This article is part of our special report Future of European Healthcare.
SPECIAL REPORT / Europe’s healthcare systems need to reform to avoid being crushed by vanishing resources, corruption and structural deficiencies, policymakers convening in Austria for the Gastein Health Forum will be told today (3 October).
“It is unacceptable, indeed intolerable, that massive cuts should be resulting in essential health services being slashed – this to the point of posing real dangers to sick people,” Günther Leiner, president of the forum, is scheduled to tell delegates in an introductory address.
But he will add that “despite the pressure to save money, resources are being poured into unnecessary structures and services”.
“If the crisis offers an opportunity, then perhaps it is this: that we will finally make sure that the limited available resources really are effectively deployed to give people the optimum treatment they need,” Leiner will tell Europe’s healthcare policymakers, meeting for the 15th year at the forum he founded.
Leiner’s message that scarce spending resources are being wasted on redundant structures and treatments will form the backdrop for discussions on how fundamental reform can counter the problems caused by spending cuts arising from Europe's financial woes.
The Organisation for Economic Co-operation and Development (OECD) says that in 2010 Ireland, Estonia and Greece slashed healthcare budgets by between 6.5% and 7.6%.
It’s not only about the money
Other figures show the Czech Republic and Latvia cut healthcare spending between 2008 and 2010 by 25% and 30%, respectively.
In Bulgaria 1,800 staff have left the health system while in Romania, 2,500 doctors emigrated since the onset of the crisis. Some 10,000 Romanian patients are awaiting chemotherapy drugs.
Despite heavily criticising the withdrawal of resources, Leiner says these alarming developments go hand-in-hand with “the apparent contradiction that in many European countries there is an excess of health structures and services, the keynotes being over-hospitalisation, over diagnosis, and over treatment”.
Leiner will call for Europe to undergo a re-think in the structure of its hospitals, claiming that there are too many within the richer states, and that these provide more expensive and problematic services.
He claims that hospitals perform better when they are larger and fewer.
He also slams “over-diagnosis” and unnecessary operations”. Echoing arguments made recently by the British Medical Journal, Leiner believes higher availability of diagnostic equipment is fuelling demand for treatment in richer states.
Healthcare in crisis is theme of forum
Meanwhile, the Gastein Forum will hear figures pointing to the wide discrepancy across the EU for the number of knee operations carried out each year per 100,000 people – which range from 213 in Germany to 42 in Ireland.
“It’s hard to imagine that such large differences can be explained medically, and evidently economic factors are playing a role here too,” Leiner is to tell the forum.
An associated problem is corruption in health systems, Leiner believes, pointing to a recent report by the European Health Care Fraud and Corruption Network that claimed that for every €1 trillion spent on health services within the EU, €56 billion disappears as a result of fraud and corruption.
“Cutting medical services is not the answer to tight health budgets, radical changes are needed in health structures,” he will conclude.
These ideas will be thoroughly aired at the four-day forum, where policymakers will mull a range of issues under the theme of “healthcare in an age of austerity”.
Sustainability of healthcare systems in the crisis, issues relating to transparency, health literacy, and ideas for innovative restructuring of health systems will be discussed in depth.
The eurozone debt crisis has forced some governments to drastically cut their public health budgets in an effort to contain deficits.
Greece was among the countries taking the toughest measures but Spain and other countries such as France and the Czech Republic have also taken similar steps.
EU health Commissioner John Dalli has warned about neglecting public health in times of austerity, saying the economic crisis should not turn into a health crisis.
- World Health Organization: Benefits of investing in healthcare systems
- World Health Organization: Margaret Chan, director general, on austerity
Surveys and data
- Clinical Medicine: Austerity: a failed experiment on the people of Europe
- The Lancet: The public health effect of economic crises and alternative policy responses in Europe: an empirical analysis
- The Lancet: Effects of the 2008 recession on health: a first look at European data
- The Lancet: Health effects of financial crisis: omens of a Greek tragedy