This week Ministers of Social Affairs and Employment gathered in Brussels and one of the items they discussed was the EU Semester process of policy coordination. Last week, following a public consultation on the Europe 2020 review, the European Commission launched new guidelines on economic and employment policies. Both these developments will have implications for health policy and could be a tool for health equity practitioners to address health promotion and the social determinants of health within this process. EuroHealthNet aims to use the 2015 European Semester and recent developments to involve member agencies and argue for better provisions for health equity.
Before taking a look at recent developments, let us first see what happens when health agencies are involved. Slovenia has successfully set up a healthy and active ageing strategy that receives financial support from EU structural funds to support national reforms. This initiative was supported by EuroHealthNet as part of pilot projects on the Social Investment Package (SIP) to link national needs with EU priorities. The Commission Communication on Social Investment for Cohesion and Growth provides an integrated framework for investing in people. The example in Slovenia is why EuroHealthNet argues for more involvement of health agencies and regional and municipal authorities in the delivery of the Europe 2020 strategy.
For around a year, the Social Protection Committee (advisory committee for Employment and Social Affairs Ministers) and the Working Party on Public Health at Senior Level (representatives from Member States responsible for health) have collaborated on the European semester process. We welcome the fact that the Committee will work with health ministries on improving public health. EuroHealthNet will support collaboration and suggest indicators and provide evidence on impacts of reforms. For the first time, the opinion of representatives working for Ministries of health will be incorporated in the political statement (known as Council Conclusions) responding to the 2015 Annual Growth Survey and Joint Employment Report: Political guidance on employment and social policies adopted on the 9 March. The following paragraph is relevant for health promoters:
“Innovation in health care and long-term care should focus on ensuring universal and equitable access to quality and safety in health services while securing their affordability, sustainability and cost-effectiveness. These innovations may include strengthening of health promotion and disease prevention in all relevant policy sectors, while ensuring integrated health care, enhancing primary health care, early diagnosis, optimising use of specialists and hospital care and securing an appropriate and skilled health workforce.”
Regarding health systems, the Commission proposal for guidelines on employment policies says: “Member States should improve the accessibility, efficiency and effectiveness of healthcare and long term care systems, while safeguarding fiscal sustainability.” Europe 2020 guidelines set out the framework for the Europe 2020 strategy and reforms at Member State level and are rooted in the Treaty on the Functioning of the European Union.
When the current state of play of the EU semester is bleak – with the poverty and employment targets unlikely to be met by 2020 – this is an opportunity for health equity practitioners to (re-)engage. A change in approach is needed to achieve the ambitious goals of the Europe 2020 strategy, and health inequalities need to be taken into consideration. With the review of Europe 2020 being postponed until the end of the year, EuroHealthNet will contribute to the findings of the DRIVERS project on how fair employment, child development and social protection reduce inequalities as part of the debate.
If reforms of health systems and social protection do not take into account the benefits of prevention and promotion as well as the importance of primary care, they will not address the underlying causes of poor health. Therefore, EuroHealthNet will encourage Member States and the European Commission to prioritise health promotion in the upcoming steps of the EU Semester in line with these recent developments. In 2014, every single EU Member State reported on health system reform in their national reform programmes and ten countries received Country-Specific Recommendations on public health. These developments could set a new tone for how health promotion and sustainability of health systems are dealt with in the EU Semester.
Through the European Platform for Action on Health and Social Equity (PHASE), EuroHealthNet and its partners in the various Member States will aim to roll our more pilot projects on the SIP. The new PHASE platform, which was launched in 2014, has a video to explain what we hope to achieve. We have also launched an online discussion board for policies and practices to reduce health inequalities. For more information about partnership opportunities click here to get engaged with our work. In 2015 we will continue to engage in the EU Semester process to draw attention to the relevance for social determinants of health and tackling health inequalities.
By Leonardo Palumbo - EurohealthNet's Health & Social Investment Senior Coordinator
To contact Leonardo Palumbo, email here