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Public Health

Health-EU newsletter 236 - Focus

European Semester: Health reforms need to continue

Director-General for Health and Food Safety Anne Bucher discusses the implications for the health sector of the ‘Spring Package’, which the Commission adopted on 5 June 2019. Each spring, the Commission presents country-specific recommendations as part of the European Semester cycle that supports the coordination of economic, fiscal and social policies among the Member States in the EU. The 2019 Spring Package included a number of recommendations to encourage health reforms in the next 12 - 18 months.

Could you explain what the European Semester cycle is, and why it includes health?

The European Semester cycle is part of the EU's economic governance framework and helps EU countries to avoid excessive government debt, prevent macroeconomic imbalances, support structural reforms in various areas, including health, and promote jobs, social inclusion, growth and investment. The Commission’s proposals present the major areas for reform and give direction. But the Commission does not act on its own. The recommendations require the blessing from the Council in July of the same year, and Member States may decide to modify them during this process. The implementation of recommendations is monitored throughout the year and reported on in the Commission's country reports in February/March the following year.

I cannot imagine a cycle of economic, fiscal and social policy coordination without health policy, which supports longer and productive working lives and aims to make essential healthcare accessible for all. Not to mention that health is one of the most innovative sectors and accounts on about one tenth of the EU’s gross domestic product. Together with the social care sector, it provides qualified jobs for about 8 % of our workforce. High-quality, affordable and accessible healthcare is key.

What recommendations has the Commission put forward on health?

The health recommendations range from ensuring fiscally sustainable health systems and strengthening outpatient care to reducing high out-of-pocket fees faced by EU citizens and strengthening prevention policies. I'd like to stress that it isn't the Commission's intention to single out countries as lacking in one way or another. We want to help them identify priorities to help make national health systems more effective, accessible and resilient. The Commission bases its analysis and recommendations on a thorough assessment of the national situation and also takes into account the knowledge provided by the State of Health in the EU initiative.

Why do the recommendations this year highlight investment needs in various policy areas?

The Commission would like to advance a ‘virtuous triangle' which combines policies to promote reforms, investment and fiscal responsibility. Identifying and addressing investment needs is thus a key priority of this year’s European Semester – also with a view to the negotiations about the future Multiannual Financial Framework, the EU’s budget for 2021 to 2027. During this year’s European Semester cycle, the Commission deepened discussion on overall investment challenges and priorities in Member States – all across the various policy areas and sectors. In the field of health, we identify investment needs for a couple of countries, and, for countries where we did not specify health investment needs, investment needs were described in the respective country-reports, which we issued earlier this year as the analytical basis for our recommendations.

Activities at EU level

EU Health Policy - Health systems coordination

European Commission – Health and Food Safety

The European Semester

European Commission – EU Economic and Fiscal Coordination


European Semester: Commission proposes health recommendations

The Commission has adopted proposals for country specific recommendations, including on health and investments in health as part of its ongoing assistance to Member States in implementing their health systems reforms in the light of an ageing population.

Read the health reform recommendations adopted by the European Commission

2019 European Semester: Annual Growth Survey

Find here the Annual Growth Survey, as well as infographics on the economic achievements made since 2014 and EU economic performance.

See the factsheet on the European Semester

What is the timeline for the European Semester, and who are the key players?

This timeline shows the roles of different EU institutions and the scheduling of the semesters.

Health Programme Projects

EU Health Programme

The EU Health Programme can provide support and funding to help Member States to implement specific actions and initiatives that may contribute to making their health systems more effective, resilient and sustainable.

Other interesting links

State of Health in the EU

The State of Health in the EU is a two-year initiative undertaken by the European Commission that provides policy makers, interest groups, and health practitioners with factual, comparative data and insights into health and health systems in EU countries.

European Observatory on Health Systems and Policies

The Observatory supports and promotes evidence-based health policy-making through comprehensive and rigorous analysis of the dynamics of health care systems in Europe.