Conclusions and recommendations

Conference of the Civil Society Organisations' Group on 'Health, Care and Prosperity after Covid-19: Swedish and European perspectives'

Stockholm, 25 May 2023

Preamble

Already overstretched by years of under-investment into the European healthcare sector and by ageing populations, in 2017 EU Member States signed up to the European Pillar of Social Rights (EPSR), which stipulated the right of all to access affordable and good quality healthcare. The subsequent Covid-19 pandemic hit Member States at their most vulnerable, exacerbating existing shortages and problems in the healthcare sectors, rendering the health emergencies into national emergencies. Against this background, Covid-19 will be remembered by many Europeans as a traumatic period for individuals, families, communities and nations. However, the pandemic will also remain in collective memory as a period when lives were saved, inter alia, because of EU cooperation on the vaccines programme. Both of these experiences require a review of lessons learnt and recommendations for future action at the EU and national levels. Part of the immediate response was the initiative of the European Commission (EC) on 'Building a European Health Union'. Further progress is now urgently required to better define and implement this ambitious proposal.

Preparing for the future in partnership: the benefits of European cooperation on healthcare

• Adapting European healthcare systems to the realities post Covid-19 will necessitate a change in mindsets socially, economically and politically;
• It is imperative to move away from the perception of public healthcare as a 'cost', towards a more progressive vision which values healthcare as a social investment, in line with the concept of the 'Right to Health' which was set as a priority at the Conference on the Future of Europe;
• In this context, EU and national investments must urgently be established at sufficient levels to ensure the resilience of EU healthcare systems and with an agreed minimum percentage of GDP set at the European level;
• Moreover, preventive surveillance and preparedness, statistical research and modelling will be crucial to ensuring that individual Member States and the EU as a whole, are better able to provide sustainable healthcare and to effectively address a potential future pandemic;
• It is particularly important that internal silos within healthcare sectors are broken down. There must be structured cooperation and integration between at least the health and social systems, and greater collaboration across wider policy areas at the national and European levels;
• Although health policy remains a national prerogative, a minimum level of EU assistance and coordination is both necessary and strongly welcomed;
•  In this context, existing EU health initiatives[1] will stimulate reforms and investments in healthcare, whilst leading to synergies, holistic approaches, pooling of expertise, better planning, cross-border cooperation and upward convergence among and within EU countries;
• European cooperation through 'Europe's Beating Cancer Plan' clearly illustrates the benefits of transborder cooperation, with a coherent approach at EU level, substantial financial resources and a clear timeline to achieve objectives;
• It is crucial to encourage and support dialogue, synergies and partnerships between all actors involved in healthcare. Civil society organisations in particular, should be directly involved in planning, implementing and monitoring healthcare, e.g., family and care organisations, associations for the elderly, women, persons with disabilities, social economy actors, etc;
• Decentralised public authorities at the local and regional level should also have a key role to play in defining effective policies and should be closely involved in future national preparedness plans.

Building resilient and qualitative healthcare systems in the EU

• Providing sustainable and qualitative healthcare will depend on a multi-disciplinary approach targeting patients, healthcare workers, informal carers and investment in infrastructure, including the digital transformation;
• Human-based, person-centred healthcare systems are central to achieving high standards and to enable patients and their families to make informed choices, whilst also taking responsibility for their healthcare. The options of home and/or community-based services should be included among those choices;
• Civil society organisations can play an important role in the delivery of qualitative care services, notably within communities and among persons who are disadvantaged or who face poverty and social exclusion;
• In particular, the social economy and the social innovation it espouses, have the potential to play a pivotal role, complementing public and private care;
• In this context, the EU should research and collect statistics within and among EU Member States, on the quality of care among different care providers (social economy, the private and public sectors). The European Social Fund (ESF) could also be used to finance the provision of qualitative care in Member States;
• Attracting new workers to the healthcare sector and investing in an educated, skilled, gender-balanced and motivated workforce, which is held in high social esteem and adequately remunerated, will be crucial to ensuring resilient and qualitative healthcare in EU Member States;
• In particular, Member States should invest in the capacity-building of the medical professions, alleviating administrative burdens, retraining and upskilling existing staff, notably in view of the digital transformation;
• The latter is already changing healthcare provision. It should be accompanied by a cross-sectoral reflection on how to best manage the transformation, whilst also ensuring multi-generational accessibility and inclusivity for all sectors of society.

Guaranteeing the right to healthcare: enhancing accessibility and protecting the most vulnerable

• It is imperative that health equity is at the heart of national and EU approaches, ensuring accessible and affordable quality healthcare which leaves nobody behind;
• In the aftermath of the Covid-19 pandemic, vulnerable groups such as the elderly and persons with disabilities should receive particular attention. More opportunities must be created for independent living, to avoid the isolation and marginalisation;
• Particular attention should be paid to informal carers of persons with disabilities or of elderly persons, the majority of whom are family members. Families should not face poverty because of caring responsibilities;
• Introducing supporting measures for informal carers, as stipulated in the 'European Care Strategy' must by prioritised by Member States. In this context, national mappings of the realities and needs of informal carers should be carried out, with a view to increasing gender balance, introducing binding quality standards and formalising their role within the care sector;
• There is also an urgent need for coordinated and immediate action across multiple sectors at the national and international levels, in order to effectively address the extensive suicides and mental health challenges facing young people;
• Steps should be taken to increase awareness, research and investment in gender equity in healthcare. Gender inequalities lead to decreased levels of quality of life and have financial consequences on women, notably among the lower socio-economic groups.

Brussels, 7 June 2023

[1] For example, the 'European Care Strategy', 'EU for Health', the 'European Health Union' and 'Europe's Beating Cancer Plan'