The ‘last chance for social Europe’: the European Pillar of Social Rights can only work if integrated into the EU’s existing policies

The European Commission published its proposals for the creation of a European Pillar of Social Rights (EPSR) at the end of April. Eleanor Brooks writes that it will be crucial to ‘mainstream’ the EPSR by integrating it into the EU’s existing policies, while civil society organisations will need to be afforded a strong role in the Pillar’s implementation if it is to meet its aims

A missed opportunity for public health:How impact assessment shaped EU rules on the marketing of unhealthy commodities to children

BackgroundThe revision of the European Union's Audiovisual Media Services Directive, which governs the marketing of alcohol and unhealthy food to minors, failed to align with international best practice. Previous research has explained this ‘missed opportunity’ with reference to deficient political will, difficulties advocating for health, and industry pressure. We explore another explanation: the role of the impact assessment (IA) process in shaping decision-making.MethodsWe first conducted an in-depth comparison of three versions of the IA report, employing qualitative content and framing analyses to establish what changed in the substantive content, framing, and evidence cited. Second, we used process-tracing, a qualitative method drawing on multiple data sources, to explore causal mechanisms, to assess why these changes occurred. Data sources include policy documents published proactively and obtained through access-to-document requests.FindingsPreviously unpublished versions of the IA report show that stronger rules on advertising were preferred early in the policy process but later abandoned, and that concern for ‘balancing’ consumer protection and competitiveness shifted to focus on the latter. Following review by the Regulatory Scrutiny Board, a revised IA report narrowed the policy options, omitting mandatory rules on alcohol advertising and presenting self- and co-regulation as the only choice. Consequently, decision-makers were provided with an IA that did not offer adequate information on available measures to protect children.InterpretationChanges made during the IA process, which determines the policy options presented to decision-makers, side-lined health concerns. We argue that engaging with the institutional structures which shape decision-making is crucial for those working to further public health

EU health law and policy:Shaping a future research agenda

The relevance of the European Union (EU) for health has been widely recognised within the health community for some time, and is increasingly apparent to European policy-makers and publics. Despite being an area of policy that national governments would prefer to keep exclusive control of, and though in the past it has rarely been at the top of the agenda, many elements of health have been gradually 'Europeanised'. This special issue marks the culmination of a British Academy-funded project - EU Health Law and Policy: Shaping a Future Research Agenda - which sought to build on the growing web of expertise in this field and reflect upon the future of health as an EU competence, at a time when it appeared to be under threat

Political Perspectives

Abstract The last two decades have seen the emergence of what is widely labelled a 'European' health policy sphere. The expansion of this traditionally national field of governance has been supported by a comparatively weak legal framework, which grants the European Union (EU) very little in the way of formal competence, instead reserving the majority of power for member states. Given the resistance of national governments to the involvement of Community institutions in this politically and culturally sensitive area, how then has such a mandate expansion occurred? The answer, at least in part, lies in the proliferating use of soft law. Employing a combination of nonbinding guidelines, mutual learning and peer review, soft mechanisms circumvent almost all of the traditional impediments to 'harder' progress, such as Community legislation or treaty revision, and enables the incremental 'Europeanisation' of sensitive policy areas. This article will assert that a European health field has emerged as a result of gradual but persistent Europeanisation through soft law. It will present an analysis of the use of soft law in European health policy through a Europeanisation framework and examine how the integration, governance and construction of EU health policy is affected by soft law instruments. Finally, it will ask what this implies for the future of this fledgling policy area and suggest that it is soft law, rather than treaty reform or EU legislation, which will play the leading role in the continued development of a European health policy

European Union health policy after the pandemic: an opportunity to tackle health inequalities?

COVID-19 has exposed and exacerbated the health inequalities across and between European Union member states. It has also raised the profile of EU health policy and the highlighted the value of European cooperation in health. Early failures to respond adequately, coupled with this increased salience, have given rise to a series of initiatives designed to strengthen and expand the EU’s role in health. This presents an opportunity to address the imbalances in the EU’s institutional and legal structure which prevent it from addressing health inequalities more effectively. Drawing on changes underway in the public health, internal market and fiscal governance elements of EU health policy, this paper explores the potential for the post-pandemic EU health policy framework to better support the reduction of health inequalities

Public health, free movement and macroeconomic coordination:mapping the evolving governance of European Union health policy

Health is a unique and intriguing sphere of European Union (EU) policy, not least of all because it has only been recognised as such for the last 15 years. From piecemeal origins in public health and occupational safety it underwent dramatic expansion as a result of exposure to free movement and internal market law in the 1990s. Now, in the aftermath of the economic crisis, it is entering another unprecedented era. As the focus of the European project has turned to fiscal sustainability and the strengthening of collective economic governance, health policy has been swept into frameworks designed for the oversight of macroeconomic policy and national expenditure. Crucially, these frameworks extend EU health influence into areas reserved in the founding treaties for exclusive national control. This thesis seeks to map the changing nature, scope and governance of EU health policy, contributing to the existing patchwork of literature and reviewing the prevailing narrative in light of the critical juncture now being faced. It draws on the theories of European integration, the Europeanisation framework and the more recent governance approaches to assess the continuing relevance of core themes – crisis politics, regulatory policy, the internal market, new modes of governance, and the role of the Court – in health policy development. Using six case studies and data from 41 interviews with experts, policy-makers and officials, it examines the catalysts, drivers and dynamics of health policy integration. It finds that as the actors and interests involved in health policy have proliferated, health issues have become increasingly politicised. Addressing the consequences of this trend, the thesis explores the growing dependence on, and progressive strengthening of, voluntarist governance, as well as the declining scope and influence of EU health policy. Finally, it reflects upon the future of health within a politicised European integration project

The manifestations of universality and cultural specificity in national curriculum policy frameworks: negotiations for culturally reflective practice in early childhood education

This paper presents findings from a review of 19 national curriculum policy frameworks (NCPFs) across the globe and discusses dominant and culturally specific discourses that shape early childhood education (ECE). We combine two frameworks of developmental universality and specificity and culturally contextualised pedagogy to explore whether and how NCPFs are venues where culturally reflective practice is negotiated. Culturally reflective practice embraces minimum, globally universal standards of children’s rights and evidence-based practice, meanwhile critically reflects on the dominance of global and local discourses that impede a glocalised interpretation of quality in ECE. The paper argues that culturally reflective policy and practice is an alternative framework to cultural appropriateness/relevance in ECE