In the health trade

A controversial new European directive is in danger of placing the interests of business above the safety of workers and consumers
  • The Guardian,
The government is backing a European commission initiative aimed at radically reducing the powers of national government over multinationals. Although it has received scant media attention in the UK, the "Bolkestein directive" has provoked mass protests and debate in France, Belgium, Sweden and Denmark.

The directive, which Britain will seek to push through when it takes up the presidency of the European Union later this year, has two main aims: to erase any national laws and standards that make it difficult for European companies to enter the markets of other member states, and to allow European companies to run businesses anywhere in the EU according to the rules of their "country of origin".


Healthcare services are thought to amount to about 10% of the EU's GDP, so the potential for private companies to make profits from healthcare is vast. But publicly funded healthcare systems have until now been protected by national laws. Under "control of entry" regulations in the UK, pharmacies are granted licences to dispense NHS prescriptions only in areas accessible to those most in need. Supermarket giants such as Asda Walmart tried to persuade the government to get rid of this rule but, after a public outcry, the Department of Health refused, knowing that deregulation would destroy many community chemists.

The Bolkestein directive would require the UK to remove these rules because it regards them as an illegal barrier to market entry.

Under the proposed "country of origin principle", European healthcare companies providing services in the UK on a temporary basis - such as mobile treatment units, or providers of homecare workers - would not be required to meet the standards of the Healthcare Commission or the Commission for Social Care Inspection. They would be allowed to operate according to the different, and sometimes lower, standards of the EU country in which the company is registered.

The government has bowed to pressure from the British Medical Association and others and promised to try to exclude "publicly funded healthcare" from the scope of the directive. But this does not offer as secure a protection as it appears. The Department of Trade and Industry has stated that it does not want to deny market opportunities to private healthcare providers and says there is no clear definition of "publicly funded healthcare" in EU law.

The fact that the DTI rather than the Department of Health is negotiating the UK position in Brussels is a further cause for concern. The DTI is also on record as saying that concerns about safety and quality standards should not be allowed to outweigh the potential benefits the initiative might bring to British businesses. Doubts have also come from outside the healthcare sector. The Security Industry Authority, a government body that regulates nightclub bouncers and private security firms, has also voiced "grave concerns" about the directive. This industry is plagued by criminal infiltration and poor standards across Europe and the SIA fears that the protection provided to British citizens by the 2001 Private Security Industry Act will be undone, as people working for companies based outside the UK fall outside its control.


Clearly, the future of the EU and UK economies lies in the development of a thriving, service-based economy. But many would argue that there is something wrong with placing the interests of business above the protection of workers and consumers.

Concerns about poorly regulated foreign companies being given a free rein in the UK should not be seen as nationalism in a different guise. As trade unions across Europe have pointed out, the directive will mean that those working for companies based in poorer countries will find it difficult to access the labour protection in the richer countries to which they are posted. Thus the much-feared "race to the bottom" will benefit least those communities in which people are most exploited.

Yet if EU-wide standards can be introduced to govern the quality of car tyres, there is no reason why standards for high-quality healthcare cannot also be worked out. Providing European citizens with a right to high-quality public services and proper worker protection may also help to address much of the public's disenchantment with the European Union.

As the debate over the EU constitution begins, there is a clear need to articulate a different vision of Europe to that contained in the Bolkestein directive, one based firmly in the European tradition of social solidarity and responsible capitalism.

David Rowland is a research fellow at the School of Public Policy, University College London.

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