Europe urges more transparency of health spending


As the Commission readies to propose rules to improve cross-border access to health care in the EU, the 27 member states together with 26 other World Health Organization (WHO) European region countries have committed to more accountability regarding the way their health systems are financed.

Some 500 European health decision-makers, including ministers of health and finance, gathered to discuss “sensitive and politically charged health issues” such as equal access to care or transparency of public health spending during the WHO European Ministerial Conference on 25-27 June. 

The main outcome of the conference was the adoption of the “Tallinn Charter“, which commits European countries to increasing the transparency and accountability of their health spending in order to improve health systems’ performance, allow better assessment of their achievements and ensure that spending is aligned to policy objectives. 

Simply increasing investment in health is not enough as the money needs to be “well spent”, argued WHO Deputy Regional Director for Europe Dr. Nata Menabde. “This means being accountable for where money is spent, choosing the appropriate technology and showing that it was the best of the available options and properly used,” she added.

As part of preparations for the Charter, a number of studies were conducted on the link between the health and wealth of the population. According to the WHO, the studies make a strong “case for giving serious political attention to the performance of health systems”.

WHO Regional Director for Europe Dr. Marc Danzon underlined that performance “includes the health ministry’s ability to influence other ministries, such as transport, environment and education, to follow policies that improve the health of the population”. His comments were endorsed by Estonian Minister of Social Affairs Maret Maripuu, who noted that an effective health system is about prevention, cure and care and that the performance of all three needs to be measured. 

A stakeholder report on financing sustainable health care in Europe, published in early 2007, had already called on the EU 27 to increase transparency in public health financing. 

It proposed the introduction of a market price-based mechanism which would help gather the necessary information about the use of healthcare resources and achieve better value for money. The report concluded that “products that provide the most value for investment must be identified and supported” and manufacturers of such products “rewarded with appropriate reimbursement and pricing schemes”.

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