EU health systems at ‘critical moment’, require common approach

While there is no silver bullet to address the many issues facing Europe’s overstretched medical systems, addressing them at the EU level is a good start, former EU Health Commissioner Vytenis Andriukaitis said.

“Europe is running out of doctors and nurses and it is a really ongoing scenario,” Andriukaitis, now a special envoy of the World Health Organisation (WHO) European region, stressed at a European Institute of Health and Sustainable Development (EIHSD) event on 30 November.

The EU’s health systems are at a “very critical moment”, he added.

Since 2010, the proportion of foreign-trained nurses and doctors has risen faster than domestically trained professionals, with increased mobility driven by rising East to West and South to North intra-European migration, research shows.

The migration of health workers results in some sending countries facing substantial inequalities in the availability of health workers across the region, despite having medical programs full of students.

The findings of the September WHO report on the health and care workforce in Europe suggested that without immediate action, health and care workforce gaps in the European region could spell disaster.

Unequal distribution of healthcare workers creates “medical deserts” –  a lack of medical personnel or medical services in certain geographical areas or communities, mostly in rural and remote regions, especially when it comes to vulnerable minority populations and they are seen all over Europe.

“Millions of Europeans don’t have a referring general practitioner,” he added, highlighting the lack of family doctors and general practitioners in rural, remote and underdeveloped areas.

For example, Lithuania’s healthcare system is currently lacking 2,000 nurses, despite nursing programmes being full, with LRT reporting that the main reason is migration. It is estimated that in the next 10 years, the number will rise to 3,000.

“Sending member states are investing a lot for expensive training. But the health workforce may end up working at the level below their qualifications,” Andriukaitis stressed, referring to staff who immigrate to other countries after they qualify.

He urged that receiving member states are using “health care professionals from poorer member states as a quick fix to the health worker shortage in their health care systems”.

Wind of change

National governments, however, cannot face the plethora of issues facing the health system alone, Corrine Hinlopen, a global health policy researcher at Wemos, highlighted.

“It’s essential that we have to look at what the EU can do,” she stressed. “We regard health as a national competence. But it isn’t in the European integrated level market.”

Investments made in one country can yield economic and health benefits in another country, she said, adding that internal market forces can override the efforts of national governments.

In the Lisbon Treaty, common safety concerns in public health matters are ‘shared competence’, while protection and improvement of human health fall under Article 6 as supporting competence. As such, the EU can only intervene to support, coordinate or complement the action of its member states.

Andriukaitis has repeatedly called for amendments of the Lisbon treaty to better enable EU institutions to effect change in health policy.

“The only right way is to keep health at the highest level as an European issue, not only as a member states’ issue,” he said.

“We need to think about possibilities to improve the Lisbon treaty to provide EU with shared competencies otherwise, there will be no possibility to push member states to be more active in face of such a big, big crisis,” he concluded.


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