Europe’s health systems can survive economic squeeze, conference hears

BMJ 2012; 344 doi: (Published 26 March 2012) Cite this as: BMJ 2012;344:e2331
  1. Tessa Richards
  1. 1BMJ

Stagnant economies are driving governments to introduce cost containing health reforms but the “huge squeeze” on health budgets “need not have an adverse effect on front line services,” said Andrew Dillon, chief executive of the National Institute for Health and Clinical Excellence (NICE), at a recent conference in Geneva.

“In the UK we have been told we must make savings of 15-20%, and this is predicted to rise to 40%,” Dillon told the conference, which was convened by the Economist to consider how European countries could sustain their health systems.

“This can be achieved and the quality of care improved too [and in all healthcare systems in Europe] if we think innovatively and use efficient new technologies which meet the expectations of the public and the aspirations of those who work in the health sector.”

Europe’s “pre-industrial” health systems must “build prevention into their systems” speakers underlined. Healthcare must be integrated with social care, avoidable hospital admissions and unwarranted practice variation reduced, and patients with chronic disease empowered to manage their own disorders. Immediate access to interoperable ehealth records at all points along the patient journey was also seen as essential.

Countries must focus on measuring health outcomes, speakers agreed, and payment to providers based on results and patient and consumer satisfaction with service provision, not input and process. Providers should be fully accountable for the money they consume.

Nicola Bedlington, director of the European Patients Forum, said that “patients want to be part of the solution” not framed as the problem. “They must be involved in shaping and evaluating services,” she said.

Turkish minister for health, Recep Akdag, described his country’s recent reforms (BMJ 2011;342:c7456, doi:10.1136/bmj.c7456) and warned governments against “paying too much for healthcare.” Market forces should be used to “drive down the cost of technologies,” such as MRI scans, he said.

Vivek Jawali, a cardiothoracic surgeon from Bangalore, also advocated market reforms to drive down costs and said Europe should follow India’s example, of recycling costly equipment.

Value based pricing of drugs was advocated, and Ulf Peterson, from the Swedish Centre for Health Economics, showed how this had enabled Sweden to reduce its drug bill.

The cost of obesity was identified as a problem that governments were failing to confront. Several participants called for countries to follow Denmark’s lead and impose taxes on food and beverages with high fat and sugar content.

In a discussion of the values which should underpin health reform in Europe it was agreed that countries should provide universal access to equitable care provided on the basis of need not ability to pay.

However, Anne Sophie Parent, secretary general of AGE Platform Europe, warned that, “some new health reforms are going against this.” She added that countries were moving to provide “minimal” baskets of care to all and allowing those who can afford it to top up their care. “In 20 years time we will pay a high price for this,” she said.


Cite this as: BMJ 2012;344:e2331

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