Health and citizenship: care for the poorest in Europe (Recommendation 26 (1996) of the CLRAE). - Council of Europe. Committee of Ministers, Ministers' Deputies - Decision 641/9.5 (September 1998)

641st meeting – 15 and 18 September 1998

Item 9.5


Recommendation 26 (1996) of the Congress of Local and Regional Authorities (CLRAE)

(CM/Del/Dec(96)583/9.1, (98)627/6.1, CM(98)124)


The Deputies adopted the following reply to the Congress of Local and Regional Authorities (CLRAE) Recommendation 26 (1996) on "Health and citizenship: care for the poorest in Europe":

"The Committee of Ministers has studied Congress of Local and Regional Authorities (CLRAE) Recommendation 26 (1996) on "Health and citizenship: care for the poorest in Europe" with great interest. It is aware of the problems facing marginalised groups of population, in particular, access to health care.

Already in 1996 the Committee of Ministers asked the Conference of Senior Officials responsible for spatial/regional planning (CEMAT) to take account of the methodological proposals on drawing-up, implementation and evaluation of public services made by the Congress of Local and Regional Authorities in its texts on the subject, as well as transmitted this Recommendation to Governments of member States, to the Commission of the European Communities and its Committee of the Regions, and asked an opinion from its Social Security Committee (CDSS). The latter was studied by the Ministers' Deputies at their 627th meeting in April 1998.

The Committee of Ministers will take account of the results of the "Human Dignity and Social Exclusion" project carried out under the authority of the Steering Committee on Social Policy. This project has in fact made it possible to prepare proposals for activities on the specific theme of access to care for the poorest people in Europe, in particular through the ideas emerging from the two Thematic Days: 27 October 1997, in Paris, on "Health and social exclusion" and 28 November 1997, in Strasbourg, under the aegis of the CDSS on "Direct and indirect obstacles to social security benefit access.

At the Helsinki Conference (18-20 May 1998), concrete proposals were put forward for meeting the care needs of populations in difficulty, based on two main lines of action: adaptation of health and social provision on the one hand, and equality of access for all to quality health care, which requires universal coverage, on the other.

The European Health Committee subsequently met from 23 to 25 June 1998 and decided to propose the following activity in its 1999 work programme: "Adaptation of the health care services to the demands for health care of people in marginal situations".

In the meantime, the Heads of State and Government recognised in the Final Declaration of their Second Summit (Strasbourg, 10-11 October 1998) that "Social cohesion is one of the foremost needs of the wider Europe and should be pursued as an essential complement to the promotion of human rights and dignity". They have decided to promote and make full use of the European Social Charter in the legal field and the Social Development Fund in the financial field, agreed to review the member States' legislation in the social field with a view to combating all forms of exclusion and ensuring better protection for the weakest members of society, and stressed the importance of a common and balanced approach to questions relating to refugees and asylum seekers, as well as affirmed their determination to protect the rights of lawfully residing migrant workers.

In the Action Plan the Heads of State and Government have resolved to promote social standards as embodied in the Social Charter and improve the exchange of good practice and information between member States, instructed the Committee of Ministers to define a social cohesion strategy1 to respond to the challenges in society and to carry out the appropriate structural reforms within the Organisation, including the setting up of a specialised unit for monitoring, comparing and handling issues linked to social cohesion.

They have also decided to reinforce the activities of the Social Development Fund and urge it to increase its investment effort in the social field and in job creation. This last aspect is of particular importance as the Committee of Ministers is fully aware that the removal of obstacles to care will not suffice as such to bring about a real and lasting improvement in the health of the poorest, many of whom will be elderly. The Committee of Ministers welcomes the fact that the CDSS is currently studying such subjects eg. "Social protection and guaranteed income" for the 1998 Report on Developments in National Social Security Legislation."

1     For this purpose the European Committee for Social Cohesion was set up by the Committee of Ministers at its 636th meeting (19 June 1998)



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