Let’s dance - the impact of the economic crisis on healthcare cues an intricate dance between EU institutions and Member States

The issue of healthcare sits in an increasingly delicate place in the European arena. Traditionally, healthcare has been a matter of Member State competence. That continues to be the case, but the impact of the economic crisis and intensified involvement of the European Commission in the economic governance of Member States, means that the institutions are cautiously engaging in a new dance on healthcare.

Now in its fourth year, the Commission provides so called ‘country-specific recommendations,’ or CSRs, on where some Member States should be focusing their budgets (and cuts). Such economic governance and scrutiny has spilled over into the arena of healthcare budgets, a large component of national government spending. These put the spotlight on the efficiency of health systems and expenditure. At the end of June the European Council generally endorsed the CSRs and today 8 July these were formally adopted by EU finance Ministers. It will now be up to the EU Member States to implement the recommendations when drafting their national budgets and other relevant policies.

As far as health is concerned, a step-change in recent years is the increasing number of countries (now 16) receiving CSRs relating to healthcare. With this trend we see European Health Ministers more ardent about claiming their stake in the economic debate, as witnessed recently when the EU’s Council of Employment, Social Policy, Health and Consumer Affairs Ministers (EPSCO) gathered round the table in Luxembourg. A primary concern of EPSCO was the perceived lack of consultation and coordination with Health Ministers on CSRs and budgetary negotiations which impact on health. This signals a growing recognition at the highest political levels that more coordinated action, is needed to address healthcare issues in the context of economic policy in the EU.

What does all of this mean for the future of healthcare in the EU? It remains to be seen both how Member States plan to implement the CSRs relating to health, and how the European Commission intends to scrutinize action in this area. Given the fairly general nature of the CSRs, which propose such actions as improving the cost-effectiveness of the health-care sector, they may prove difficult to evaluate. Nevertheless, we are seeing a growing momentum by the EU to do more in health, and an increasing necessity for economic and healthcare decision makers to start dancing to the same tune.

Lindsay Hammes