Comments on the implementation of the EU Health Strategy

EPHA is both a member and the Secretariat of the EU Health Policy Forum, and as such undertook the first draft of the document. This text was distributed for consultation to EU Health Policy Forum members, and approved on 16 November 2009. The final version was submitted with annexes to the Swedish Presidency on 16 November 2009.

Please find a summary of the input below, and the submission with annexes attached:

The EU Health Policy Forum:
 Welcomes this opportunity to contribute to discussions of the Senior Level Working Party.
 Refers the SLWP to our Resolution of January 2009 on the Implementation of the Health Strategy, where we welcome the strategic approach taken with a view to addressing health across all policy competences.
 Welcomes the growing engagement of member states in EU health policy development via the Health Action Programme, the High Level Group on Health Systems and other bodies, and welcomes their involvement of consultations with expert and civil society bodies during their deliberations.
 Expresses concern that the initial arrangements for involvement of regional bodies, expert and civil society organisations is not sufficient for good governance or to achieve the objectives of Together for Health.
 Feels that the implementation of the strategy should reflect the current economic situation, and refers the SLWP to our Open Letter on the Crisis and Health from January 2009

In relation to the progress so far:
 Supports the number of good initiatives that have been achieved so far, specifically on health inequalities, global health, cancer, alcohol, nutrition, and the ‘Europe for Patients’ instruments. 7- Greater progress could have been made under Principle 3, ‘Health in All Policies’.
 More progress is necessary to tackle demographic change and promote healthy and active ageing.
 Climate change and the impact on health and healthcare in Europe are not sufficiently addressed so far.
 More progress is needed to address chronic and non-communicable diseases, and in particular cardiovascular diseases.
 Welcomes the work so far on eHealth as facilitating the organisation, management and delivery of healthcare and stresses that, when applying technological solutions, due consideration should be given providing added value to existing methods and ensuring that healthcare is made accessible to the most vulnerable of our citizens.
 Recognises that important synergies with the Health Theme of the 7th Framework Programme for Research have been realised, with to-date 81 projects in the field of public health being supported representing some 200 million €.

Priorities for the forthcoming period
 Continuing to maintain a public health approach to policy-making, including work on the core determinants of ill-health such as tobacco, alcohol and diet.
 Ensuring that health and well-being is at the centre of economic planning, including the post-Lisbon Strategy and the Better Regulation agenda, including the importance of investing in health and health systems.
 Further operationalisation of Health in All Policies

a. Agriculture – greater cooperation with DG Agriculture on integrating health considerations, including inequalities, into payment schemes and addressing the impact on global health

e. Research – better integration of the results of research for public health policy and practice at national as well as European level.

 In implementing Principle 3, a review of the impact assessment approach should be undertaken in order to ensure an appropriate balance between competitiveness and public interest goals.
 An integrated approach to healthcare and health workforce planning, including promoting and maintaining quality standards and patient safety.

The Public Health Programme
 Needs sufficient resources in order to act as the implementation tool of the health strategy. Current resources are not sufficient, and do not reflect the value EU citizens place upon health.
 Should be used as a driver for policy change at European and national level, including integration of the evidence base and recommendations from funded projects into policy processes.
 Ensure that funded projects and activities should contribute to the long-term strategic goals of the Health Strategy and not be limited to annual priorities.
 It should also be used as a ‘spring board’ to enable projects to link with relevant funding programmes and initiatives in other DGs in the spirit of ‘Health in All Policies’, in particular in relation to research, information society and the structural funds.
 Projects should demonstrate (with clear indicators) how they will contribute to improving health outcomes for citizens in Europe, and add value to discussions of this issue.

Conclusions
 The arrangements for inclusion of experts into discussions as set out in the Council annex to the annex of 9639/08 should conform to good governance practices.
 The health strategy should be operationalised through clear annual objectives that feed into the strategic principles and objectives, with clear outcomes and measurable targets which can be delivered by a diverse group of not-for-profit stakeholders.
 The operationalisation of the health strategy should include explicit responsibilities for all the European institutions including the European Parliament, Committee of the Regions and Economic and Social Committee – in addition to the Commission and the Council.
 The next stage of implementation should increase work on Health in All Policies.
 The Public Health Programme should have sufficient resources to deliver the goals of the health strategy.
 Outcomes from the Public Health Programme and FP7 programme should be disseminated and taken up by the public health community in order to contribute to policy-making and the long term strategic goals of the Health Strategy.
 We, the EU Health Policy Forum, offer our support and expertise to the Council, Commission and Parliament in the implementation and delivery of the Health Strategy

EPHA related articles
 Response to the Court of Auditors Report on the 1st Public Health Programme
 EU Health Policy Forum meeting - 16 October 2009
 EU Health Policy Forum, May 2009

EUHPF input into Senior Level Working Party on Health (Council)

Annex 1: EUHPF Resolution on Implementation of the Health Strategy

Annex 2: EUHPF Open Letter on the Economic Crisis