Text proposed by the European Commission

CoR amendment

While Member States are responsible for their health policies, they are expected to protect public health in a spirit of European solidarity. Experience from the ongoing COVID-19 crisis has demonstrated that there is a need for a further firm action at Union level to support cooperation and coordination among the Member States in order to improve the prevention and control of the spread of severe human diseases across borders, to combat other serious cross-border threats to health and to safeguard the health and well-being of people in the Union.

While Member States are responsible for their health policies, they are expected to protect public health in a spirit of European solidarity , as also provided for in Article 222 TFEU, which stipulates that the Union and its Member States shall act in a spirit of solidarity . Experience from the ongoing COVID-19 crisis has demonstrated that there is a need for a further firm action at Union level to support cooperation and coordination among the Member States and local and regional authorities and, where necessary, public institutions, in order to improve the prevention and control of the spread of severe human diseases across borders, to support the development of and make available the products needed to prevent and treat disease , to combat other serious cross-border threats to health and to safeguard the health and well-being of people in the Union.

Text proposed by the European Commission

CoR amendment

Due to the serious nature of cross-border health threats, the Programme should support coordinated public health measures at Union level to address different aspects of such threats. With a view to strengthen the capability in the Union to prepare for, respond to and manage health crisis the Programme should provide support to the actions taken in the framework of the mechanisms and structures established under Decision No 1082/2013/EU of the European Parliament and of the Council and other relevant mechanisms and structures established at Union level. This could include strategic stockpiling of essential medical supplies or capacity building in crisis response, preventive measures related to vaccination and immunisation, strengthened surveillance programmes. In this context the Programme should foster Union-wide and cross-sectoral crisis prevention, preparedness, surveillance, management and response capacity of actors at the Union, national, regional and local level, including contingency planning and preparedness exercises, in keeping with the ‘One Health’ approach. It should facilitate the setting up of an integrated cross-cutting risk communication framework working in all phases of a health crisis — prevention, preparedness and response.

Due to the serious nature of cross-border health threats, the Programme should support coordinated public health measures at Union level to address different aspects of such threats. With a view to strengthen the capability in the Union to prepare for, respond to and manage health crisis the Programme should provide support to the actions taken in the framework of the mechanisms and structures established under Decision No 1082/2013/EU of the European Parliament and of the Council and other relevant mechanisms and structures established at Union level. This could include strategic stockpiling of essential medical supplies, promoting investment in the production of devices and pharmaceutical products to combat pandemics and other public health scourges in order to ensure European sovereignty, capacity building in crisis response, or support for the development by Member States of a statistical protocol making it possible to compare data on the impact of pandemics at NUTS 2 level, preventive measures related to vaccination and immunisation, or strengthened surveillance programmes. In this context the Programme should foster Union-wide and cross-sectoral crisis prevention, preparedness, surveillance, management and response capacity of actors at the Union, national, regional and local level, including contingency planning and preparedness exercises, in keeping with the ‘One Health’ approach. It should facilitate the setting up of an integrated cross-cutting risk communication framework working in all phases of a health crisis — prevention, preparedness and response.

Text proposed by the European Commission

CoR amendment

With a view to protect people in vulnerable situations, including those suffering from mental illnesses and chronic diseases, the Programme should also promote actions which address the collateral impacts of the health crisis on people belonging to such vulnerable groups.

With a view to protect people in vulnerable situations, including those suffering from mental illnesses and chronic diseases (including obesity) , the Programme should also promote actions which address the collateral impacts of the health crisis on people belonging to such vulnerable groups. In order to ensure high standards for essential health services, the Programme should encourage, particularly in times of crisis and pandemic, the use of telemedicine.

Text proposed by the European Commission

CoR amendment

Experience from the COVID-19 crisis has indicated that there is a general need for the support to structural transformation of and systemic reforms of health systems across the Union to improve their effectiveness, accessibility and resilience. In the context of such transformation and reforms, the Programme should promote, in synergy with the Digital Europe Programme, actions which advance digital transformation of health services and increase their interoperability, contribute to the increased capacity of health systems to foster disease prevention and health promotion, to provide new care models and to deliver integrated services, from the community and primary health care to the highly specialised services, based on people’s needs and ensure an efficient public health workforce equipped with the right skills, including digital skills. The development of a European health data space would provide health care systems, researchers and public authorities with means to improve the availability and quality of healthcare. Given the fundamental right to access to preventive healthcare and medical treatment enshrined in Article 35 of the Charter of Fundamental Rights of the European Union and in view to the common values and principles in European Union Health Systems as set out in the Council Conclusions of 2 June 2006 (12) the Programme should support actions ensuring the universality and inclusivity of health care, meaning that no-one is barred access to health care, and those ensuring that patients’ rights, including on the privacy of their data, are duly respected.

Experience from the COVID-19 crisis has indicated that there is a general need for the support to structural transformation of and systemic reforms of health systems across the Union to improve their effectiveness, accessibility and resilience. These reforms, in the context of a revamped European Semester, need to strengthen the specific features of European health systems based on strong public services and substantial public investment. Health services are services of general interest intended to strengthen the European Pillar of Social Rights, which cannot be made subject to private-sector thinking. In the context of such transformation and reforms, the Programme should, taking into consideration how the Member States organise their health systems, organise the coordination and funding of stress tests in the Member States in order to identify weaknesses and to assess their ability to respond to pandemics. The programme should furthermore promote, in synergy with the Digital Europe Programme, actions which advance digital transformation of health services and increase their interoperability, contribute to the increased capacity of health systems to foster disease prevention and health promotion, to provide new care models and to deliver integrated services, from the community and primary health care to the highly specialised services, based on people’s needs and ensure an efficient public health workforce equipped with the right skills, including digital skills. The development of a European health data space would provide health care systems, researchers and public authorities with means to improve the availability and quality of healthcare. Given the fundamental right to access to preventive healthcare and medical treatment enshrined in Article 35 of the Charter of Fundamental Rights of the European Union and in view to the common values and principles in European Union Health Systems as set out in the Council Conclusions of 2 June 2006 (12) the Programme should support actions ensuring the universality and inclusivity of health care, meaning that no-one is barred access to health care, and those ensuring that patients’ rights, including on the privacy of their data, are duly respected.

Text proposed by the European Commission

CoR amendment

The Programme therefore should contribute to disease prevention throughout the lifetime of an individual and to health promotion by addressing health risk factors, such as the use of tobacco and related products and exposure to their emissions, the harmful use of alcohol, and the consumption of illicit drugs. The Programme should also contribute to the reduction of drugs-related health damage, unhealthy dietary habits and physical inactivity, and exposure to environmental pollution, and foster supportive environments for healthy lifestyles in order to complement Member States action in these areas. The Programme should also therefore contribute to the objectives of the European Green Deal, the Farm to Fork Strategy and the Biodiversity Strategy.

The Programme therefore should contribute to disease prevention throughout the lifetime of an individual and to health promotion by addressing health risk factors, such as the use of tobacco and related products and exposure to their emissions, the harmful use of alcohol, and the consumption of illicit drugs. The Programme should also contribute to the reduction of drugs-related health damage, unhealthy dietary habits and physical inactivity, and exposure to environmental pollution, and foster supportive environments for healthy lifestyles in order to complement the action of Member States and local and regional authorities in these areas. The Programme should also therefore contribute to the objectives of the European Green Deal, the Farm to Fork Strategy and the Biodiversity Strategy.

Text proposed by the European Commission

CoR amendment

The Programme will work in synergy and complementarity with other EU policies, programmes and funds such as actions implemented under the Digital Europe Programme, Horizon Europe, rescEU reserve under the Union Civil Protection Mechanism, Emergency Support Instrument, European Social Fund+ (ESF+, including as regards synergies on better protecting the health and safety of millions of workers in the EU), including the Employment and Social Innovation Strand (EaSI), the InvestEU fund, Single Market Programme, European Regional Development Fund (ERDF), Recovery and Resilience Facility including the Reform Delivery Tool, Erasmus, European Solidarity Corps, Support to mitigate Unemployment Risks in an Emergency (SURE), and EU external action instruments, such as the Neighbourhood, Development and International Cooperation Instrument and the Instrument for Pre-accession Assistance III. Where appropriate, common rules will be established in view of ensuring consistency and complementarity between funds, while making sure that specificities of these policies are respected, and in view of aligning with the strategic requirements of these policies, programmes and funds, such as the enabling conditions under ERDF and ESF+.

The Programme will work in synergy and complementarity with other EU policies, programmes and funds such as actions implemented under the Digital Europe Programme, Horizon Europe, rescEU reserve under the Union Civil Protection Mechanism, Emergency Support Instrument, European Social Fund+ (ESF+, including as regards synergies on better protecting the health and safety of millions of workers in the EU), including the Employment and Social Innovation Strand (EaSI), the InvestEU fund, Single Market Programme, European Regional Development Fund (ERDF), Recovery and Resilience Facility including the Reform Delivery Tool, Erasmus, European Solidarity Corps, Support to mitigate Unemployment Risks in an Emergency (SURE), and EU external action instruments, such as the Neighbourhood, Development and International Cooperation Instrument and the Instrument for Pre-accession Assistance III. Where appropriate, and if necessary, in coordination with the managing authorities of the European Structural and Investment Funds, common rules will be established in view of ensuring consistency and complementarity between funds, while making sure that specificities of these policies are respected, and in view of aligning with the strategic requirements of these policies, programmes and funds, such as the enabling conditions under ERDF and ESF+.

Text proposed by the European Commission

CoR amendment

The Union health legislation has an immediate impact on public health, the lives of citizens, the efficiency and resilience of the health systems and the good functioning of the internal market. The regulatory framework for medical products and technologies (medicinal products, medical devices and substances of human origin), as well as for tobacco legislation, patients’ rights in cross-border healthcare and serious cross-border threats to health is essential to health protection in the Union. The Programme therefore should support the development, implementation and enforcement of Union health legislation and provide high quality, comparable and reliable data to underpin policymaking and monitoring.

The Union health legislation has an immediate impact on public health, the lives of citizens, the efficiency and resilience of the health systems and the good functioning of the internal market. The regulatory framework for medical products and technologies (medicinal products, medical devices and substances of human origin), as well as for tobacco legislation, patients’ rights in cross-border healthcare and serious cross-border threats to health is essential to health protection in the Union. The Programme therefore should support the development, implementation and enforcement of Union health legislation and provide high quality, comparable and reliable NUTS 2 regional-level data to underpin policymaking and monitoring.

Text proposed by the European Commission

CoR amendment

Cross-border cooperation in the provision of healthcare to patients moving between Member States, collaboration on health technology assessments (HTA), and European Reference Networks (ERNs) are examples of areas where integrated work among Member States has shown to have strong added value and great potential to increase the efficiency of health systems and thus health in general. The Programme should therefore support activities to enable such integrated and coordinated work, which also serves to foster the implementation of high-impact practices that are aimed at distributing in the most effective way the available resources to the concerned population and areas so as to maximise their impact.

Cross-border cooperation in the provision of healthcare to patients moving between Member States or European Groupings of Territorial Cooperation (EGTCs), collaboration on health technology assessments (HTA), and European Reference Networks (ERNs) are examples of areas where integrated work among Member States and local and regional authorities has shown to have strong added value and great potential to increase the efficiency of health systems and thus health in general. The Programme should therefore support activities to enable such integrated and coordinated work, which also serves to foster the implementation of high-impact practices that are aimed at distributing in the most effective way the available resources to the concerned population and areas so as to maximise their impact. For example, as recommended by the European Committee of the Regions in its opinion on cross-border healthcare, the programme should set up ‘health corridors’ between the border regions, making it possible for patients and health professionals to continue moving across the border during the lockdown to guarantee access to and provision of care.

Text proposed by the Commission

CoR amendment

In order to ensure that all of these objectives are implemented at Union level, the European Commission should strengthen the budget and mandate of the various European agencies responsible for health, such as the European Centre for Disease Prevention and Control, the European Medicines Agency, the European Food Safety Authority, the European Chemicals Agency and the European Agency for Safety and Health at Work. Furthermore, the work of these agencies should be better coordinated so that they can more effectively contribute to achieving the objectives of the EU4Health programme, and their role in the governance of this programme should be strengthened.

Text proposed by the Commission

CoR amendment

Given the specific nature of the objectives and actions covered by the Programme, the respective competent authorities of the Member States are best placed in some cases to implement the related activities. Those authorities, designated by the Member States themselves, should therefore be considered to be identified beneficiaries for the purpose of Article 195 of the Financial Regulation and the grants be awarded to such authorities without prior publication of calls for proposals.

Given the specific nature of the objectives and actions covered by the Programme, the respective competent authorities of the Member States and local and regional authorities with competences in the field of public health are best placed in some cases to implement the related activities. Those authorities, designated by the Member States themselves, should therefore be considered to be identified beneficiaries for the purpose of Article 195 of the Financial Regulation and the grants be awarded to such authorities without prior publication of calls for proposals.

Text proposed by the European Commission

CoR amendment

Reflecting the importance of tackling climate change in line with the Union’s commitments to implement the Paris Agreement and the United Nations Sustainable Development Goals, this Programme will contribute to mainstream climate action in the Union’s policies and to the achievement of an overall target of 25 % of the EU budget expenditures supporting climate objectives. Relevant actions will be identified during the Programme’s preparation and implementation, and reassessed in the context of its mid-term evaluation.

Reflecting the importance of tackling climate change in line with the Union’s commitments to implement the Paris Agreement and the United Nations Sustainable Development Goals, this Programme will contribute to mainstream climate action in the Union’s policies and to the achievement of an overall target of 30 % of the EU budget expenditures supporting climate objectives. Relevant actions will be identified during the Programme’s preparation and implementation, and reassessed in the context of its mid-term evaluation.

Text proposed by the European Commission

CoR amendment

The implementation of the Programme should be such that the responsibilities of the Member States, for the definition of their health policy and for the organisation and delivery of health services and medical care, are respected.

The implementation of the Programme should be such that the responsibilities of the Member States and, if necessary, the regions or other tiers of government involved in drafting health policy , for the definition of their health policy and for the organisation and delivery of health services and medical care, are respected.

Text proposed by the Commission

CoR amendment

Strengthen health systems and the healthcare workforce, including by digital transformation and by increased integrated and coordinated work among the Member States, sustained implementation of best practice and data sharing, to increase the general level of public health.

Strengthen health systems and the healthcare workforce, including by digital transformation and by increased integrated and coordinated work among the Member States and the local and regional authorities with competences in the field of public health, through the coordination of health and social care actors in areas that match population centres , through the sustained implementation of best practice and data sharing, to increase the general level of public health.

Text proposed by the European Commission

CoR amendment

The general objectives referred to in Article 3 shall be pursued through the following specific objectives, in keeping with the ‘One Health’ approach where relevant:

The general objectives referred to in Article 3 shall be pursued through the following specific objectives, in keeping with the ‘One Health’ approach where relevant:

Text proposed by the European Commission

CoR amendment

Text proposed by the European Commission

CoR amendment

The Commission shall consult the health authorities of the Member States in the Steering Group on Health Promotion, Disease Prevention and Management of Non-Communicable Diseases on the work plans established for the Programme and its priorities and strategic orientations and its implementation.

The Commission shall consult, at the national or — where competences are shared — at the regional and local level, the health authorities of the Member States in the Steering Group on Health Promotion, Disease Prevention and Management of Non-Communicable Diseases on the work plans established for the Programme and its priorities and strategic orientations and its implementation. This will ensure that local and regional authorities that are responsible for health policies are involved in this exercise.

Text proposed by the Commission

CoR amendment

Support knowledge transfer actions and Union level cooperation to assist national reform processes towards improved effectiveness, accessibility, sustainability and resilience, in particular to address the challenges identified by the European Semester and to strengthen primary care, reinforce the integration of care and aim at universal health coverage and equal access to healthcare;

Support knowledge transfer actions and Union level cooperation to assist national reform processes , in consultation with regional and local authorities competent in the field of public health, towards improved effectiveness, accessibility, sustainability and resilience, in particular to address the challenges identified by the European Semester and to strengthen primary care, reinforce the integration , coordination and gradation of care and aim at universal health coverage and equal access to healthcare;

Text proposed by the Commission

CoR amendment

Audit of Member States preparedness and response arrangements (such as crisis management, antimicrobial resistance, vaccination);

Audit of Member States’, and where appropriate, regional and local authorities preparedness and response arrangements (such as crisis management, antimicrobial resistance, vaccination);

Text proposed by the Commission

CoR amendment

Support upwards convergence of national systems’ performance through indicator development, analysis and knowledge brokering and the organisation of stress tests of national healthcare systems;

Support upwards convergence of national systems’ performance through indicator development, analysis and knowledge brokering and the organisation of stress tests of national healthcare systems, involving local and regional authorities with competences in the field of public health ;

Text proposed by the Commission

CoR amendment

Support the establishment and implementation of programmes assisting Member States and their action to improve health promotion and disease prevention (for communicable and non-communicable diseases);

Support the establishment and implementation of programmes assisting Member States , local and regional authorities and their action to improve health promotion and disease prevention (for communicable and non-communicable diseases) , enabling their actions to be promoted when drafting and implementing actions tailored to their specific public health features ;

Text proposed by the Commission

CoR amendment

Support Member States’ actions to put in place healthy and safe urban, work and school environments, to enable healthy life choices and promote healthy diets taking into account the needs of vulnerable groups;

Support Member States’ and local and regional authorities’ actions to put in place healthy and safe urban, work and school environments, to enable healthy life choices and promote healthy diets taking into account the needs of vulnerable groups;

Text proposed by the Commission

CoR amendment

Support for Member States to strengthen the administrative capacity of their healthcare systems through benchmarking, cooperation and exchange of best practices;

Support for Member States , and where appropriate, for local and regional authorities, to strengthen the administrative capacity of their healthcare systems through benchmarking, cooperation and exchange of best practices;

Text proposed by the Commission

CoR amendment

Communication to promote disease prevention and healthy lifestyles, in cooperation with all concerned actors at international, Union and national level.

Communication to promote disease prevention and healthy lifestyles, in cooperation with all concerned actors , and tailored to the local, regional, national, international and Union level.

Text proposed by the Commission

CoR amendment

Text proposed by the Commission

CoR amendment

Quality and completeness of EU and MS preparedness and response planning for serious cross border threats to health

Quality and completeness of EU, MS and where appropriate, regional and local preparedness and response planning for serious cross border threats to health

Text proposed by the Commission

CoR amendment

Number of actions and best practices directly contributing to the SDG 3.4/Member State

Number of actions and best practices directly contributing to the SDG 3.4/Member State, including best practices from the regional and local level, where appropriate.

Text proposed by the Commission

CoR amendment

Implementation of best practices by EU Member States

Implementation of best practices by EU Member States , and local and regional authorities competent in the field of health.

Text proposed by the Commission

CoR amendment

Number of Member States with improved preparedness and response planning

Number of Member States , and where appropriate, local and regional authorities with improved preparedness and response planning