The 15th European Health Forum Gastein (EHFG) took place between 3-6 October 2012 in Austria. This year’s conference theme was “Crisis and Opportunity – Health in an Age of Austerity’’, and the various plenary sessions, parallel forums and workshops covered topics ranging from health system sustainability to disease prevention, global health governance and the future of public health, research and innovation.
In a sense, this year’s EHFG felt like a natural progression of the work undertaken by EPHA in 2012, which resulted in our annual conference that looked at austerity in a novel way, bringing together representatives of NGOs and international organisations including WHO, OECD, IMF and the EU institutions (see also our Press Statement and the related briefing notes).
This year’s EHFG marked the end of founder Dr. Leiner’s 15-year presidency. Dr Leiner has now been replaced by Prof Helmut Brand of the University of Maastricht (and President of EPHA member ASPHER).
The opening plenary included a welcome speech by Zsuzsanna Jakab, Regional Director of the WHO Regional Office for Europe whose presentation, ’’Health and wellbeing in times of austerity’’ outlined the economic case for investing in preventative measures and health promotion to tackle non-communicable diseases in particular, and called for more coherence in policies and programmes. She also emphasised the benefits of fiscal policies such as sin taxes used to discourage alcohol and tobacco intake, which create tangible short-term benefits both for the health of the population and for public finances. Efficiency gains could also be achieved by eliminating inefficient services, improving rational drug use, allocating more funds to primary and outpatient specialist care and investing in infrastructure that is less costly to run. Her conclusions for dealing with the crisis were as follows:
Avoid across-the-board cuts;
Target public expenditures on the poor and vulnerable;
Protect access to services by focusing on supply-side efficiency gains; and
Implement counter-cyclical public spending (save in good times, and spend in bad times)
Jakab also said it was crucial that a stronger dialogue is established between health and finance ministers, and to improve health governance and increase participation of civil society.
Paola Testori Coggi, Director-General of DG SANCO underlined the need for sustainability of health systems in times of austerity.
Toomas Ilves - President of the Republic of Estonia - described the response to crisis and austerity as experienced in the Member States.
Barbara Kestiens of DG Research, Infectious Diseases and Public Health unit stated that Horizon 2020 was an opportunity to stimulate ’’smart investments in R&D that lead to employment and economic growth’’, while simultaneously accelerating the process from basic research to the market. She also stated that available funds could be used more strategically for research on prevention and managing chronic diseases in order to bring about change. But to use EU funding more effectively, stronger links should be established between national and European R&D efforts so that the ’’gap between knowing and doing’’ could be closed.
The European Health Award was presented to HLS-EU, European Health Literacy Project by Antoniya Parvanova MEP (ALDE, Bulgaria).
EPHA was highly visible at the conference with Secretary General Monika Kosinska actively contributing to a number of sessions, beginning with a roundtable discussion on ‘’Communicating Health’. At this EPHA called on the public health community to better sell health, as a ’product’ that can be fun (citing the example of Stockholm’s ’piano stairs’ in its underground train system, which succeeded in encouraging people to use stairs rather than an escalator). Monika cautioned that otherwise, industry would be left to do the job unchallenged. She also described EPHA’s positive experiences using social media and stated that civil society was one step ahead of the mainstream health community in this regard. She stated that the crucial underlying question was to find out what needs to be done to capture the public interest.
Monika also took part as a panellist discussing ‘’Health challenges in Europe 2050’’ (click here for more information), the external factors influencing these, and the role of health reseearch.
The closing plenary entitled ‘’Health in an age of austerity’’, included a keynote presentation by former Commissioner for Health and Consumer Policy, John Dalli and a video reflection on the conference theme by independent EU health advocate Tamsin Rose. EPHA contributed to the discussion alongside representatives of the OECD, WHO, Commissioner Dalli and others. In her presentation, Philipa Mladovsky of the London School of Economics provided the following concluding thoughts:
Fiscal sustainability is a constraint, not a policy objective
Cost containment does not equal efficiency
(Extra) spending needs to demonstrate value
Be transparent & explicit about trade-offs
Don’t forget the other social sectors
Learn to communicate the case for Health and Wealth
Increases in performance by reducing costs through greater efficiency, e.g. hospital reconfiguration, improved purchasing, rational use and pricing of drugs, and evidence based medicine
In addition, EPHA (represented by Policy Coordinator Sascha Marschang) took part in a workshop entitled ‘Connecting new science, research and healthcare needs: Is the contract between society and the pharmaceutical industry up for renewal?’, in which EPHA highlighted civil society’s principal concerns about the market-driven practices of the pharma industry, the pitfalls of genomics and personalised medicine, and the trend towards public-private partnerships (PPPs), as highlighted in a recent consultation response.
The OECD presented two sessions looking at how to build sustainable health systems.
The first session addressed protecting and expanding the fiscal space for high quality healthcare, offering examples from the Netherlands, Estonia and the UK. Notably, Philipa Mladovsky presented a useful overview of health systems’ responses to the economic crisis containing relevant data.
The second workshop focused on ensuring quality and value for money in the context of an increasing burden of chronic disease and multiple comorbidity in European populations, and examined the role of patients and health professionals in the path towards sustainable health systems. In this session, a presentation by Thomas Plochg, from the University of Amsterdam, was of particular interest as it examined how health professionals could be ’’reconfigured’’ to meet the challenge of multi-morbidity.
Overall, while this Gastein forum did not produce any groundbreaking new thoughts on how to tackle the crisis, the discussions nonetheless helped shape a clearer picture on the current situation and its multiple and overlapping challenges, including some interesting data on the economic impacts of health and illness.
For further information
EPHA related articles
Towards an effective implementation and delivery of the Health 2020 strategy in times of austerity
EPHA Press Release: MEPs lead urgent plea from health community to prevent health crisis in Europe
Time to Act: WHO Global Code of Practice on International Recruitment of Health Personnel