The good and the great of EU health policy gathered for the final Latvian EU Presidency health conference in Riga earlier this week. It was an event that both took stock of how things have progressed since the 2013 Vilnius Declaration, and set out to develop a future roadmap for improving health systems in Europe based on the Vilnius principles.
Side note: The Vilnius set out to establish people-centred, sustainable and inclusive European health systems. It further defined how to achieve this as follows:
1) Increasing investment in health promotion and disease prevention
2) Ensuring universal access to high-quality, people-centred health services
3) Ensuring that health system reforms are evidence-based and focus on cost-effectiveness, sustainability and good governance.
What the final roadmap and its strategies look like as a result of this conference are due out shortly, but in the meantime here’s my top five takeaways. There are more of course, so if you’re feeling curious, you can check them out via our twitter handle and hashtag #rhc15
1. ‘Bring a friend’
One of the conference speakers was Monika Kosinska, former European Public Health Alliance (EPHA) Secretary General and now Governance for Health Programme Manager for the World Health Organization. Hearing her speak is always a breath of fresh air. This time she challenged everyone to ‘bring a friend’, someone outside of the healthcare community, to the next big health policy convention. This simple yet brilliant idea goes back to the need for health policy leaders in Europe to better engage stakeholders outside of the healthcare space in health policy debates and decision making. As Monika put it, "patients do not live in silos”, so nor should the health leadership in Europe. And she’s right. If you thought Brussels was a bubble, the health policy community might be considered e a bubble within the bubble. I for my part, and as a starter for ten, will seek out a non-health policy related stakeholder to be a guest blogger on LillyPadEU.
2. From ‘call to action’ to ‘plan of action’
I couldn’t have put it better myself, and I didn’t. Health Commissioner Andriukaitis did, and he hit the nail on the head when he said, “Now is the time – after the call for action – to come up with a plan for action.” His impassioned speech not only called for action but outlined some of the actions he is taking already. These included a call for the first European Reference Networks of healthcare experts by the end of the year - the networks will enable experts to share knowledge and help in particular patients with rare diseases to gain access to the right expertise and care. He also plans to enhance HTA cooperation and avoid duplication among competent national authorities by facilitating an exchange of information between competent national authorities.
3. The ‘mismatch’
In debating how to ensure treatment options are sustainable for all healthcare stakeholders, Mark Pearson, Head of the Health Division at the Organisation for Economic Co-operation and Development (OECD), stated: “There is a mismatch between governments in panic mode and drug expenditures flatlining during the last decade". This reminded me of a recent blog post by my colleague Jeremy Morgan who referenced this not-unrelated OECD fact: “Medicines constitute a small percentage of public health care spending, totaling just under a fifth of all public health care spending across Europe.” I think the broader point is that if we want to create more efficient, sustainable and equitable health systems, we need to be taking a look at the issue ‘beyond the pill’ as it were, and with an outside perspective too coming back to Monika’s point.
4. How do we measure efficiency?
Whether it’s Gastein, Riga or Brussels, Josep Figueras, Director of the European Observatory on Health Systems and Policies and Head of the WHO European Centre on Health, has got to be my favourite moderator. He opened day two in Riga with energy and moved quickly to ask both speakers and the audience: how do we measure efficiency and how do we measure cost benefit? His own response always worth hearing was as follows: “If we measure the impact on society and social cohesion and the economy, or issues of human suffering, many of these economic measurements would improve”. The forthcoming Roadmap from this conference, alongside including strategies to improve health outcomes and healthcare systems in Europe, should also define a path to measure progress and success too.
5. And finally, what’s the ‘uber’ in healthcare?
What does Uber have to do with healthcare you ask? Well, it’s an app that has turned some city taxi services upside down. Where is the ehealth innovation that is going to have such a disruptive effect on healthcare, and impose dramatic change? Only Richard Bergstrom, EFPIA President, could come up with such a vivid and quirky anecdote when talking to what will make healthcare systems more equitable and efficient. Here’s what he had to say ahead of the conference, and with that, I end my overview of what I liked about Riga.