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The accession of the ten new Member States to the European Union on 1 May 2004 (the Ten) and the other two (Romania and Bulgaria) on  1 January 2007 (the new Twelve) reinforced the process of economic and political renewal that has been underway for almost two decades. A primary aim of enlargement is to approximate the economic and political well-being of the population to the standards of the “old” EU members: the “EU 15”. The multiple efforts by so many public and private initiatives engaged in this common goal are driven by the recognition that improving the well-being of the 75 million new “EU Europeans” will benefit the Union as a whole. There is a priority to encourage the Twelve to maintain and elevate health as an investment priority under the future framework 2007-2013.

The European Commission estimates that it takes Member States about two years to elaborate their national programmes for spending EU funds. It is important therefore for national authorities to ensure that national programmes identify health improvements as a priority: without an appropriate and explicit national framework in place, there can be no EU funding allocation to health.

The differences in standards of and accessibility to healthcare across EU states are of particular concern to increasingly wider circles. They were best described in the Paris based Institut de la Science de la Santé’s (ISS) Guide on “Health and Health Systems in the New Member States.” The guide stresses that despite great strides made by the Ten, “since 1970 the decline in avoidable mortality has been slower in the East than that in Western Europe. Furthermore, about 25 % of the difference in mortality rates between East and West Europe has been attributed to inadequacies in healthcare.”


The health gap between the EU 12 and the EU 15

In the new Member States people live shorter lives and spend longer periods of their lives with a disability (WHO European Health for All databases, January 2002):

  • Life expectancy at birth is 78.72 years for the EU 15 on average compared to 74.37 for Poland, 72.56 for Hungary, 70.71 for Estonia. The best figures in the Ten are for Slovenia (76.49) and the Czech Republic (75.43), Malta (78.85) and Cyprus (79.35).
  • On average, the share of GDP devoted to the health sector is roughly a modest half (4.5 %) of the share devoted by the EU 15 (8.5 %).


Improving health and healthcare systems in the Twelve deserves prime attention of the decision makers and the public in both the EU 15 and the Twelve. Some of the 12 have already managed to devote Structural Funds to domestic healthcare projects such as the development of the primary healthcare sector, the reduction of cardiovascular incidents etc. Significant amounts have become available for the EU financial period 2007-2013. The Twelve have been encouraged to prioritise projects in order to multiply and intensify their efforts to improve healthcare in their countries.





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