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Trečiadienis, 2015 m. rugsėjo 9 d. - Strasbūras

18. Sveikatos priežiūros sistemų tvarumas Europoje: ateities iššūkiai (diskusijos)

  Przewodniczący. – Kolejnym punktem porządku dnia oświadczenie Komisji w sprawie stabilności systemów opieki zdrowotnej w Europie: przyszłe wyzwania.

  Valdis Dombrovskis, Vice-President of the Commission. – Mr President, the Commission acknowledges that healthcare systems need to be reformed in order to ensure quality healthcare through efficient structures. Furthermore, the Commission is addressing sustainability challenges in healthcare systems in the EU by including relevant criteria in various actions – as has been the case, for example, in previous exercises of the European Semester – and by using a variety of policy tools.

The Commission shares the general concern about the affordability of new medical products and the related risks of inequalities arising in access to care, and it is committed to helping Member States respond to this challenge. This commitment was highlighted in the Commission’s communication of April 2014 on effective and resilient health systems, which, among other things, focuses on increasing the accessibility of health systems.

The communication stressed the need for improved cooperation, increased transparency and better coordination to minimise any unintended effects that current national pricing systems may have in terms of accessibility throughout the EU. The Commission has no competence to regulate the level of prices of medical treatments: these are determined by Member States individually. The Commission could, however, explore other avenues, for example by pursuing improved exchanges of information among Member States on their pricing policies, with a view to minimising negative effects on the accessibility of medicines in the EU. Another way in which the Commission could assist would be through further exploring the use of the Joint Procurement Mechanism to encourage more advantageous price offers from the pharmaceutical industry.

The transposition deadline for the directive on patients’ rights to cross- border healthcare was 25 October 2013. A number of Member States were either late transposing the directive or transposed it incompletely. Where necessary, the Commission launched infringement proceedings against these Member States. As a result, nearly all Member States have now transposed the directive in its entirety. There is a small number of cases outstanding, which will be resolved in a near future. The next stage for the Commission is to assess whether Member States have transposed the directive correctly.

The Commission and the Member States are exploring the possibility of producing a joint EU health technology assessment (HTA) report to inform decision makers about clinical outcomes of new health technologies. Member States will continue to work under the remit of the upcoming European Network for Health Technology Assessment (EUnetHTA) joint action to implement the HTA strategy adopted in October 2014, cooperating together on joint assessments of technologies and addressing methodological challenges. Joint forces and expertise will help decision-makers to make more informed and faster choices on access to innovative treatments. There is, however, no willingness to harmonise decisions on either the uptake of technologies or pricing and reimbursement.

Cooperation on HTA is complemented by discussions in the Commission Expert Group on Safe and Timely Access to Medicines for Patients (STAMP), which looks at ways to make the best use of existing instruments.

  Elisabetta Gardini, a nome del gruppo PPE. – Signor Presidente, onorevoli colleghi, la sostenibilità dei sistemi sanitari è un tema di importanza decisiva, difatti, anche se fondati sugli stessi valori, valori comuni, esistono profondi divari tra i ventotto paesi, tante volte abbiamo parlato per questo di un'Europa delle disparità.

Nonostante questo, ci sono alcuni problemi trasversali che accomunano tutti i sistemi, anche quelli dei paesi più ricchi: i dati ci dicono infatti che, per esempio, ben l'86% degli ospedali europei soffrono carenza di medicinali, spesso si tratta di carenze molto gravi, che riguardano perfino farmaci essenziali come quelli per le terapie chemioterapiche di base. Questo è un vero e proprio paradosso! Le medicine vengono approvate a livello europeo, ma l'Unione non ha un piano coordinato d'azione per far fronte allo shortage di medicinali. Anche l'importazione parallela, come ha ricordato il Commissario qualche giorno fa, è spesso causa di ineguaglianze di accesso ai farmaci essenziali. In questo contesto, ritengo necessario creare un quadro europeo completo per avere la fotografia delle carenze. Gli sforzi di EMA per mettere insieme un catalogo europeo delle carenze sono encomiabili, ma purtroppo non hanno finora portato i frutti sperati.

Non esiste poi un quadro di riferimento del costo delle medicine a livello europeo, oggi ciascuno Stato membro ha le proprie procedure, questo vuol dire che lo stesso farmaco è valutato 28 volte con conseguente spreco di risorse, di tempo, e col mancato accesso ai farmaci salvavita. Faccio un esempio, il Trastuzumab, un potente farmaco contro il tumore al seno che è incluso nella lista dei farmaci essenziali dell'Organizzazione mondiale della sanità, non è stato distribuito in maniera equa in Europa e in alcuni paesi europei ci sono voluti più di 7-8 anni perché il farmaco venisse messo a disposizione dei pazienti. Allora, quanti cittadini europei sono morti?

È necessario, al fine di tendere verso un'armonizzazione nella definizione dei prezzi tra i vari paesi a livello europeo, definire una valutazione di Health Technology Assessment a livello europeo, che valga come riferimento per tutti i paesi. Abbiamo presentato anche una dichiarazione scritta con altri colleghi. Mi fermo qui, ma dobbiamo veramente affrontare quest'emergenza tutti insieme.

  Soledad Cabezón Ruiz, en nombre del Grupo S&D. – Señor Presidente, me alegro de este debate por conveniente y por importante. Alegar que las competencias sanitarias no entran dentro de las competencias del ámbito europeo es algo habitual, o demasiado habitual, a pesar de que la protección de la salud es un derecho fundamental en la Unión Europea y de que no se ha librado del tratamiento ideológico que se ha venido haciendo de la crisis, como también es un derecho fundamental la atención sanitaria a los ciudadanos de terceros países que se encuentran en territorio europeo.

Sin embargo, el Gobierno de España ha sacado del sistema sanitario español a 800 000 extranjeros y ha roto el principio de universalidad, mientras que la Comisión acaba de publicar que la universalidad y la atención sanitaria a los inmigrantes no solo son un deber moral sino que, además, es más eficiente que negarse a prestársela.

Señor Presidente, le pregunto: ¿es cierto que la Comisión estudia sanciones a las autoridades españolas ―como ha amenazado el ministro de Sanidad español a las regiones que no han acatado esta injusticia―? Por otro lado, a una pregunta mía, el señor Comisario respondía recientemente que se estudian posibles compensaciones por la migración de los profesionales sanitarios. ¿Qué hay de nuevo al respecto? Y, finalmente, el precio de la farmacia, la sostenibilidad del sistema sanitario es clave. ¿No creen conveniente también, además de las medidas anunciadas, revisar el sistema de patentes y su relación con un posible abuso de posición dominante legalizado?

  Νότης Μαριάς, εξ ονόματος της ομάδας ECR. – Kύριε πρόεδρε, η μαζική ανεργία και η φτώχεια που πλήττουν την Ευρωπαϊκή κοινωνία λόγω της οικονομικής κρίσης και της κρίσης δημόσιου χρέους οδηγούν στον κοινωνικό αποκλεισμό, στην περιθωριοποίηση και τελικά στον περιορισμό του δικαιώματος ίσης πρόσβασης των Ευρωπαίων πολιτών στην υγειονομική περίθαλψη και στις υπηρεσίες υγείας. Η καταστροφική πολιτική του μνημονίου και της Τρόικας στην Ελλάδα διέλυσαν τη δημόσια υγεία και τα νοσοκομεία. Για να υπάρξουν βιώσιμα συστήματα υγειονομικής περίθαλψης στην Ευρωπαϊκή Ένωση, πρέπει να υπάρξουν αυξημένες δημόσιες δαπάνες. Επίσης, επαρκείς πόροι μπορούν να προέλθουν μόνο από την ανάπτυξη, η οποία θα οδηγήσει σε αύξηση των φορολογικών εσόδων του κράτους και στη συνακόλουθη αύξηση των δημόσιων δαπανών για την υγεία. Η ανάπτυξη θα οδηγήσει επίσης και σε δημιουργία νέων θέσεων εργασίας και έτσι οι ίδιοι οι κοινωνικοί εταίροι θα έχουν τη δυνατότητα, κατά το μέρος που τους αναλογεί, να διασφαλίσουν πόρους για τη διατήρηση της βιωσιμότητας των συστημάτων υγειονομικής περίθαλψης στην Ευρωπαϊκή Ένωση. Eυχαριστώ.

  Philippe De Backer, on behalf of the ALDE Group. – Mr President, I would first of all like to thank the Commissioner very much for his comments. However, I think that we should go to the core of the issue.

The core is that our healthcare systems were developed in a previous century when people mainly died from malnutrition and infections. But now we see people suffering from chronic diseases, requiring years of innovative treatment. Healthcare spending in the EU has grown by nearly 50% since 2000, to almost 12% of European GDP, and it will continue to rise. Nor is it only drug pricing which is to blame.

This means that we have to look fundamentally at how we run our healthcare systems if we want to keep them open, qualitative and affordable for everybody. I have heard many good proposals coming from the Commissioner’s side. The Commission is trying to coordinate, invest and exchange information, setting up networks and sharing best practices, but this will not result in the changes that we really need.

Therefore, I would like to make three concrete proposals. First of all, there are major differences in healthcare spending between Member States. The European Semester could serve as a tool to monitor healthcare quality, organisation and spending. Recommendations per Member State and follow-up of implementation of best practice by the Commission would then be key.

Secondly, the World Health Organisation (WHO) has estimated that 20% to 40% of healthcare budgets are wasted due to inefficiencies. So we have to keep a competitive edge when it comes to innovation. This means creating a simplified, stable and favourable environment for investing in healthcare, ranging from drug development to e-health applications to prevention strategies, bringing down the cost for the whole system.

Thirdly, I want to make a very concrete suggestion as to where the EU can really provide added value. It is in the field of rare diseases and orphan drugs. I call for the establishment of a European rare disease fund which would harmonise the health technology assessment procedure, making it easier for companies to enter all European markets and obtain reimbursement. The combined Member States would have a stronger negotiating position over the price and the fund would guarantee access for all patients suffering from a rare disease to the most novel and innovative treatments. The Rare Disease Regulation is a decade old so let us finish this work.

We have to change our thinking about healthcare and the way that we look at European healthcare systems, so I count on the Commission to lead the way. I think that we will support you in many aspects.

  Luke Ming Flanagan, on behalf of the GUE/NGL Group. – Mr President, it is a very opportune time to have this debate, in particular for my constituents and the people of my home county. When it comes to the sustainability of the Irish Health Service it is quite clear that it is not sustainable, and one of the reasons is because we are haemorrhaging money paying for the collapse of a banking system, a system that collapsed but for which we – and not the speculators – paid the price. EUR 11 million is all that is needed in funding to keep the 90 residents in place at this home that helps our health system, but we cannot afford to pay for it.

I heard today Mr Juncker say that we made sure taxpayers never again have to pay for the greed of financial speculators. Well that is wonderful, Mr Juncker, but the reality is that people in Ireland are still paying for this every day, and the EUR 11 million that the people of Roscommon need, instead of it going to healthcare, well last year EUR one billion was borrowed and destroyed, and Ireland got nothing for it. This year EUR 500 million will be destroyed and we will get nothing for it.

How can you have a sustainable healthcare system when the taxation that is paid for our health and for our education is spent on paying back a debt that was never ours? In 2016, we will have to pay EUR 500 million a year again and burn it, same in 2017, same in 2018. How the hell can that be sustainable? I thought you were here to help us. You are haemorrhaging us. You are destroying us. You are killing us.

  Michèle Rivasi (Verts/ALE). – Monsieur le Président, Monsieur le Commissaire, chers collègues, il y a un an exactement, lors de la plénière de septembre 2014, notre Assemblée débattait sur l'accès aux médicaments vitaux en Europe, à l'initiative du groupe des Verts/ALE. La grande majorité des parlementaires présents a alors dressé le même constat que celui qui nous rassemble aujourd'hui, à savoir que les systèmes de soins en Europe sont au bord de l'asphyxie et que leur viabilité est menacée.

Si l'accès aux soins pour tous est menacée partout en Europe c'est avant tout – par rapport à mon collègue qui est intervenu – parce que les médicaments innovants sont très chers. Le cas du sovaldi – dont nous avions discuté –  ce médicament contre l'hépatite C vendu en France coûte à peu près 41 000 euros, mais comme il faut y ajouter un autre médicament, cela revient à 100 000 euros par patient et par an, et cela coûtera 700 millions d'euros par an à la sécurité sociale. Quand vous rajoutez tous les nouveaux médicaments qui sont très chers, c'est sûr que cela fait exploser les comptes de la sécurité sociale. On se demande pourquoi ils sont si chers, d'autant plus que, quand on fait une analyse précise – déjà faite dans le cas du sovaldi par des associations –, on s'aperçoit qu'il y a des doses d'argent public importantes qui ont justement permis directement ou indirectement leur invention. C'est surtout parce que notre modèle de recherche et de développement dans le domaine pharmaceutique est gravement atteint de perversion chronique.

Les marges nettes et les profits pour certaines entreprises vont de 10 à 40 %, vous voyez que c'est incroyable. L'industrie pharmaceutique est la plus lucrative, à l'heure actuelle, et il faut donc introduire une conditionnalité. Moi, je suis pour l'aide aux laboratoires pharmaceutiques, mais seulement s'il y a de l'argent public. Il ne doit pas y avoir de brevet, c'est-à-dire qu'on soumet l'idée suivante: innovation OK, mais pas de brevet et le prix des médicaments peut-être accessible à tous. C'est cela qu'il faut refondre dans le cas de ce monopole par rapport aux entreprises.

  Diane James, on behalf of the EFDD Group. – Mr President, this seems to be the tip of the iceberg. This clearly looks like EU harmonisation of healthcare systems by the back door, but using pricing of drugs as the mechanism. I would like to point out that there is a huge difference between the insurance- and privatised—based model of healthcare prevalent in most of Europe and the contributory taxation—based National Health Service model that we have in the United Kingdom. I am not at all sure that this step, which seems to be being launched, will not represent a disastrous threat to the quality, cost and provision of UK healthcare services. My voters and my citizens do not want that.

We have got stop blaming the elderly. Many of the chronic healthcare conditions that create the demand are coming about because of lifestyle choices by patients and by individuals of all age groups. We need to do more – if we are going do anything at all – to tackle the source of those problems and start talking about the business interests and the lobbying companies that push the products and create the environmental factors that create the illnesses and the problems for the EU.

I would finally like to point out that if you cannot control your borders, cannot control your population and cannot control demand, you will never, ever be able to meet supply. So if healthcare systems cannot plan because they do not know the number of patients, they do not stand a chance.

  Alojz Peterle (PPE). – Stanje zdravja in zdravstvenih sistemov je eden ključnih izzivov Evropske zveze, ki ga staranje prebivalstva in naval beguncev še zaostrujeta.

Pozdravljam odločitev komisarja za zdravje za ustanovitev strokovne skupine za oceno delovanja zdravstvenih sistemov držav članic. Potrebno se je sistematično lotiti zagotavljanja večje vzdržnosti zdravstvenih sistemov in za zmanjševanje razlik v njihovi kakovosti. Ustanovitev ekspertne skupine pomeni korak v pravi smeri.

Pregled nad razlikami v delovanju zdravstvenih sistemov držav članic ima lahko samo Evropska zveza. Akcijo lahko vodi samo tisti, ki ima pregled nad celoto.

Prepričan sem, da bi model evropskega semestra, kot ga poznamo na gospodarskem oziroma finančnem področju, lahko koristno uporabili tudi na področju zdravja, in vesel sem, da se veča število teh, ki delijo isto misel. Tako bi lahko uveljavili letni cikel koordinacije zdravstvene politike in razvili okvir za reformiranje in konvergenco zdravstvenih sistemov. Lahko bi razvili tudi skupne standarde glede odnosa do javnih sredstev, ki jih porabimo v javnem zdravstvu.

Gospod komisar je povedal, da pri državah članicah ni volje do harmonizacije ne pri tehnologiji ne pri cenah. Oboje gre v škodo bolnikov, ki ne marajo neenakosti. Nič nimam proti različnosti, kadar zagotavlja napredek, nasprotujem pa ji, kadar je izraz nepripravljenosti za sodelovanje in gre v škodo bolnikov.

Pomembno je, da bolniki čutijo sodelovanje na področju zdravja kot dodano vrednost Evropske zveze. Lizbonska pogodba nam ne preprečuje, da bi naredili več.

  Biljana Borzan (S&D). – Gospodine predsjedniče, europski zdravstveni sustavi će se u budućnosti suočavati s istim problemima kao i danas, no razmjeri problema bit će daleko veći. Epidemija pretilosti, kronične nezarazne bolesti, i sve više starijeg pučanstva samo su neki od njih, a sve podcrtava činjenica da je zdravstvo sve više u rukama ekonomista i fiskalne politike, a sve manje u rukama struke. Činjenice da su antibiotici sve manje učinkoviti, da procijepljenost opada i da geopolitička nestabilnost u susjedstvu Europske unije potiče masovne pokrete stanovništva dovode do zaključka kako će pritisci na zdravstvene sustave biti sve veći i veći.

Države članice u prosjeku troše oko 10 % BDP-a na zdravstvo. U većini zemalja oko 80 % troškova zdravstvenih sustava pokriva se javnim novcem. To je održivo dok snažno rastu BDP-i, a demografska slika ide u smjeru povećanja radno sposobnog dijela stanovništva. No kao što znamo, realnost je drugačija.

Europska unija nema široke ovlasti po pitanju zdravstva, no neki od alata koji su joj na raspolaganju, poput Europskog semestra, mogu napraviti razliku. Povjerenik Andriukaitis je na početku mandata govorio o zdravstvenoj uniji i zaista, europski zdravstveni sustavi imat će bolju budućnost ako ujedine ljudske i materijalne resurse.

(Govornica se složila da odgovori na pitanje podizanjem plave kartice na osnovi članka 162. stavka 8. Poslovnika.)

  Jonathan Arnott (EFDD), blue-card question. – We’ve discussed migration in some detail, but one issue that hasn’t been raised very often is that, in the UK and a number of other countries within Europe, we bring in doctors and nurses from the Philippines and from very poor countries like Malawi. We’re actually depriving some of the poorest countries in the world of much needed professionals, and I believe that’s because we’re not training enough doctors and nurses in the UK and the rest of Europe. Do you agree with that assessment?

  Biljana Borzan (S&D), odgovor na pitanje postavljeno podizanjem plave kartice. – To je realnost Europske unije dokle god je ona, a hvala Bogu da je, jedna sigurna luka za mnoge siromašne na svijetu. Dakle, za očekivati je dokle god Europska unija bude bogata i napredna kao što je danas da će nam dolaziti ovamo ljudi iz siromašnijih zemalja, a naravno na našim zdravstvenim sustavima je da se nose s tim kako znaju i obrazuju dovoljan broj svojih liječnika.

  Ivo Vajgl (ALDE). – Razvito zdravstveno varstvo, visoki standardi in univerzalna dostopnost do javnih zdravstvenih storitev mora ostati ključna sestavina tega, kar je odlika življenja v Uniji: visoke kakovosti življenja.

Strategija, ki vodi k tem ciljem, mora upoštevati naslednja dejstva: da so leta krize dodatno obremenila delovanje zdravstvenih sistemov, predvsem v smislu nižanja stroškov v javnih zdravstvenih blagajnah, pri čemer so bile bolj na udaru tiste države, ki so morale tudi sicer bolj ostro se spopasti s posledicami krize. Potem, da so demografske spremembe ključen dejavnik vpliva na delovanje in razvoj zdravstvenega sistema. In da podaljševanje življenjske dobe pomeni tudi, da se podaljšuje doba, ko oseba potrebuje stalno zdravstveno oskrbo.

Javno zdravje vpliva na več drugih sfer družbenega življenja. Na življenjski slog, prehrano, stanovanjske razmere, delovne pogoje in varnost pri delu, farmacevtsko razsežnost zdravljenja in celo na davčno politiko. Končno, učinkovitost, dostopnost in vzdržnost so usodno odvisni tudi od prodornosti evropske znanosti, raziskav in tehnološkega razvoja, kar moramo podpirati.

  Francesc Gambús (PPE). – (El diputado comienza hablando en catalán), los retos de futuro para los sistemas de salud europeos son muchos y podríamos estar debatiendo aquí, en esta Cámara, semanas enteras sobre este tema. En este sentido, quiero agradecer la intervención hoy de la Comisión Europea.

Los sistemas de salud son la «joya de la corona» de los Estados del bienestar que construimos tras el fin de la Segunda Guerra Mundial. En los últimos años la situación de crisis económica ha tensionado este sistema de bienestar y el tránsito hacia la sociedad del bienestar se nos hace algo más cuesta arriba. Y debemos ser conscientes de que Europa afronta un envejecimiento general de su población, lo que llevará a un mayor uso de los sistemas de salud. Debemos estar, pues, preparados para ello.

Aun así, hemos podido garantizar la preservación de la calidad de los servicios sanitarios cuando nuestros ciudadanos nos lo han reclamado. En este sentido, quisiera poner en valor a los profesionales del sector sanitario, tanto los asistenciales como los investigadores.

Los retos de futuro son muchos ―como decía―, pero creo que las formas de afrontarlos las podemos reducir a dos aspectos: la investigación y la inversión. Una investigación que nos garantice la mayor calidad de nuestros sistemas de salud, una investigación que requiere inversión pública e inversión privada para tener éxito, y también inversión para mantener unas condiciones de trabajo dignas para todos los profesionales del sector sanitario. Debemos mantener la confianza en ellos y dar una estabilidad que posteriormente se refleje en la calidad del servicio recibido por nuestros ciudadanos y quizás avanzar en la medida de lo posible para coordinar a nivel europeo los estándares de dichos sistemas de salud. Esto es fundamental.

Debemos hacer todo aquello que esté en nuestra mano para poder garantizar no solo la viabilidad de los sistemas de salud en Europa, sino también la mejor calidad de servicio para nuestros ciudadanos.

  Tibor Szanyi (S&D). – Juncker bizottsági elnök úr ma több uniót szorgalmazott Európában, és azt hiszem, hogy sokan ezzel egyetértünk. Sok területen vannak közös politikáink, ám lássuk be, főleg azon területeken, ahol a tőke igényeinek kedvezünk. Mintha kicsit elfelejtettük volna a „Social Europe”, a szociális Európa gondolatát, hát ideje, hogy újraélesszük. Haladjunk szép lépésekben egymás után. Vannak standardjaink, normáink például az állategészségügy terén, de szinte alig van figyelmünk a humán egészségügyre. Kicsit élesebben fogalmazva a haszonállataink már unióban érezhetik magukat, nekünk embereknek úgy tűnik még várni kell erre egy kicsit. Jó jel azonban, hogy legalább az egészségünket alapvetően meghatározó élelmiszereink dolgában fellelhető az unió. Sorolhatjuk a kihívásokat. Nem kell jósnak lenni ahhoz, hogy ezek súlya ma már akkora, hogy egyetlen tagország sem tud ezeknek egyedül megfelelni. A jövőt, a jövő válaszait a közös európai egészségpolitikában látom.

  Андрей Ковачев ( PPE). – Г-н Председател, г-н комисар, радостен съм, че имаме възможност да обсъдим въпроса за устойчивостта на здравните системи в Европа.

Въпреки ограничените правомощия на Европейския съюз в областта на здравеопазването, то трябва да стане наш приоритет не само на думи, но и на дела.

Трудно е да обясним на европейските граждани защо се занимаваме повече със здравето на селскостопанските животни, отколкото със здравето на хората. Предизвикателствата в бъдеще ще стават все по-големи поради демографските промени, застаряването на населението, нарастването на хроничните заболявания.

Тази реалност трябва да намери своето отражение при изготвянето на препоръките до страните членки в рамките на Европейския семестър.

Необходими са конкретни ангажименти за провеждането на структурни реформи, които да гарантират не само финансовата устойчивост, но и равен достъп на европейските граждани до качествено здравеопазване, адекватно за 21 век. В Европа все още има големи здравни неравенства между различните страни членки, които спъват икономическото и социалното сближаване.

Смятам, че преодоляването на тези проблеми изисква европейските институции да се ангажират още по-задълбочено в оценката на функционирането на нашите здравни системи, наблюдението на техните резултати и – много важно за мен, измерването на достъпа до качественото здравеопазване в рамките на Европейския семестър чрез въвеждане на нови здравни индикатори.

Това ще помогне на страните членки да се учат една от друга, да обменят добри практики и да идентифицират ефективни решения. То също така ще позволи да се направи и оценка на спазването на правата на пациентите при трансграничното здравно обслужване.

Позволете ми, г-н комисар, накрая един въпрос да задам към Комисията, а той е: в публикувания миналата седмица доклад се посочва, че липсата на информация е основна причина пациентите да не могат да се възползват максимално от правата си според европейското законодателство. Какви конкретни мерки би могла да вземе Комисията, така че всички европейски пациенти да знаят своите права като европейски граждани?

  Doru-Claudian Frunzulică (S&D). – Mr President, making healthcare sustainable is a very important part of the political agenda in Europe and it is crucially important for a safe and sound European population.

Something needs to be done in order to face the great challenges that are putting too much pressure on our healthcare systems – including our ageing population and the rise of chronic diseases on which we spend most of the EU healthcare budget. Through the use of digital tools, fundamental improvements to our healthcare systems become possible. Service will improve, science will develop and a great quantity of financial resources can be saved to be used for something else within the healthcare budget.

We must agree on a practicable common vision, and use innovation and technology to find effective solutions. Through our efforts we will be able to enact positive healthcare transformations that can adapt and, over time, produce high-quality and universally accessible health services in a financially sustainable way.

  Theodor Dumitru Stolojan (PPE). – Domnule președinte, sistemele medicale din multe țări europene se află în suferință. Noile tehnologii medicale, noile medicamente, precum și îmbătrânirea populației determină creșterea continuă a cheltuielilor medicale. Consider că un factor major pentru sustenabilitatea sistemelor medicale este întărirea acțiunilor preventive: să apelăm mai mult la stimulente. Oamenii răspund la stimulente. Dacă o persoană, ca să exemplific, nu efectuează vizita medicală anuală, prezintă un risc sporit pentru firmele de asigurări medicale și va trebui să plătească o primă de asigurare medicală mai mare. Apreciez că, la nivelul Uniunii Europene, se pot face mai multe analize, trebuie acordată mai multă atenție economiei sănătății, care este necesară pentru sănătatea economiei. Este inacceptabil ca un medicament nou apărut, care vindecă hepatita C, până nu demult nevindecabilă, să coste zeci și zeci de mii de euro. Iată, aici avem ceva de făcut.

Pytania z sali

  Κώστας Χρυσόγονος (GUE/NGL). – Κύριε Πρόεδρε, είναι υποκριτικό να συζητούμε για τη βιωσιμότητα των συστημάτων υγειονομικής περίθαλψης στην Ευρώπη γενικά και αόριστα, όταν υπάρχουν τεράστιες διαφορές μεταξύ των κρατών, ανάλογα με την οικονομική τους κατάσταση. Για να δώσω ένα παράδειγμα, σύμφωνα με τα στοιχεία που μας δίνει η ίδια η Επιτροπή στην ανακοίνωσή της αριθ. 215 του 2014, οι θάνατοι που θα μπορούσαν να αποφευχθούν εάν υπήρχε έγκαιρη και επαρκής υγειονομική περίθαλψη είναι στη Λιθουανία και στη Λετονία περίπου 15 φορές περισσότεροι από τους θανάτους στη Γαλλία. Στη Ρουμανία είναι περίπου 10 φορές περισσότεροι. Με την πάροδο του χρόνου, οι διαφορές χειροτερεύουν αντί να μικραίνουν. Παραδείγματος χάριν, έχουμε στην Ελλάδα τα τελευταία 5 χρόνια, λόγω των δολοφονικών προγραμμάτων λιτότητας, μια αύξηση τουλάχιστον κατά 10% στο συνολικό αριθμό των θανάτων. Για να είναι πραγματική η ευρωπαϊκή αλληλεγγύη θα έπρεπε, προδήλως και πρωτίστως, να εκδηλώνεται στον τομέα αυτό, εάν μας ενδιαφέρει εμπράκτως η υποτιθέμενη ευρωπαϊκή συνοχή.

  Jonathan Arnott (EFDD). – Mr President, my brother worked as an aid worker in Malawi, and at that time that country had the lowest number of medical professionals per capita in the world. He saw massive, massive queues – he ended up working actually as a surgeon’s assistant out there – and the conditions were horrific. Yet even though that country had so few health care professionals, we still imported doctors and nurses from those countries to come and work in the British health care system, and the same happens in other countries in Europe. That has a massive, negative, profound impact on those countries, and I just wanted to raise that issue – that problem – and to say that we need to think about the ethics of what we’re doing when that happens.

(koniec pytań z sali)

  Valdis Dombrovskis, Vice-President of the Commission. – Mr President, first of all, I would like to thank you for this discussion and for the views expressed here tonight. I can assure you that the Commission will continue to work hard in support of Member States to address future challenges as regards the sustainability of health systems.

Europe’s ambition is to have a social ‘triple A’. One way to achieve this could be through ensuring effective social protection systems with universal access to good-quality healthcare. The Commission will naturally continue to actively support Member States in their endeavours to attain this goal. Long—term challenges exist in this area, which is one of the areas constituting a significant part of public expenditure. At the same time, we need to ensure broad access to affordable and high-quality health services. So the Commission will continue to monitor Member States’ reforms in healthcare and pension systems.

Let me close by thanking Parliament once again for its interest and its activities in support of our common objectives in these important areas.

  Przewodniczący. – Zamykam debatę