Protection of public health is a fundamental obligation of a state. In my native Greece, ensuring the health of citizens is a democratic obligation enshrined in our constitution. Health policies reflect social values, political choices and democratically formed national priorities, things which differ across the European Union’s member states.
Maintaining national sovereignty in this field therefore does not constitute a rejection of European co-operation but is a necessary condition for ensuring the effectiveness and social acceptance of interventions.
European policymaking seeks to take decisions at the level best suited to achieving a goal, not to impose uniform policies for the sake of co-ordination and integration. In the field of health, the ultimate goal is to ensure the optimal healthcare services for all citizens.
This article is part of The Parliament's latest policy report, "Building a healthier Europe."
The dangers of unnecessary uniform European policies were shown in the economic crisis, in which Greece suffered greatly. Uniform European policies led to significant cuts in healthcare spending, which had serious social consequences.
These included an increase in the number of children without access to essential health services, limited access to basic healthcare for vulnerable populations and the degradation of primary care. The impact of fiscal discipline on health was laid bare for all to see.
Varied health challenges across member states
Country-specific realities underscore the importance of national control in shaping policy. For example, Greece has a wide geographical dispersion of its citizens across its islands and mainland. It also has an ageing population. Disease patterns in the country, such as the high frequency of cardiometabolic conditions, also differ from those in Scandinavian or Central European countries.
The imposition of uniform policies without sufficient adaptation to local conditions like these carries serious risks. The healthcare needs of an urban centre like Thessaloniki are not the same as those of Kastellorizo, a Greek island. One-size-fits-all policies are therefore ineffective.
Efforts at standardisation may lead to inefficiency and citizen disengagement. Policies imposed with a ‘top-down’ logic risk being faced with resistance or mistrust, especially in sensitive areas.
Excessive bureaucratic adherence to common European standards could also stifle innovation. Greece has demonstrated several examples of inventive solutions, such as social clinics or the use of telemedicine in remote areas. These solutions emerged from necessity and were adapted to the local environment.
EU as a co-ordinator for health
This need to focus on a country’s diversity does not mean that the EU has no role in health. European co-operation is essential in areas such as epidemic management, pharmaceutical research and development, digital system interoperability and healthcare in remote regions.
Its role must remain supportive. The EU should continue to provide a framework for co-ordination, encourage the exchange of best practices and issue funding for effective management of issues, without imposing uniform policies in nationally sensitive sectors.
Maintaining national sovereignty in health policy is not an obstacle to European integration. It is a prerequisite for achieving fairer, more effective and socially acceptable policies.
Each member state must have the ability to tailor its strategies to the needs and values of its citizens, making the most of what European co-operation offers without undermining its national autonomy.
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