Resources Hub for sustainable investing in health

Health systems are facing significant challenges from a fiscal sustainability perspective. Due to factors such as costly technological progress in medical services, higher expectations on the quality and scope of care, and the growing health and long-term care needs of an ageing population in the European Union (EU), public health spending has risen in most EU Member States and represents a significant and increasing share of total government expenditure. Spending on health has typically outpaced economic growth in most countries and is expected to make up for 19% of public budgets by 2040.

The COVID-19 pandemic put additional pressure on the sustainability of health systems, with significant increases in public health expenditure in 2020 and 2021. This has put health systems in the spotlight, exposing existing weaknesses and highlighting the urgent need to strengthen the quality, resilience and sustainability of health systems.

The EU provides a wide range of funds and tools for supporting health systems and their transformation. However, Member States often struggle to access these funds and combine efficiently the use of the different funds and tools with their national health needs. The funding landscape at EU level is complex and the process of mutual learning between Member States is challenging. Moreover existing funds generally cover research and buildings’ financing but no structural less costly reforms.

In addition, public health authorities often struggle to demonstrate the effectiveness of existing policies and their financing needs when advocating for additional resources. There is a need to increase the profile and priority of implementing public health policies and bring awareness to the budgetary constraints and sustainability challenges faced by the Ministries of Health. The impact of the COVID-19 pandemic on health systems has clearly demonstrated the importance of sustainable investments in health, thus providing the momentum to strive for better, sustainable and efficient healthcare systems.

Make the case for public investing in health

This project is a joint initiative aiming to address the needs of three European Union Member States (Austria, Belgium and Slovenia) in reaching EU funding available for improving the quality of health systems, and in effectively advocating at national and EU level for additional resources for health investment, while ensuring synergies and mutual learning between the Member States.

This multi-country project is a Technical Support Instrument financed by the Directorate General for Structural Reform Support (DG REFORM) from the European Commission and implemented by Expertise France. The project officially started on Sept 13, 2022 and aims to support the three Member States’ Ministries of Health in their effort to make a more effective and efficient use of their national resources and of the European Union funding mechanisms for the health sector, in order to strengthen the resilience and sustainability of their health (financing) systems and thus improve the quality of health services.

The project is structured around two workstreams:

1. Strengthening the capacity of the three Member States’ Ministries of Health to make the case for public investment in health.
2. Strengthening the capacity of the three Member States to reach EU funding available for health. This second workstream is envisaged through the settlement of a “hub” that should enable Member States and project promoters in Member States to identify how they could best use EU support to invest in the health sector and implement public health reforms.

Addressing core challenges of health financing systems - varied priorities

Pilot projects are implemented within each Member State through each workstream making this initiative a 6 projects in 1, to which should be added the hub definition and conceptualisation.

• Austria will focus on policy measures linked to health expenditures forecasting on the one hand and greening the healthcare facilities on the other hand.
• Belgium is working on a health impact assessment tool and will elaborate a digital dashboard to support the implementation of population health management.
• Slovenia chooses to address strengthening of primary health care and health economics skills.