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1 PES SOCIALISTS & DEMOCRATS AFFORDABLE AND QUALITY HEALTHCARE FOR ALL! Conclusions of the PES Social Europe Network 3 FOREWORDS In the whole European Union, people have been living balconies and windows to applaud doctors, nurses and through difficult times. COVID-19 has created serious others working in healthcare. On behalf of the socialist repercussions for the health of citizens and for the func- and democratic political family, I warmly repeat our gra- tioning of our health and care systems. It has exposed titude and appreciation for their work. But our thanks is shortcomings. And it has demonstrated the need for not enough. change. For us the conclusion is clear: it is time to build As a society, we must ensure healthcare workers and strong and inclusive healthcare systems fit to deliver the systems in which they operate are well resourced, quality and affordable access to all. world-leading and accessible to all citizens. This is how Already for a very long period, socialists and democrats we honour the contribution of those who bravely got us are leading the fight for strong welfare states. Across through this crisis, including the women and men who Europe we succeeded in building sophisticated health gave their own lives to save ours. Speaking about gua- and care systems. But now, after a ranteeing health at work, we must step up our efforts to decade or more of neoliberal policies prevent work-related illnesses, accidents and other phy- following the 2008 financial crash, sical or psychological stresses. Nobody should die from austerity has taken its toll. It is time to her or his job, we set the target at zero work-related reverse this damage and boost our deaths. investments in this field. Lastly, we cannot overlook the question of access to At this critical moment, our political medicines. We must ensure that Europe is no longer family is addressing the rising completely dependent on third countries when it comes challenges in health. We are coming to the global chain of production and supply for basic forward with concrete social-demo- medical equipment. At the same time, in order to cratic policies. With this document, guarantee the access to medicines to all citizens, we we hope to put our social democratic must ensure enough stocks, support fair and transpa- common positions and policies at the rent pricing of drugs and invest in future development heart of the EU’s health agenda. of new quality medicinal products. Agnes Jongerius Very soon, if it has not already begun, I would like to take the opportunity to thank PES party Chair of the PES Social Member States will begin to assess their response to representatives, MEPs, trade unions and the different Europe Network the COVID-19 pandemic. The first observation from this civil society organisations for their rich contributions to crisis – one which ignored national borders – is clear: the PES Social Europe Network. By working together healthcare may be a national competence, but EU co- and applying our vision on health – contained in the operation will be vital to increase resilience and pages that follow - we can ensure that every single per- strengthen national systems. This truth cannot be son in Europe has access to quality and affordable understated. public healthcare. This should be our goal and we The second principal observation is this: we must should accept nothing less. Now, let’s begin the fight to immediately address the concerns of healthcare wor- achieve it. kers. Over the previous months of lockdown, citizens across Europe have spontaneously come to their 4 Since the beginning of this year, healthcare has domi- healthcare is at the core of our values, principles and nated public discussion and political debate. The ideology. It is not simply a reaction to today’s challen- COVID-19 crisis has put our societies under immense ges. It is to future-proof healthcare for citizens, so our pressure, drawing into question the readiness and resi- systems are ready to meet the tests that will emerge. lience of Europe’s health systems. That is why we are continuing our fight for the recovery Societies have rightly applauded the dedication and of our healthcare systems, for workers to be paid pro- professionalism of doctors, nurses and the countless perly and enjoy good working conditions, for universal others working in healthcare. But the debate on how to access to health and care services, and for increasing support and strengthen healthcare must not end. On European autonomy in medicines and equipment. the contrary, now is the time to look at ways to build By delivering on these proposals, as set out in this their resilience. document, we are showing where our political family Healthcare has long been a priority for our political stands. We will keep pushing to improve the readiness family. As socialists and democrats, we are at the fore- and resilience of our health systems. Together, across front of the battle for strong social welfare systems. We Europe, we will prioritise the health of citizens. We will hold universal access to affordable and quality health- leave no one behind. care as a mark of a prosperous and social society. This paper is the culmination of efforts, over many years, to achieve this aim. The PES has mobilised our political family to deepen our work and discussions in this key area. These constructive exchanges have resulted in this document - an important step forward for the PES’s vision of a Social Europe. This paper is published at an important time. For far too long, the area of health in EU member states has been dominated by conservative and neoliberal policies. Measures they have pushed for, such as budget cuts in health, have undermined healthcare and public services. The consequences of this austerity have been thrown into sharp relief by the COVID-19 pandemic. A dark rea- lity has been revealed - doctors and frontline workers Sergei Stanishev are ill-equipped and overworked. Access to healthcare PES President is still limited for some people. And as a continent we are overly dependent on foreign supply chains for equipment and medicines. This cannot go on. This crisis has proven what socialists and democrats have long stated – our push for the best possible 5 The European socialist and democratic family has a family’s position on health. The key conclusions of this clear overarching mission: to improve the lives of all work form the basis of this document. citizens based on solidarity, equality and respect. We Although the decision to create a document on health fight for excellent education and employment, good was taken long before the pandemic hit Europe, much quality homes, a clean environment, and solid public of the work to produce this brochure took place at a services that can be relied upon in times of need. time when Europe was facing its biggest health crisis in Achieving this aim – the creation of a truly social and a century: COVID-19. democratic European Union – depends on health, and This crisis inevitably shaped this document, as we wide- more specifically: effective and inclusive health policy. ned the text to include specific measures and proposals After all, the good health of our society is reliant upon on COVID-19, but it also provided ample evidence which the good health of our citizens. reaffirmed our political family’s core belief: that quality, The political debate on health – at national and Euro- universally accessible healthcare must be a priority for pean level - has always needed a strong social-demo- our societies. cratic dimension. We are the voice pushing for invest- This paper is a toolbox of policy proposals to achieve ment and better public services, and against those this aim. It is by promoting the principles and positions which treat healthcare as a commodity. It is a funda- described in this text that we will ensure that Europe mental right which must be guaranteed. and its Member States provide and deliver quality and To strengthen this voice, we - the PES - have stepped affordable health and care services to all. Let’s work up our work in this area over the course of several towards making this a reality! years. At the ministerial level we have established the PES Health Ministerial Network which meets ahead of EU Health Councils. At the same time, the PES Social Europe Network has proved a valuable platform to hold ongoing discussions on health with our parties and partners. At the beginning of this year, the PES Presi- dency adopted the PES Action Plan for 2020, and took the decision to formally define our political family’s common principles and positions on health. This docu- ment - Quality healthcare for all - sets out these com- mon principles, values and ambitions. This brochure is the culmination of discussions with representatives from PES member parties, NGOs, social partners and MEPs, held through the Social Europe Network. Under the fruitful chairpersonship of MEP Yonnec Polet Agnes Jongerius, we were able to lead many construc- PES Deputy Secretary General tive exchanges which helped solidify our political TABLE OF CONTENTS 1. Introduction – Europe, a history of improving healthcare access for all 7 2. Addressing inequalities in health: delivering truly universal access 10 2.1 Health inequalities in and between member states 10 2.2 Public health services: a pillar of the EU social model 15 2.3 A multigenerational challenge 16 3. Reviewing the financing of healthcare systems in Europe 18 4. Better prevention: promoting a healthy lifestyle 22 5. Training the most qualified doctors and nurses 26 6. Access to medicines and medical supplies 28 6.1 Guaranteeing affordable medicines 28 6.2 Having control over medicine production 30 7.

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