How should public health policy be developed? A case study in European public health

Article 129 of the Treaty of Rome (as amended at Maastricht) gave new powers to the European Union (EU) institutions to develop and implement public health programmes at EU level. The authors were invited by the cabinet of Commissioner Flynn to assist the Commission by developing new policy proposals in certain specific areas.

The approach was agreed with officials of the Public Health Unit (now the Public Health and Safety Directorate) in DG V. Working groups of experts were appointed to review policy options in five discrete areas. The experts were resident in 13 of the 15 current EU member states, and were employed in academic departments, in health ministries, in local government, and in non-governmental organizations. Draft reports were presented to an evaluation panel of additional experts, whose comments contributed to the final report to the Commission.

The final report consisted of five main chapters, corresponding to the work of the five working groups. The recommendations were grouped into those for which implementation would be short term, medium term or longer term, and these were summarized as a Plan of Action.

Five criteria for good public health policy development were satisfied, but the approach used was excessively expensive and time-consuming. Some further lessons for future policy development work have also been recorded. This work provided a fascinating insight into the workings of the EU institutions.