Speech by President Séamus Boland on 'The State of Health in the EU'

Conference on 'The State of Health in the EU', organised by the EESC Civil Society Organisations' Group, in partnership with the Centre Hospitalier Universitaire de Liège and the Hôpital de la Citadelle, in the framework of the Belgian presidency of the Council of the EU, 4 June, Liège (Belgium)

Dear Minister, esteemed speakers, guests and colleagues,

It is with great pleasure that I would like to welcome you to this conference in Liège on 'The State of Health in the EU'. The event takes place in the context of the Belgian Presidency of the Council of the EU which will come to an end this month. We, the Civil Society Organisations' Group of the European Economic and Social Committee, have had the opportunity and pleasure to co-organise this conference with Centre Hospitalier Universitaire de Liège and the Hôpital de la Citadelle. It is only by working closely with healthcare professionals, that it will it be possible to define and implement a sustainable and comprehensive European Health Union that is fit for the future.

I would also like to express my sincere thanks to Alain Coheur, who took the lead on this event among our Belgian Members. Alain, I think that you should receive a medal from the municipality of Liège for all the events you have organised here! Boundless energy, important intellectual and strategic contributions to the work of our Group and the Committee – and always with a smile and a sense of humour! I hear that you are also organising a beer tasting this afternoon, so you really do tick all my boxes as the perfect Member!

Ladies and gentlemen, with only a couple of days left before the beginning of the elections to the European Parliament, I find myself looking both backwards and forwards. Backwards, towards all that has happened over the last five years within the EU and globally. And forwards, towards all that must still be done, in order to consolidate past achievements. And very much at the heart of this reflection, is the state of health in the EU.

Everyone in this room has their own memories of the Covid-19 pandemic, some of which I am certain, are very painful. In contrast, at the macro-level, I see three good things that came out of that health crisis. The first, was European cooperation in terms of research and distribution of the vaccines. The second, was European solidarity on joint EU debt, known as the Next Generation EU scheme, which provided vital help in reinvigorating pandemic-stricken national economies. The third, was that Health was catapulted to the very top of the Union's political, strategic and policy agenda.

The EU speeded ahead towards the creation of the EU4Health programme, with its 5.3 billion Euro budget. And it launched the European Health Union (EHU), which laid the foundations for an EU vision on health and healthcare systems. The problem of course, is that in February of this year, Member States in the Council decided to withdraw 1 billion Euros from the EU4Health programme, to be redeployed towards other policies. Such a decision is the clearest possible indication that Health has already slipped down the EU's political agenda.

Today's event, aims to make a very strong plea in favour of including health as a key strategic priority in the EC Agenda, the new European Parliament and Council for the period 2024-2029. Crucially, the European Institutions must embrace an approach that promotes the inter-linkages between health policy and changing demographics, the digital and environmental transitions, economic security, even industrial policy.

The four panels during today's conference will highlight that health policy does not exist in a vacuum. On the contrary, it is directly linked to research and innovation, digital health, artificial intelligence and the environment. And it can only properly function, alongside accessible, adequate and high-quality social services and public social policies, which are staffed with sufficient numbers of well-trained health professionals.

Let me remind you that it is estimated that by 2030, there will be a global shortage of 10 million healthcare workers! And without proper planning, financing, upskilling and reskilling of the health workforce, there is a very real risk of increasing poverty and inequality levels within our societies, as access to quality healthcare is reduced. It is precisely this sense of urgency that we must communicate to the incoming European Institutions and to our national governments.

Health is in fact one of the most critical sectors of the EU's economy, alongside energy, food security and technology. And what is required, is a new European and global health architecture, to address all of the above challenges in an ambitious and holistic way.

Let us take the issue of One Health, otherwise known as Planetary Health, that will be explored during the first panel. Individual health, is based on the collective health of society, which in turn is based on the health of ecosystems. Scientists and policy-makers are aware of these interlinkages. Indeed, it is estimated that one-tenth of premature deaths in the EU, are attributed to pollution. What is now required, is to break down the policy silos so that we can address the health of people, animals and the planet, all together. The decision of the European Commission to create a One-Health Directorate is a good first step. However, much more is necessary in order to reduce silos in EU policy-making.

If we turn now to digital innovations and their impact on health. Artificial intelligence (AI) and digitalisation offer appealing solutions, if only by the sheer size of the problems needing to be addressed. I previously mentioned that by 2030, there will be a ten billion global shortage of healthcare workers. There is already evidence that AI systems can both relieve administrative burdens from healthcare professionals, as well as enhance diagnostic accuracy, disease tracking, etc. All of which, will help to boost efficiency in hospitals.

Of course, there are serious concerns to be addressed, such as ethical considerations regarding data, cybersecurity, rising inequalities in terms of access to digital technologies, etc. IT companies have a duty to ensure that their products are safe and reliable, with humans remaining in control. But without doubt, the digital transition in the health sector will require countries to work together, in order to learn from each other and to agree on common standards. No single EU government will be able to introduce legislation with sufficient speed, in order to match the rapidity of AI innovations.

Moving on to the panel on the sustainability of health systems. I anticipate that much of the discussions will centre on the necessity for a political debate on how health should be viewed as a social investment, rather than as a pure cost. Apparently, within the EUevery Euro invested in healthcare has an economic return of 14 Euros! However, finding the right balance between quality care and the most appropriate use of resources will always be challenging.

But what I hope will also arise from the discussions during this panel, is the recognition that sustainable and qualitative health systems also imply placing the patient and civil society organisations at the centre of the system. You may have heard of the four Ps. Healthcare should be predictable, preventive, personalised and participatory. Coming from the civil society sector, I am strongly in favour of giving patients a degree of direct involvement and responsibility.

The same can be said about civil society organisations (CSOs), active in the health and care sectors. The take up and success of European health initiatives and programmes are dependent on transparent, regular and structured dialogue with CSOs. Their ability to carry out this work is in turn dependent on obtaining sustainable and predictable funding.     

Finally, allow me to say a few words on rare diseases and European solidarity. Today there are some 30 million Europeans who live with rare diseases. As you can imagine, these individuals and their families, who are often their carers, are highly vulnerable economically, socially and psychologically. It is imperative that we develop partnerships on rare diseases at the European level. Bringing together policy-makers, researchers, health authorities, mutual societies and health insurers. Only with such a collaborative approach, will it be possible to ensure the necessary long-term funding for research and innovation.

I would like to make one final comment before bringing my statement to a close. And this involves the gender perspective of health. As in many professional sectors, also in health, research into and participation by women is woefully imbalanced. Much more attention in research needs to be placed on how women are affected by certain illnesses. In addition, despite occupying the majority of positions as care workers, women are often underrepresented in decision-making roles within European healthcare systems. It is high time that this changes!  

In conclusion, during the next five-year period, health must be firmly placed at the top of national and European political agendas. It is imperative to invest in a skilled healthcare workforce and in a new European architecture for health, which embraces holistic approaches across policy areas and new technologies. All relevant actors must find their place in this new architecture, including CSOs and patients!  Allow me to end with a quotation by the father of medicine, Hippocrates, who 2.500 years ago said that: 'Healing is a matter of time, but it sometimes is also a matter of opportunity'. Within the EU, we still have many opportunities – we just have to seize them!