitä isoja rakenteellisia uudistuksia jäsenvaltioissa, jotta sosiaali- ja terveydenhuoltojärjestelmät voidaan rakentaa jatkossa kestävälle pohjalle. Mielestäni on sen tähden lyhytnäköistä vastustaa rakenteellisia uudistuksia, mutta uudistukset on toki tehtävä järkevästi heikommassa asemassa olevien asemaa puolustaen. Se, mihin yhteiskunnassa panostetaan ja mistä puolestaan leikataan, se on aina arvokysymys.

  Andrea Cozzolino (S&D). - Signor Presidente, onorevoli colleghi, signor Commissario, il paradosso di questa nostra discussione è terribile.

Noi siamo qui a discutere degli effetti e delle conseguenze delle nostre scelte, delle nostre politiche. Se cresce l'area della vulnerabilità, che interessa l'intero ciclo della vita, cioè bambini, donne, giovani, immigrati, terza età, è perché in questi anni noi abbiamo perseguito con determinazione una politica cieca di austerità, che ha tagliato i nostri bilanci pubblici e dunque ha messo in discussione un intero modello di welfare e di benessere sociale fino al punto che in molti paesi dell'Europa si sta privatizzando ciò che era pubblico ormai da 10, 15, 20, 30 anni e che faceva degli investimenti sociali la sostanza e l'identità della politica europea.

Che fare allora? Innanzitutto rovesciare queste politiche – non ce la facciamo con politiche di contenimento dei conti pubblici – e riprendere una politica di investimenti pubblici che, appunto, riduce l'area del rischio e mette in campo politiche di prevenzione. Contemporaneamente – ed è l'ultima osservazione – proviamo ad utilizzare la politica di coesione attraverso anche gli investimenti territoriali integrati per tenere insieme Fondo sociale e FESR, quartieri, case e anche politiche attive di assistenza.

  Edit Bauer (PPE). - Jean Lambert jelentése a válság következményeivel küzdő, kiszolgáltatott csoportok gondjaira hívja fel a figyelmet a tőle megszokott alapossággal és józansággal. A Eurofund ügynökség kutatási eredményei azt mutatják, hogy a válság következtében a szegények még szegényebbé válnak, s nem lehet kétségünk afelől sem, hogy a leginkább érintett és legkiszolgáltatottabb csoport a gyermekeké.

A gyermekszegénység főleg a korai stádiumban súlyos következménnyel jár. Az alultápláltság, a kellő egészségügyi ellátás – például az oltások hiánya – olyan fejlődésbeli rendellenességet okozhat, aminek a későbbi kezelése vagy korrigálása sokkal nagyobb terhet ró a társadalomra. Rég elfeledett betegségek, mint például a tuberkulózis jelennek meg újra, mert gyakran az oltások nem ingyenesek, vagy a gyógyításuk drága gyógyszereket igényel. Az óvodáskorban például minden év óvodai oktatás 10%-kal javítja a gyerek esélyét, hogy később érteni fogja, amit olvas, és enélkül nyilván a lifelong learningről nem beszélhetünk.

Az alapszolgáltatásokhoz való hozzáférést a megszorító intézkedések nem veszélyeztethetik oly mértékben, hogy a közkiadások szempontjából később többszörös terheket jelentsenek. Itt is érvényes, hogy a legolcsóbb megoldás a prevenció, és tény az, hogy az Európai Unió nem tudja ezeket a gondokat megoldani, de az Európai Szociális Alap jó kihasználásával sokat enyhíthetünk a gondokon.

  Jutta Steinruck (S&D). - Herr Präsident! Ist es nicht schlimm? Die Pflege wird zum Sparobjekt der öffentlichen Haushalte, sie wird zur Ware reduziert. Die Folgen sind auf der einen Seite eine Verschlechterung der Arbeitsbedingungen der Pflegekräfte. Da geht es um Anerkennung, um Qualifizierung, um die Rolle der Sozialpartner und auch um tarifvertragliche Vereinbarungen. Dass der Druck auf die Pflegekräfte zunimmt, zeigen uns auch die Statistiken, die sagen: Burn-out steigt an, nicht nur in Deutschland, auch in Griechenland. Auf der anderen Seite haben wir eine Verschlechterung der Fürsorge für die hilfsbedürftigen Menschen.

Die Realität ist doch, wenn wir uns die Demografie anschauen, dass wir mehr und bessere Pflege brauchen. Dazu müssen die nationalen Pflege- und Gesundheitssysteme umgestellt und neu aufgestellt werden. Man muss sich Gedanken über die Finanzierung machen. Wir brauchen mehr Pflegekräfte, wir brauchen bessere Pflegekräfte. Da muss der Staat sich aufstellen. Das ist ein europäisches Problem, das wir angehen können, indem wir uns austauschen, indem wir Best-practice-Beispiele angehen, die dann natürlich auch in der Verantwortung der Mitgliedstaaten umgesetzt werden müssen.

  David Casa (PPE). -

L-iskop ta' dan ir-rapport li għandna quddiemna huwa biex jiġi studjat l-impatt li l-kriżi ħalliet fuq il-gruppi l-aktar vulnerabbli. Dan għandu żewġ dimensjonijiet: l-impatt tal-kriżi per se u l-impatt addizzjonali li rriżulta mir-rispons. Bħalma qalet sew ir-rapporteur Jean Lambert, l-impatti fuq dawn il-gruppi vulnerabbli kien estensiv ħafna. Sfortunatament, ir-realtà li għandna quddiemna hija li s-servizzi soċjali huma b'saħħithom biss daqs l-ekonomija li fuqha huma bbażati. Ghalhekk hemm bżonn bilanċ bejn is-servizzi soċjali adegwati u l-politika ekonomika ta' dixxiplina li tkun sostenibbli.

Naqbel mija fil-mija mal-enfasi li qed issir fuq is-settur tas-saħħa speċjalment l-isforz li qed isir fil-pajjiżi membri biex dawk li jaħdmu fil-qasam tal-kura jkunu aktar rikonoxxuti. Dawk li jieħdu ħsieb lill-qrabathom ħafna drabi jkollhom iħallu x-xogħol tagħhom, parzjalment jew kompletament, u dan għandu jiġi rikonoxxut mill-Istat. Per eżempju, billi l-ħin li jkunu taw jiġi allokat għal fini ta' eleġibilità għal pensjoni u benefiċċji oħra li jixirqilhom. Min stħarriġ li sar, il-kura informali hija mod aktar effiċjenti sabiex jiġi pprovdut servizz, li jkun ta' kwalità ogħla u b'inqas spejjeż. Madankollu ħafna pajjiżi membri m'għandhomx qafas li jkopri lil dawn il-persuni u m'hemmx linji ta' gwida komuni mal-pajjiżi membri kollha.

Kollox ma' kollox allavolja ma nistax inkun favur kull element inkluż f'dan ir-rapport, dan huwa rapport tajjeb ħafna, ibbilanċjat u jien ser nappoġġjah u nixtieq ngħid prosit lir-rapporteur.

  Kinga Göncz (S&D). - Többször foglalkoztunk a válság szociális hatásaival, jelentések készültek a lehetséges megoldásokról. Ezek fő üzenete az volt, hogy az Unió alapvető értékeit válság idején is tiszteletben kell tartanunk, hogy az egészségügyi-szociális ellátást alapjogként kell kezelnünk, hogy külön figyelmet kell fordítanunk a legsérülékenyebb társadalmi csoportokra. Ugyanakkor azt látjuk, hogy minden igyekezetünk ellenére a szegénység kockázatának kitett lakosság aránya nagyon magas, nő az egyenlőtlenség, a kirekesztés, a szegények még inkább elszegényednek. Az egészségügyi és szociális ellátásra fordított keretek csökkentek, romlott az ellátások minősége és az azokhoz való hozzáférés, egyes tagállamokban a legkiszolgáltatottabbak bűnbakként kezelése, kriminalizálása is folyik. A szociális munkát jórészt idősödő emberek, nők, vendégmunkások végzik. Ezúton is kérjük a tagállamokat, hogy javítsák a szociális munka imázsát, támogassák a szociális munka oktatását, a fiatalok toborzását erre a szakmára, és ahelyett, hogy csökkenteni akarnák, inkább használják az Európai Szociális Alap 2014-ben megnyíló pénzügyi lehetőségeit a legszegényebbek társadalmi befogadására.

  Ádám Kósa (PPE). - A Lambert-jelentés helyesen utal arra, hogy a fogyatékossággal élő személyek jogairól szóló ENSZ-egyezmény 19. bekezdése rögzíti a többféle otthoni, intézményi vagy közösségi ellátó, támogató szolgáltatásokhoz való hozzáférést. Az Európai Unió ennek az egyezménynek részese. A jelentés számos pontjában, különösen a 14., 15. és 16. pontjaiban kitér erre részletesen. A Bizottságot ennek alapján arra kérem, hogy gyakoroljon nyomást a tagállamokra annak érdekében, hogy a jelentés alapján az intézményi vagy közösségi ellátásokon a fogyatékossággal élő személyek méltóságának és igényeinek alapján változtassanak, és oldják ezeket meg.

Én tudom, hogy ez a folyamat hosszú és nehéz. Magyarországon két évvel ezelőtt kezdődött el ez a változás és 30 éves intézménykiváltási stratégia született. Az Európai Unió forrásainak felhasználásával elkezdődött a kis létszámú intézmények kiépítése. Sajnos az Európai Unióban kevés jó példa van erre. Én azt szeretném, hogyha az Unió minden tagállama ezt az utat követné, és a fogyatékossággal élő emberek valóban méltó ellátást kaphatnának a jövőben.

ΠΡΟΕΔΡΙΑ: ΑΝΝΥ ΠΟΔΗΜΑΤΑ
Αντιπρόεδρος

  Antigoni Papadopoulou (S&D). - Madam President, I would like to congratulate the rapporteur. Health protection is a right for every citizen. Unfortunately, however, the current economic crisis has had serious repercussions in several fields, including health policies. Budget cuts in social and health policies mean a dramatic deterioration in access to care services, pharmaceuticals, treatment programmes and even to heating and cooling, with severe consequences for citizens’ health. Among the most vulnerable are the poor, the old, marginalised groups including women, jobless young people, migrants and people with disabilities.

Austerity measures, unjust Euro Group decisions and troika failures have hit hard both carers and those receiving care, spreading distress – mostly in Southern Europe, namely Greece, Cyprus, which is my country, Portugal and Spain, but also in Ireland – through high levels of youth unemployment, intolerable pressures on care services and health systems, poverty and malfunctioning of public health and a spreading social crisis. This chaotic situation necessitates emergency action: social impact assessment, effective measures, reforms, funding and an alternative approach for growth, jobs and investment for the benefit of the people.

Παρεμβάσεις με τη διαδικασία "catch the eye"

  Joanna Katarzyna Skrzydlewska (PPE). - Pani Przewodnicząca! Projekt rezolucji, który rozpatrujemy, kieruje naszą uwagę na sytuację tych wszystkich osób, które ze względu na swoje ograniczone możliwości finansowe z przyczyn czysto ekonomicznych nie mogą w pełni korzystać z dostępu do opieki zdrowotnej. Odnosi się to przede wszystkim do tych, którzy z powodu bezdomności czy długotrwałego braku pracy utracili uprawnienia do ubezpieczenia zdrowotnego. Z tego też względu zagrożeni są wykluczeniem społecznym, a ich życiowa sytuacja ciągle się pogarsza. Dlatego dobrze, że Parlament Europejski dostrzega ten istotny problem, daje wyraźny sygnał skierowany do Komisji Europejskiej i rządów państw członkowskich, że kryzys gospodarczy nie może uzasadniać wprowadzenia ograniczeń uniemożliwiających dostęp do publicznej służby zdrowia dla osób trwale bezdomnych czy bezrobotnych.

  Маруся Любчева (S&D). - Г-жо Председател, г-н Комисар, днес е изключително важно да говорим и да правим повече за социалната политика на Европейския съюз, не само заради кризата, а за да осигурим перспектива за европейските граждани, да се борим срещу бедността.

Докладът обръща внимание на много проблеми, на много проблемни групи, бих откроила два съществени.

Първо, ниското заплащане в системите на образованието, здравеопазването и социалните дейности. Нелогично е да говорим за интелигентен растеж, приобщаващ растеж, при положение че тези, от които зависи образователният и здравен статус на населението, самите те са с нисък стандарт.

Второ, една група, на която трябва да се обърне специално внимание, е тази на жените в селските региони. Често те биват изолирани и маргинализирани, лишени са от възможност да участват във формулирането на политиките в областта на селското стопанство, биват изолирани от системите на социално и здравно осигуряване, не получават реален достъп до програми за професионална квалификация и стимулиране на предприемачеството.

Обезлюдяването на селата и окрупняването на селското стопанство довежда селската жена до бедност и безперспективност.

  Danuta Jazłowiecka (PPE). - Pani Przewodnicząca! Stwierdzenie, że obecny kryzys ekonomiczny spowodował ograniczenie dostępności usług opieki, jest truizmem. Oczywistym jest, że kłopoty budżetowe państw członkowskich wymusiły ogromne cięcia w wydatkach w sferze socjalnej. Pytanie, które nurtuje obecnie większość ekonomistów i polityków europejskich, dotyczy jednak tego, czy te cięcia nie były zbyt głębokie. Coraz więcej jest głosów wskazujących, że radykalne ograniczenie wydatków budżetowych pogłębiło jedynie kryzys i doprowadziło do zubożenia społeczeństwa.

Nie ma co ukrywać, że dużą część winy za to przypisuje się Komisji Europejskiej, która w ramach trojki narzucała określone rozwiązania. Nadszedł czas, aby dokonała ona autorefleksji i wyszła z propozycjami naprawy sytuacji. Zgadzam się z Jean Lambert, że warto wykorzystać do tego wnioski z Europejskiego Roku Aktywności Osób Starszych i Solidarności Międzypokoleniowej.

Warto też, aby programy przygotowywane przez Komisję w ramach tzw. europejskiego semestru skupiały się nie tylko na stabilności finansowej, ale brały również pod uwagę długofalowe inwestycje społeczne. Coraz bardziej bowiem widać, że podejmowane działania sanacyjne przynoszą krótkotrwałe oszczędności i niestety wywołują długofalowe problemy. Dzisiejsze zaniedbania w sferze ochrony zdrowia, zabezpieczenia społecznego czy wsparcia słabszych grup społecznych zmuszą kraje członkowskie w przyszłości do jeszcze większych wydatków. Dlatego też wszelkie działania oszczędnościowe muszą być robione rozsądnie i poprzedzone analizą potencjalnych problemów, jakie mogą wywołać w przyszłości.

  Monika Flašíková Beňová (S&D). - Sociálne nerovnosti v európskych regiónoch sa neustále prehlbujú a situácia medzi najzraniteľnejšími skupinami obyvateľov Únie sa zo dňa na deň zhoršuje.

Nič neriešiacimi škrtmi a úspornými opatreniami sme sa dopracovali k stavu, že chudobní sú ešte chudobnejší, zraniteľní ešte zraniteľnejší a mnohí európski občania nemajú prístup k základným službám zdravotnej starostlivosti či k službám sociálnej starostlivosti.

Nízky či chýbajúci príjem spôsobuje, že ľudia nemajú prístup ani len k základným službám, akou je napríklad vykurovanie. To má v súvislosti so zraniteľnou skupinou obyvateľstva, ako sú starší či chorí ľudia, extrémne negatívne následky.

Reakcia Európskej únie na krízu preto musí mať najmä sociálny rozmer. Škrty a úsporné opatrenia vlád dlhodobo a výrazne zhoršujú kvalitu života obyvateľov Európskej únie.

A tak sa pýtam, aké konkrétne účinné opatrenia, ktoré skutočne zlepšili situáciu z dlhodobého hľadiska, sme v poslednej dobe vlastne prijali? Európania sú skeptickí, mnohí žijú na hranici chudoby ďaleko za hranicou ľudskej dôstojnosti, nemajú prístup k liekom, základným službám a dnes už ani k práci.

  Hannu Takkula (ALDE). - Arvoisa puhemies, voidaan sanoa näin, että yhteiskunnan todellinen sivistyksen mitta löytyy sitä kautta, millä tavalla me huolehdimme heikommassa asemassa olevista lähimmäisistämme. Näin ollen voidaan sanoa, että Euroopan unioni tai sen jäsenvaltiot ovat juuri niin vahvoja kuin niiden heikoin lenkki. Tässä suhteessa meillä on kyllä valtava sosiaalinen vastuu huolehtia siitä, että ne heikommassa asemassa olevat lähimmäisemme voivat myöskin saada hyvät palvelut siitä huolimatta, että me elämme tällä hetkellä taloudellisen taantuman aikaa.

Tietenkin tässä jäsenvaltioilla on se ensimmäinen rooli, mutta on toki huolehdittava myöskin siitä, että kun sisämarkkinoilla ollaan, Euroopan unionissa tehdään yhteistä politiikkaa, että jonkunlaisen parhaiden käytäntöjen vaihdon kautta, avoimen koordinaation kautta huolehditaan siitä, että elämässä pärjäämisen edellytykset voivat kaikilla Euroopan unionin kansalaisilla toteutua ja ennen muuta jokaisella Euroopan unionin kansalaisella on mahdollisuus ihmisarvoiseen ja hyvään elämään.

  Ruža Tomašić (ECR). - Željela bih zahvaliti izvjestiteljici radi pokretanja ovog važnog pitanja i pozdravljam priliku rasprave o tome koji je način najbolji za postupanjem sa ranjivim grupama diljem Europske unije. Odredba o krizi važan je socijalni izazov s kojim se suočavaju mnoge zemlje članice Europske unije te jedna od onih odredaba koja se kreirala gotovo većinu ovoga desetljeća.

Dok potuno podupirem mnoge točke ovog izvješća, ne mogu poduprijeti poziv na inicijativu na nivou Europske unije koji bi uz najbolje namjere potencijalno mogao zaobići sposobnost država članica da financiraju i organiziraju odredbu o brizi utemeljenoj na njihovim vlastitim socijalnim potrebama. Važno je naći dobru ravnotežu između vrijednosti koje unapređuje Europska unija te kompetencija država članica.

Nažalost, ovo izvješće sadrži i neke paragrafe za koje vjerujem da bi mogli postaviti opasan presedan pozivom na jednolični koncept u koji se sve zemlje članice moraju uklopiti. EU ima izuzetno važnu ulogu u davanju dodatne vrijednosti područjima u kojima su zemlje članice već odradile svoj posao, što uključuje promicanje olakšavanja razmjene najbolje prakse te koordinaciju političkih inicijativa na način da se poduzmu koraci prema primjerenom funkcioniranju i privođenju kraju jedinstvenog tržišta i promoviranja mobilnosti, sve ono za što u potpunosti vjerujem da će pomoći državama članicama da se razvijaju, kreiraju nova radna mjesta, da na koncu pomognu onima kojima je pomoć najpotrebnija da dobiju priliku za postavljanje i podizanje iz siromaštva.

  Andreas Mölzer (NI). - Frau Präsidentin! Zweieinhalb Millionen Menschen ohne Krankenversicherung, die sich einen Arztbesuch nicht leisten können, Krankenhäuser, denen es an Ärzten und Medikamenten fehlt, Kinder, die nicht geimpft werden – das klingt nach einem Dritte-Welt-Land, tatsächlich jedoch sind das die Zustände im EU-Mitgliedstaat Griechenland! Würden sich nicht so viele Griechen zusammenschließen und Selbsthilfeinitiativen gründen, um Menschen in Not ärztliche Behandlung oder einfach nur Lebensmittel zur Verfügung zu stellen, gäbe es sicher längst eine massive humanitäre Krise. Frisch ausgebildetes medizinisches Personal, etwa für die Altenpflege, welches vor Ort seinen Lebensunterhalt nicht mehr verdienen kann, wandert zunehmend in andere EU-Staaten ab.

Wenn wir schon vom Zugang schutzbedürftiger Gruppen zu medizinischer Versorgung reden, dann sollten wir eben auch an die griechischen Kinder denken. Es ist eine Schande, dass die EU zwar jedem Krisengebiet in der Welt mit Medikamenten unter die Arme greift, dass beinahe jeder Asylwerber medizinische Grundversorgung erhält, dass Brüssel allerdings seinen eigenen Bürgern auf EU-Gebiet in einer schweren Stunde wenig oder zu wenig Hilfe angedeihen lässt. Europäische Solidarität sollte vielleicht weniger für die Bankenrettung instrumentalisiert werden, sondern eher für die Unterstützung und medizinische Versorgung von Kindern.

  Iosif Matula (PPE). - Actuala criză economică a generat constrângeri bugetare în rândul sistemelor de sănătate din Europa. Presiunile financiare au condus la implementarea politicilor de austeritate, subminând, astfel, accesul universal şi calitatea serviciilor, cu precădere pentru persoanele vulnerabile. Doresc să atrag atenţia asupra unei situaţii grave existente în ţara mea, România, cauzată de închiderea, în urmă cu aproape 2 ani, a Centrului de Patologie Neuromusculară „Dr. Radu Horia” din Vâlcele, judeţul Covasna. Ca urmare a desfinţării singurului spital de profil din ţară, persoanele diagnosticate cu dizabilităţi neuromusculare sunt private de îngrijire medicală de specialitate. Acest spital trebuie redeschis urgent. Consider că ajustările bugetelor destinate sănătăţii publice nu trebuie să afecteze categoriile cele mai vulnerabile. Dimpotrivă, este important ca aceste categorii să constituie o prioritate. Se impune o reformă aprofundată în sprijinul sectoarelor serviciilor de sănătate şi de îngrijire, care să fie completată de investiţii publice sporite şi mai eficiente, în vederea satisfacerii nevoilor cetăţenilor, şi, în special, a persoanelor vulnerabile.

  Phil Prendergast (S&D). - Madam President, I would like to thank the rapporteur, Jean Lambert, for her wonderful work on this report, and also Marian Harkin, our own MEP, who works very hard on behalf of carers.

Carers are the forgotten workers, the people who look after their loved ones, seeking to create better value for money by using really limited resources effectively. They want to continue to prioritise service quality and continuity for the most vulnerable and they help to deliver strategic improvements in public policy. Every one euro spent on respite saves five euros in institutional care. Carers in Ireland provide 3.7 million hours a week.

These groups are dependent on financial support from fundraisers and a wide range of charities and local fundraising efforts. So funding for carers should be valued, evaluated, costed and red-circled, with built-in reviews. Carers need a break.

  Petru Constantin Luhan (PPE). - Într-o perioadă în care criza economică şi financiară persistă, se pare că persoanele afectate sunt şi cele vulnerabile. Veniturile acestora au continuat să se deterioreze din acest punct de vedere şi au afectat, în mare măsură, accesul la îngrijire. Consider că aceasta reprezintă o ameninţare majoră pentru această categorie socială şi Comisia Europeană, cât şi guvernele naţionale, trebuie să intre în acţiune şi să implementeze măsuri noi. Combaterea sărăciei nu trebuie să se bazeze doar pe măsuri de austeritate, ci trebuie să se bazeze şi pe o creştere economică, pe ocuparea forţei de muncă, coroborat cu o protecţie socială modernă şi eficientă. Pentru aceasta, trebuie să depunem toate eforturile pentru o mai bună strategie între politicile europene şi naţionale, pentru eliminarea discrepanţelor dintre statele membre şi, nu în ultimul rând, pentru promovarea unor parteneriate durabile la nivel internaţional între instituţiile implicate, atât la nivel european, cât şi la nivel naţional şi regional.

  Antonio López-Istúriz White (PPE). - Señora Presidenta, quisiera simplemente añadir que estas cuestiones a veces la izquierda las utiliza en detrimento de la actividad que están realizando los Gobiernos, por ejemplo el Partido Popular Europeo, en España, donde dedicamos especial interés a las cuestiones sociales, debido también a la crisis que nos ha afectado, y así lo está demostrando mi Gobierno.

Estamos colaborando desde aquí también en cuestiones tan importantes, por ejemplo, la de los niños, que es un sector de la población muy afectado. Estamos proporcionando también ahora las líneas de comunicación europeas, como el teléfono 116, para que los niños puedan expresar todas las cuestiones que están sufriendo en estos momentos. Puede tratarse de maltrato, de secuestros, etc.

Está sucediendo mucho en la Unión Europea; es una población también muy afectada y me gustaría, en esta intervención, pedir que esta cuestión sea abordada realmente como una prioridad, que sé que lo es para la Comisión Europea. También me gustaría que en este Parlamento discutiéramos mucho más sobre ello y aportáramos ese tipo de decisiones.

(Τέλος παρεμβάσεων με τη διαδικασία "catch the eye")

  Johannes Hahn, Mitglied der Kommission. − Frau Präsidentin! Ich möchte meine Gesamtredezeit nicht überschreiten, daher möchte ich eigentlich nur noch einmal meinen Dank für die engagierte Diskussion heute, für den Bericht in Summe, der ganz wichtige Impulse für unsere Arbeit liefern wird, zum Ausdruck bringen.

Ich möchte nochmals in Erinnerung rufen, dass die Bekämpfung der Armut eines der zentralen Ziele der Europa-2020-Strategie ist. Das führt eben dazu, dass auch erhebliche Mittel gerade im Kohäsionsbereich dafür bereitgestellt werden und das eine der thematischen Konzentrationen darstellt. Insofern bin ich überzeugt, dass wir in den nächsten Jahren diesbezüglich signifikante Fortschritte im Interesse unserer Bürgerinnen und Bürger erzielen werden.

  Jean Lambert, rapporteur. − Madam President, my thanks to colleagues who have taken part in today’s discussion. I think we have a great deal of consensus here. I just want to reiterate certain of the points, such as the issue of the social impact assessment of cuts that have been made. I think this is coming through as something which people feel is extremely important. I know that it was said that it was almost as if we were demanding of Member States that they do additional homework that we should not be asking them to do. Well, in my earlier life I was a teacher, so maybe I am used to asking people to do homework, but it is also the fact that our Member States have signed up and made a number of commitments.

It was pointed out that they signed up to the UN Convention on the Rights of People with Disabilities. That carries certain responsibilities and implications with it but, even in terms of the national reform plans, there are certain things there which our Member States have agreed to do and agreed to share, and therefore the issue – whether it is about benchmarking, impact assessment or whatever – is about taking account of what they are doing and looking at how they are going to deal with the effects of that in terms of the anti-poverty targets, in terms also, as many have stressed, of the issues of human dignity and indeed what we consider to be solidarity within the European Union and acceptable standards, which I think is extremely important.

The issue about the growing inequalities is also something that I think we should really be concerned about. We are well aware of what the adverse impacts of health inequalities are for people’s life chances. There is a lot I think that can be done, even if you are not looking at particularly radical reform: at least close the gaps in systems that allow people to fall through them and lose their right to access care – people who were maybe working on temporary contracts or whatever and who therefore do not actually gain the health benefits that they might otherwise have done in full-term contracts. There are things that can be done to reduce the gaps, to reduce the barriers in terms of access to care.

A lot of points have been made, as well, about the role of carers themselves. It is true – we have heard the figures from all of our Member States about what it actually saves public services when people are caring on an informal basis – but that does need to be recognised. People should not be asked to give up their opportunities to work – their own work-life balance, as it were – to provide that ongoing service without some form of recognition. Recognition within the pension system was mentioned, but it is also extremely important in terms of the support and the care of carers.

There is more that can be done as well, we believe, in terms of actually improving the quality, the decent work side, of those who are providing care on a paid basis. Given the future demands that we have seen, we need to address that very rapidly. Yes, there is money there from the Cohesion Fund, not as much as many of us would have liked, but again that was a political choice made by our national governments, and indeed some in Parliament, but we ought to make sure that this money is spent effectively and to the maximum. Thank you again for the debate and we look forward to the follow-up action on this.

  Πρόεδρος. - Η συζήτηση έληξε.

Η ψηφοφορία θα διεξαχθεί σήμερα στις 12.00.

Γραπτές δηλώσεις (άρθρο 149)

  Minodora Cliveti (S&D), în scris. – În mai multe state membre, inegalitățile sunt în continuă creștere din cauza înrăutățirii situației celor mai sărace și mai defavorizate persoane din aceste state. În 2011, aproximativ 24,2 % din populația UE era considerată ca aflându-se în situație de risc de sărăcie sau excluziune socială. Un rol important îl joacă serviciile publice în domenii esențiale pentru bunăstare, inclusiv sănătate, educație, justiție, apă, locuințe, transport și asistență în favoarea copiilor și a persoanelor în vârstă. Comisia și statele membre trebuie să stabilească priorități pentru a elimina carențele și a furniza acces efectiv la servicii medicale pentru grupurile vulnerabile, inclusiv femeile sărace, migranții și romii în ceea ce privește protecția socială în domeniul sănătății, garantând disponibilitatea, accesibilitatea ca preț și calitatea îngrijirilor de sănătate, precum și finanțarea adecvată în toate regiunile geografice. De asemenea, prestarea de servicii mobile este importantă pentru a aduce serviciile la cei care le solicită, în zonele urbane şi rurale. Comisia și statele membre trebuie să stabilească priorități, să reducă diferențele dintre bărbați și femei și să asigure accesul efectiv al femeilor la serviciile de sănătate și planificare familială, precum și să acorde o atenție specială altor grupuri vulnerabile și defavorizate care au nevoie de protecție socială în domeniul sănătății.

  Sergio Gaetano Cofferati (S&D), per iscritto. – È timore diffuso che la crisi che stiamo vivendo in questi anni non abbia ancora dispiegato i suoi effetti più duri. Le politiche fin qui messe in campo si sono rivelate inefficaci nel contrastarne gli effetti sociali più gravi ed, in molti casi, hanno avuto effetti controproducenti portando ad un netto peggioramento le situazioni di maggiore debolezza. Le situazioni di maggiore vulnerabilità sono quelle che hanno visto gli effetti peggiori della crisi perché, ad una situazione di debolezza iniziale, si sono da subito aggiunti gli effetti di tagli lineari a servizi essenziali. Tra questi i servizi sanitari e l´accesso universale alle cure dovrebbero essere considerati come elementi non negoziabili, il cui mantenimento e la cui apertura sono essenziali per ampie fasce della popolazione europea. La via dell´austerità è sbagliata ed economicamente inefficace, ma oltre a questo rischia di acuire ingiustizie e sofferenze; l´Europa, anche e soprattutto in un momento di crisi, deve difendere e rafforzare il suo modello sociale, è infatti questo l´unico modo per definire in maniera equa l´uscita dalla crisi.

  Valdemar Tomaševski (ECR), na piśmie. – Panie Przewodniczący! Nie ulega wątpliwości, że kryzys gospodarczy, który przeżywa Unia Europejska, ma negatywny wpływ na dostęp słabszych grup społecznych do opieki. Niepokojące jest wprowadzanie środków oszczędnościowych, które w sposób bezpośredni lub pośredni dotykają tę grupę osób. Dlatego należałoby przedefiniować priorytety walki z kryzysem tak, aby wymiar społeczny stanowił nieodłączny element działań Unii podejmowanych w reakcji na kryzys.

Na wsparcie zasługuje szczególnie sektor usług opiekuńczych dla osób starszych, osób niepełnosprawnych fizycznie lub mających trudności w uczeniu się. Oszczędności nie mogą dotyczyć projektów wspierających dzieci i młodzież, a także osoby o szczególnych potrzebach socjalnych. Cięcia w wydatkach nie powinny dotyczyć osób wymagających opieki oraz osób ją zapewniających. Walka z pogłębiającym się ubóstwem i wykluczeniem społecznym powinna stać się domeną nie tylko poszczególnych państw, ale też instytucji unijnych. Dlatego propozycje sprawozdawcy, w których zawarty jest apel do Komisji i Rady o podjęcie działań mających na celu zwiększenie finansowania dla programów ukierunkowanych na słabsze grupy społeczne, są warte poparcia.

Nie można się jednak zgodzić z tezą, że niektóre systemy zabezpieczenia społecznego, których struktura opiera się na koncepcji rodziny, są mniej zdolne do radzenia sobie ze zwiększonymi trudnościami wynikającymi z kryzysu. Jest to podejście błędne, gdyż to rodzina stanowi podstawę wsparcia i pierwszą pomoc dla osób znajdujących się w trudnej sytuacji życiowej.