Working materials for Copenhagen

Similar presentation for all videos (titles, description, ...)
Location in Goggle Earth.

Distribution in already created platforms:

Spotlight in YouTube front page.

Debate directo CNN/YouTube y recepción de contribuciones:
http://www.youtube.com/Cop15

AEBR contribution to the UN Copenhagen Climate Change Summit

The Association of European Border Regions has begun to tackle Climate Change as a discussion topic during its last General Assembly and Annual Conference on 5th – 7th November 2009 in Ghent (Euregio Scheldemond). Ms Caitriona Mullan (ICBAN, Ireland) drafted a discussion paper already distributed to AEBR members. You can order a copy of that document at info@aebr.eu

During the Ghent Conference it was also discussed to use this kind of topics to activate a more dynamic participation way for AEBR members, and to do more and better things together.

On the other hand, the Committee of Regions (CoR) has asked the regional associations to react to the UN Copenhagen Climate Change Conference (7th – 18th December 2009). On 16th December, a CoR activity is foreseen in which traditional contributions are expected, but we propose something much participative, cheap, and with some more impact.

- Proposal: The AEBR asks its members to record short messages in video (if you have a press department with recording capacities, you can use them, but domestic video recordings without aspiring too much are also welcomed) in order to produce clips to be uploaded in YouTube. A message with links to these video clips will be sent to all participants in the UN Copenhagen Climate Change Summit. A selection of clips will be presented in the CoR event in Copenhagen on 16th December.

Our members (and the visitors of this blog as well) can send their rough recordings, and we will mount the final clips. In some places, maybe there is someone very keen on taking videos that can be very helpful. As a background, it can be decided to do it:

- outdoors: nice location near the region/euroregion premises (recommended);
- indoors: maybe a good poster full of meaning as a background.

- The interviewed people could be: own colleagues (maybe also politicians) in the Region/Euroregion; and/or citizens passing by the camera in the street, park, etc. It is also recommended to use a tripod to fix the camera and get better images.

- These messages, no longer that one minute each, should answer the questions below, taking into account that the current crisis is a good chance to change behaviours, to change the way we get in touch with the earth and with others. The motto should be related to the growing world trend towards generosity (ethical banking, fair trade, NGOs, social networking, etc.), towards a vision of the world based on the fact that human beings come not before Nature. There is no way back, because it is not sustainable:

- Questions:

For people engaged in CBC:
- What could be the role of local/regional authorities to face climate change?
- How could CBC promote "cleaner", environmentally friendly, behaviours?

For the general public:
- What could you do to face climate change?
- Are you ready to change some of your habits (diet, fossil energy consumption, self-restraint) to contribute to a common goal?

- How to proceed? Whenever you have your video ready, you can upload it directly to YouTube (please mention “AEBR / European Border Regions Campaign to face Climate Change”), and linked it to your own website, but please do not forget to send it to us, preferably in AVI format (but also 3GP of MP4 formats are ok). As files can be very heavy, you can upload your file directly into our YouTube account: Please go to http://upload.youtube.com/my_videos_upload and then register using:
USERNAME: c.pandary@aebr.eu;
PASSWORD: climatechange

How do you see this? Do you feel like engaging yourself in this activity? Please send us your video. We will collect contributions until the last days before the 16th December. If you can only prepare this afterwards, do it anyway, as our campaign will not end just by Copenhagen.

Contribute to fight against Climate Change, and be active in your AEBR!

Territorial Cooperation and Territorial Cohesion

Almost 400 answers were sent to the Green Paper on Territorial Cohesion. This crucial European debate was promoted by the European Commission, following an initiative of the former Commissioner Danuta Hübner (PL), currently Chairwoman of the EP’s Committee on Regional Development. One of those answers, elaborated by the Association of European Border Regions (AEBR), is attached to the AEBR Newsletter number 15, September 2009. You can get our contribution to the Green Paper by following these simple indications:

Go to the AEBR online forum (http://forum.aebr.net/en/index.php). Log in by introducing "aebr" as user, also "aebr" as password. Then, go to "AEBR Newsletter - September 2009" and click on "English version with English Annexes". The first document is the Newsletter, and the third one is our statement on the Green Paper on Territorial Cohesion. If you have any difficulty, just paste the following link in your navigation bar after logging in:
http://forum.aebr.net//en/forum_topic.php?topic_id=49

There, you can also find some other AEBR contributions: on the future CBC, the Lisbon Strategy after 2009, a proposal for a EU Strategy on the former Iron Curtain areas, the discussion document on rural development initiated by the Landrat Hermann Steinmaßl (Traunstein, DE), the report of MEP Tune Kelam (EE), suiveur of the European Parliament on CBC issues, the AEBR position papers on TEN-T Networks, CB Health and Patients' Rights, and on the Barca Report, as well as some recommendations to improve the EGTC and the Interreg Programmes. We also include a summary on the Eastern European Partnership, the new proposal to strengthen the European Neighbourhood Policy.

Please leave your reply there and help us to improve our communication efforts with European border and cross-border regions.

Coming back to the Green Paper on Territorial Cohesion, main hint of the territorial debate since long ago, it has situated territorial cooperation at the core of territorial cohesion and has promoted an extraordinary debate within all European territorial stakeholders. These contributions have confirmed the added value of territorial cooperation, as the own Commission affirmed in the presentation of the Seminar organized last 25th September 2009 in Brussels, devoted to the cross-border, transnational and interregional strands of territorial cooperation.

The Seminar had as general purpose to stock contributions to the Green Paper in the field of territorial cooperation by:
• Giving a general overview of the contributions (convergent and controversial aspects)
• Presentint significant contributions coming from cross-border regions and transnational networks (best practices and answers to Green paper's questions)
• Concluding on possible policy options, and the policy process state of the art.

You can see the programme, download presentations and even see video recordings of the interventions at the following CoR link:
http://ec.europa.eu/regional_policy/conferences/territorial/programme_en.cfm?nmenu=2

Make your comments, participate, use any available channel to raise your opinions, suggestions, or proposals. Our tasks in the AEBR (and therefore Cross-Border Cooperation) can be very much enriched with your valuable participation!

Your AEBR Team

A Cross-Border Priest Helping to Heal a Divided People

Under this link, there is an interesting article about one of those heroes of Cross-Border Cooperation:
http://borderireland.info/discuss/?p=116

Shargan The Eight, the last narrow gauge track in Europe

This link has being sent to me by Mr. Zdravko Zivkovic, who works at the Executive Council of the Autonomous Province of Vojvodina. This video, shot by himself and very cross-border oriented, shows another effort to recover European heritage:

http://www.youtube.com/watch?v=0avWCy_pllw

Mr. Zdravko Zivkovic informs that the last narrow gauge tracks in Europe, built in the year of 1925, connecting Belgrade, Sarajevo and Dubrovnik for half of the last century, is re-opened again. This time only for tourists that have an opportunity to go back in the history, feel the passing times, hear the unforgettable sounds of the iron wheels on the old narrow tracks of 760 millimeters, pass the 22 tunnels and 5 bridges on the most attractive 10 miles section, climb up to the three rocky mountains seeing beautiful landscape from top of them, go down to the valley again, all that in the original passenger coaches made in Germany in the year of 1923 all of solid wood.

The name of the train: Shargan The Eight is because the tracks are built in the shape of digit 8 to climb to the top of the mountain!

Commissioner Hübner welcomes the AEBR

La Comisaria de Política Regional de la Unión Europea mantuvo una reunión con una delegación de la Asociación de Regiones Fronterizas Europeas con el fin de intercambiar impresiones sob

re el futuro de la Política de Cohesión en general y de la Cooperación Transfronteriza en particular. Hay buenas perspectivas para el desarrollo regional en Europa durante los próximos años, y la Comisaria se está encargando de mantener muy vivo el debate con la reciente presentación del cuarto y quinto informes de cohesión o la inminente del Libro Verde sobre la Cohesión.

La ARFE recibió el agradecimiento institucional europeo por sus aportaciones a las consultas sobre desarrollo regional que realiza la Comisión, muy frecuentes en los últimos años, así como una serie de interesantes observaciones por parte de la Comisaria, en particular sobre la necesidad de fortalecer la Cooperación Transfronteriza en las fronteras exteriores de la UE y la toma en consideración de los grandes retos a los que se enfrentan no sólo los europeos, sino toda la Humanidad, como es el caso del envejecimiento de la población en los países desarrollados, la necesidad de cumplir con los Objetivos de Desarrollo del Milenio o el calentamiento global. En particular se refirió a la necesidad de que las regiones con más experiencia y mayor desarrollo ayuden a las que se van incorporando o a las que disponen de menos recursos mediante el intercambio de experiencias y la transmisión de buenas prácticas.

La Sra. Danuta Hübner sigue animando la utilización innovadora del instrumento legal (Agrupaciones Europeas de Cooperación Territorial), y se comprometió a seguir introduciendo el elemento regional como componente esencial de la mayor parte de las políticas europeas.

Viktor has passed away

Martín Guillermo, Viktor Frhr. von Malchus, Frau Isolde von Malchus, Jens Gabbe

Much to our regret, the AEBR has to inform that our original member and for decades leader of the advisory committee, Dr. Viktor Baron von Malchus has passed away today, 31st July 2008.
Despite of his long illness, which did not impede him to work during the last years and until the very last moment, his decease has surprised the whole European Cross-Border family. We sorrow for a friend and colleague who has influenced the cross-border cooperation for the past 40 years with his unique knowledge about the border areas.

So long, Viktor, wherever you are!


Con gran pesar, la ARFE ha de informar del fallecimiento de su miembro fundador y líder durante décadas del Comité Asesor, el Dr. Viktor Barón de Malchus en la tarde de hoy, 31 de julio de 2008. A pesar de su larga enfermedad, la cual no le impidió trabajar durante estos años y hasta el último momento, su fallecimiento nos ha pillado por sorpresa a todos los que formamos parte de la familia de la cooperación transfronteriza en Europa. Sentimos la pérdida de un amigo y compañero que ha influido en la cooperación transfronteriza de los últimos 40 años con su conocimiento único de las áreas fronterizas.

¡Hasta siempre Víctor, donde quiera que estés!

La cooperación transfronteriza y la construcción europea de vínculos en Irlanda no han sido suficientes

Ayer y hoy, 12-13 de junio de 2008, hemos celebrado en Dundalk (Irlanda) una Conferencia sobre la aportación del Proceso de Paz en Irlanda a la Construcción Europea: Cross-Border Cooperation as part of the Northern Irish Peace Process: Some Lessons for Europe, organizado por el Centre for Cross Border Studies.

Aquí podéis ver el programa del evento, muy bien organizado, como todo lo que hace Andy Pollack, Director del CCBS y auténtico luchador de la Cooperación entre irlandeses:
http://www.crossborder.ie/events/lessons.php

Mientras nos reuníamos en Dundal, era el pueblo irlandés el que daba una auténtica lección a Europa. A pesar del extraordinario alcance del proceso de reconciliación y el protagonismo que ha tenido la UE, los ciudadanos irlandese no han entendido o no han querido entender la trascendencia del momento y han votado en clave interna, como suele suceder en estos casos. El resultado del referéndum irlandés para la ratificación del Tratado de Lisboa ha llenado de incertidumbre un proceso ya de por sí complejo. Ahora habrá que esperar qué se sacan de la chistera los líderes de la Unión.

A continuación, transcribo el texto de mi intervención durante la Conferencia de Dundalk, en la que me tocó responder al Sr. Dermot Ahern, Ministro de Justicia, Igualdad y Reformas Legislativas de la República de Irlanda, por aquello de la honrrilla, pero la sensación es francamente inquietante:

First of all, I would like to thank my dear colleague Andy Pollack and the Centre for CB Studies and Cooperation for the invitation to the AEBR to take part in this Conference. On the other hand, I would like to thank Minister Ahern for his words. Coming from a National State, the acknowledgment of CBC is of great importance for all of us.

Yesterday I had the chance to make the way from Dundalk to Newry and back, to meet with representatives of the East Border Region, the Newry and Mourne District Council, together with the Louth County Council, as we are planning to organize our General Assembly and Annual Conference 2010 here.

And I should say that I am extremely impressed at seeing how the border has disappeared. What one day was a real border, not only physical, but also psychological and many other things, is now a meeting place and a very important cluster for development. Some years ago, I was always talking with my Irish colleagues about peace, promotion of underdeveloped areas, measures to keep young people here, etc. Now we talk about infrastructures, new initiatives, strengthening of tourism and trade, etc.

When we listen to the Minister and the extraordinary agenda you are developing here together, the Republic of Ireland and Northern Ireland, we can see that we are in the middle of a crucial corridor Belfast-Dublin, but also of a crucial corridor for the flow of peoples’ lives.

As the Minister has said, this is also a very important day for Europe. And it could be even better after looking at the results of the referendum. So, it is not a bad day to talk about what the European Union can do for us. There are plenty of Programmes, but the AEBR’s main interest is Territorial Cooperation.

Today, CBC is on the top of the political agenda of the EU as one of the three priorities of the European regional development policy.

But, CBC has never been a national priority in many countries: anyway, it's a European task and political objective of the EU. This is justified as CBC contributes significantly to the European integration and to the implementation of the Lisbon Strategy.

When we talk about CBC in the whole Europe: old internal borders, former external borders, new internal and external borders… we realized that the diversity of Europe should be cultivated and promoted. This diversity is reflected in the social and cultural life of all states and regions of Europe. Over the centuries these various cultures and social systems have led to certain administrative structures and powers, fiscal and social legislations, and many other different areas of political activity.

Our citizens have grown up in these different social and cultural environments, and they will not always wish to sacrifice aspects of their everyday lives for the cause of European harmonization, particularly where this would result in the loss of Europe's diversity.

Despite the reduction of barriers along the EU's internal and external borders, these differences (including the various administrative structures and systems) will continue to exist for many decades, and will encounter each other at the borders. No state in Europe ─inside or outside the EU─ will alter its tried and trusted structures, systems and powers on account of the problems that arise in border regions.

Furthermore, no state is able to draft its laws in such a way that they harmonise with all the neighbouring states on its borders. The consequences will be felt for a long time: economic and social problems, and obstructions to cooperation affecting the population on either side of each border. Bilateral or trilateral CBC at regional/local level will therefore remain a necessity over the long term. That may not only prevent cross-border conflicts and overcome psychological barriers, but also improve the economic development on both sides of the border as it significantly contributes to the implementation of the Lisbon Strategy, and many other strategies.

How? Through CBC value added, which has been analysed by the AEBR in terms of European, political, institutional, economic and socio-cultural value added.

a) European value added: people living together in neighbouring border regions want to cooperate and thereby make a valuable contribution to the promotion of peace, freedom, security and the observance of human rights.

b) Political value added, making a substantial contribution towards:
- the development of Europe and European integration;
- getting to know each other, getting on together, understanding each other, and building trust;
- the implementation of subsidiarity and partnership;
- increased economic and social cohesion and cooperation;
- preparing for the accession of new members;
- using EU funding to secure CBC via multiannual programmes, and ensuring that the necessary national and regional cofinancing is committed in the long term.

c) Institutional value added:
- active involvement of citizens, authorities, political and social groups on both sides of the border;
- secure knowledge about one's neighbour (regional authorities, social partners, etc.);
- long-term CBC in structures that are capable of working efficiently:
- joint drafting, implementation and financing of cross-border programmes and projects; joint bank accounts

Jointly developed programmes and projects can be most effectively implemented and realised if the regional and local partners play a considerable role.

d) The socio-economic value added becomes apparent in the respective regions, albeit in different ways, through:
- the mobilisation of endogenous potential by strengthening the regional and local levels as partners for and initiators of CBC;
- the participation of actors from the economic and social sectors (for example, chambers of commerce, associations, companies, trade unions, cultural and social institutions, environmental organisations and tourism agencies);
- the opening up of the labour market and harmonisation of professional qualifications;
- additional development, e.g. in the fields of infrastructure, transport, tourism, environment, education, research and cooperation between SMEs, and job creation;
- lasting improvements in the planning of spatial development and regional policy (including the environment);
- the improvement of cross-border transport infrastructure.

e) Socio-cultural value added:
- lasting, repeated dissemination of knowledge about the geographical, structural, economic, socio-cultural and historical situation of a cross-border region (remarkably with the media's help);
- the overview of a cross-border region afforded in maps, publications, teaching material, and so on;
- the development of a circle of committed experts (multipliers), such as schools, youth and adult educational establishments, the conservation authorities, cultural associations, libraries, museums, and so forth;
- equal opportunities and extensive knowledge of the language of the neighbouring country, or dialects, as a component of cross-border regional development and a prerequisite for communication.

The main barriers to joint CBC are the different national structures of authority, administrative structures and legal systems. It must be said that CBC between regional and local authorities is of key importance.

CBC should not be seen primarily as a national foreign policy, but rather as a European domestic policy. Regional and/or local authorities used to have to engage in tough exchanges with their respective national authorities in a bid to ascertain whether or not cooperation was possible, and if so, under what circumstances and to what extent. But, nowadays, the willingness to engage in practical cooperation is firmly established.

Over the past 15 years, EU programmes designed to promote all forms of cooperation have been particularly instrumental in substantially boosting awareness of subsidiarity and partnership between local, regional, national and European players. Efforts are no longer centred on what cross-border activities local and regional authorities may engage in, but rather securing CBC in the long run, by providing both political and legal guarantees at national and European level.

This is the general framework for CBC in Europe. But then, we have the special case of Ireland. Usually, our main adversary is the National Government, but this is not the case, and I guess that Minister Ahern had something to do with this. As far as I know, he is part of our CB Family in Europe. And we can still feel it when listening to him.

But it is clear that the Irish case is a very singular one. Actually, when CBC began in this island, the main topic was Peace and Reconciliation. So, a Special EU Programme had to be implemented, in order to give a clear response from the EU to what was happening here. Many positive things were moving in Ireland, and they were moving so fast. With the implementation of the PEACE Programme, everything shows that the movement went even faster.

We have been listening carefully to the many economic advances to generate diverse activities in the economic, trade and community spheres… generating at the end of the day, a solution for another main obstacle in those days: employment.

CBC is nowadays generalized in Ireland, and many examples are used as best practises for others joining us, especially in the New Member States. In some parts of Europe, above all in Central Europe, the engagement between local and regional authorities across the border was being done as early as the Fifties. This supposed the creation of many CB structures (Euroregions), and they created afterwards the AEBR.

But, with the joining of the New Member States, at the Eastern part of Europe, we have to face very elementary difficulties once again: not only structural, economic, etc., but also regarding democratic, culture, citizens’ participation and overcoming of psychological barriers. The example of cases like the Irish one is a very important tool to design new procedures to tackle these challenges.

The experience of PEACE and INTERREG programmes in Ireland has given to us a lot of information on the many scenarios we can find. One of them is precisely the constitution of cross-jurisdictional bodies, like the Irish Special EU Programmes Body, another result of the Good Friday Agreement, one more, to show clearly the will (and the results) of this society to overcame something that, looking just some years back, seemed to take decades to be solved. There is a temptation to try to use the same procedure in other cases that can be considered similar, but they are not. In any case, we should use all available information to help processes.

There is another interesting message: “PEACE programme participants are generally more likely to have contact with members of the other community than the average population in Northern Ireland.”

The neutrality of European funding is a main topic and its internationality. People feel to be part of something bigger, ever when it is difficult for them the consideration of being part of a smaller community. Here I would like to mention that, when European Elections take place, the participation rate is generally smaller that in National, Regional or Local Elections: Low Rate of participation in European Elections is the norm. But, we have studied the participation in border areas: in most of the cases, border regions participate much higher than national averages.

What can we say about making Europe? We have always said that European integration is practised at the border areas in a daily basis. So, we can consider CBC as the Laboratories for European Integration. This can be seen in the new relations between Ireland and Britain, between Spain and Portugal, Germany and Poland (despite of the football), but also at the External Borders of the Union, we can see very interesting movements related to CBC between Greece and Turkey, Finland and the Russian Federation, and many other examples with Ukraine, Belarus, Moldova, etc.

The same feeling is to be translated to the Mediterranean. Similar frameworks and policies regarding Neighbourhood should be developed with the Southern Mediterranean countries regarding many fields, but always under the umbrella of a cooperation framework, in development, in trade, in economic advance, in democracy and human rights, …

And, I can even tell you that the African Union, or the Integration System for Central America are also in close contact with us in order to develop (at their level) framework conditions for real CBC cooperation in these areas of the world.

But coming back to our case, once again we use the Irish example when we have to explain practical results of CBC and European Programmes. And everyday we have some advances, the restored Northern Ireland Executive and Assembly is a fantastic reality, the relationships with the two Governments are growing and growing, on the basis of CBC, where Ministers from both sides can meet, discuss and cooperate on manifold issues, infrastructures, development of tourism potential in many areas, but also energy, sustainable development and specific CB topics (roaming, tariffs, CB workers, students, customers, etc.).

I also agree with Minister Ahern about the need of involving everyone in CBC, especially the local level, but also civil society, and this is a reality in Ireland, especially looking at the platforms created for CBC, like the North West Region CB Group, the Irish Central Border Area Network, or the East Border Region Committee.

This is a model that we would like to transfer to other areas in Europe, and we have found very active representatives when they come to our meetings. But, there is nothing like coming to the ground and talk to the real actors. I had the chance last night to do it and I also hope to have it today and tomorrow, listening very carefully to the speakers at the very interesting programme organized by the Centre for Cross-Border Studies.

Flamante Presidente de la Junta de Extremadura

Ayer tomó posesión como nuevo Presidente de la Junta de Extremadura Guillermo Fernández Vara. Después de organizar la Sanidad Extremeña desde la asunción de esas competencias en el año 2002 y tras haber sido partícipe del desarrollo de la Cooperación Extremeña, tal y como la conocemos ahora, el ya Presidente anunció en varias ocasiones durante la campaña electoral su intención de crear una Agencia Extremeña de Cooperación Internacional.

El 30 de marzo de 2007, la Asociación de Regiones Fronterizas Europeas contó con su presencia durante el Comité Ejecutivo de la Asociación celebrado en Trujillo. En esa ocasión, pudimos conocer de primera mano cuáles son sus ideas respecto a la cooperación transfronteriza en materia de sanidad. A continuación, incluyo la entrada correspondiente a su intervención en las actas de dicho Comité (disponible en inglés, francés y alemán):

(English)
ITEM 4 CB Health Cooperation

Mr Fernández Vara thanked the invitation by the AEBR to explain what Extremadura does in cross-border health. Extremadura and Alentejo have been working together for a long time within the European framework. Now they have a common cross-border health strategy, brought to fruition in a set of concrete realities: pregnant women from the Portuguese side can deliver their babies in Badajoz, patients from both sides are treated in any place because of a common protocol. He was not talking only about emergencies, but also scheduled interventions. There are also some agreements to take care of patients treated with radiotherapy, cancer patients, chronics, dialysis, paediatric surgery, etc. There are also some common services, born to serve both regions, as it is the case of the Positronic Emission Tomography (PET), thanks to Interreg. Together they can think in services that could be impossible alone. So, cross-border health initiatives build Europe bottom-up, from the citizens’ level.

But there are some difficulties, mainly legal. For instance, there is no legal capacity to sign agreements with regions located in different countries. Health is a full competence in Spanish regions. But this is not the case in Portugal. So, there is an asymmetry between the competent authorities: regional ministries in Spain, and national ministries in Portugal. Another difficulty is the register of births. The last Spanish-Portuguese Summit in Badajoz constituted a working group to deal with the legal framework to cooperate in medical care, training, research, protection of health, etc. A good example is the sharing of a Vaccination Schedule, as viruses and bacteria do not know about borders.

(...) Mr Fernández Vara explained that establishing a European legal framework which meets the regions’ needs is one of the biggest problems. In Extremadura the only solution, up to now, is the way of fact: to take care of anyone, and afterwards we will see who is paying for this care. Actually, the Portuguese government is paying, and we have agreed with them the prices of services. But, without European level measures, we cannot go forward, for instance, in the field of training. We have a real possibility, and the political will, to educate doctors in a cross-border basis, but we cannot do it from a legal point of view. This is something that we know is good: for instance, European Funds allow ambulances across the border to be equipped with GPS. We have also some advances in forest fires. He also made an interesting comparison: if we were talking about cows crossing Europe, they would find similar legislation while they are crossing borders, but in the case of human beings, they will not find any kind or harmonisation.

(Français)
Point n°4 Coopération de la santé transfrontalière

Monsieur Fernández Vara remercie l’ARFE de son invitation et de la possibilité ouverte de rendre compte des activités de la Région d’Estrémadure dans le domaine de la santé transfrontalière. L’Estrémadure et l’Alentejo coopèrent depuis longtemps dans le cadre européen. Ils disposent maintenant d’une stratégie de santé transfrontalière commune qui se manifeste dans plusieurs exemples pratiques concrets : les femmes enceintes portugaises peuvent mettre au monde à Badajoz et les patients des deux côtés de la frontière peuvent se faire traiter n’importe où, grâce à un protocole commun. Ceci est non seulement valable pour les cas d’urgence mais aussi pour les traîtements planifiés. En outre, il existe des accords, par exemple pour les traitements des patients sous radiothérapie, atteints de cancers ou en dialyse, malades atteints de maladies chroniques, enfants ou patients qui doivent être opérés. Et en plus de cela, grâce à Interreg, sont proposés des services médicaux d’emblée créés pour les régions des deux côtés de la frontière, comme par exemple la tomographie à émission de positrons. Ensemble, les régions peuvent penser à des services qu’aucune d’elles isolée n’aurait pu proposer. Pour cette raison, les initiatives de santé transfrontalières construisent l’Europe de bas en haut, en partant de l’échelon citoyen.

Il existe tout de même quelques difficultés, notamment de nature juridique. Par exemple, il n’y a aucune possibilité de conclure des contrats engageant sur le plan juridique avec des régions d’un autre pays. Le secteur de la santé relève en Espagne entièrement de la responsabilité des régions. Au Portugal il n’en va pas de même. Il en découle une asymétrie entre administations en charge. En Espagne il s’agit des ministères régionaux, au Portugal des ministères nationaux. Autre problème : le registre des naissances. Lors du dernier sommet luso-espagnol de Badajoz, un groupe de travail a été créé, devant se préoccuper du cadre juridique de la coopération dans les domaines de la santé, de la formation, de la recherche, de la protection sanitaire, etc. Un bon exemple est un plan de vaccination commun, les virus et bactéries ne s’arrêtant pas aux frontières.

(...) Monsieur Fernández Vara explique que c’est là l’un des obstacles majeurs que de créer des cadres juridiques permettant une action au niveau régional indépendamment du niveau national. Jusqu’à présent, la seule solution de traiter des questions est ainsi apparue : chacun est soigné et c’est seulement après qu’est réfléchi qui prend financièrement en charge le traîtement. Dans les faits, les frais engagés pour les services de santé sont pris en charge par le gouvernement portugais sur la base d’un agrément existant relatif à l’ampleur des coûts. Sans mesures au niveau européen, il n’est pas possible d’atteindre de plus amples progrès, notamment dans le domaine de la formation. Les possibilités comme la volonté politique de former le médecins de manière transfrontalière sont là, seuls les fondements juridiques ne le permettent pas. Le consensus existe certes sur le bien-fondé de l’affaire. Et c’est grâce à des moyens européens que les ambulances sont équipées du GPS des deux côtés de la frontière. Il y a des progrès aussi dans le domaine des feux de forêts. Monsieur Fernandez présente une comparaison intéressante : les bovins sillonnant l’Europe trouvent aux traversées de frontières une législation comparable. Lorsque les humains traversent les frontières, ils ne trouvent aucune harmonisation.

(Deutsch)
TOP 4 Grenzübergreifende Gesundheitskooperation

Herr Fernández Vara bedankt sich für die Einladung der AGEG und die Möglichkeit, über die Aktivitäten der Region Extremadura im Bereich grenzübergreifende Gesundheitsversorgung zu berichten. Extremadura und Alentejo arbeiten schon lange im europäischen Rahmen zusammen. Sie verfügen jetzt über eine gemeinsame grenzübergreifende Gesundheitsstrategie, die sich in verschiedenen konkreten Praxisbeispielen zeigt: schwangere Frauen von der portugiesischen Seite können ihre Babys in Badajoz zur Welt bringen, und Patienten von beiden Seiten der Grenze können sich aufgrund eines gemeinsamen Protokolls überall behandeln lassen. Dies gilt nicht nur für Notfälle, sondern auch für planmäßige Behandlungen. Darüber hinaus gibt es Vereinbarungen beispielsweise zur Versorgung von Strahlentherapie-, Krebs-, und Dialysepatienten, chronisch kranken Menschen, Kindern oder Patienten, die sich einer Operation unterziehen müssen. Daneben werden dank Interreg verschiedene, von vorneherein für die Regionen auf beiden Seiten der Grenze geschaffene medizinische Dienstleistungen angeboten, wie beispielsweise die Positronen-Emissions-Tomographie. Gemeinsam können die Regionen an Dienstleistungen denken, die keine von ihnen allein hätte bieten können. Deshalb bauen grenzübergreifende Gesundheitsinitiativen Europa von unten nach oben auf, beginnend auf Bürgerebene.

Es gibt jedoch einige Schwierigkeiten, insbesondere rechtlicher Natur. Beispielsweise gibt es keine Möglichkeit, mit Regionen in anderen Ländern rechtsverbindliche Verträge abzuschließen. Das Gesundheitswesen fällt in Spanien vollständig in den Zuständigkeitsbereich der Regionen. In Portugal ist das jedoch anders. Somit ergibt sich eine Asymmetrie zwischen den zuständigen Behörden. In Spanien sind es die regionalen, in Portugal die nationalen Ministerien. Ein weiteres Problem ist das Geburtenregister. Auf dem letzten spanisch-portugiesischen Gipfel in Badajoz wurde eine Arbeitsgruppe ins Leben gerufen, die sich mit den rechtlichen Rahmenbedingungen für die Zusammenarbeit in den Bereichen medizinische Versorgung, Ausbildung, Forschung, Gesundheitsschutz etc. befassen soll. Ein gutes Beispiel ist ein gemeinsamer Impfplan, da Viren und Bakterien nicht an Grenzen halt machen.

(...) Herr Fernández Vara erklärt, dass es eines der größten Hindernisse ist, rechtliche Rahmenbedingungen zu schaffen, die ein Handeln auf regionaler Ebene unabhängig von der nationalen Ebene ermöglichen. Bisher sehe die einzige Lösung in Extremadura so aus, dass Tatsachen geschaffen werden: Jeder werde behandelt, und erst danach werde überlegt, wer für die Behandlungskosten aufkommt. Tatsächlich werden die Kosten für die medizinischen Dienstleistungen auf der Grundlage einer bestehenden Vereinbarung über die Höhe der Kosten von der portugiesischen Regierung getragen. Ohne Maßnahmen auf europäischer Ebene sei es jedoch nicht möglich, weitere Fortschritte, beispielsweise im Ausbildungsbereich, zu erzielen. Die Möglichkeiten, und auch der politische Wille, Ärzte grenzübergreifend auszubilden, seien vorhanden, doch aus rechtlichen Gründen könne dies nicht geschehen. Es ist jedoch unbestritten, dass es hier um etwas Sinnvolles geht. So sind dank europäischer Mittel die Krankenwagen auf beiden Seiten der Grenze mit GPS ausgestattet. Auch auf dem Gebiet der Waldbrände gebe es Fortschritte. Herr Fernandez stellt einen interessanten Vergleich an: Kühe, die quer durch Europa unterwegs sind, finden bei der Überquerung von Grenzen eine ähnliche Gesetzgebung vor. Überqueren dagegen Menschen Grenzen, so finden sie keinerlei Harmonisierung.