At the same time as HEALTH has become a top priority on the European agenda, many colleagues have for some years noticed a gradual but significant change in the way preventive healthcare is organised for staff in European institutions.
PREVENTIVE HEALTHCARE OFFERED TO EU STAFF
Every year, according to Article 59(6) of the staff regulations, officials and other agents must undergo a preventive medical check-up, but if they don’t – no reaction!
Colleagues in Brussels ‘holding a post at risk’ can, if they wish, still undergo the annual medical check-up at the Medical Service in Brussels while others, not holding a post at risk, should first book an appointment at the Brussels Medical Service laboratory and then undergo the check-up with their general practitioner (GP).
Colleagues in Luxembourg and Ispra may choose to take the annual medical check-up either with their GP, or with an occupational health doctor at the Medical Service.
The annual preventive check-up done by the Medical Service is complemented by a preventive health screening programme [1] offered by the Commission health insurance provider (JSIS) and the participation is voluntary and can be done in a health screening center [2].
The annual check-up and the screening programs are reimbursed at 100% if within the limits of the ceilings [3] but as staff are not automatically invited to participate the responsibility lies solely on each individual staff member.
However, the reality experienced by some colleagues, increasingly reported to Generation 2004, is different.
More preventive services appear to be shifting away from the Medical Service towards external providers, GPs or pharmacies. In practice, this has made prevention more burdensome, less accessible, and for some colleagues, effectively less likely to happen at all.
Several colleagues have told us that they no longer carry out regular preventive examinations because the process has become significantly more complicated compared to the previous system.
This is particularly concerning in a context where prevention should become more important, not less.
CANCER RATES CONTINUE TO RISE
Cancer remains one of the leading causes of death in Europe, and prevention and early detection remain among the most effective tools for reducing mortality and improving treatment outcomes.
According to the latest European cancer data [4], around 2.7 million new cancer cases and approximately 1.3 million cancer deaths occur every year in the EU.
Breast cancer remains the most common cancer affecting women in Europe. Belgium itself has one of the highest breast cancer incidence rates in Europe. Recent analyses [5] estimate incidence rates above 110 cases per 100,000 women, among the highest levels in Europe.
At the same time, international projections suggest that the global burden of breast cancer will continue to rise sharply in the coming decades. WHO-linked projections [6] estimate that breast cancer cases could increase by around 38% globally by 2050, while mortality could increase by approximately 68% [6] if prevention and early detection efforts are not strengthened.
This is why screening and early detection matter so much.
European studies consistently show that organised mammography screening programmes significantly improve survival through earlier diagnosis. Research published in 2025 [7] estimated that between 25% and 30% of avoided breast cancer deaths in Europe over recent decades are linked directly to screening and early diagnosis.
The OECD/European Commission Country Cancer profile for Belgium [8] indicates that women participating in organised mammography screening programs have around 50% lower risk of dying from breast cancer compared to non-participants.
Therefore, concerns raised and reported by colleagues about not being invited or even allowed to take part in any national screening programme are well-grounded.
Several colleagues have informed us that preventive screening elements previously integrated into the annual medical check-up no longer appear to be systematically included in the same way as before.
Colleagues report that mammography screening, which used to form part of the preventive medical follow-up integrated into the annual check-up for women above the age of 40, is no longer included with the same intervals.
Colleagues have also raised concerns that ophthalmological examinations which were previously included as part of preventive medical monitoring no longer appear to be systematically available within the annual check-up framework.
At the same time, vaccination campaigns previously organised directly through the Medical Service increasingly appear to have been redirected towards external providers such as pharmacies or private doctors.
The message increasingly perceived by staff is simple:
“Find yourself a doctor or pharmacy next by – policy”
But this ignores an important reality.
A GROWING GAP IN ACCESS TO PREVENTION
Several colleagues, particularly in Belgium, have pointed out a practical problem linked to the specific status of EU staff.
As EU officials and other servants are covered by the Joint Sickness Insurance Scheme (JSIS) rather than a national healthcare system, they may not always benefit automatically from the same preventive screening programmes available to people integrated into a national social security system.
Women affiliated to the national health care systems in Belgium and Luxembourg are invited every two years to take part in the national screening programmes for breast cancer (Belgium age 50-69 and Luxembourg age 45-74).
As a result, some colleagues increasingly feel caught in a grey zone:
- institutional preventive services are reduced or externalised,
- while national screening systems are not always easily accessible under the same conditions.
This raises serious questions about equal access to preventive healthcare for staff working for the European institutions.
A BROADER TREND OF EXTERNALISATION?
The concern expressed by several colleagues is that these developments are not isolated adjustments, but part of a broader trend of gradual externalisation and cost reduction in internal medical services.
Vaccinations that were previously organised directly by the Medical Service are increasingly redirected towards pharmacies or external doctors. Preventive examinations that used to be integrated into institutional medical follow-up now depend more heavily on individual initiative and external coordination.
Of course, many of these services remain available somewhere outside the institution, but prevention works best when it is simple, systematic, and easily accessible.
The more fragmented and burdensome the process becomes, the more colleagues postpone examinations, delay follow-up, or simply stop participating in preventive programmes altogether.
And when it comes to screening of cancer or other serious diseases, delayed detection can have very real consequences.
WHAT DO THE STAFF REGULATIONS SAY?
The Staff Regulations establish the institution’s responsibility regarding working conditions, health protection, and medical supervision of staff.
Preventive medicine is not simply an optional administrative service. It is part of the institution’s duty of care towards its staff.
The purpose of annual medical surveillance is precisely to identify problems early, reduce long-term health risks, and protect staff wellbeing.
Reducing preventive access may generate short-term administrative savings but can also create significantly higher long-term human and financial costs.
PREVENTION SHOULD NOT DEPEND ON PERSISTENCE
One of the strongest messages received from colleagues is that prevention increasingly depends on personal persistence, available time, and the ability to navigate within external healthcare systems.
But effective prevention cannot rely only on individual determination.
The easier preventive healthcare is, the more colleagues participate. The more complicated it becomes, the more people delay examinations – sometimes until it is too late.
GENERATION 2004 CALLS FOR TRANSPARENCY AND CLARIFICATION
Generation 2004 believes these developments deserve serious discussion and greater transparency.
We believe the administration should clarify:
- which preventive services have been reduced, modified, or externalised,
- what impact this has had on staff participation in preventive screening,
- whether equal access to prevention remains guaranteed for all staff,
- and what long-term vision exists for preventive healthcare within the institutions.
At a time when institutions increasingly rely on staff resilience, flexibility and performance, prevention should be strengthened, not progressively weakened.
Because prevention is not a luxury.
It is one of the most important investments an institution can make in its staff.
Health screening: hoops to jump through [9]
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