It is often not appreciated enough that the EU hass
wide and growing powers to affect British people’s
health. Linda McAvan MEP, 44, represents the Labour party in Europe's
party’s views on health issues - and pretty important health is in the EU too.
The rights of patients to go anywhere in Europe for treatment - putting pressure on dire domestic services. The right of health service providers - national health systems to you and me - to compete directly with their fellow systems across borders.
All is mooted and up in the air.....
Why did you become an MEP?
A colleague of mine said “If you want to be someone, go to Westminster, if you want to do something, go to Brussels.” We seldom become household names but 60 percent of national legislation is passed down from Brussels.
How did you become an MEP?
I got on my bike in 1980 aged 17 because I couldn’t get a job in England, and became a lobbyist for a youth organization in Brussels. Studying modern languages, later at university, I am fluent in French and Spanish - although today the EU institutions are increasingly English-speaking.
After working in local government back in the UK for a few years as a European specalist I was elected to the European parliament in 1998.
What do you do all day?
It is a Monday to Thursday job, the rest of the week we spend back in our home countries doing constituency work. We spend three weeks a month in Brussels, often in committee – all MEPs are members of one and they are powerful legislative bodies. Mine is health and consumer affairs. The fourth week is spent in Strasbourg where legislation is voted through in "plenary" sessions. The European parliament, confusingly, has two seats, Brussels and Strabsourg, each of which are huge, modern building complexes.
Our job is to monitor and amend – often considerably – legislative proposals that come out of the European commission. We also hold the commission to account – they can be sacked by a vote of no confidence. We control the European union’s budget.
Are British MPs jealous of what you do?
I don’t think they are aware. Their ideas about
what MEPs can do is twenty years out of date. The
growth in our powers is quite recent. We were
directly elected only in 1979, and until the mid
eighties our powers vis-a-vis the European commission
were purely consultative. In other words they could
ignore what we said; but a number of treaties in the
1990s - the Maastricht and Amsterdam treaties - have
gradually increased our powers, so that we have
codecision - equal rights to legislate - in a large
number of areas, including the environment, food safety,
public health,
transport, consumer protection and 40 or so other
areas. Many of these issues are not health-legislation per se (governments jealously guard their national health services), but they impact greatly on health.
Because this legislation passes from us to be
rubber-stamped through by national parliaments before
entering national legislation, and media tend to
report the laws as coming from national parliaments,
the European origins of much legislation affecting
British people today tends to be obscured.
Are you pro-European or Eurosceptic?
Oh, I am passionately pro-European.
What do you think of recent European Court of justice
judgments that allow patients to be reimbursed by
national health systems for care taken
abroad. Would you approve of this theoretical
expansion of choice to enjoy care anywhere in Europe?
The idea that you could go to your GP, look at a
choose-and-book menu, and having, in addition to the
offer of that hospital in Sunderland, another, say, in
the South of France, or Bavaria.
It is not a free-for-all at the moment! That choice is
subject to to the condition that there are “too long”
waiting lists in the home country! Although what the
reference point as to what constitutes an unreasonably
long waiting list is a bit unclear at the moment. Be
also aware that the patient would have to pay upfront
to the care provider abroad before applying for
reimbursement by the NHS.
I think too much freedom will completely upset health
systems’ ability to plan care. How would the Belgian
health system for instance cope if suddenly a large
number of patients come from the UK. It would be very
destabilising. There is also the complications for
the patient of travelling, language differences, and
follow up care,
I do think this is more relevant to small countries
which cannot provide the whole spectrum of care
themselves, say Slovenia or Luxembourg, and of course
border areas, where it makes sense for hospitals on
either side of the border to share responsibilities.
Neither of these conditions apply to the UK. Despite
the judgments the overwhelming majority of people in
big countries will continue to have care at
home. The number of British people using these
judgements to enjoy care abroad is very low.
I think the right to care should be enshrined in
legislation though, not ECJ judgments.
MEPs are powerful, but there doesn’t seem to be a
career progression. You can’t be tempted into loyalty
to office, on the other hand, does that make you
independent of the national Labour party?
We are whipped by the Labour party, and have quite
good relations with the party back in the UK. Not as
split as the Tories.
What opportunities are there for medical graduates in Brussels?
There are about two dozen MEPs with medical background, including a few from Britain. Health is becoming more and more important in Brussels. There are so many NGOs where a health background is useful – European Men’s Health Forum, European Public Health Alliance, European respiratory society, just to give you a flavour. The big pharmaceutical companies have operations in Brussels.
What else is coming up in terms of European medical
legislation?
There is the medical devices and alternative therapies
directive - just as authorisation for medicines is
being centralised across Europe at the European
Medicines Agency, which is based in London, so will
the regulation of medical devices and alternative
therapies be harmonised. There
is a new public health programme, and there is
nutrition and health claims directive; it will be
illegal to make extravagant and general claims about
foodstuffs such as “it is good for you” “or low fat”
without specific substantiation. Surprisingly the
industry has lobbied strongly for legislation on
this, as they prefer a single regulatory regime for
the whole of Europe, even if it sometimes more
restrictive. It will also ban basically unhealthy
foodstuffs from selling themselves in
positive claim: for instance, there are high calcium
so-called healthfood chocolate sold in Belgium.
Cereals that are high in salt won’t be able to claim
they are healthy for instance by saying they are high
in fibre also. Hopefully all this will contribute to
fighting Europe’s growing obesity problem.
Health is a subject close to people’s hearts. Do you
get a bigger mailbag than your colleagues?
Not really. But I do get a lot of letters, especially
complaints about the new European healthcard. It has
not been made clear enough in the literature
accompanying the card that the free acute healthcare
applies only to public hospitals in Europe, not the
private clinics that dot many holiday resorts.
Private care can be very expensive. Also, the card
obviously does not cover transport home - one person
wrote in because her husband was killed and had to pay
thousands of pounds to bring the body home. There is a
danger that the card fosters false sense of security;
it is definitely NOT a substitute for travel
insurance. In fact, one of the proposals that might be
under discussion in the EU soon is compulsory travel
insurance for all travellers in Europe.
Do you enjoy living in Brussels? It is possible to
have quite a good life here, especially if you are on
a tax free commission salary!
I don’t really like to say I am “living” here, nor
that I “live it up”. I come here from Monday to
Thursday and stay in my office from 830 am to 830 pm.
But my home is Sheffield. To be honest I don’t really
like Brussels. Everyone is so status conscious: at
parties everyone sizes you up. ‘So what do you do? Ah,
you are an A-grade.'
Where do you stand on Indian doctors?
Well, the demand for work permits was a British
government decision. Nothing to do with the EU! The right of EU doctors to come to the UK to work is a basic EU right, though.
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