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The impact of the European Union on nursing in the UK

16 December 2013
Updated December 2014. The UK Coalition Government are currently undertaking a two year programme of reviews of the EU's competence in a number of areas, including health, compared with the UK's own powers. This briefing outlines the most significant issues and also provides more detail in the annexes on the RCN's key European alliances and on how the EU institutions work.

Overall, many EU initiatives have heralded important improvements in nurses‟ working lives here in the UK and across Europe. Whilst the RCN has not always agreed with all the detail of individual legislative proposals it has always sought to engage constructively and negotiate with EU policy and decision makers, both directly and in collaboration with our European alliances, to seek changes, where we think these are necessary. Working at European level has also heralded much closer cooperation between counterpart nursing organisations and greater understanding and sharing of best practice to deliver better health services and improve health.

The RCN does not currently see the need for an expansion of EU competences, nor would it want to see repatriation of the EU‟s existing powers in relation to health or social affairs. However, the balance between differing EU competences, whose objectives at times may conflict with each other, do need to be addressed. In particular health and social concerns have sometimes been overridden by a strongly market orientated approach in Europe, particularly focused on completing the single European market. The prime consideration for health services in the UK should be to serve the needs of the population and not the liberalisation of services in the EU.

Similarly, in considering recognition of health professionals and their ability to practice in another EU country, precedence has often been given to "removing barriers to free movement" rather than considering the paramount importance of patient safety and public protection. It is also important to ensure that at a time of economic downturn in Europe with a focus on austerity measures and EU policies to boost growth and trade, the EU does not neglect public health concerns designed to improve the health of the population. Given that health is influenced by so many other areas of EU intervention such as environmental policy, agriculture, consumer protection and transport, the EU‟s health in all policies approach and its remit to "ensure a high level of health protection" should be more actively pursued in relation to public health and patient safety implications of its legislation.

The RCN has strongly supported the provision of decent standards of employment and working conditions across the EU as a contributor to economic prosperity and health and wellbeing. The European Commission estimates that the health and social care sector represents on average about 10% of employment in each member state, so this contribution is not insignificant. The RCN would not to want to see a weakening of the EU's functions in continuing to uphold these standards or a repealing of existing social provisions, including social dialogue, in the hospital and health care sector.

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