EUREGIO III
NEW PERSPECTIVES ON THE USE OF STRUCTURAL FUNDS FOR HEALTHCARE INVESTMENT
EUREGIO III was funded to explore and assess the use of Structural Funds for health investment in the 2000-2006 and 2007-2013 SF cycles. During the project all EU regional health systems were facing significant change: demographic, epidemiological, technological and economic. This was compounded by the financial and economic crises of 2007-2009 that initiated an ongoing period of short-term policy solutions, static public budgets and unstable funding for health care providers. Despite this, project evidence identified important precedents and learning experience for the future; where investment strategy driven by economic conditions and demands from the “better informed” public must address at minimum:
- The need to deal with changing demands on healthcare (ageing populations and the rise in chronic illnesses)
- A slow down in (and likely reduction) in new resource availability especially for capital infrastructure investment
- The need for healthcare investment to make a more visible contribution to the real economy.
EVIDENCE and FINDINGS – This unstable policy and operating environment demanded a reshaping of how case examples were selected and assessed. We also choose to identify and select a comparator set of non-SF funded case examples with the intention of benchmarking SF investments against good practice examples. We ended up with 10 case examples from SF investment from an initial selection of over 40 potential cases. Overall, we showed the need to improve significantly the effectiveness of SF investment in healthcare especially to help overcome the severe and debilitating legacy problems resulting from previous underinvestment in the then EU12. Among the main findings were the need for solutions and investment that is:
- More adaptable and dynamic to respond to the changing demands, priorities and resource outlook of a 21st century health system
- More integrated to create the tipping point for structural reform and process change to improve affordability, quality, accessibility and sustainability
- Able to incorporate smart innovation principles in particular relating to partnerships with the private sector and in contributing fully to economic growth – enacting the health is wealth ethos in more direct and measurable terms
- More results orientated in terms of project delivery and performance.
IMPACT – The project was timely and relevant to evolving EU health priorities and exceeded the outcomes predicted when it started. Evidence from EUREGIO III helped shape the Hungarian EU Presidency programme content and was given in a presentation to the informal meeting of EU health ministers (Godollo, Hungary, April 2011). The EU Council then endorsed the programme recommendations (including those for heath and structural funds) in the EU Council Conclusions of 6th June 2011. EUREGIO III learning was also used for: a WHO/EU Equity project briefing – Opportunities for health systems to influence the use of Structural Funds to reduce health inequities in the European Union; as the basis for an introductory guide for DG REGIO desk officers – Health infrastructure and health service priorities in the post 2013 programming period in convergence regions. Also, selected case studies and learning from EUREGIO III contributed to evidence for the High Level Reflection Sub-Group 2 led by Miklos Szocska the then Hungarian Minister of State for Health which addressed – Defining success factors for the effective use of Structural Funds for health investments. Finally, The project was selected by DG SANTE as one of 33 success stories co-financed by the EU health programme (EU 2012, Health for the EU in 33 success stories). Subsequently, the Commission and CHAFEA built on EUREGIO III with the funding of other projects (e.g. HealthEquity 2020) and has commissioned several further assignments to better inform the use of ESIF for health and healthcare. This includes the most recent commission: ESIF support in the area of health in which HCN provides the expertise for one of six thematic blocks: research and innovation.