On June 6th 2012 the European Public Health Alliance (EPHA) held a day-long conference entitled ’’Restructuring health systems: How to promote health in times of austerity?’’ The debate, hosted by the European Economic and Social Committee (EESC), brought together for a first time more than 20 speakers (1) from all across Europe’s health professions, experts and civil society along with several institutional actors (2) and an audience of around 200 people in an exercise aimed at assessing the impact of the current downturn in the continent’s health systems and identifying actions to move forward. (3)
Policy-makers and civil society warned about the risks of neglecting public health in times of austerity
June 8, Brussels - In her intervention Zsuzsanna Jakab (4), WHO Regional Director for Europe, captured well the spirit of the conference when she stressed that “European countries and regions must think about the way they pursue the well-being of their people. Health should be a priority for heads of government and not only for ministries of health.”
One of the key cautionary messages in which most speakers agreed to was the humanitarian crisis that Europe is facing. There was a widely-shared feeling in the room that this long-standing economic and financial crisis is exarcebating vast inequalities, with the poor being the first and worst-hit victims.
The French MEP Pervenche Berès (S&D Group and Chair of the Employment and Social Affairs Committee in the European Parliament) said that the social safeguards built since the Second World War no longer hold, “the repercussions that this crisis has on wealth redistribution dangerously resemble the scale of the ones which led to the Great Depression of 1929.” Pascal Garel, Chief Executive of the European Hospital and Healthcare Federation, noted that many patients can hardly afford the out-of-pocket medical expenses they are being asked to cover.
The hardship is also affecting health professionals. Paul De Raeve, Secretary General of the European Federation of Nurses’ Associations, noted that “in some countries, nurses are feeding their children with salaries as low as €100 a month in Moldova, which also has a bearing on the quality and safety of the services that patients received.”
Several of the speakers emphasized the need to recognise health as a human right and not as a commodity, making public health a fundamental component of mainstream public policy-making. The Spanish MEP Alejandro Cercas (S&D Group) pointed at his country, where social gains achieved over the last decades are being thrown down the drain.
Cost-effectiveness (e.g. putting an emphasis in prevention) and innovation emerged as by-words to fit effective public health systems into the current wave of budget belt-tightening. The speeches delivered along the day shared two common denominators: that Europe is wasting an awful amount of human capital essential for growth; and that well thought-through investments in health will make public care sustainable. The prevailing atmosphere in the room was underpinned by the certainty that good health is a pre-condition for economic growth. As David Stuckler, Social Epidemiologist and Lecturer at Cambridge University, UK, pointed out, “there is an alternative which is good for the economy and good for health.”
In his keynote speech Commissioner Dalli stressed his conviction that “difficult times can indeed provide an incentive to think creatively and push forward in-depth reforms (5) and contain costs, while building modern, responsive, and sustainable health systems fit for the future.”
“We are sleep-walking into catastrophe. If we let our health systems to slip away, long-gone burdens like certain communicable diseases will make a comeback. We need value-based leadership”, stressed John Ashton, Director of Public Health and County Medical Officer for Cumbria (UK). In a similar vein, Monika Kosińska, Secretary General of EPHA, voiced that “we need political solutions for the economic and health dilemmas currently faced by Europe. Governments do have the power to fix the current status quo - banning marketing to children would build on the gains from fiscal measures aimed at reducing consumption of junk food and boosting consumption of whole grain, fruit and vegetables. Why are we letting unaccountable financial markets lead us in Europe? It is our politicians who need to show the leadership and vision to get us out of the crisis."
In his closing speech, Commissioner Dalli encapsulated the spirit of the whole gathering when asserting that “the economic crisis should not turn into a health crisis. Financial hardship cannot jeopardize people’s health and access to healthcare. What Europe needs now is to deliver more and better healthcare within sustainable health budgets.”
(1) You can get the full list of speakers in the conference’s agenda
(2) From the European Parliament, the European Commission, the Organisation for Economic Co-operation and Development (OECD), and the International Monetary Fund (IMF).
(3) To know more you can read EPHA briefing notes - The economic crisis & EPHA fact & figures on the impact of the financial crisis on health
(5) Sanjeev Gupta, Deputy Director Fiscal Affairs Department and one of the conference’s speakers, shared an informative presentation on Fiscal Challenge and Health Care Reform in Advanced Economies.
. In England, alcohol sin tax has benefits close to €600 million in reduced health and welfare costs and reduced labor and productivity losses, at an implementation cost of less than €0.10 per capita.