The COVID-19 pandemic has highlighted the critical need for an upgraded and resilient European health system. This project aims to address challenges faced by Member States in accessing EU funding mechanisms and advocates for additional resources for health investment. The initiative focuses on two work streams: Making the Case for Public Investment in Health and establishing an EU Health Resource Hub.

This mission opportunity is part of the implementation of the “Resources Hub for sustainable investing in health”project in support to Ministry of health in Austria, Belgium and Slovenia.

Health systems are facing significant challenges from a fiscal sustainability perspective. Due to factors such as costly technological progress in medical services, higher expectations on the quality and scope of care, and the growing health and long-term care needs of an ageing population in the European Union (EU)[1] public health spending has risen in most EU Member States (MS) and represents a significant and increasing share of total government expenditure. Spending on health has typically outpaced economic growth in most countries and is expected to make up for 19% of public budgets by 2040[2].

The COVID-19 pandemic put additional pressure on the sustainability of health systems, with significant increases in public health expenditure in 2020 and 2021. This has put health systems in the spotlight, exposing existing weaknesses and highlighting the urgent need to strengthen the quality, resilience and sustainability of health systems.

The EU provides a wide range of funds and tools for supporting health systems and their transformation. However, Member States (MS) often struggle to access these funds and combine efficiently the use of the different funds and tools with their national health needs. The funding landscape at EU level is complex and the process of mutual learning between Member States is challenging.

In addition, public health authorities often struggle to demonstrate the effectiveness of existing policies and their financing needs when advocating for additional resources. There is a need to increase the profile and priority of implementing public health policies and bring awareness to the budgetary constraints and sustainability challenges faced by the Ministries of Health. The impact of the COVID-19 pandemic on health systems has clearly demonstrated the importance of sustainable investments in health, thus providing the momentum to strive for better, sustainable and efficient healthcare systems.

This project is a joint initiative aiming to address three Member States’ needs (Austria, Belgium and Slovenia) in reaching EU funding available for improving the quality of health systems, and in effectively advocating at national and EU level for additional resources for health investment, while ensuring synergies and mutual learning between the Member States.

The general objective of this project is to support Austria, Belgium and Slovenia in their efforts to design, develop and implement reforms, which could encourage investment and fiscal sustainability, increase competitiveness and assist in achieving sustainable economic and social convergence, resilience and recovery. This should also strengthen their institutional and administrative capacity, including at regional and local levels, to facilitate socially inclusive, green and digital transitions, to effectively address the challenges identified in the country-specific recommendations and to implement Union law.

The specific objective of this project is to support the 3 Member States’ Ministries of Health in their effort to make a more effective and efficient use of their national resources and of the Union funding mechanisms for the health sector in order to strengthen the resilience and sustainability of their health (financing) systems and thus improve the quality of health services. The project will aim to:

• Develop know-how in order to better support the process of preparing investment decisions in the field of health at national and EU level.
• Strengthen the capacity of the 3 MS to demonstrate clear evidence that investments in public health systems have positive long-term effects and to show cost-effectiveness.
• Facilitate the exchange of best practices between MS.
• Create an EU Health Resource Hub, which should facilitate the access of MS to Union funding mechanisms in a more strategic, effective and coherent way. This in turn aims to increase the funding of national projects in health and to maximise the impact of investments in the field of health systems.

To this end the project is structured around two work streams:

• Work stream 1 (WS 1) aims at strengthening the capacity of the three Member States’ Ministries of Health to make the case for public investment in health at national and EU level, and demonstrate clear evidence of the socioeconomic benefits of already undertaken or planned public investments in health.
• Work stream 2 (WS 2) aims at strengthening the capacity of the three Member States to reach EU funding available for health.

Beneficiary EU Member State authorities

The national authorities that requested technical support and will benefit from this Project are:

• The Federal Ministry of Social Affairs, Health, Care and Consumer Protection of Austria (Bundesministerium für Soziales, Gesundheit, Pflege und Konsumentenschutz),
• The Federal Public Service Public Health, Food Chain Safety and Environment of Belgium (Service Public Fédéral Santé Publique, Sécurité de la Chaine Alimentaire et Environnement), and
• The Ministry of Health of Slovenia (Ministrstvo za zdravje).

The project will support specific ongoing reforms in the three MS, though the MS specific national pilot case to be conducted under WS 2:

• Austria: greening of the Austrian Health Care Facilities.;
• Belgium: development of integrated care;
• Slovenia: strengthening of primary health care.

A draft logical framework was prepared at the project launch but has not been validated by the partners (See the draft logical framework at the end of the “Detailed Project Description” attached to the present Terms of References)

[1] The 2021 Ageing Report: Economic and Budgetary Projections for the EU Member States (2019-2070), 07 May 2021

[2] Fiscal Sustainability of Health Systems, Bridging Health And Finance Perspectives, OECD, 24.09.2015