Written by Gianluca Quaglio and Amr Dawood
Over the last decade, EU health systems have faced growing common challenges: increasing cost; the rise of chronic diseases and multi-morbidity conditions leading to growing demand for healthcare; shortages of health professionals; technological advances; and inequities in access to healthcare. EU Member States’ future ability to provide universal and equitable access to high-quality care will depend on making health systems more resilient, more capable of coping with the challenges ahead, while remaining cost-effective and sustainable. The issue was discussed in a workshop on the future of EU health systems, organised in the European Parliament. The event was chaired by Paul Rubig (EPP, Austria), First STOA Vice-Chair, and moderated by Professor Helmut Brand, Head of the Department of International Health at Maastricht University in the Netherlands. The keynote speaker, Andrzej Rys, Director for Health systems, medical products and innovation at the Director General for Health and Food Safety of the European Commission, highlighted the Commission’s consistent promotion of the exchange of experiences between Member States, a process that helps develop national performance assessment systems by identifying best practices and replicable methodologies.
The governance of health
Complications related to governance are not the only problems for health service policies. Complexity, emerging from inadequate finances, poor technical resources, the interlinking of clinical developments, demographics, and many other factors, is increasing. Nonetheless, governance is a recurring problem, according to Josep Figueras, Director of the European Observatory on Health Systems and Policies. Figueras suggested five main features for good governance: Transparency of decision-making coupled with clear mechanisms, lines of Accountability, Participation of key stakeholders, Integrity, and Policy Capacity (known as the TAPIC framework).
The Veneto model: a regional approach to tackling health challenges
The the Veneto Region health sector in Italy was presented as an example of innovative governance. Antonio Maritati, Director of the Health and Social Affairs Department in the Veneto Region, explained that the region recently approved a reform with two fundamental areas of innovation. The first is the establishment of a new central body (or ‘zero enterprise’), positioned between the Regional Council (responsible for the programme’s direction) and local healthcare authorities (responsible for the provision of services). The second is the merging of local healthcare units. Expected outcomes are a standardisation of costs and procedures, and the rationalisation of back-office functions.
Routine data reuse: a pathway towards smarter health systems
The generation and use of EU health system data is an essential tool supporting health system governance, enabling performance comparison across service providers, and health outcomes within and across countries. Pooling clinical data allocated to geographic areas, or care providers into a single dataset, allows the development of comparable performance indicators, as well as more reliable benchmarking. These issues were presented to the workshop and analysed in-depth by Professor Enrique Bernal-Delgado, of the Institute for Health Sciences in Aragon, Spain.
Improvement in lifestyle and citizen participation
Finally, Professor Pedro Oliveira from the Católica-Lisbon School of Business and Economics, explained that patients and their caregivers, when faced with a need imposed by their diseases or health conditions, often developed innovative solutions by themselves to help them cope with their disease. He also reported about the platform he founded, ‘Patient Innovation‘, a non-profit and open online platform designed to allow patients and caregivers of any disease and geography to share innovative solutions they develop to fight their diseases, as well as to foster collaboration among patients, caregivers and others. Over 700 innovations were shared and curated at Patient Innovation in 3 years from a community of over 50.000 patients.