Advocacy that makes a difference- hands-on advice on how to engage efficiently

1. Sunday, 30 March Advocacy that makes a difference- hands-on advice on how to engage efficiently MihaelaMilitaru, ECPC DIRECTOR

2. Training

3. Agenda • Introduction to the EU environment (20’) • Basic principles for good advocacy (20’) • Practical exercise: making melanoma a priority (40’)

4. Objectives • To understand …. • The EU institutions and their roles • The health competencies of the EU and Member States • Advocacy processes and tools

5. Introduction to the EU environment

6. Healthadvocacy – a crowdedspace Trade Associations & Industry Media Patient Groups Think Tanks, Stakeholder Coalitions, Forums Public Bodies Professional Bodies & Scientificsocieties

7. Competitive lobbying environment Second biggest lobbying place after Washington DC • 28 Member States • 25-30,000 policy and decision-makers • Around 200 diplomatic representations • > 3,000 interest groups • > 15,000 lobbyists • 5,000 lobbyists accredited to European Parliament and Commission • High media presence (EU press, press correspondents)

8. Why is the EU important for you? Important legislative power (80% of national legislation is decided at EU level e.g. Clinical Trials Regulation ) Capacity to influence national health agendas e.g National plans on cancer Approval of medicines (EMA centralised procedures) Development of guidelines (e.g. European guidelines for quality assurance in breast cancer) Facilitating cross-border healthcare (e.g establishment of European Centres of Reference, recognition of prescriptions) Epidemiological control (e.g. establishment of the European Network of Cancer Registries) Recognition of professional qualifications for doctors Setting healthcare objectives (e.g. to reduce cancer incidence by 15% by 2020)

9. Whatisyourrole in the policyspace?

10. Whatisyourrole in the policyspace? • Inclusion of patients’ viewpoints in healthcare policies • Provide first-hand knowledge of healthcare delivery practice • Educate policy-makers and other patients on cancer related issues • Raise awareness on serious health issues important for society

11. Health policy

12. EU health policy: contradictions and challenges • Health Policy in the EU has a • fundamental contradiction: • Art. 168 TFEU, as the definitivestatement on the scope of EU law, states thathealthcareis the responsability of MS • As MS involve interactions with people (eg. staff and patients), goods (e.g. pharmaceuticals and devices) and services (eg. provided by healh care funders and providers), all of which are grantedfreedom of movementacrossborders by the sameTreaty, many national healthactivities are in factsubject to EU law and policy • Source: Elias Mossialos and Baeten, 2010

13. EU health “competency”

14. INSTITUTIONS & Procedures

15. Institutional triangle Commission Nominated by EU MS and approved by the EP Proposes Right of initiative Directly elected by EU citizens Governments of EU MS Parliament Council amends/decides Direct representative of patients amends/decides Negotiations of national interests

16. Roles • Council of the EU • European Parliament • European Commission • EU interest • Increased politicisation • Appointed Commissioners • Civil servants • Organised in DGs • Initiates legislative proposals • Implements adopted legislation • Acts as “guardian of the Treaties” • Manages EU budget • Represents EU on international stage • Mediates in negotiations between Council and EP • Rules on competition cases • Citizens’ interest • Debating ideas and co-deciding • Overseeing Commission • Increased competences • Directly elected MEPs • Political staff • Officials • Direct contact with their MS • Platform for political debate • Legislative power: Amends and adopts, recommends • Budgetary power: Co-decides on budget • Supervisory power: approval of Commissioners, oral/written questions • National governments’ interest • Co-deciding or deciding • Strongest institution • Ministers • Ambassadors, civil servants, experts • Officials • Decision-maker (with the EP) • Representing 28 national governments • Different formations: Ecofin, Competitiveness, EPSCO… • Rotating presidency every 6 months • Diplomatic, secretive

17. “Golden rules” to influence EU acts The earlier, the better • Interact with Commission: Consultations, workshops, meetings, communication materials… Provide solutions • Importance of constituency impact • Amendments to EP • Meetings with decision-makers and policy advisers • Voting recommendations Long-termism • Don’t endanger long-term relationship with policy-makers • Engage and provide positive contribution to policies • Build alliances

18. Lobbying the European Commission “80% of a Commission’s proposal remains in the final act” • Early involvement • Leading DG is not necessarily sufficient • Technical advice is welcome • Political (cabinet) and technical (DG) levels • Going beyond traditional lobbying: alliances, press, etc. • Continuous link throughout the process

19. Lobbying the European Parliament The favourite but complex lobbying field • 10-20 MEPs play a critical role on each file • “Leading committees” are key, but “opinion-giving committees” should not be neglected • Use of political and emotional arguments, supported by facts • Need for timely and quick input • Political and regional agendas matter • Relevant, credible and concise information

20. Lobbying the Council Difficult but effective institution to approach • Technical information and contact with attachés (Working Group) • Critical & political issues with ambassadors/deputies (COREPER) • Sustained contacts with Council Presidency • Actions at EU and national levels (ministries) • Playing the “national card” is crucial • Alliance building among Member States to build qualified majorities/blocking minorities

21. Interactions EUROPEAN COMMISSION Initiates Policy Institutes and controls Nominates Proposes EUROPEAN PARLIAMENT Amends/Decides on Policy EUROPEAN COUNCIL President/Heads of States Negotiates with Proposes Codecision Assists Instructs COUNCIL OF THE EU Member States Ministers Amends/Decides on Policy Committee of Permanent Representatives (COREPER) Helps Assists Institutional Relationships Legislative Process Permanent Representations

22. Hard and soft policy tools Regulation Directive Implementing Measures and Delegated Acts Green Papers, White Papers, Communications A Regulation is binding in its entirety and directly applicable to Member States. Action Plans setting out policy, legislative strategies Often include elements for legislative proposals A Directive needs to be transposed into national law. It leaves to National Authorities to decide upon choice of form and methods of application. Implementing Measures and Delegated Acts are both legally binding. They develop specific aspects of Regulations and Directives.

23. Alternative policytools

24. INTRODUCTION TO PUBLIC AFFAIRS & LOBBYING

25. key advocacy principles • Be prepared • Know yourinterlocators’brief • Be targeted • Know whatyouwant to achieve • Be constructive • Bring/be part of the solution • Be credible • Use evidence & 3rd party advocacy • Be relevant • Play the constituencycard & link messaging to policypriorities • Be noticeable • Build and leverage networks and coalitions • Beflexible • Anticipate and adjust to changingpriorities • Be respectful • Build bridges, develop trust, value partnerships • Be timely • Interveneat the right time in the process

26. the earlier you intervene…

27. some do’s and don’ts • don’t • Waste their time by meeting for the sake of meeting • Lose your message by telling them everything at once • Make up policy positions off the cuff • Offer biased, incomplete or incorrect information • Use standardised communications • Be aggressive, criticise or be in conflict with their interests • Let them assume it’s the end of the conversation • Abuse their willingness to help • do • Tailor your messages to your interlocutors’ time and needs (know what their position is) • Personalise your communication • Be friendly and down-to-earth • Listen ! • If you do not know the answer say so and offer to follow up with the correct answer • Provide them with useful information even if nothing is at stake for you • Follow-up with a thank you note and a brief statement of your interest and the action you wish them to take

28. advocacy process, tactics and tools

29. building an advocacy campaign

30. step 1: define yourdesiredoutcomes Define your desired outcome (ambitious but realistic) Translate into clear and focussed tactical objectives / policy asks

31. step 2: identify the critical path New policy initiatives to be created Identify the critical path Ongoing political debates and initiatives which could be leveraged Ongoing or upcoming regulatory initiatives

32. step 3: identify & prioritise audiences • Identify … • …relevant policy-makers through • organigrams • policy-makers’ public communications • trusted third parties/experts • Prioritise… • ….according to • Relevance • Influence • Favourability • Accessibility

33. step 4: arguments & messages Provide solutions, not problems Be clear and coherent Adapt key messages to your target audience Develop solid evidence Ensure consistency of messaging

34. step 5: tools & channels Tools One-to-one meetings Events & profilingplatforms • Conferences • Workshops • Receptions • Debates Position Papers • channels • Direct contact • Consultations • Media (incl. social media) • Umbrella organisations • Alliances & coalitions • Third party advocates Alliances, coalitions and campaigns

35. step 6: engage Preparation is key ! Remember key advocacy principles Keep track of meetings/contacts made Always follow-up and maintain dialogue

36. step 7: assess & review Engage Assess Inform Adapt

37. Practical exercise: making melanoma a priority for the EU after the EP elections

38. Thank you very much! Website www.ecpc.org Twitter @cancereu Facebook Page https://www.facebook.com/ECPCfb CHAMPIONING THE INTERESTS OF EUROPEAN CANCER PATIENTS (change footnote using Menu "View > Change headline/footnote")