Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-05T03:42:56.455Z Has data issue: false hasContentIssue false
  • English
  • Français

Supporting health systems in Europe: added value of EU actions?

Published online by Cambridge University Press:  22 August 2013

Timo Clemens ,
Kai Michelsen  and
Helmut Brand
Timo Clemens*
Affiliation:
Department of International Health, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
Kai Michelsen
Affiliation:
Department of International Health, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
Helmut Brand
Affiliation:
Department of International Health, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
*
*Correspondence to: Timo Clemens, Department of International Health, CAPHRI School for Public Health and Primary Care, Maastricht University, Duboisdomein 30, NL-6229 GT Maastricht, The Netherlands. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Since the start of the economic crisis, the European Union's (EU's) predominant discourse has been austerity and fiscal consolidation. The detrimental effects on Europe's health systems and the health status of its citizens are well described. However, little is known about the emerging EU-level initiatives to support national health systems handle the challenges of efficient care provision and system reorganisation aimed to meet their future needs. This review analyses the manner, conditions and prospects of such EU support. First, health system objectives are increasingly entering the EU health policy agenda. Second, professional and patient mobility provisions may support member states (MS) in copying with crisis related health challenges but can potentially acerbate them at the same time. Third, in recent initiatives health system goals are more closely tied to the EU's economic growth narrative. And fourth, health system issues are taken up in existing EU-level structures for debate and exchange between MS. In addition, the design of some policies may have the potential to intensify socioeconomic and health inequalities rather than ameliorate them.

Type
Articles
Information
Health Economics, Policy and Law , Volume 9 , Issue 1 , January 2014 , pp. 49 - 69
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ahtonen, A. (2012), ‘Healthy and active ageing: turning the ‘silver'economy into gold’, EPC Policy Brief, Brussels: European Policy Centre.Google Scholar
Aluttis, C., Brand, H., Michelsen, K., Costongs, C., Chiotan, C., Van den Broucke, S., Otok, R., Jelfs, E., Baer, B., Barnhoorn, F., Levin-Zamir, D.Rechel, B. (2013), Review of Public Health Capacity in the EU, Luxembourg: European Commission, DG SANCO.Google Scholar
Azzopardi Muscat, N., Grech, K., Cachia, J. M.Xuereb, D. (2006), ‘Sharing capacities – Malta and the United Kingdon’, in M. Rosenmöller, M. McKee and R. Baeten (eds), Patient Mobility in the European Union: Learning from Experience, Copenhagen: World Health Organization, 119–136.Google Scholar
Baeten, R. (2011), ‘Past impacts of cross-border health care’, in M. Wismar, W. Palm, J. Figueras, K. Ernst and E. van Ginneken (eds), Cross-border Health Care in the European Union – Mapping and Analysing Practices and Policies, Copenhagen: World Health Organization, 255–288.Google Scholar
Bala, M. M.Lesniak, W. M. (2005), ‘Poland is losing its doctors’, BMJ, 331(7510): 235.Google Scholar
Barros, P. P. (2012), ‘Health policy reform in tough times: the case of Portugal’, Health Policy, 106(1): 17–22.Google Scholar
Bongardt, A.Torres, F. (2010), ‘The competitiveness rationale, sustainable growth and the need for enhanced economic coordination’, Intereconomics, 45(3): 136–141.Google Scholar
Borg, A. M. (2012), ‘Health Inequalities amidst the Economic Crises and Austerity: An Issue for EU Policy-making’, Master Thesis, Maastricht University, Maastricht.Google Scholar
Bundesagentur für Arbeit (2012), Hintergrundinformation: Auswirkungen der EU-Schuldenkrise auf den deutschen Arbeitsmarkt [Background note: Effects of the EU debt crisis on the German labour market], Nuremberg: Bundesagentur für Arbeit.Google Scholar
Busse, R., Van Ginneken, E.Wörz, E. (2011), ‘Access to health care services within and between countries of the European Union’, in M. Wismar, W. Palm, J. Figueras, K. Ernst and E. Van Ginneken (eds), Cross-border Health Care in the European Union – mapping and analysing practices and policies, Copenhagen: World Health Organization.Google Scholar
Chalmers, D. (2012), The European Union Court of Justice has taken on huge powers as ‘enforcer’ of last week's Treaty on Stability, Coordination and Governance. Yet its record as a judicial institution has been little scrutinized. LSE EUROPP (blog), March 7. http://blogs.lse.ac.uk/europpblog/2012/03/07/european-court-of-justice-enforcer/.Google Scholar
Council of the European Union (2010a), Council Conclusions on Investing in Europe's Health Workforce of Tomorrow: Scope for Innovation and Collaboration, Brussels: Council of the European Union.Google Scholar
Council of the European Union (2010b), Council Conclusions: Innovative Approaches for Chronic Diseases in Public Health and Healthcare Systems, Brussels: Council of the European Union.Google Scholar
Council of the European Union (2010c), ‘Council Decision 2010/707/EU of 21 October 2010 on guidelines for the employment policies of the member states’, Official Journal of the European Union, L308/46–51.Google Scholar
Council of the European Union (2011a), Council Conclusions: Towards Modern, Responsive and Sustainable Health Systems, Luxembourg: Council of the European Union.Google Scholar
Council of the European Union (2011b), Working Party on Public Health at Senior Level, Note for Discussion by Commission 14115/11 SAN 177, Brussels, 21 September 2011.Google Scholar
Council of the European Union (2011c), Working Party on Public Health at Senior Level, Note for Discussion by Presidency 14114/11 SAN 176, Brussels, 28 September 2011.Google Scholar
Council of the European Union (2012a), Working Party on Public Health at Senior Level of 8 February 2012, Outcome of Proceedings 7311/12 SAN 47, Brussels, 7 March 2012.Google Scholar
Council of the European Union (2012b), Working Party on Public Health at Senior Level on 28 September 2012, Outcome of Proceedings 15014/12 SAN 238, Brussels, 23 October 2012.Google Scholar
de Belvis, A. G., Ferre, F., Specchia, M. L., Valerio, L., Fattore, G.Ricciardi, W. (2012), ‘The financial crisis in Italy: implications for the healthcare sector’, Health Policy, 106(1): 10–16.Google Scholar
European Commission (2008), Green Paper- On the European Workforce for Health, Brussels: European Commission.Google Scholar
European Commission (2011a), Proposal for a Directive of the European Parliament and of the Council amending Directive 2005/36/EC on the recognition of professional qualifications and Regulation on administrative cooperation through the Internal Market Information System, COM(2011) 883 final, Brussels: European Commission.Google Scholar
European Commission (2011b), Proposal for a Regulation of the European Parliament and the Council on establishing a Health for Growth Programme, the third multi-annual programme of EU action in the field of health for the period 2014-2020, COM(2011) 709 final, Brussels: European Commission.Google Scholar
European Commission (2012a), ‘Commission Decision 2012/C 198/06 of 5 July 2012 on setting up a multisectoral and independent expert panel to provide advice on effective ways of investing in health’, Official Journal of the European Union, C198/7–11.Google Scholar
European Commission (2012b), ‘Commission Implementing Decision of 28 November 2012 Concering the Adoption of the 2013 Work Plan in the Framework of the Second Programme of Community Action in the Field of eHealth (2008-2013),… (2012/C 378/07)’, Official Journal of the European Union, C378/6–40.Google Scholar
European Commission (2012c), Commission Staff Working Document on an Action Plan for the EU Health Workforce, SWD(2012) 93 Final, Strasbourg: European Commission.Google Scholar
European Commission (2012d), Communication Taking forward the Strategic Implementation Plan of the European Innovation Partnership on Active and Healthy Ageing COM(2012) 83 Final, Brussels: European Commission.Google Scholar
European Commission (2012e), European Innovation Platform on Active and Healthy Ageing, List of funding opportunities, https://webgate.ec.europa.eu/eipaha/funding [19 October 2012].Google Scholar
European Commission (2012f), Proposal for a Regulation of the European Parliament and of the Council Laying Down Common Provisions on the European Regional Development Fund, the European Social Fund, the Cohesion Fund, the European Agricultural Fund for Rural Development and the European Maritime and Fisheries Fund covered by the Common Strategic Framework and Laying Down General Provisions on the European Regional Development Fund, the European Social Fund and the Cohesion Fund and Repealing Council Regulation (EC) No 1083/2006, COM(2011) 615 Final/2, Brussels: European Commission.Google Scholar
European Court of Auditors (2009), The European Union's Public Health Programme (2003-2007): An Effective Way to Improve Health? Special Report No 2//2009, Luxembourg: European Court of Auditors.Google Scholar
European Federation of Nurses Associations (2012), Caring in Crisis: The Impact of the Financial Crisis on Nurses and Nursing, Brussels: European Federation of Nurses Associations.Google Scholar
European Hospital and Healthcare Federation (2011), The Crisis, Hospitals and Healthcare, Brussels: European Hospital and Healthcare Federation (HOPE).Google Scholar
European Hospital and Healthcare Federation (2012), ‘The current crisis, hospitals and healthcare’, Hospital Healthcare Europe, 2012: 36–58.Google Scholar
European Parliament and Council of the European Union (2002), ‘Decision 1786/2002/EC of the European Parliament and of the Council Adopting a Programme of Community Action in the Field of Public Health (2003–2008)’, Official Journal of the European Union, L271/1–11.Google Scholar
European Parliament and Council of the European Union (2007), ‘Decision 1350/2007/EC of the European Parliament and of the Council of 23 October 2007 establishing a Second Programme of Community Action in the Field of Health (2008–2013)’, Official Journal of the European Union, L301/3–13.Google Scholar
European Parliament and Council of the European Union (2011), ‘Directive 2011/24/EU of the European Parliament and of the Council of the European Union of 9 March 2011 on the Application of Patients’ Rights in Cross-border Healthcare’, Official Journal of the European Union, L88/45–65.Google Scholar
Fahy, N. (2012), ‘Who is shaping the future of European health systems?’, BMJ, 344 (e1714).Google Scholar
Føllesdal, A. (1998), ‘Subsidiarity’, Journal of Political Philosophy, 6(2): 190–218.Google Scholar
Garcia Rada, A. (2011a), ‘Is Spanish public health sinking?’, BMJ, 343 (7445).Google Scholar
Garcia Rada, A. (2011b), ‘Wages are slashed and waiting lists grow as Catalonia's health cuts bite’, BMJ, 343: d6466.Google Scholar
Glinos, I. A. (2012), ‘Worrying about the wrong thing: patient mobility versus mobility of health care professionals’, Journal of Health Services Research & Policy, 17(4): 254–256.Google Scholar
Glinos, I. A.Baeten, R. (2006), A Literature Review of Cross-Border Patient Mobility in the European Union, Brussels: Observatoire Social Européen.Google Scholar
Glinos, I. A., Baeten, R.Boffin, N. (2006), ‘Cross-border contracted care in Belgian hospitals’, in M. Rosenmöller, M. McKee and R. Baeten (eds), Patient Mobility in the European Union: Learning from Experience, Copenhagen: World Health Organization, 97–118.Google Scholar
Greer, S. L. (2008), ‘Choosing paths in European Union health services policy: a political analysis of critical juncture’, Journal of European Social Policy, 18(3): 219–231.Google Scholar
Greer, S. L.Vanhercke, B. (2010), ‘The hard politics of soft law: the case of health’, in E. Mossialos, G. Permanand, R. Baeten and T. K. Hervey (eds), Health Systems Governance in Europe, Cambridge: Cambridge University Press, 186–230.Google Scholar
Hatzopoulos, V.Hervey, T. (2013), ‘Coming into line: the EU's Court softens on cross-border health care’, Health Economics, Policy and Law, 8(1): 1–5.Google Scholar
Hervey, T. K.Vanhercke, B. (2010), ‘Health care and the EU: the law and policy patchwork’, in E. Mossialos, G. Permanand, R. Baeten and T. K. Hervey (eds), Health Systems Governance in Europe – The Role of European Union Law and Policy, New York: Cambridge University Press, 84–134.Google Scholar
Houston, M., Day, M., de Lago, M.Zarocostas, J. (2011), ‘Health services across Europe face cuts as debt crisis begins to bite’, BMJ, 343: d5266.Google Scholar
Jesse, M.Kruuda, R. (2006), ‘Cross-border care in the north: Estonia, Finland and Latvia’, in M. Rosenmöller, M. McKee and R. Baeten (eds), Patient Mobility in the European Union: Learning from Experience, Copenhagen: World Health Organization, 23–37.Google Scholar
Kentikelenis, A., Karanikolos, M., Papanicolas, I., Basu, S., McKee, M.Stuckler, D. (2011), ‘Health effects of financial crisis: omens of a Greek tragedy’, Lancet, 378(9801): 1457–1458.Google Scholar
Lamping, W. (2012), EU Finanzkrise, Solidarität und Subsidiarität: Erhalt der Gestaltungsfreiheit in der nationalen Gesundheitspolitik? [EU financial crisis, solidarity and subsidiarity: Sustaining the scope for action in the national health policy?] Presentation held at the 14. GVG Euroforum on October 11, 2012 in Potsdam, Germany.Google Scholar
Maier, C. B., Glinos, I., Wismar, M., Bremner, J., Dussalt, G.Figueras, J. (2011), ‘Cross-country analysis of health professional mobility in Europe: the results’, in M. Wismar, C. B. Maier, I. Glinos, G. Dussalt and J. Figueras (eds), Health Professional Mobility and Health Systems – Evidence from 17 European countries, Copenhagen: World Health Organization, 23–66.Google Scholar
Matrix, Insight (2012), EU level Collaboration on Forcasting Health Workforce Needs, Workforce Planning and Health Workforce Trends – A Feasibility Study, Brusssels: European Commisssion.Google Scholar
Mladovsky, P., Srivastava, D., Cylus, J., Karanikolos, M., Evetovits, T., Thomson, S.McKee, M. (2012), Health Policy Responses to the Financial Crisis in Europe, Policy Summary 5, Copenhagen: World Health Organization.Google Scholar
Mossialos, E., Permanand, G., Baeten, R.Hervey, T. K. (eds) (2010), Health Systems Governance in Europe – The Role of European Union Law and Policy, Cambridge: Cambridge University Press.Google Scholar
Peeters, M. (2012), ‘Free Movement of Patients: Directive 2011/24 on the Application of Patients’ Rights in Cross-Border Healthcare’, European Journal of Health Law, 19(1): 29–60.Google Scholar
Peeters, M., McKee, M.Merkur, S. (2010), ‘EU law and health professionals’, in E. Mossialos, G. Permanand, R. Baeten and T. K. Hervey (eds), Health Systems Governance in Europe: The Role of the European Union Law and Policy, Cambridge: Cambridge University Press, 589–634.Google Scholar
Public Health Evaluation and Impact Assessment Consortium (2011a), Mid-Term Evaluation Health Programme (2008–2013) – Final Report, Bologna: Public Health Evaluation and Impact Assessment Consortium.Google Scholar
Public Health Evaluation and Impact Assessment Consortium (2011b), Mid-Term Evaluation of the EU Health Strategy 2008–2013 – Final Report, Bologna: Public Health Evaluation and Impact Assessment Consortium.Google Scholar
Rosenmöller, M., McKee, M., Baeten, R.Glinos, I. A. (2006), ‘Patient mobility: the context and issues’, in M. Rosenmöller, M. McKee and R. Baeten (eds), Patient Mobility in the European Union, Copenhagen: World Health Organization, 1–7.Google Scholar
Scharpf, F. W. (2010), ‘The asymmetry of European integration, or why the EU cannot be a ‘social market economy’, Socio-Economic Review, 8(2): 211–250.Google Scholar
Starkiene, L., Smigelskas, K., Padaiga, Z.Reamy, J. (2005), ‘The future prospects of Lithuanian family physicians: a 10-year forecasting study’, BMC Family Practice, 6(1): 41.Google Scholar
Steering Group on the European Innovation Partnership on Active and Healthy Ageing (2011), ‘Strategic Implementation Plan for the European Innovation Partnership on Active and Healthy Ageing – Steering Group Working Document’, Brussels, 17 November 2011.Google Scholar
Watson, J. (2009), Health and Structural Funds in 2007-2013: Country and Regional Investment, Brussels: European Commission, Directorate General for Health & Consumers.Google Scholar