Citizen-centred health systems and the close involvement of local and regional authorities in a "European health union" are two of the key elements presented in the opinion prepared by Roberto Ciambetti, President of the Veneto Regional Council, which was adopted by an overwhelming majority in the May plenary session of the European Committee of the Regions (CoR).

​In assessing the components of the European Health Union presented by the European Commission, ECR Member Mr Ciambetti said: "Local and regional authorities are responsible, to varying degrees, for health care in 19 of the 27 member states, and they also help fund health care in many of those countries. A 'European health union' capable of swiftly curbing pandemics is not possible without the close involvement of these authorities. We need a network of gold-standard hospitals, greater production capacities in Europe, large emergency stockpiles, and better data so that we know where our weak points are."

In the opinion, he also argued that the EU's plans to withstand health crises is undermined by health systems that are disconnected either from the territory or from the characteristics of the local socio-economic fabric. "We need to have more public investments in national health systems to ensure that they have the resources and means they need to emerge from the current crisis, as well as to strengthen their resilience in the long term", Mr Ciambetti urged. To complement the idea of more resilient societies Mr Ciambetti called for more investment in scientific research within the EU, "given that the transition to a more resilient society requires significant technological changes".

​The principle of subsidiarity is referred to several times in the opinion and for the rapporteur it proves to be an essential operational principle of reference: "regions and cities must be protagonists in the management of strategies and policies in order to give substance to decisions and measures quickly and promptly". There is of course scope and a necessity to improve coordination and to strengthen the EU's response to serious cross-border health threats but in this regard he calls on the CoR, as the EU's assembly of regional and local representatives, to be represented in all the discussions at EU level on health competences, including in the ambit of the Conference on the Future of Europe.