Health care and care for the elderly

Lambert (Verts/ALE). - Mr President, as a visibly greying member of the population I have a considerable interest in this debate, as do many others in this House. I have some concern about the climate of it. I would like to believe that it is genuinely about providing universal high-quality care in a variety of situations and circumstances, but that is certainly not the tone of the debate as it often comes across in a number of our Member States, where it seems to be all about how we can cut costs and find the money to make provisions. As others have said, that is not the only way in which we should be looking at this issue, if we should be looking at it that way at all.

One way of improving the situation is to pay reasonable wages to well-trained and qualified staff. I am aware that non-medical care is one of the fastest growing areas in terms of job creation. However, it is all too often very poorly paid, it is often done by women, by migrant women, and the staff are often recruited with difficulty. It is certainly a boom area for temporary work agencies in the UK. Yet those workers are then treated as if they are some sort of disposable commodity and as if the work is unskilled, whereas care work is immensely skilled and stressful.

We also need to look at the implications of the current employment policy which not only encourages but actively pushes more people, especially women, into the workforce and away from the caring role they might have fulfilled or the voluntary work they might have done.

I am not saying that women should be forced to stay at home. I have never believed that. But it means that we must look carefully at the financial and social support for carers, which should reflect the much larger costs that society would otherwise bear.

We also need to recognise that carers who are in work need leave provision, not just parents. We need to look at the employment needs of carers. I am pleased to say that the equal funding is being used for at least one such project involving the UK.

Some of my other concerns also focus on the issue of discrimination in the provision of health care for the elderly. This is observed in quite a number of Member States. It is a useful area for comparison between Member States and might at some point be part of another horizontal directive for Article 13.

We mentioned in the debate the issue of an adequate income for older people. I am very pleased that paragraph 7 of Mr Mantovani's report, quoting the World Health Organisation, talks about health being best served in a more socially cohesive, egalitarian society with a smaller burden of relative deprivation.

People have raised the question of the internal market in health care, not just in terms of cross-border treatment, although, judging by the post I receive, the ability to transfer disability allowances and carers' allowances across borders under Regulation 1408/71 would be welcomed. It is also an issue of cross-border service providers and increasing provision from third country providers.

As Ms Evans said, it is not yet clear what impact the future negotiation on GATS will have on service provision and which aspects of health care and other care for the elderly will be put into any EU offer for discussion under the World Trade Organisation's agreements. It is certainly the view of my group that such services should not be included.

It is also clear that at some point we will need a framework for the cross-border liability of service providers. I agree with Mr Crowley on the issue of risk equalisation in the private sector, to avoid cherry-picking of the purely profitable. We also need to consider, both inside and outside the Convention, to what extent health care and general care are services of general interest and whether universal and affordable access should be guaranteed in the Treaties of the European Union.

We have to look further at what constitutes goods or services in health and other care. I am aware that Denmark has already introduced legislation on this. It would be another useful area for comparison in an open method of coordination.