Devolved UK in danger of losing power in Europe

A report from health policy think tank the Nuffield Trust examines how devolution in the UK could erode the nation’s current influential position in shaping European Union health policy.

Press release

Published: 20/11/2008

The Nuffield Trust is launching a new report, as part of its extensive work on healthcare and devolution. Becoming European, released on 20th November 2008, examines how devolution in the UK could erode the nation’s current influential position in shaping European Union health policy, which could significantly impact health and healthcare in the UK.

Report author, Scott L. Greer, assistant professor at the University of Michigan and senior research fellow at the London School of Economics, explores how the health systems of France, Germany, Spain and the UK engage with the EU, comparing their ability to influence EU health policy. The report found very different country approaches to EU health policy-making, with the UK and France currently found to be the most influential with their active and highly coordinated practices.

Greer highlights that the UK success in influencing EU affairs is predominantly due to its strong central and departmental coordination as well as its commitment to information-sharing. However, Greer goes on to argue that the UK faces a special challenge and is set to experience the greatest change in determining EU policy because of devolution. He states:‘The European Union responds best to a coordinated, active approach to policy….’ and ‘…devolution is inexorably reducing the UK’s ability to create a single united line.’

Greer concludes that the UK will need to adapt its system of EU health representation in response to the challenges now faced by devolution: ‘…the UK will have to reconfigure its EU policies to fit with the impossibility of achieving a high degree of coordination in a devolved country.’

In answer to this challenge and following his research and country comparisons, Greer concludes with a series of considered recommendations to help avoid a weakening influence in respect to EU health policy.

  • The UK 's four nations must engage successfully both with each other and directly with the EU to maintain British influence over EU health policy.
  • UK intergovernmental relations should be formalised to maximise consensus and the adoption of joint policy over EU health issues. This would enable a common UK position to reflect distinct national priorities.
  • To underpin this, the UK should build a culture of information-sharing between the four nations, within a formal, legal framework.
  • Successful engagement demands skills and knowledge on the part of policy-makers and officials. The UK should therefore invest in programmes to build both of these.
  • 'Regional' governments represent significant constituencies; their governments (including the UK ) should therefore promote their involvement at health summits aimed at shaping EU policy.

Throughout the report Greer makes a compelling case in stressing the importance of a united country approach: “There is a real risk that health policy will be made not by health policy-makers but by EU lawyers, economics ministries, or other groups that do not understand or sympathise with the specific problems and goals of health policy. Facing this challenge and making sure that health is the main concern of EU health policy, requires active, engaged and strategic member states…”