The European Pillar of Social Rights one year on: growing evidence of the need to address unequal access to health services

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A new report from the European Commission, just released, demonstrates the serious and persisting problem of inequalities of access to healthcare, leading to wider health inequalities. On the first anniversary of the endorsement of the European Pillar of Social Rights, it responds to principle 16 of the Pillar which stresses the right to ‘timely access to affordable, preventative, and curative health care of good quality’. The report reinforces the need to link health and health inequalities to the European Semester process of economic and fiscal policy coordination.

“European action for a healthier, fairer Europe depends on strong leadership, collaboration, and expertise building and sharing on public health in parallel to and enhanced by action on the macro-economic determinants of health’’, said Caroline Costongs, Director EuroHealthNet.

“Inequalities in access to healthcare – a study of national policies 2018’’ describes the extent of inequalities in access to healthcare in different European Countries, analyses country-specific challenges, and provides examples of good practices.

The report concludes that significant inequalities in access to healthcare persist, both between and within countries. Large shares of the EU population face multiple hurdles and therefore do not obtain the care they need. People on a low income or with low health literacy find it difficult to access healthcare. Geographical mobility can also hinder accessibility. High out-of-pocket payments and lack of protection of vulnerable groups from user charges are among the main challenges identified. Even in countries providing nearly universal population coverage, some specific population groups fall through the safety net. Socio-economic inequalities are also reported in access to health promotion and preventative services such as cancer screening, vaccinations and preventative dental care.

The report is complimentary to the ongoing work of DG SANTE on the State of Health in the EU (update to be published this week), on the inclusion people experiencing vulnerability, people experiencing poverty and social exclusion, and on addressing inequalities in health and social outcomes in general.

Successful implementation of the European Pillar of Social Rights depends on a proactive approach to addressing health inequalities. It must be linked to the economic and fiscal planning through the semester process. It should also be linked to EU funding mechanisms such as the European Social Fund+ and a well-resourced and coordinated future Health Programme.