By Sachi Inoue, EHMA Secretariat
Prompted by the White Paper on the Future of Europe released by the European Commission and other emerging issues related to healthcare, the future of health systems has become an increasingly hot topic. A growing aging population in Europe, coupled with health budget cuts, has made it evident that new measures to address these challenges must be discussed and developed. EHMA has been actively engaged with the topic as shown by the theme of the recently concluded EHMA 2017 Annual Conference entitled, “Health Futures” and the ongoing development of the TO-Reach project that aims to establish the foundation of a joint European research programme on health services and systems.
To gather further updates on the future of European health systems, the EHMA Secretariat attended a debate on the 27th of June, 2017, hosted by the Interest Group on Access to Healthcare and chaired by MEPs Andrey Kovatchev, Cristian Bușoi, Karin Kadenbach, Lieve Wierinck and PACT Secretary General Stanimir Hasardzhiev. This debate was entitled, “Future Scenarios for the EU: What role for Healthcare?” and included speakers, Robert Madelin, former Director General of DG Santé, Andrzej Jys, current director of DG Santé, Justina Januševičienė from the Lithuanian Ministry of Health and Yann Le Cam of EURORDIS.
The value of health and social security
The value of health and the conclusion that economic growth can only be achieved with healthy populations serves as the established reason as to why health systems remain important in discussions concerning the future of Europe. Due to this, growing health threats that may significantly impact the health of European citizens such as Antimicrobial Resistance (AMR) and challenges associated with aging populations remain a priority for policy makers and regulatory bodies to properly respond to. Member States, with support from the Commission, are in the process of developing national health systems that are to be sustainable and resilient in times that are constantly changing and unpredictable.
The health sector is a vital component of the economy representing 10% of the EU’s GDP and accounts for 8% of its total workforce [i]. This noteworthy statistic shows how health is not only an important social aspect but is heavily intertwined with the economy.
Figure 1: Health expenditure as a share of GDP, 2015 (or nearest year)
Source: OECD Health Statistics 2016; Eurostat Database; WHO, Global Health Expenditure Database
1.Includes investments. 2. OECD estimate
Just as statistics such as these show the impact health has on various socio-economic areas, there is a greater call for value-based systems and outcomes based measurements that would highlight progress, or the lack of it, in health systems. These measurements that would quantify the effectiveness of new policies and regulations implemented would lead to evidence-based evaluations and conclusions. Data gathered would then be considered into The Bermuda Triangle of Policy that is composed of scientific evidence, political judgment and value preference to further influence future projects and proposed plans.
Collaboration across borders
The health system dilemma is constantly discussed with the role of stakeholders in mind. However, to fully reform health systems to adapt to new challenges, these stakeholders should instead be viewed in light of the community as a whole. There is enhanced value if outcomes can be measured and patient reports that detail the effectiveness of new policies can be analysed to identify good and bad practices. Actions designed to assess the performances of various health systems would not only allow improvements to be objectively measured, but potentially could be used to benchmark hospitals regionally, nationally and across Europe.
For Europe to become a best practice region on specific health issues, there is a need for collaboration and an exchange of knowledge to occur on national levels. The European region cannot be identified as a best practice region if some Member States are implementing policies that are effective while others are falling behind due to a lack of resources or support. Methodologies for the collection of data to ensure detailed reports that are complete and comparable across different regions are necessary if exchange and implementation of best practices across borders is to occur. As with the collection and exchange of data, protection of individual personal information is always a concern and this issue must be addressed if plans are to continue in this direction. Despite all the challenges in the way of collaboration across borders, however, it is evident that there is something to be learned when some countries spend more on health with poorer outcomes while others spend less on health with better outcomes.
The future of health systems is a topic that will continue to be discussed during times when new challenges continue to arise and actualisation of solutions become more complex. The goal of ensuring quality healthcare to European citizens across borders is a noteworthy direction to move towards; however, specific policies and guidelines are necessary to overcome broad barriers to establish best practices across regions. Unfortunately, there is no one sole solution to ensure the preparedness of health systems to address issues such as AMR and the prevalence of chronic diseases. Moving forward, it will be necessary to maintain engagement with the material by following national action plans, exchanging knowledge on best practices through networks and contributing to the discussion on the future of health systems. Believing in the importance of innovation and research evidence to identify effective and sustainable ways to restructure current health systems to tackle these challenges, EHMA maintains engagement through the To-reach project, which can be further explored here.
Included is a collection of further reading to supplement the contents of this article. Find below links to current projects and initiatives by the European Commission, a detailed report on the state of Health in Europe developed by the Organisation for Economic Co-operation and Development (OECD) and information on national health systems collected by the European Observatory on Health Systems and Policies.
- Health Systems Performance Assessment by the European Commission: https://ec.europa.eu/health/systems_performance_assessment/policy_en
- European Reference Networks: https://ec.europa.eu/health/ern/policy_en
- State of Health in the EU: Pooling Expertise, Strengthening Knowledge: http://ec.europa.eu/health//sites/health/files/state/docs/2016_factsheet_en.pdf
- 2016 Health at a Glance: Europe Report developed by the Organisation for Economic Co-operation and Development (OECD) with support from the European Commission: https://ec.europa.eu/health/sites/health/files/state/docs/health_glance_2016_rep_en.pdf
- The Health Systems and Policy Monitor by the European Observatory on Health Systems and Policies: http://www.hspm.org/mainpage.aspx
Sources:[i] https://www.oecd.org/els/health-systems/Health-at-a-Glance-Europe-2016- CHARTSET.pdf
 TO-REACH – Transfer of Organisational innovations for Resilient, Effective, equitable, Accessible, sustainable and Comprehensive Health Services and Systems. (Grant Agreement 733274). Website: www.to-reach.eu