European social dialogue in the hospital sector is still very new: the Sectoral Social Dialogue Committee (SSDC) was not established until 2006. It involves the European Federation of Public Service Unions (EPSU) for the workers, and the European Hospital and Healthcare Employers Association (HOSPEEM) for the employers. The main topics of discussion for the time being are staff recruitment, workforce profiling and new skills. A code of conduct on ethical cross-border recruitment and retention in the hospital sector was adopted in 2008: it is regarded as one of the major achievements of this social dialogue.

For the record, the issue of healthcare was first addressed by the EU in the form of Regulation 1408/71 of 1971 on the coordination of social security schemes (making it possible to finance healthcare abroad). Public health and healthcare issues then rose up the European agenda from the 1990s onwards, when a legal basis was incorporated first into the Maastricht Treaty of 1992 and then, crucially, into the Amsterdam Treaty of 1997.

The Commission launched some Community action programmes based on these provisions, and legislation gradually came into being – on blood products en 2002, on human tissue and cells in 2004, and so on. A European Centre for Disease Prevention and Control was founded in 2005. Finally, the Lisbon Strategy for 2000-2010 introduced an open method of coordination in the fields of social protection and social inclusion.

One of the most important features of this sector should be highlighted from the outset: although a Community health policy is tending to emerge, the Member States remain responsible for organising their own health systems. The EU is exerting gentle pressure to promote a common attitude towards hospital sector issues; moreover, the enforcement of the single market rules is having a major impact on hospitals (procedures for procurement of medical equipment, collection of blood products, working conditions of health professionals, etc.).

This, then, was the backdrop to the very gradual establishment of European social dialogue in this sector in the early 2000s. An initial conference was organised by the Danish social partners in May 2000 under the European vocational training programme Leonardo. A website was created at that time ( — the website has since been closed down) as a tool for exchanges of experience between the social partners (CEEP for the employers and EPSU for the workers). This first meeting dealt mainly with labour market issues: recruitment, skills, etc.

A second conference took place in February 2002 to reflect more broadly on developments in the sector, the European challenges it faces, sectoral social dialogue and how to strengthen it in the new Member States. This conference paved the way for the creation of the SSDC, the inaugural meeting of which took place on 20 September 2006. Meanwhile, the “hospital” members of CEEP – which represents all public-sector employers – set up a new organisation, HOSPEEM, so as to comply with the Commission’s criteria on representativeness (HOSPEEM has remained a member of CEEP).

So it was not until 2006 that sectoral social dialogue was put on a formal footing and the new employers’ body was recognised by the Commission. The topics included in the first work programme, for 2006-2007, were staff recruitment, workforce profiles and new skills. Two joint texts have been adopted since then: a joint opinion on health services in 2007 (in the light of the draft directive on cross-border healthcare), and in 2008 a code of conduct on ethical cross-border recruitment and retention in the hospital sector.

This code of conduct, which constitutes a reciprocal commitment on cross-border mobility for health professionals, is regarded as a major success story of this (still new) sectoral social dialogue. Referring to the ILO standards, it is aimed at protecting workers’ rights, ensuring that highly skilled staff are available to the employers, accessibility and quality in public health services, as well as transparency, justice and equity in the management of human resources.

In July 2009 the social partners in the sector went on to conclude an important Framework Agreement on prevention from sharp injuries in the hospital and healthcare sector. This document assesses the risk of injury to hospital workers caused by medical sharps (including needlesticks), as well as risk prevention, protection and elimination, training and awareness raising, and response and follow-up procedures. The social partners explicitly call upon the EU institutions to make this text legally binding.

Folder Sources
Sectoral Social Dialogue Factsheets