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Miercuri, 23 octombrie 2019 - Strasbourg Ediţie revizuită

23. Declarația politică la nivel înalt a ONU privind acoperirea universală cu servicii de sănătate (dezbatere)
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  Presidente. – L'ordine del giorno reca la discussione sulla dichiarazione del Consiglio e della Commissione sulla dichiarazione politica di alto livello delle Nazioni Unite sulla copertura sanitaria universale (2019/2861(RSP)).


  Tytti Tuppurainen, President-in-Office of the Council. – Mr President, honourable Members, if you allow me, I might remark that speaking about health at such a late hour is a bit contradictory. Having been at this very plenary since 9.00 this morning, I think we all should be resting already at this point – if we think about our health.

Nevertheless, however, it is a pleasure to discuss with you the recent high-level event that took place on 23 September in the context of the United Nations General Assembly on Universal Health Coverage: Moving Together to Build a Healthier World. That event brought together heads of states, political and health leaders, policy makers and universal health coverage champions, to advocate for better health for all.

Universal health coverage means that all people, including the most vulnerable – or should I say, especially the most vulnerable – have access to the health care they need, when and where they need it, without facing financial hardship.

The aim was to harness financial and political commitments to sustain health investments, with the focus on accelerating progress towards universal health coverage, including access to essential health services, a skilled health workforce, financial risk protection and access to safe, quality, effective and affordable medicines and vaccines for all.

This ambitious aim was achieved in the form of an action-oriented political declaration on universal health coverage endorsed by heads of states representing the entire United Nations membership. This is all the more remarkable as this was our last opportunity before 2023 – the midway point, to reach the sustainable development goals by 2030 – to mobilise the highest levels of political support, to bring the entire health agenda under the umbrella of universal health coverage.

The declaration is accompanied by a concrete global action plan for healthy lives and well-being that will serve as a blueprint for global health and development agencies as well as national governments to meet health needs.

We are all aware, of course, that big question marks still remain concerning the significant financing needed now until 2030 in order to live up to our ambitious commitments. This will have to be secured through a mix of domestic financing based on individual country contexts, and international aid-funding mechanisms. This is no doubt our main task ahead. It is daunting, but our credibility will be at stake if we fail.

Finally, I would like to stress the leadership role that the EU and its Member States must continue to play on the issue of universal health coverage, in the multilateral context that is so dear to us but which we should not take for granted.

2020 will be a test year in that regard, with the 25th anniversary reviews of the 1994 Cairo International Conference on Population and Development and the 1995 Beijing Platform for Action.

The EU and its Member States will need to position themselves at the forefront to protect the progress achieved 25 years ago and ensure that there is no stepping back. Such European leadership was demonstrated once again during the high-level event on universal health coverage, and I wish to commend Minister Kaag of the Netherlands for leading a strong coalition of 58 countries in support of sexual and reproductive health and rights.

These are part and parcel of the 2030 agenda and a cornerstone of a universal health coverage. Investing in sexual and reproductive health and rights is affordable and cost-saving and can make health coverage truly universal, in line with our key promise under the 2030 agenda: that we shall leave no one behind.

I want to stress that the Presidency will spare no effort to continue to promote universal access to health care, which all human beings, in particular the most vulnerable, need, when and where they need it, in line with the ‘economy of well-being’ approach introduced by our Finnish Presidency.


  Neven Mimica, Member of the Commission. – Mr President, honourable Members, on 23 September heads of states, governments and health ministers convened on the margins of the United Nations General Assembly for the first time ever for a high—level meeting on universal health coverage. They endorsed a landmark political declaration – universal health coverage moving to build a healthier world.

The Commission welcomes this historical event at which the United Nations member states recognised that universal health coverage implies access for everyone to promotable, preventive, curative, rehabilitative and palliative essential health services, and access to effective medicines and vaccines.

The United Nations member states committed to invest in primary health care, to ensure financially affordable health care, to protect women and children’s health and to strengthen the health workforce and reinforce government health capacity. Regrettably, the declaration also demonstrated the visible division among UN Member States on sexual and reproductive health and rights. The Netherlands delivered a statement on behalf of 54 countries strongly supporting universal health coverage for sexual and reproductive health and rights. The United States, along with 19 other countries, dissociated from the relevant paragraph in the declaration, in a call to roll back on sexual and reproductive health and rights.

Commissioner Andriukaitis, speaking on behalf of the European Union, stressed the EU’s commitment to the sustainable development goals, and to the protection and promotion of everyone’s right to enjoy the highest attainable standard of physical and mental health. Health is essential for achieving stable and prosperous societies, economic and social well—being and security. To address health comprehensively, along with the rights—based approach already used through the implementation of the European pillar of social rights, we need a ‘health in all policies’ approach going beyond the boundaries of the health sector alone. Working in parallel on gender equality, water and sanitation, education, food and nutritional security, decent work and social protection, environment and security, could bring us the tangible results we aim at. In that vein, the European Union should remain committed to the promotion, protection and fulfilment of all human rights, including sexual and reproductive health rights, and continue the full and effective implementation of the Beijing Platform for Action, as agreed in the new consensus on development.

The upcoming Nairobi Summit in November will also celebrate and reinforce the commitments made with the programme of action from the International Conference on Population and Development adopted 25 years ago. I am pleased that a delegation of the European Parliament will attend this high—level meeting.

The Union’s actions have produced impressive results. Between 2013 and 2017, the European Union contributed to over 19 million births attended by skilled health personnel. More than 13 million children were fully immunised. 57 million women were supported to use contraception. Eleven million people were put on life—saving treatment for HIV and 600 million bed nets were distributed for malaria protection and prevention.

We also support the World Health Organisation (WHO). Just recently, the Union signed an agreement with the WHO for an EUR 102 million partnership programme prioritising strengthening health systems and universal health coverage. As a global leader, the European Union will continue supporting partner countries in their efforts to build strong, good quality and resilient healthcare systems by providing equitable access to medical services and universal health coverage. As such, we will strive to reach our ambitious goal of universal health coverage for all by 2030.


  Dolors Montserrat, en nombre del Grupo PPE. – Señor presidente, hemos avanzado mucho en la lucha contra las principales causas de muerte y enfermedades del mundo: la esperanza de vida ha aumentado exponencialmente, las tasas de mortalidad infantil y materna han disminuido, hemos cambiado positivamente el rumbo del VIH, y la mortalidad debida a la malaria se ha reducido a la mitad.

Sin embargo, el progreso en el mundo ha sido desigual. Sigue habiendo un gap de treinta y un años entre los países con la esperanza de vida más corta y la más larga. Cuatrocientos millones de personas no tienen acceso a servicios de salud básicos. Cada dos segundos alguien entre treinta y setenta años de edad muere prematuramente a causa de enfermedades no transmisibles. Y una de cada tres mujeres ha sufrido violencia física o sexual en algún momento de su vida.

Por tanto, los hechos nos demuestran que la cobertura universal sanitaria nos da mejor esperanza de vida, pero también es un motor de crecimiento económico y social para todas las sociedades del mundo. Uno de los grandes ejemplos de éxito, por supuesto, es Europa, donde tenemos el mejor sistema nacional público del mundo; donde nosotros invertimos en prevención y promoción de la salud desde la atención primaria; donde investigamos en los tratamientos más avanzados; donde formamos para disponer de los mejores profesionales sanitarios; y donde sobre todo tenemos calidad y universalidad en la atención y el acceso a los tratamientos.

Por tanto, esta declaración política al final lo que está buscando es cumplir globalmente con el tercer Objetivo de Desarrollo Sostenible. En Europa disponemos de dos grandes instrumentos, que son nuestra fortaleza, para poder cumplir con los objetivos. El primer instrumento que tenemos es nuestro modelo europeo de atención sanitaria y el segundo, nuestro modelo de cooperación internacional.

Por tanto, pido a la Presidencia finlandesa y a la Comisión que promuevan más las alianzas intersectoriales de nuestros sistemas públicos de salud con los de otros países del mundo para compartir conocimiento, investigación y acceso a los tratamientos.

Y, ya que en Europa somos líderes mundiales en cooperación internacional y le dedicamos más de 72 000 millones de euros al año —y muchos de los programas financiados son de sanidad—, prioricemos los programas de cooperación internacional para programas de salud como, sobre todo, aquellos que hacen fuerza en la prevención y promoción de la salud, que comienza con la nutrición y desde la atención primaria; y prioricemos que nuestros programas de cooperación vayan dirigidos sobre todo a la reducción de la tasa mundial de mortalidad materna e infantil, también a reducir la mortalidad prematura por enfermedades no transmisibles, y a poner fin a las epidemias de las enfermedades transmisibles. Solo así, con estos grandes instrumentos que tiene Europa, y con nuestro liderazgo, podremos conseguir que en el año 2030 tengan cobertura universal todos los rincones del mundo.


  Presidente. – Grazie onorevole, c’era stato un problema tecnico sul cronometro, quindi diciamo che ha sforato un po’, ma ovviamente essendoci stato un problema nostro, capisco che era complicato per Lei osservare effettivamente a che punto fosse nel suo intervento.

Segnalo all’onorevole Pereira, che aveva chiesto una “blue card”, che per prassi abbiamo stabilito che nel primo round, il round di interventi dei gruppi politici, tendiamo come Vicepresidenti a non accordare la “blue card” per prassi concordata.


  Heléne Fritzon, för S&D-gruppen. – Herr talman! Vi socialdemokrater välkomnar FN:s politiska deklaration. Vi gör det för att vi vill nå hållbarhetsmålet att åstadkomma en allmän hälso- och sjukvård för alla. Det är viktigt för att stärka människors hälsa i världen. För oss socialdemokrater är tillgången till hälso- och sjukvård en grundläggande mänsklig rättighet. Alla människor ska kunna få en säker och god vård när de behöver den, och det oavsett var man bor någonstans, om man är man eller kvinna, om man är ung eller gammal och oavsett samhällsklass: Ingen får lämnas utanför.

Tyvärr ser vi i dag att människor i olika delar av världen inte har tillgång till god vård. Det gäller också rätten till god och säker sexuell och reproduktiv hälsovård. I många delar av världen berövas i dag kvinnor denna rätt. Det är helt oacceptabelt. EU och framför allt dess medlemsstater har i sitt ledarskap ett väldigt stort ansvar för att stå upp för aborträtten för alla kvinnor. Det är en fundamental rättighet att varje människa själv ska få bestämma över sin egen kropp. Vi socialdemokrater kommer att fortsätta och ta fajten för alla människors lika rätt och värde och för rätten till en god och säker hälso- och sjukvård.


  Véronique Trillet-Lenoir, au nom du groupe Renew. – Monsieur le Président, la déclaration de l'Assemblée générale des Nations unies sur la couverture sanitaire universelle reconnaît l'impact majeur des conditions environnementales sur la santé humaine. La pollution de l'air est responsable de 400 000 décès prématurés par an en Europe et de nombreux cancers. La contamination de la nourriture et de l'eau par des agents toxiques peut entraîner des troubles de la reproduction. Le réchauffement climatique favorise la prolifération d'infections liées à la transmission par des moustiques. Ces épidémies gagnent actuellement l'Europe: deux cas de virus Zika autochtones ont été décelés dans mon pays, la France, aujourd’hui même.

La lutte contre le dérèglement climatique est donc un des axes à part entière de la couverture sanitaire universelle. Bien conscient de cette réalité et du rôle de leader que doit jouer l'Union européenne, vous l'avez rappelé, Madame, le Parlement européen et la Commission européenne font du Green New Deal une priorité absolue. L'accord de Paris rappelle par ailleurs que le droit à la santé est un des droits fondamentaux de l'être humain. L'objectif principal du Green New Deal doit à terme rester la santé humaine, et plus généralement la santé globale, qui désigne le cercle vertueux reliant santé humaine, santé animale et santé environnementale.

Dans notre lutte contre le réchauffement climatique, nous devrons privilégier l'éducation des citoyens afin d'éviter de générer de nouvelles inégalités de santé qui guettent les plus vulnérables. Enfin, le lien indissociable entre environnement et santé devrait nous conduire à évaluer les politiques environnementales en utilisant des critères d'espérance de vie en bonne santé. Ce sera le meilleur indicateur d'efficacité du Green New Deal.


  Petra De Sutter, on behalf of the Verts/ALE Group. – Mr President, I welcome the speech by Commissioner Andriukaitis at the High—Level Meeting on universal health coverage, stating that the EU will continue its efforts to ensure universal health coverage becomes a reality in EU countries, as well as in our partner countries. In particular, I appreciate that he stressed the need for a ‘health in all policies’ approach, as well as highlighting the EU’s commitment to a rights—based approach. However, these words and commitments should also put be put into action, and only by investing in the health rights of all people and ensuring equal access to health care can we make universal health coverage truly universal.

I want to speak about something quite particular. As the Chair of the European Parliamentary Forum for Sexual and Reproductive Rights, I am very concerned that several governments, including some European ones, opposed sexual and reproductive health and rights and gender equality in the High—Level Meeting outcome document. Fortunately, a strong alliance of progressive countries was able to ensure that standards on sexual and reproductive health and rights (SRHR) and women’s rights were included in the final political declaration.

In line with its rights—based approach, the EU should continue to stand united to defend the rights of women and girls within the EU and at the global level. It is clear that there will be no universal health coverage without universal access to sexual and reproductive health, and I want to thank Commissioner Mimica and Minister Tuppurainen for their commitment in this domain.


  Simona Baldassarre, a nome del gruppo ID. – Signor Presidente, onorevoli colleghi, garantire a tutti i cittadini del mondo la possibilità di ricevere un'assistenza sanitaria di qualità e cure adeguate, indipendentemente dal censo e dalla nascita, in quanto parte dei diritti fondamentali dell'individuo: ecco cosa significa copertura sanitaria universale.

Purtroppo, ad oggi, oltre la metà della popolazione mondiale non gode di servizi sanitari essenziali e ogni anno più di cento milioni di persone cadono in estrema povertà per fronteggiare spese sanitarie personali. La risorsa economica principale sta nel risparmio che deriverebbe da un'adeguata cultura della prevenzione.

Tre punti per raggiungere gli obiettivi: destinare risorse finanziarie ai sistemi nazionali, sensibilizzare la popolazione sull'adesione di screening di prevenzione mirati alla diagnostica precoce per evitare malattie devastanti e investire in ricerca e innovazione.

Quindi, in Europa, focalizziamoci sui fondi alla ricerca ed alla prevenzione, e nei paesi più poveri, concentriamoci su riforme sociali ed economiche per tutelare il diritto ad una vita dignitosa.

Concludo, nella consapevolezza di rappresentare la nostra Italia, che è in cima alla classifica dell'OMS per la qualità e l'universalità delle cure fornite. Un esempio, quello della sanità pubblica italiana ancora migliorabile, ma che per molti aspetti, può essere guida per i suoi principi e le sue caratteristiche.


  João Ferreira, em nome do Grupo GUE/NGL. – Senhor Presidente, pelo menos metade da população do mundo não tem cobertura completa de serviços essenciais de saúde. As Nações Unidas propuseram-se alcançar a cobertura universal de saúde daqui a onze anos. Se tudo continuar como até aqui, dificilmente o conseguiremos.

O regime universal de cuidados de saúde significa que todos os indivíduos e comunidades recebem os serviços de saúde de que precisam, prevenção, tratamento, reabilitação, cuidados paliativos, sem que para isso tenham de sofrer dificuldades financeiras. O direito à saúde é um direito humano fundamental e universal. Como o podemos efetivar na prática, não será, seguramente, por via da crescente mercantilização da saúde ou por via do desinvestimento nos serviços públicos de saúde a que assistimos em vários países.

É necessário olhar para dentro, olhar para os retrocessos que se têm verificado aqui, na União Europeia. A saúde é um direito, não pode ser um negócio. É necessário também olhar para fora e incrementar os nossos esforços no domínio da cooperação para o desenvolvimento. É necessário olhar e é necessário agir. É muito aquilo que há por fazer e, por isso, lamentamos que os principais grupos políticos deste Parlamento tenham recusado associar a este debate uma resolução com recomendações deste Parlamento sobre o caminho a seguir.


  Cindy Franssen (PPE). – Voorzitter, beste collega's, het is goed dat we hier vandaag het debat voeren over een universele gezondheidszorg. Wereldwijd zijn er inderdaad nog heel wat mensen die geen toegang hebben tot de gezondheidszorg. Ook binnen de EU zijn er nog steeds te veel mensen die om financiële redenen geen toegang hebben tot de zorg waar ze behoefte aan en recht op hebben.

De politieke verklaring van de VN gaat terecht uit van de benadering van “gezondheid op alle beleidsterreinen” en van de duurzaamheidsdoelstellingen. Ik wil op een aantal zaken ingaan. Vooreerst de omgevingsfactoren. We kunnen niet over gezondheid spreken zonder het te hebben over een gezonde leefomgeving en de bescherming tegen schadelijke stoffen. Dat geldt ook voor de gezondheid op de werkvloer, want wereldwijd worden nog al te veel werknemers niet beschermd tegen giftige stoffen. De gezondheidskloof is ook een van mijn stokpaardjes. Arm maakt ziek en ziek maakt arm. Nog steeds te veel mensen krijgen niet de nodige zorgen om financiële redenen. Dat is onaanvaardbaar. We dragen een immense verantwoordelijkheid in het vaccinatiebeleid, niet alleen in Europa maar ook internationaal. Niet vaccineren betekent een gevaar voor de hele bevolking.

We moeten eveneens inzetten op mentale gezondheidszorg, ook op ons eigen continent. De totale kosten hiervan worden geschat op 600 miljard euro in de Unie. We moeten hiervoor niet één maar twee versnellingen hoger schakelen. Rond de problematiek van seksuele en reproductieve gezondheidszorg is hier terecht al heel wat meegegeven. Ik onderschrijf dat ook.

Collega's, de ambities zijn groot: een universele gezondheidszorg tegen 2030. Om onze doelstellingen te halen – en daarmee rond ik af – zullen we een en ander nauwgezet moeten monitoren en in de nodige budgettaire ruimte moeten voorzien.


  Sara Cerdas (S&D). – Senhor Presidente, os cuidados de saúde primários são a forma mais eficiente e custo-efetiva para atingirmos a cobertura universal de saúde. Mas, para atingirmos os objetivos de desenvolvimento sustentável até 2030, precisamos de acelerar o passo. Quando olhamos para a concentração dos recursos humanos em saúde, esta é elevada nas grandes zonas urbanas, provocando uma escassez de recursos em zonas mais distantes. A Madeira e o Porto Santo, como ilhas de uma região ultraperiférica, são exemplo desta realidade, onde apenas 64% dos habitantes têm médico de família atribuído, deixando um terço da população sem um médico responsável pela gestão da sua saúde.

Precisamos de mecanismos por parte da União Europeia que apoiem os Estados-Membros na criação e implementação de políticas promotoras de saúde, com maior investimento em todas as áreas da saúde, desde os determinantes socioeconómicos e ambientais aos serviços prestadores de cuidados de saúde. É necessário o incentivo a mais apoios para reter os profissionais de saúde nos locais mais carenciados e remotos, melhorando assim a acessibilidade e a saúde de qualidade. Sendo que, em última instância, a saúde é uma escolha política, nós podemos tomar essa decisão. Se não investirmos na saúde, estamos a desinvestir na nossa sociedade.

(A oradora aceita responder a uma pergunta formulada ao abrigo do procedimento “cartão azul” (artigo 171.º, n.º 8, do Regimento))


  Tomislav Sokol (PPE), pitanje koje je postavio podizanjem plave kartice. – Kolegice Cerdas, drago mi je da ste spomenuli kao jedan od problema koji doista još uvijek postoji, a to je razlika u mogućnosti pristupa zdravstvenoj zaštiti unutar Europske unije, pa, evo, zanima me koje mislite da europske politike najviše mogu doprinijeti rješavanju tog problema, konkretno mislim na kohezijsku politiku.

Mislite li da kohezijska politika može biti adekvatan instrument da bi se ovi problemi koji postoje na Madeiri, ali i u drugim dijelovima Europe, pogotovo srednjoistočnoj, mogli riješiti?


  Sara Cerdas (S&D), blue-card answer. – Thank you, colleague, for your question. It is important that Member States receive the necessary support to tackle these constraints they have in providing health care. And human resources for health is, without a doubt, one of the main problems we have that will allow citizens to receive and get access to proper healthcare.

If we have remote areas that don’t have the proper human resources for health, that means our citizens are not getting access to the healthcare they deserve.


  Katalin Cseh (Renew). – Mr President, health is a fundamental human right – we all agree on that. But how can we make sure that people can actually exercise their fundamental rights? Today we have way too many unmet needs and unequal experiences in our European Member States. As a medical doctor, I can tell you that access to high quality healthcare in my home country, Hungary, is not a fundamental right but rather a privilege. Life expectancy is among the lowest in the EU, with unbelievably high health inequalities based on the place of residence or social status. Access to care often only depends on the ability to pay, instead of needs.

Human capital is the core of any well-functioning healthcare system – let’s acknowledge that. We absolutely have to make sure that doctors and nurses are properly valued, as they are the strongest pillars of a healthy society. Guaranteeing high-quality health care is a key objective of social protection and should be the priority of Member States.

We have to fight to ensure that EU cohesion policy could better serve the health of our citizens. We need to put pressure on governments to make sure that all citizens can exercise their fundamental right to health care and enjoy good health, regardless of their age, sex or social status.


  Kateřina Konečná (GUE/NGL). – Pane předsedající, někteří z vás si ještě možná pamatují, že jsem se v roce 2017 stala jednou z tváří kampaně u příležitosti vytvoření plánu cesty k dosažení univerzálního zdravotního pojištění pro všechny do roku 2030, který vytvořilo Evropské fórum pacientů.

Tehdy jsme společně vyzvali instituce EU a členské státy, aby uznaly, že pacienti kdekoliv v EU, bez ohledu na to, ve které zemi původu žijí, mají právo na spravedlivý přístup k vysoce kvalitní péči, aby se zavázaly k udržitelnému investování do zdravotní péče či zajistily, že léky, zdravotnické prostředky a služby budou opravdu dostupné pro všechny. Taktéž je nutné ukončit diskriminaci a stigmata, kterým pacienti čelí, a zajistit, aby nebyli vyčleňováni ze společnosti. Je nutné dodat, že žádná z těchto výzev nebyla členskými státy vyslyšena. Je sice hezké, že se světoví představitelé, mezi nimi i ti z EU, v probírané deklaraci poplácali po zádech, jací jsou pašáci, ale měli by si nejdříve udělat své vlastní úkoly doma.

Mohli bychom začít rovnou u nařízení HTA, kde jsme se jako Parlament dovolávali většího zapojení pacientů a které zcela záměrně členské státy blokují.


  Tomislav Sokol (PPE). – Poštovani predsjedavajući, znamo, i to se vidi i u ovoj raspravi, da doista postoji konsenzus o tome da je pravo na zdravstvenu zaštitu univerzalno ljudsko pravo. Međutim, činjenica je da se to univerzalno ljudsko pravo još uvijek u velikim dijelovima svijeta ne može realizirati.

Međutim, ono što bih svakako istaknuo je, a to je rečeno i u nekima od prijašnjih rasprava, da velike razlike i problemi s dostupnosti zdravstvene zaštite postoje i unutar same Europske unije. I doista možemo vidjeti razlike između pojedinih dijelova urbanih centara zapadnih dijelova u odnosu na ruralna područja, u odnosu na područja srednjoistočne Europe i otoke i ostala daleka područja koja su puno slabije dostupna.

Nažalost, i Europska unija je u nekoj mjeri doprinijela problemima vezanim uz dostupnost zdravstvene zaštite kroz politiku štednje, i to drakonske štednje u mnogim situacijama za vrijeme gospodarske krize. Drago mi je da se ta politika mijenja, drago mi je da je i moja politička grupacija, to je Europska pučka stranka, prepoznala trenutak, da je postavila pravo na zdravstvenu zaštitu na vrh prioriteta Europske unije i doista mislim da se svi trebamo založiti u tom smislu da se ti problemi što prije riješe.

Europska unija ima više instrumenata kojima može djelovati na problem neadekvatnog pristupa zdravstvenoj zaštiti, a jedan od tih instrumenata je kohezijska politika. Kohezijska politika postoji bazirana na načelu solidarnosti kako bi upravo oni slabije razvijeni dijelovi mogli sustići one više razvijene u svakom smislu, a to se odnosi i na pristup zdravstvenoj zaštiti.

Dakle, jačajmo kohezijsku politiku, stavimo zdravstvenu zaštitu na vrh prioriteta Europske unije i doista pomozimo da se to univerzalno ljudsko pravo što više može realizirati.


  Tudor Ciuhodaru (S&D). – Domnule președinte, voi încerca să fiu scurt, dar atunci când vorbesc despre sănătate, mai ales că sunt medic, medic de urgență, v-am mai spus, în Iași, la Spitalul Clinic de Urgență Nicolae Oblu, unde un spital, un colectiv, un oraș fac urgențe și neurochirurgie la nivel european, este foarte greu să faci acest lucru.

Dar, pe de altă parte, da, haideți să vorbim despre sănătate ca un drept fundamental, și atunci sunt două bariere care se opun acestui deziderat: cea educațională și cea economică. Iar, din punctul meu de vedere, educația pentru sănătate trebuie predată de la școală – să știe fiecare dintre noi ce trebuie să facă pentru a promova un stil de viață sănătos, și nu mă refer doar la mediu. Pe pe de altă parte, bariera economică ne face mari probleme și poate ar trebui să ne gândim astăzi, împreună cu Comisia Europeană, cu Consiliul Europei, să introducem acel standard european de calitate în sănătate – în așa fel încât să pot fi tratat la Iași la fel ca la Bruxelles, la Strasbourg, la Paris și la Roma. Cel puțin în ceea ce privește un program european de sănătate a femeii pentru diagnosticarea și tratamentul precoce al celor mai frecvente forme de cancer, precum cel de col uterin, cel de sân, un program european pentru sănătatea reproducerii și asigurarea gratuită de analize pentru mamă și nou-născut, un program european de luptă împotriva cancerului și mecanismul european de protecție civilă.

Voi mai vorbi, dar uitați-vă că sunt doar zece oameni în această sală deși vorbim de sănătate.


  Pierfrancesco Majorino (S&D). –Signor Presidente, onorevoli colleghi, le Nazioni Unite, lo scorso settembre, adottando una dichiarazione politica sulla copertura sanitaria universale, hanno preso un impegno importante, solenne. Non sarà però scontato dare corpo concreto e tangibile a questo traguardo.

La salute per tutti, infatti, è un diritto che dovrebbe essere indiscutibile, ma sappiamo che non è sempre certo così e raggiungere un'effettiva copertura sanitaria universale vuol dire garantire a tutti l'accesso a servizi sanitari essenziali di qualità, la disponibilità di medicinali e vaccini essenziali sicuri ed efficaci, la reperibilità di infermieri, medici e anche operatori sociali. Vuol dire prendersi l'impegno di non lasciare indietro nessuno e per questo serve una radicale inversione di rotta in alcuni contesti e sempre e comunque un investimento significativo. Non si tratta di un costo, si tratta di un investimento.

Questo principio banale, penso che dobbiamo saperlo riaffermare sempre con i nostri comportamenti e con le nostre scelte, per garantire il benessere fisico e mentale delle donne e degli uomini.

(L'oratore accetta di rispondere a una domanda "cartellino blu" (articolo 171, paragrafo 8 del regolamento)).


  Tomislav Sokol (PPE), pitanje koje je podizanjem plave kartice postavio. – Kolega, spomenuli ste više stvari koje smatrate da bi se trebale napraviti kako bi se ovaj problem riješio. Sada, mene zanima, znamo da su države članice te koje su u Europskoj uniji primarno nadležne za pitanja zdravstvene zaštite, međutim, Europska unija ima sve veću i veću ulogu.

Pa Vas pitam vrlo konkretno: Mislite li da Europska unija treba imati još veće nadležnosti u području zdravstva, treba li dobiti veća sredstva kojima će djelovati na zdravstvene politike država članica i možemo li više kroz zajedničku akciju Europske unije tome doprinijeti nego samo kroz djelovanje pojedinih država?


  Pierfrancesco Majorino (S&D), Risposta a una domanda "cartellino blu". – Onorevole Sokol sono convinto di sì. L'Unione europea deve investire risorse e mi viene da dire, l'Unione europea deve essere coerente con sé stessa. In fondo il pilastro sociale già vede principi e scelte indicate importanti. Il tema è di non considerare tutto questo il momento dedicato all'attenzione ai più fragili, da aggiungere alle politiche dell'austerità.

La discussione di oggi dovrebbe condizionare le politiche complessive dell'Unione europea e penso che questo Parlamento si debba battere con determinazione in questa direzione.


  Nicolás González Casares (S&D). – Señor presidente, la declaración de las Naciones Unidas es un gran paso adelante.

Miren: en 1986, un héroe de la democracia española, socialista, catalán, Ernest Lluch, puso en marcha la Ley de Sanidad que instituye en nuestro país la cobertura universal. Veinticinco años después, un Gobierno del Partido Popular la retiraba, rompiendo uno de los principios básicos de nuestro sistema de salud, la justicia sanitaria.

Esta decisión dio lugar a que cientos de miles de personas quedaran sin cobertura, aumentando los riesgos epidemiológicos y provocando que miles de jóvenes, que habían emigrado por la crisis, se quedaran sin asistencia sanitaria. En 2018, otro Gobierno socialista —de Pedro Sánchez— restituyó la cobertura universal.

¿Por qué este breve trazo de la historia sanitaria de España? Pues sirve para demostrar que no bastan solo las declaraciones. Debemos estar vigilantes a nuestra derecha para no quedarnos en meras intenciones y que la tentación de los recortes sanitarios vuelva a Europa.

El derecho a la protección de la salud no entiende de raza, de sexo, de color, de condición, de fronteras. Supone un esfuerzo, pero es la inversión con mayor retorno de progreso al que pueden aspirar nuestros países. A defenderlo siempre.

(El orador acepta responder a una pregunta formulada con arreglo al procedimiento de la «tarjeta azul» (artículo 171, apartado 8, del Reglamento interno)).


  Dolors Montserrat (PPE), pregunta de «tarjeta azul». – España nunca ha dejado de tener la sanidad universal y gratuita para todos los españoles. Usted ha mentido.


  Nicolás González Casares (S&D), respuesta de «tarjeta azul». – Yo le tengo que contestar a la señora Montserrat, que ha sido ministra de Sanidad de mi país, que sí, que ellos hicieron un decreto donde retiraban la universalidad de la sanidad.

Ella dice: «para todos los españoles». Es cierto; porque una ministra, previa a ella, trataba de discriminar a aquellos que no fueran españoles o a aquellos jóvenes españoles que salían del país durante más de tres meses y se quedaban sin derecho a asistencia sanitaria; como algunas jóvenes que querían venir a dar a luz a nuestro país y no podían hacerlo porque el PP les había retirado sus derechos sanitarios.

Ya sé que usted no fue la que tomó aquella medida, pero usted es corresponsable de la misma. Además, hoy en día, en la Comunidad de Madrid también se está tratando de hacer lo mismo en estas políticas sanitarias —porque en España están transferidas a las regiones—.


Procedura "catch the eye"


  Julie Ward (S&D). – Mr President, I am proud to be from the political party that created the National Health Service. The Labour Party made it a universal right for everyone, from cradle to grave, that they should be entitled to healthcare that is free at the point of use, and we did this just after the Second World War when rationing was still in place.

We are a party that wants a truly universal health service, by scrapping prescription charges, taking on Big Pharma and delivering free personal care, so that our healthcare system puts public health ahead of private wealth and people before profit.

This is a basic human right, but sadly, not everyone has such a vital safety net. However, I am proud that the EU has supported 57 million women to use contraception, immunised 13 million children, given 11 million life-saving treatments for HIV and distributed 600 million bed nets for malaria prevention. We must work towards the 2030 agenda of universal healthcare for all, and make sure that we continue with the commitment of not leaving anybody behind.


(Fine della procedura "catch the eye")


  Neven Mimica, Member of the Commission. – Mr President, Madam Minister, honourable Members, thank you for your lively and most useful debate.

I believe that it has come out very clearly that we all share the values of universality, quality and equity of access to health care that underpin the goal of universal health coverage and that all health systems in the European Union are built on.

The adoption of the UN Declaration is an important achievement, as it promotes key EU values. But we need to make sure that the important commitments made by the UN member states will now turn into concrete actions across the globe.

In that vein, we welcome the fact that the declaration includes a formal review mechanism that allows us to take stock of the progress made in 2020 and 2022. The results should serve as a basis to adapt our approach and efforts before reconvening for another high-level meeting in 2023 for a comprehensive review of the implementation of the commitments made.

The European Union will continue supporting all countries willing to make progress towards universal health coverage through our external actions, including the external side of relevant EU policies and our international partnerships at country, regional and global level.


  Tytti Tuppurainen, President-in-Office of the Council. – Mr President, to conclude, I wish to thank the honourable Members for the very useful debate and assure you that this Presidency of Finland will spare no effort to continue to promote universal access to health care, which all human beings need, in particular the most vulnerable, when and where they need it. This is also in line with the so-called economy of well-being approach introduced by the Finnish Presidency. In our thinking, universal health coverage is a sustainable investment.

Particular attention should – and will – be devoted to the needs and rights of women and girls, including sexual and reproductive health and rights. The EU and its Member States, as key supporters of multilateralism with the United Nations at its heart, together with the European Parliament, will promote and protect those rights in the context of the review of the International Conference on Population and Development and the Beijing Platform in Action in 2020.

So thank you very much again for your attention, and now I think it’s time to say goodnight and sleep well. It is good for our health.


  Presidente. – La discussione è chiusa.

Dichiarazioni scritte (articolo 171)


  Sirpa Pietikäinen (PPE), kirjallinen. – Arvoisa puhemies, YK:n korkean tason poliittinen julistus yleiskattavasta terveydenhuollosta on merkittävä askel kohti kestävän kehityksen tavoitteen saavuttamista. Yleiskattava terveydenhuolto tarkoittaa, että kaikilla, erityisesti heikoimmassa asemassa olevilla, on pääsy välttämättömään terveydenhuoltoon. Kestävän kehityksen osatavoite 3.8 on ”saavuttaa yleiskattava terveydenhuolto, mukaan lukien turva taloudellisilta riskeiltä, pääsy laadukkaiden ja olennaisten terveydenhoitopalvelujen piiriin sekä turvalliset, tehokkaat, laadukkaat ja edulliset välttämättömät lääkkeet ja rokotukset kaikille.”

EU:n tulee olla johtavassa asemassa yleiskattavan terveydenhuollon eteenpäin viemisessä niin kansalaisilleen kuin kansainvälisestikin. Tässä on vielä paljon tehtävää myös EU:n sisällä. Erityistä huolta herättää eräiden jäsenmaiden suhtautuminen seksuaali- ja lisääntymisterveyteen ja -oikeuksiin.

Ultima actualizare: 6 martie 2024Aviz juridic - Politica de confidențialitate