Reflecting on ‘Supporting health systems in Europe: added value of EU actions?’

Hervey, Tamara

doi:10.1017/s1744133115000262

Cited by 4 publications

(4 citation statements)

References 29 publications

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“…Therefore, this study established that, to date, the dominant focus for health services organisation and delivery resides at the national level. However, Hervey’s observation that the influence of the EU permeates ‘virtually every aspect of such [health] policies’ [ 5 ] also receives support from our findings because the EU appears to be exerting an indirect effect on health policy making by stimulating the production of several national health strategies.…”

Section: Discussionsupporting

confidence: 75%

“…Hence, the responsibility for organising and financing health systems remains a Member State responsibility in accordance with the principle of subsidiarity [ 2 , 3 ]. Of course, this position leads to some ambiguity, which is also reflected in the mixed outcomes of European health policy [ 4 , 5 ]. European level stakeholders perceive the results of the EU health policy as a mixture of achievements, failures and missed opportunities [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Europeanisation of health systems: a qualitative study of domestic actors in a small state

et al. 2016

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BackgroundHealth systems are not considered to be significantly influenced by European Union (EU) policies given the subsidiarity principle. Yet, recent developments including the patients’ rights and cross-border directive (2011/24 EU), as well as measures taken following the financial crisis, appear to be increasing the EU’s influence on health systems. The aim of this study is to explore how health system Europeanisation is perceived by domestic stakeholders within a small state.MethodsA qualitative study was conducted in the Maltese health system using 33 semi-structured interviews. Inductive analysis was carried out with codes and themes being generated from the data.ResultsEU membership brought significant public health reforms, transformation in the regulation of medicines and development of specialised training for doctors. Health services financing and delivery were primarily unaffected. Stakeholders positively perceived improvements to the policy-making process, networking opportunities and capacity building as important benefits. However, the administrative burden and the EU’s tendency to adopt a ‘one size fits all’ approach posed considerable challenges. The lack of power and visibility for health policy at the EU level is a major disappointment. A strong desire exists for the EU to exercise a more effective role in ensuring access to affordable medicines and preventing non-communicable diseases. However, the EU’s interference with core health system values is strongly resisted.ConclusionsOverall domestic stakeholders have a positive outlook regarding their health system Europeanisation experience. Whilst welcoming further policy developments at the EU level, they believe that improved consideration must be given to the specificities of small health systems.

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Section: Discussionsupporting

confidence: 75%

Section: Introductionmentioning

confidence: 99%

Europeanisation of health systems: a qualitative study of domestic actors in a small state

et al. 2016

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“…Other studies mention that the EU at least touches upon "virtually every aspect of such policies" [31]. The accession process provides an opportunity for health system reform by offering important support such as technical and financial assistance, capacity building as well as by overcoming local resistance to change [32].…”

Section: Discussionmentioning

confidence: 99%

Europeanization of health policy in post-communist European societies: Comparison of six Western Balkan countries

et al. 2022

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“…The adoption of the directive on patients’ rights and cross-border care in 2011 (European Union, 2011: 45) is traditionally considered important for clarifying the rights of patients to reimbursement of cross-border care following a spate of judgements by the European Court of Justice. However, an often overlooked aspect of this directive is the establishment of a legal basis for cooperation between health systems in areas such as rare diseases, health technology assessment and e-health (Clemens et al ., 2014: 49–69; Hervey, 2015: 1–5). This is a rapidly developing area of health policy development at EU level through which Member State (MS) may benefit from seeking to cooperate in specific areas of EU added value as they are urged to respond to common challenges facing health systems throughout the EU (European Commission, 2014a).…”

Section: Introductionmentioning

confidence: 99%

The European Union Joint Procurement Agreement for cross-border health threats: what is the potential for this new mechanism of health system collaboration?

Azzopardi-Muscat

Schröder‐Bäck

Brand

2016

HEPL

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The Joint Procurement Agreement (JPA) is an innovative instrument for multi-country procurement of medical countermeasures against cross-border health threats. This paper aims to assess its potential performance. A literature review was conducted to identify key features of successful joint procurement programmes. Documentary analysis and a key informants' interview were carried out to analyse the European Union (EU) JPA. Ownership, equity, transparency, stable central financing, standardisation, flexibility and gradual development were identified as important prerequisites for successful establishment of multi-country joint procurement programmes in the literature while security of supply, favourable prices, reduction of operational costs and administrative burden and creation of professional expert networks were identified as desirable outcomes. The EU JPA appears to fulfil the criteria of ownership, transparency, equity, flexibility and gradual development. Standardisation is only partly fulfilled and central EU level financing is not provided. Security of supply is an important outcome for all EU Member States (MS). Price savings, reduction in administrative burden and creation of professional networks may be particularly attractive for the smaller MS. The JPA has the potential to increase health system collaboration and efficiency at EU level provided that the incentives for sustained commitment of larger MS are sufficiently attractive.

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Reflecting on ‘Supporting health systems in Europe: added value of EU actions?’

Cited by 4 publications

References 29 publications

Europeanisation of health systems: a qualitative study of domestic actors in a small state

Europeanisation of health systems: a qualitative study of domestic actors in a small state

Europeanization of health policy in post-communist European societies: Comparison of six Western Balkan countries

The European Union Joint Procurement Agreement for cross-border health threats: what is the potential for this new mechanism of health system collaboration?

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