The EU Health Coalition highlights the need for concrete measures for better health for people in light of the publication of the State of Health in the EU
The EU Health Coalition welcomes the publication of the 2019 edition of the State of Health in the EU country profiles and companion report. Assessing and benchmarking health system performance, with focus on their ability to deliver better health for citizens and patients, is an important tool for creating public awareness of the role and functioning of health systems, identify policy options and incentivize change. While several countries have their own processes for Health Systems Performance Assessment, a European wide process can add substantial value in terms of identifying and exchanging good practices, pooling knowledge and scaling up solutions. The EU Health Coalition has elaborated several high-level recommendations that aim to leverage health systems performance and to improve health systems outcomes across Europe. The relevance of these recommendations and the positive impact that they might have on people are highlighted below.
Standardized collection of patient-relevant health outcomes across diseases and conditions
The Country Profiles confirm that several EU Member States have underfinanced health systems which lead to lower-than average life expectancy and poor health outcomes. In this regard, the lack of comparable data to assess health system performance in terms of outcomes that matter for patients is a key hurdle to achieving a deeper level of analysis at European level. It can be noted that the main indicator used to compare the effectiveness of health systems is preventable mortality, which, while important, is too general to identify the specific areas in which different health systems fail to deliver, and inform policy actions. In an age when most EU countries struggle with rising incidence of chronic diseases and multimorbidity, comparable information on patients’ quality of life, capacity to work and participate in the society is more and more important in order to understand health system performance. For this reason, one of the key recommendations is for the EU to support the standardized collection of patient-relevant health outcomes across diseases and conditions. Such an effort would greatly increase the capacity to analyse variation and identify best practice, as well as underpin more people-centred health systems through the use of people- and patient-relevant data for healthcare decision-making at all levels.
Evidence-based programmes for prevention
The EU Health Coalition welcomes the focus on vaccination in the Companion Report. The importance of evidence-based programmes for prevention is recognized in the first recommendation of the Coalition, including the role that the EU can play in supporting Member States in implementing such measures. Vaccines are one of the bedrocks of modern medicine underpinning the great advancement of human health, and one of the most cost-effective ways to protect populations from preventable disease and avoid unnecessary utilization of healthcare resources. In this regard, tackling vaccine hesitancy and misinformation about vaccines is an important public health priority.
The digital transformation & European Health Data Institute
The digital transformation of healthcare has the potential to greatly improve the efficiency of care while empowering individuals and making prevention and care more tailored to their needs. Though most investments in health data and digital health infrastructure are done at national or regional level, the EU could play an important role in supporting strategic investments and setting standards and a common governance framework for health data which would greatly scale up the potential of digital health in Europe. The EU Health Coalition has for that reason recommended the setting up of a European Health Data Institute to drive the digitalization of European health systems and help analyse health data for use in policy making, and also recommended educational initiatives to ensure that people have equal opportunities to utilize digital tools to better manage their health.
Access to high-quality healthcare
Access to high-quality healthcare is a central right for the EU population, as recognized in the European Pillar of Social Rights. Currently, the level of access differs across and within countries, including for reasons relating to the level of public spending on healthcare, high rates of Out of Pocket expenditure in some Member States, waiting lists, staffing shortages, underdeveloped primary care services, poor health literacy among vulnerable communities and lack of infrastructure in remote areas. It should also be noted that access to healthcare does not automatically mean that services are of high quality, as there are significant variations in outcomes between or within Member States which cannot solely be explained by underlying risk factors or expenditure levels. The EU Health Coalition therefore agrees with the need to develop more granular data in order to strengthen the evidence base on health inequalities in Europe. Better data and evidence could in turn guide EU support to health system reform and capacity building through the European Structural and Investments Fund and the Structural Reform Support Programme.
A well-educated, dynamic and resilient health workforce is necessary for well-functioning health systems, and the EU Health Coalition therefore supports the focus on task-shifting and other skill mix innovation. This focus is in line with the EU Health Coalition recommendation to promote and support frontline initiatives exploring the appropriate composition and availability for a sufficient and highly qualified health and social care workforce, improving the access to continuous professional development, contributing to minimise the gaps between the needs and the supply of health workforce, and guiding Member States in scaling-up innovative workforce composition models for integrated, patient-centred care.
High-Level Forum on Access to Innovation
The EU Health Coalition agrees that access and affordability of safe and high-quality medicines is an important part of ensuring equal access to healthcare in Europe. Regarding access to innovative medicines, the average delay between market authorisation and patient access can vary by a factor greater than seven across Europe, with patients in Northern/Western Europe accessing new products on average 100-200 days after market authorisation and patients mainly in Southern/Eastern Europe between 600-1,000 days. Also, within countries there can be significant differences in time to access. Including for this reason, the Coalition has recommended the setting up of a High-Level Forum on Access to Innovation between European institutions, Member States and stakeholders, to discuss root causes and concrete actions on how to facilitate appropriate access to health innovation in Europe.
The EU Health Coalition welcomes the opportunity to be part of the dialogue on the State of Health in the EU and will seek to engage European policy-makers and stakeholders on several of these topics in the course of 2020 and throughout the State of Health cycle.
The EU Health Coalition was created after the first ever EU Health Summit, which took place in November 2018, to promote a shared vision of health in Europe, based on jointly developed recommendations. The purpose is to ensure health remains high on Europe’s political agenda and bring the necessary changes to address the unprecedented challenges and opportunities driven by an ageing population and increased prevalence of chronic diseases that healthcare systems and citizens across Europe are facing. The EU Health Coalition is composed of patient organisations, EU research-oriented medical societies, industry organisations, regional and local health authorities and other relevant stakeholders that share a common vision for health.