Power to the consumer

In an interview with The Times, the European Commissioner for Health and Consumer Policy, John Dalli speaks about his first five months in office.

You are now past your honeymoon period as European Commissioner and have entered your sixth month in office. How would you describe your experience so far? What is it that you really do not like and what is it you like?

It has certainly been a challenging five months. Getting to grips with the dossier was a challenge in itself but I can honestly say that I am relishing every single bit of it. I love the policy aspect of the role as a commissioner.

As a commissioner you are less involved in the nitty-gritty and more involved in establishing clear policy. The challenge lies in steering that policy through, explaining what you want to achieve and finally sitting down and negotiating with Parliament and the member states.

I am trying to do things differently by involving everyone in the process as early as possible. This has always been my style. I believe you can always achieve more like that.

The main dislike is the length of time it takes to finalise an initiative because of the structured process. It must be said that this has been set up to achieve transparency and to give each member state and all stakeholders a voice in policy.

Being a member of the European Commission is similar to being a Cabinet minister only whereas before you were answerable to 400,000 people you are now accountable for 500 million. Does it make a difference? How?

There are similarities in that you have to act in a collegial way and that the decisions are binding for all but I would say that there is where they stop.

The College meeting (the equivalent of the Cabinet meeting), held every Wednesday, or Tuesday when it is Strasbourg week, is the final step of a process which would have started weeks before. As I said previously, at commissioner level you deal with policy, politics at its very best. The ground work would have been done at services level and at Cabinet level by my staff in the Cabinet after seeking political direction from me.

Every commissioner is loyal to his portfolio and sometimes there are opposing views with a compromise having to be reached. However, everyone around the table knows we are there to serve the half a billion citizens of our continent and this is what finally makes the compromise possible. We are all pulling one rope, whether we are Maltese, Finnish, British or Bulgarian. Then, most of the time in College is dedicated to discussions of policy matters.

How do you compare sitting on the European Commission in Brussels with serving as a government minister in Malta?

There are certainly differences. You are away from local politics, which tends to be too partisan at times but, on the other hand, you are also away from the people on the ground, which is dangerous. When people criticise the Commission as being too aloof, like the princess locked up in the ivory tower, this is what they are criticising. You are surrounded by excellent people all day who, however, are used to the Commission's structures.

It is up to the commissioner to think outside the box, to challenge every concept and to make sure he stays in touch with European citizens. In Malta, as a minister you are clearly more familiar with the situation on the ground. As a commissioner, however, the realities are quite vast, varied and sometimes divergent. That is why I make it a point to visit the various countries and regions in Europe to come in touch and understand the realities that make up this diverse Europe.

Soon after you assumed office in Brussels you made a very controversial decision, about GMOs. Did you need to take it so early in your tenure? Was it a decision nobody wanted to make before you? Was the technical advice available to you not already there?

The GMO decision certainly made headlines. But it really was the only decision to take. There was no choice. The procedures adopted by the Commission, as voted for in Council and in Parliament, dictated my position. We have to decide on whether to cultivate a crop or not on scientific reasons only and the science was all there. We had asked three times for further studies to be made and, once all the studies were exhausted, we simply had to decide. Had we not decided, the European Courts would have decided for us. Then, decisions need to be taken. My decisions opened the debate on innovation in Europe. A very important issue on which Europe's future is resting.

Is GMO 100 per cent safe? How can one be sure that GMO items do not find themselves in the food chain in a roundabout way?

First and foremost GMOs are already in our food chain. We import most of the protein we feed to our cattle from the US and Latin America, which have been using GMOs for decades. However, every single GMO for use in Europe has to undergo an authorisation process that adheres to strict scientific guidelines. This is the way we go about ensuring the safety of our citizens. We, in Europe, take all the precautions necessary to ensure that the food that we eat is the safest possible. We do this by setting the highest standards in the world, from the farm to the fork, and on the question of GMOs it is the same. We have undoubtedly the highest standards possible.

You have declared that a consumer should not only be in the driving seat of his own lifestyle but also be able to influence policy through the consolidation of micro decisions taken in the market. In practice, how will that happen during your tenure? What changes/ new initiatives will you be proposing to ensure that does indeed occur?

We are trying to focus our energies in ensuring that the European citizen is informed at every level possible. I have already made it clear from my first day in office, and even before in the hearing, that I do not want a Commission that tells people what to do, what to eat. I want a well-informed citizen to be able to choose for himself what to consume and in those everyday decisions it is the citizen himself that would be influencing policy. We know that our citizens already value, for example, animal welfare and this has to be reflected in our policy.

What we are trying to do with our regulation on food information and information to patients is to increase the level of meaningful information that the consumer, the patient, the EU citizen has at his disposal to be able to make such decisions.

Empowering consumers means that consumers are given the correct and understandable information which they are educated to interpret and use in their purchasing decisions.

You say that to secure the sustainability of health systems one must focus on prevention. Prevention is, of course, better than cure but there will always be need for cure, especially in an aging population, and cure costs money. Now, mainly for political reasons, many governments keep insisting that, come what may, healthcare will remain free of charge, as is the case in Malta. In the circumstances, could free healthcare ever be sustainable? Don't you see the risk that, in order to ensure free healthcare, and so win votes, governments will have to draw money from other sources, which, more often than not, means more direct or indirect taxes on people?

I was Minister for Finance for many years so I know that there is no such thing as a free lunch. It is obvious that revenue has to be generated to keep health systems sustainable. Whether healthcare is free or not is the competence of every member state.

What we concentrate in Europe is on other areas where Europe can give value added. Prevention is one such area. I was shocked to find out that Europe's healthcare systems only spend three per cent of their outlay on prevention. So much more can be done here.

We have initiatives that fight obesity and smoking which between them kill more European citizens and cost more money to our health systems than anything else.

We also do our best so that European patients get a better deal. One such piece of legislation I am pushing through at the moment is on cross-border healthcare. This would serve to cut waiting lists and ensure a better service all round for European patients.

Another key area is e-health, where, by means of technology, we can indeed make a difference both to the quality of a patient's life but also to the sustainability of the health systems through efficiency gains. This for me is a crucial area because we all know that, in a decade's time, the demands on our health system will be higher. Therefore, we have to find ways of doing more with less while guaranteeing patient safety. This is where e-health can play a real role and where I am trying to concentrate my efforts.

Another controversial issue, at least in Malta, is the cost of medicines. You must know that the price of many medicinals in Malta are higher, in some cases, far higher, than those in other EU states. Are you happy with that situation? What can you do as European Commissioner for Health and Consumer Policy to address this situation?

Any decision on the pricing and also the reimbursement status of medicines is a national decision. There are only certain procedural and transparency rules which the member states have to respect.

But from a public health point of view, the current situation is clearly not satisfactory.

I am therefore envisaging, together with my colleague Vice-President Antonio Tajani, how the European Union can help member states in assessing the real therapeutic value of medicines and translate them into their national decisions. This is an area where I want to deliver and where it is amply clear that action at European level has sound benefits for both the patients and for member states themselves.

Once more, it is an area where we can make efficiency gains. In other words we do not focus solely on the safety of medicines but add on another crucial layer - efficacy: how the medicines actually work on patients. Having such information helps national ministers to make more informed decisions about pharmaceuticals and needs of patients.

Speaking of consumer policy of course brings to mind consumer rights. What sort of policies will you be implementing to ensure that every individual consumer in every member state has his/her rights protected on the ground and in an effective way and that every country should have at least a well-organised and well-funded consumer's association? You must know very well that in Malta this is not the case.

There is one issue in Malta which I hope will be resolved and that Malta will have a well organised and well-funded consumer organisation that would ensure that consumers are having their rights redressed. We are, however, trying to solve the situation.

We have a number of initiatives aimed at increasing the rights of the consumer. The most important one is collective redress, which would empower groups of consumers to fight for their rights as a group. We are trying to find ways to bring these rights to the European consumers and increasing the alternative ways to resolve disputes between providers of goods and services and the people who consume them.

We will also be undergoing a number of sweeps whereby we see how certain markets and areas of the economy are operating and whether the consumer is at a disadvantage. In a nutshell, what we are trying to do is to seek out wherever the consumer can be at a disadvantage and address the situation. By tackling enforcement issues, consumers are more confident and more discerning and, therefore, more empowered.

We all know that it is money that makes the world go round and everything depends on funds. So how can you defend consumers in the wider sense of the word and still allow companies to profit at their expense? Don't you think that in this crisis-ridden world where competition is a lot more than cutthroat, companies will do their utmost to milk the consumer dry as much as possible, at times even exploiting them?

Competition usually works in favour of the consumer not the other way round. There are always companies that will try to exploit but, as I have said before, an informed consumer will make the right choices. Our job, however, is to see that the markets are working well, that there are no hidden agendas, that the competition is really there, that the consumers not only know their rights but also know how to obtain redress.

We also have to oversee the single market and make sure that there are no aberrations to the market to the detriment of European consumers. If we look, for example, at innovation it is a typical example of where both industry and the consumer stand to benefit. If we have responsible innovation then there are spin-offs both for the consumer and for industry.

What we can do is to ensure that we enable innovation in the market that is beneficial to our consumers and provide a framework to ensure that products and services are safe. We have to continue to enforce our standards and make sure that the products on our shelves are safe. Plenty of work to do as you can see!

You are on record saying - I think you were referring to healthcare - that you will only do what is worthwhile. What yardstick will you use to determine what is worthwhile? Indeed, what would be worthwhile?

Worthwhile means value added to the European citizen. If something is better done by the member states than there is certainly no need for the EU to be involved. We should focus our energies where we can be most effective. Prevention in healthcare is one area, for example, as is healthy aging.

We should try and support and sustain member states in areas where we can be most useful. I mentioned above the issue of e-health and health technology assessment where we can provide the regulatory framework to allow private and public entities to exploit technologies to the advantage of EU citizens.

I am a firm believer that those things that are worthwhile doing are also worth doing well. I certainly do not want to do things simply for the record. I want to do things well, take the decisions that have to be taken and making sure that what we do brings that something more for the citizens. It is not an easy task but it is exactly that which makes it all the more exciting.