HOSPEEM

Issues including the Working Time Directive (WTD) and the resolution of the 'on-call' situation - Europe-wide patient mobility and the prevention of needlestick injuries are among those recently concerning the sector.

Formed in 2005 and recognised as a Social Partner by the European Commission in July 2006, HOSPEEM is a 'powerful voice' in pre-consultation discussions with EC officials.

Mr Perera, in his third year as Secretary General, says: "As a Social Partner, the European Commission (EC) has a legal duty to consult us on any draft proposals likely to affect the health sector. We are much more than a lobby group - of which there are hundreds in Brussels who do not have any rights."

He believes that as around three-quarters of all employment legislation is now made by the EC, it is vital that healthcare employers involve themselves in early discussions rather than reacting once decisions have been made. He cites the WTD as an example of how difficult it is to change legislation once it has been passed.European Union member states could not reach agreement on proposed changes to the WTD in December 2007 in Brussels.

Any agreement would in any case have been too late to affect NHS planning for the implementation of the 48-hour week for doctors in training by August 2009 because changes need to be agreed by the European Parliament as part of the long co-decision process.

Employment ministers were also unable to reach agreement on the draft Temporary Workers Directive and the dossiers have now passed to the Slovenian Presidency of the European Union which took effect on 1st January 2008.

Mr Perera accepts that the issue has a higher priority in the UK than other EU countries, where it is less problematical. "All hospital employers would like to have some flexibility," he says. "But the Department of Health has been preparing for the reduction from 56 to 48 hours for a long time and it will be ready for August 2009," he says. European healthcare employers would all like to see the ‘on-call' issue resolved as a matter of urgency, he adds.

The Simap/Jaegar judgement in the European Court of Justice stated that a required physical presence in hospital - a resident on-call doctor - constitutes working time. But Godfrey Perera says: "We want a more sensible definition than that." Similarly it is suggested that compensatory rest be given as soon after the point of disruption as possible, again causing difficulties for working patterns.

HOSPEEM participates in the Hospital Sector Social Dialogue committee with the European Federation of Public Service Unions (EPSU). It is also a sectoral member of the European Centre of Enterprises with Public Participation (CEEP) with whom it has worked very closely on WTD.

Mr Perera, also president of CEEP in the UK, urges senior NHS staff to consider playing a part in influencing thinking of major European healthcare issues by becoming members of the European Workforce Forum, created within and acting as a sub-committee of the NHS Employers Policy Board.

The Forum, which meets three times a year, includes NHS representatives including chief executives, HR directors and chairmen of NHS trusts.

"We need people at a senior level in the NHS who are interested in Europe, to get involved," he says. "Discussions at Forum level can influence our thinking ahead of our subsequent contact and consultations with EC officials."

HOSPEEM offers the NHS the opportunity to influence workforce policy developments affecting the healthcare sector, as well as the chance to learn from the sector's employers in other countries.

The benefits to the NHS of being involved in formalised Social Dialogue in the hospital sector include gaining an early insight into European policy developments likely to affect the health sector. It also creates the possibility of fewer EC Directives in the future, through the adoption of Social Partner agreements in the health sector.

Mr Perera says that while a potential health directive on patient mobility - allowing patients the right to choose to be treated anywhere within the EU - may be good for in some situations, it could have serious implications for healthcare services across Europe.

A public consultation on cross-border health services was launched in September 2006 and the EC is currently preparing its proposals for a directive.

A common decision is also being sought on the issue of needlestick injuries to protect healthcare workers from blood-borne infections caused by such injuries. HOSPEEM believes action should be taken to raise awareness of such injuries and to ensure there is more effective implementation of the current legislation, rather than the introduction of new legislation.

"As well as giving us direct access to EC officials on issues like these, the Commission welcomes such sectoral groups at HOSPEEM as a mean of receiving the collective views of the healthcare employers' sector across Europe" says Mr Perera.