Why are the health systems in crisis?

Healthy Europe asked three prominent decision-makers why Europe’s health systems are facing a crisis. Hans Kluge, WHO Regional Director for Europe, Sandra Gallina, Director-General, European Commission Directorate-General for Health and Food Safety, and Johannes Rauch, Federal Minister of Social Affairs, Health, Care and Consumer Protection, Austria, responded.

Portrait of Hans Kluge
Photo: WHO

Hans Kluge, WHO Regional Director for Europe

The theme of this year’s European Health Forum Gastein is timely: our health systems are in crisis and stretched thin. The signs are evident: the burden of non-communicable diseases, an ageing population, gaping health disparities. We must now rise to this challenge with unwavering determination and collective action. COVID-19 exposed the fragility of our preparedness, illuminating the need to fortify our defences against future pandemics and climate-related threats. Our vulnerability stares us in the face, urging us to heed the call for resilience. As patients continue to endure agonising waiting times with inadequate access to critical care, the time to act is now. Swift action is paramount. We must invest in sophisticated surveillance systems, robust early-warning mechanisms and meticulous pandemic preparedness. The shortage of healthcare professionals exacerbates our plight, leaving us ill-equipped to meet a soaring demand for quality care. To overcome this, we must attract, retain, and empower our health and care workforce through competitive incentives and continuous professional development. Together, we can create an environment that nurtures their skills and compassion.

We must attract, retain, and empower our health and care workforce.

Underinvestment has crippled our healthcare infrastructure, leaving us ill-prepared to face the oncoming tide. We must commit to decisive action – channelling resources to bolster our health systems, hospitals and primary care facilities, ensuring equitable access to cutting-edge medical technologies, and expanding our capacity to deliver essential services. The time for rhetoric is over. Let us be architects of our destiny, forging a path of unity, solidarity and commitment. We are more than capable of building health systems that not only endure the trials of today but also triumph over the uncertainties of tomorrow. WHO/Europe stands ready, unwavering in its support to friends and partners. In unity, there is strength; in commitment, there is hope. Together, let us steer our health systems towards a brighter future.

Photo: European Commission

Sandra Gallina, Director-General, European Commission Directorate-General for Health and Food Safety

In recent years, the COVID-19 pandemic has highlighted the vulnerabilities present in our health systems. It was clear that they were not fully equipped to handle such a challenge. Weaknesses need to be addressed through investment to make health systems more resilient. By increasing the capacity of our health systems, we give them the tools they need to handle surges in demand while still providing regular and emergency care. Health must be reframed as an investment for our societies and economies, rather than a cost. The European Commission responded by adopting several health policy initiatives to create a stronger European Health Union, matching the policies with funding. The EU’s Recovery and Resilience Facility supports Member States’ health systems with over EUR 43 billion planned for reforms and investments. From this amount, around EUR 14 billion is allocated to digital health infrastructure, telemedicine, and healthcare workers’ digital skills.

Health systems in Europe are ill-prepared to face major threats

The EU4Health programme funds projects for the training of healthcare professionals’ digital skills, best practice sharing in primary care, and improving the capacity of Member States for health workforce planning, while the development of tools for testing health system resilience is also underway. The diagnosis is clear: health systems in Europe are ill-prepared to face major threats. The cure? Invest more in healthcare infrastructure, strengthen the healthcare workforce, accelerate digital skills and improve primary care. The European Commission is taking steps to support Member States in providing the healthcare that is needed for a European Health Union that leaves no one behind.

Portrait of Johannes Rauch, Federal Minister of Social Affairs, Health, Care and Consumer Protection in Austria
Photo: Darko Todorovic

Johannes Rauch, Federal Minister of Social Affairs, Health, Care and Consumer Protection in Austria

The COVID-19 pandemic highlighted the role of strong public health systems all around the world. At the same time, its effect was like a magnifying glass, bringing the structural weaknesses of our medical services to the fore. While we have learned to live with the virus, the European health systems are now facing similar challenges: the demographic development of the population is leading to an ever-growing demand for health services and also an increasing requirement for long-term care. In Austria alone, we will need 76,000 additional caregivers before 2030.

In Austria alone, we will need 76,000 additional caregivers before 2030.

The Austrian health system continues to do outstanding work, as was confirmed by the most recent report of the Organisation for Economic Co-operation and Development (OECD). Per capita health expenditure is among the highest of the European Union countries. In addition, the density of doctors in Austria is at a high level. Nevertheless, there is an acute need for action in some cases. For instance, there is a problem with finding new health service doctors, such as general practitioners and paediatricians, especially in rural areas. People who cannot afford to go privately are forced to use hospital services. But the health personnel there are often already at the limit of their capabilities. This means that structural reform is urgently needed. Reforms will have to secure medical care for the population in the future, in the form of targeted investment. To achieve this, we will need to provide doctors’ surgeries with support and also to press ahead with digitalisation in healthcare, where patients receive rapid medical assistance in accordance with the guiding principle “digital then outpatient then inpatient”, which also takes the pressure off the health professions.