The member states’ governments must make the most of the debt crisis to improve the effectiveness of their health care systems, among others by refraining from ill-considered budget cuts. This is the message that was voiced, on 6 June, by the vast majority of the participants in a conference on the theme of public health and the crisis, which was co-organised by the European Public Health Alliance (EPHA) and the European Economic and Social Committee (EESC).

Commissioner John Dalli, in charge of the dossier, and the Regional Director of World Health Organisation (WHO) Europe, Zsuzsanna Jakab, also pushed this message. Dalli said that health care was a long-term investment and that “the health care sector is a key job creator and a driver of innovation and technology. This is why cutting back on health care delivery is invariably a false economy, triggering worsening outcomes in the longer term”. Jakab added that the WHO was not opposed to budget cuts but that cuts should be considered and concentrated on areas where work is being doubled-up. Jakab therefore invites the member states to avoid useless budget cuts; to better target public spending on poor and vulnerable people; to improve effectiveness by using medicines and technology more intelligently and to rationalise service provision structures; and, lastly, to anticipate financial difficulties.

According to an investigation conducted by the EPHA, the crisis has led to a decrease in budgets dedicated to health care, a decrease in the number of hospitals, as well as a decrease in the number of services and of health care professionals. In Lithuania, for example, the health care budget decreased by 25% between 2008 and 2010 (going from €822 million to €617 million); the largest cuts related to public health care (-88.6%), the administration of the financing of health care (-67%) and the central administration (-58.6%). According to the European federation of Nurses’ Association’s 2011 report ‘Caring in crisis: The impact of the financial crisis on nurses and nursing’, the cost of hospitals in Lithuania increased by 150% between 2006 and 2010, the number of hospitals went from 106 to 39 and the number of beds went from 761 to 493. Similarly, nurses’ salaries have decreased by 20-40% since 2009. Yet, the EPHA warns that health has an impact on economic growth, stressing that the average cost of workplace absenteeism represents around 2.5% of the gross domestic product (GDP) of a country.

“The crisis, however, has simply magnified the need for sustainability, which has been there all along and growing by the day. Indeed, health care expenditure across the EU is projected to increase by one quarter by 2060 just on account of ageing,” Commissioner Dalli concluded, calling on member states to increase the profitability of their health care systems and to work together (in particular via the evaluation of health care technologies and online health care) to find innovative models.