Workshop: using Structural Funds in health

Professor Jonathan Watson PhD FRSMHCN Executive Director/Board of TrusteesSpecial Professor of Health & Public Policy, University of Nottingham Medical SchoolGovernor – Edinburgh Napier UniversityExternal Partner- Bilbao Consortium (Deusto, Vilnius, Corvinus, Verona)European Masters Degree in Sustainable Regional Health Systems

Europe's health economies exchange

Financing regional healthcare workshop, AER, Katowice 19 March 2009

items

The Structural Fund processHow regions have used SFChallenges in using SF for healthAchieving added value investments

direct health sector investment (€5 bn -1.5%?)

00 02 04 06 08 10 12

Infrastructure

e-health

Education & training

Quality management

Emergency services

Health promotion

Inpatient care

Outpatient services

Access to services

Other

operating environment for SF and health

Best actions & lessons learned

about health investments 2000-2006

…best actions

…lessons learned

NONONO

Medical technology

and telemedicineThe elderly

Prevention & rehabilitation

building regional networks

composed of all players

common* clinical pathways

cross-linked by telemedicine

extending telemdicine by telecoaching

*trans-sectoral

close to home medicine

financed directly with the least bureaucratic

detours

Challenges in using SF for health

• Different metrics in each EU MS

• Is the new health infrastructure funded by SF increasing the health status of population?

• Developing indicators and gathering the needed statistical data.

• Developing cost-benefit analysis for investment projects

• The process of prioritizing needs and referring them to aims of the Operational programmes

• Preparing the project according the EU standards

• Bureaucracy - Complicated and often changed formulas - too many attachments, permissions, opinions, consent..

• Too strong tendency to standardize all kinds of projects e.g. indicators that fit to industrial and business projects not fit to health or education ones. .

Challenges

Separate OP Negotiation with EC

Creation of new Managing Authority for separate OPH

Content of OPCreation of balanced and realistic OP

(Inpatient vs. Outpatient Health Care Infrastructure)

State aidImplementation of the Commission Decision

2005/842/EC in the conditions of the Slovak healthcare system

MINISTRY OF HEALTH OF THE SLOVAK REPUBLIC

EIII events

• Workshop A and Master class A (Budapest October 2009)

• Workshop B (Kaunas, November 2009)

• Stakeholder Conference (Venice February 2010)

• Master class B (Stockholm March 2010)

• Workshop C (Tallinn May 2010)

• Workshop D and Master class C (Krakow July 2010)

• Interim challenge workshop (Brussels CoR January 2011)

• Workshop E (Cluj-Napoca March 2011)

• Final conference (Brussels October 2011)

non-health sector investment with potential health gain

00 05 10 15

Knowledge hubs

Inclusive employment

Innovation clusters

Urban development

Sustainable transport

Environmental quality

Social cohesion

Leisure facilities

Active ageing

Community engagement

Renewable energy

Integrated planning, one-stop shops (rural), health tourism, green spaces, procurement

MAs assessing added value

• In performance measurement terms there are 3 key challenges that flow from the principle of cost effective investments that maximise health gains at regional and sub-regional level:

• First - identifying outcome measures that are systemic products and reflect added value for SF and national/regional investments

• Second - simplifying accountability mechanisms

• Third - use existing data available across sectors that can be interpreted to inform key indicators (where possible).

• Added value/health gains:

Increasing local employment

Increasing the skills base in local labour markets

Increasing wealth in the region

Promoting business growth (SMEs) competitive in wider markets

Healthier lifestyles

Enhancing community well being and social cohesion

Protecting the environment by decreasing transport miles.

questions…

•Does your region spend Structural Funds for health?

•How do you spend the money?

•What are the challenges you are facing?

•What help/support do you need?