28 October 2010
In these days when the use of taxpayers’ money to bail out failing economies, and politicians are grappling with rising public debt, it is always timely to reflect on how the Commission spends our money. Without obvious evidence that it understands the notion of ‘belt-tightening’, meetings where the minutes are taken and the hours are lost will continue to proliferate without some mechanism to constrain this upward spiral of expenditure. Can Council members constrain this growth with the funding of the European institutions, when they themselves are beneficiaries of the very same profligacy with taxpayers’ money in their own countries?
As health is my area of expertise, I am always interested in how the Commission determines its direction in the health space, how it uses the various agencies operating at the EU level to counterbalance the influence of the member states. And of course how criticism is absorbed or neutralised within this great steampunk machine.
I wondered about this when I was reading the latest (draft) minutes of the renewed (!) Health Policy Forum. I was struck by the possibility that this group is not designed to be a critical participant in the developing of ideas and therefore, I wondered what purpose it served.
There is a clue on the Forum website: “The Health Policy Forum brings together pan-European stakeholder organisations in the health sector at EU level to ensure that the EU’s health strategy is open, transparent and responds to public concerns.”
But the efforts at renewal were designed specifically, as far as I can see, to align this group with the Commission’s workplan and to ensure that it acts favourably toward Commission initiatives. We read (of the opening of the meeting): “In her introduction to the meeting Ms Testori Coggi presented herself and underlined the importance, role and mandate of the EU Health Policy forum. She stressed in particular the importance of activities in the field of disease prevention and health promotion including lifestyle related activities and health literacy.” In other words, this is what is important, regardless of whether you think otherwise. I have no difficulty with these as general goals but they are largely opaque generic terms. The devil is always in the detail, and that is what we didn’t read about.
The meeting must have been most enjoyable, as it seemed to consist of a parade of presentations (no doubt more ‘death by powerpoint’) by people telling the Forum attendees what they were doing. Why bring your brain to a meeting like this?
I was also taken by this interesting line in the minutes: “Member organisations of the EUHPF are in particular invited to talk to their constituencies in the Member States in view to engage as well the national, regional and local level with the aims and objectives of the EU 2020 strategy in order to strengthen the health and social impact in the implementation of the strategy.” In other words, your job it to get the word out, not to engage with ‘us’ critically about what the strategy should be. Do your job, we bought you lunch.
The minutes indicate that questions were asked, such as CPME’s on e-health and cross-border healthcare, to which the presidency ‘agreed’, but whether anything will actually happen isn’t clear. The questions were absorbed into the rhetoric of the meeting, with soft noises of agreement and acknowledgement. But nothing really challenging was asked (assuming the minutes reflect the dynamism of the meeting) and, no doubt, no one was offended.
I wonder if those attending knew they were quiety being co-opted to act as agents of policy rather than engage in a meaningful policy-oriented discussion within a market-place of ideas.
I guess that’s what a Health Policy Forum is for.
Is there a directory of entities like these, do we know what are they for, do we know what they cost, and do we know if they make a difference?
Am I bad tempered about this? No. I want these processes to work, I just worry that in the rush to be accepted as a stakeholder, these groups may neglect their critical perspective. One must always be mindful of rent-seeking behaviour by the Commission, especially when it comes to forms of consultation.
NOTE: The forum lasted one day, involved 10 Commission employees, a secretariat of 4 people, 2 people from the Council (Belgium, Spain) and some 67 people from the ‘renewed’ stakeholder membership.EuroSante