This article is part of our special report Future of European Healthcare.
European governments should not be neglecting public health in times of austerity, the EU's health Commissioner John Dalli has warned.
Dalli, who was speaking on 6 June at a conference held by the European Public Health Alliance (EPHA) at the premises of the European Economic and Social Committee (EESC), stressed that financial hardship cannot jeopardise people's access to healthcare.
"What Europe needs now is to deliver more and better healthcare within sustainable health budgets," he said in his keynote.
The Maltese commissioner added that "difficult times can indeed provide an incentive to think creatively and push forward in-depth reforms and contain costs, while building modern, responsive, and sustainable health systems fit for the future."
Many countries in Europe have cut public health budgets drastically since the beginning of the global financial crisis in 2008.
In France, the government expects to reduce spending by €2.4 billion on the health insurance side. Some 40% of these reductions will be made through a shift to generic medications and savings on medical devices, while measures in favour of greater efficacy in hospitals are expected to lower cost by €1.5 billion.
The Czech Republic's Ministry of Health suffered a budget cut of €81 million in 2010 – a decrease of 30% compared to 2008. The country's budgetary cuts amounted for 15%-20% for all social sectors.
The health budget for 2011 in Greece decreased by €1.4 billion, with €568 million reduced through salary and benefit-related cuts. Hospital operating funds were cut by €840 million.
Health inequalities widen
Zsuzsanna Jakab, director for Europe at the World Health Organisation (WHO), emphasised that the financial and economic crisis was creating vast inequalities, with the poor being the first and worst-hit victims.
"European countries and regions must think about the way they pursue the well-being of their people. Health should be a priority for heads of government and not only for ministries of health," Jakab said.
She was backed by French MEP Pervenche Berès (Socialists & Democrats), who said that the social safeguards put in place since the Second World War no longer hold. "The repercussions that this crisis has on wealth redistribution dangerously resemble the scale of the ones to which the Great Depression of 1929 led," Berès said.
In Estonia since July 2009, the sickness benefit rate has been reduced from 80% to 70% of the insured person's income. The sickness benefit rate in the case of caring for a child under 12 was reduced from 100% to 80%.
The Greek government this year decreased its mental health services by 50%, and the budget was further reduced to cover only 45% of the psychosocial rehabilitation services.
In Latvia, nurses' salaries have fallen 20-40% since 2009. Between 2006 and 2010, the number of hospitals in Latvia have decreased to 39 from 106 and the number of hospital beds decreased to 493 from 761.
"We are sleep-walking into a catastrophe. If we let our health systems to slip away, long-gone burdens like the certain communicable diseases will make a comeback. We need value-based leadership," said John Ashton, director of Public Health and County Medical Officer for Cumbria in Britain.
Monika Kosi?ska, secretary-general of the European Public Health Alliance (EPHA), a network of NGOs working in the field of public health, said: "We are looking to political solutions for the health dilemma currently faced. As already seen in some countries with alcohol and junk food taxing, as well as with the ban on marketing and advertising to children, governments do have the power to fix current distress undergone by Europe's public health. Health should stop being the slave of the financial markets and be regained by the people."
The financial and economic crisis has had a double impact on health systems as an increased demand on health services coincides painfully with cuts made to government health budgets.
Poverty, more people at risk of food insecurity, more people and children vulnerably housed, an increase of alcohol consumption, and a rise in unemployment – all have led to poor health, an increased incidence of suicide, and mental ill health.
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