# C_2011202EN.01001001.xml

| 8.7.2011 | EN | Official Journal of the European Union | C 202/10 |
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Council conclusions: towards modern, responsive and sustainable health systems

2011/C 202/04

THE COUNCIL OF THE EUROPEAN UNION,

| 1. | RECALLS that under Article 168 of the Treaty on the Functioning of the European Union, a high level of human health protection shall be ensured in the definition and implementation of all Union policies and activities; as well as Union action is to complement national policies and be directed towards improving public health; it is also to encourage cooperation between the Member States in the field of public health and, if necessary, lend support to their action, and fully respect the responsibilities of the Member States for the organisation and delivery of health services and medical care; |
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| 2. | RECALLS the Council conclusions on the Commission White Paper ‘Together for Health: A Strategic Approach for the EU, 2008-2013’ adopted on 6 December 2007; |
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| 3. | RECALLS the Council conclusions on common values and principles in EU health systems adopted on 2 June 2006( 1 ), and particularly the overarching values of universality, access to good quality care, equity and solidarity; |
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| 4. | RECALLS the Tallinn Charter on Health Systems for Health and Wealth, signed on 27 June 2008 under the auspices of the World Health Organisation (WHO); |
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| 5. | RECALLS the Joint Report on Health Systems prepared by the European Commission (EC) and the Economic Policy Committee (EPC) finalised on 23 November 2010, as well as the Council conclusions on the EC-EPC Joint Report on Health Systems, adopted on 7 December 2010; |
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| 6. | ACKNOWLEDGES the work carried out by the Social Protection Committee (SPC) and RECALLS the objectives agreed within the framework of the Open Method of Coordination for social protection and social inclusion at the European Council of March 2006 to ensure accessible, high-quality and sustainable healthcare and long-term care; |
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| 7. | RECALLS the discussion at the Informal Meeting of Ministers of Health held in Gödöllő on 4-5 April 2011 on ‘Patient and Professional Pathways in Europe — Investing in the health systems of the future’; |
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| 8. | RECALLS the Europe 2020 Strategy and WELCOMES the Commission's initiative in bringing forward the pilot European Innovation Partnership on ‘Active and Healthy Ageing’ and its ongoing work; |
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| 9. | RECOGNISES that Member States face common challenges due to an ageing population, changing population needs, increasing patient expectations, rapid technology diffusion and growing costs of healthcare as well as due to the current uncertain and fragile economic climate resulting particularly from the recent global economic and financial crisis which is progressively limiting the resources available to Member States' health systems. The growing rise of chronic diseases represents one of the major challenges to health systems; |
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| 10. | RECOGNISES that, whilst ensuring equitable access to high quality healthcare services in circumstances of scarce economic and other resources has always been a key question, at present it is the scale and urgency of the situation that is changing and, if unaddressed, it could become a crucial factor in the future economic and social landscape of the EU; |
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| 11. | RECOGNISES the need for smart and responsible innovation, including social and organisational innovation, to balance future demands against affordable and sustainable resources in order to be able to respond to all these challenges; |
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| 12. | CALLS for the need that the health sector should play an adequate role in the implementation of the Europe 2020 Strategy. Investments in health should be acknowledged as a contributor to economic growth. While health is a value in itself, it is also a pre-condition to achieve economic growth; |
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| 13. | EMPHASISES that in order to create modern, responsive, efficient, effective and financially sustainable health systems that provide equitable access to health services for all, European Structural Fund resources can be used, without prejudice to the negotiations on the future financial framework, in complementing the financing of health sector development of eligible regions of Member States, including inter alia capital investments, particularly because:
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achieving social cohesion, reducing major disparities and closing serious health gaps existing between and within Member States are of utmost importance, —
developing ‘new generation’ approaches to healthcare will require appropriate funding to foster transformation of health systems and rebalance investment towards new and sustainable care models and facilities; | — | achieving social cohesion, reducing major disparities and closing serious health gaps existing between and within Member States are of utmost importance, | — | developing ‘new generation’ approaches to healthcare will require appropriate funding to foster transformation of health systems and rebalance investment towards new and sustainable care models and facilities; |
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| — | achieving social cohesion, reducing major disparities and closing serious health gaps existing between and within Member States are of utmost importance, | | | | |
| — | developing ‘new generation’ approaches to healthcare will require appropriate funding to foster transformation of health systems and rebalance investment towards new and sustainable care models and facilities; | | | | |

| 14. | EMPHASISES the fundamental importance of the effectiveness of investments in the health systems of the future, which should be measured and monitored by the respective Member States; |
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| 15. | RECOGNISES the importance of evidence-based policy-making and decision-making processes supported by adequate health information systems; |
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| 16. | RECOGNISES that, in the European Union, there is a need for sharing evidence on health systems' modernisation and of new healthcare approaches; |
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| 17. | RECOGNISES that health promotion and disease prevention are key factors for the long-term sustainability of health systems; |
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| 18. | EMPHASISES that the availability of sufficient numbers of adequately trained health professionals in each Member State, is a key pre-condition for the operation of modern, dynamic health systems and each Member State should fulfil its needs and adhere to the WHO Global Code of Practice on international recruitment; |
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| 19. | EMPHASISES the need to join forces and enter into more coordinated EU-level cooperation in order to support Member States, when appropriate, in their efforts to ensure that their health systems meet future challenges, building on results achieved through national and EU initiatives, as well as activities carried out by intergovernmental organisations, such as the Organisation for Economic Cooperation and Development (OECD) and the WHO; |
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| 20. | UNDERLINES the leading role of Ministers of Health in developing and pursuing effective, health policy-driven approaches in order to adequately address macroeconomic, health and societal challenges including those related to ageing population, and ensure future long-term health sector strategies, with particular emphasis on health sector investment and human resource strategies; |
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| 21. | INVITES Member States to:
—
reinforce their commitment to play an active role in developing effective, health policy-driven approaches to adequately address macroeconomic challenges and health and societal challenges, —
ensure that health is adequately addressed in the National Reform Programmes submitted by Member States within the framework of the Europe 2020 Strategy, —
reposition the perception of health policy, making it more visible when macroeconomic issues are at stake and shifting it from being regarded as just an expenditure post to being an acknowledged contributor of economic growth, —
consider innovative approaches and models of healthcare responding to challenges, and develop future long-term health sector strategies, with particular emphasis on effective investment in the health sector and in human resources with the aim of moving away from hospital-centred systems towards integrated care systems, enhancing equitable access to high quality care and reducing inequalities, —
further strengthen health promotion and disease prevention in an integrated manner in the spirit of the Health in All Policies approach, —
foster health technology assessments and ensure smarter use of e-health solutions to ensure value for money and benefits for health and health systems, —
make smarter use of EU financial programmes, including inter alia Structural Funds, which can contribute to health system innovation and to reducing health inequalities, and can trigger further economic growth; | — | reinforce their commitment to play an active role in developing effective, health policy-driven approaches to adequately address macroeconomic challenges and health and societal challenges, | — | ensure that health is adequately addressed in the National Reform Programmes submitted by Member States within the framework of the Europe 2020 Strategy, | — | reposition the perception of health policy, making it more visible when macroeconomic issues are at stake and shifting it from being regarded as just an expenditure post to being an acknowledged contributor of economic growth, | — | consider innovative approaches and models of healthcare responding to challenges, and develop future long-term health sector strategies, with particular emphasis on effective investment in the health sector and in human resources with the aim of moving away from hospital-centred systems towards integrated care systems, enhancing equitable access to high quality care and reducing inequalities, | — | further strengthen health promotion and disease prevention in an integrated manner in the spirit of the Health in All Policies approach, | — | foster health technology assessments and ensure smarter use of e-health solutions to ensure value for money and benefits for health and health systems, | — | make smarter use of EU financial programmes, including inter alia Structural Funds, which can contribute to health system innovation and to reducing health inequalities, and can trigger further economic growth; |
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| — | reinforce their commitment to play an active role in developing effective, health policy-driven approaches to adequately address macroeconomic challenges and health and societal challenges, | | | | | | | | | | | | | | |
| — | ensure that health is adequately addressed in the National Reform Programmes submitted by Member States within the framework of the Europe 2020 Strategy, | | | | | | | | | | | | | | |
| — | reposition the perception of health policy, making it more visible when macroeconomic issues are at stake and shifting it from being regarded as just an expenditure post to being an acknowledged contributor of economic growth, | | | | | | | | | | | | | | |
| — | consider innovative approaches and models of healthcare responding to challenges, and develop future long-term health sector strategies, with particular emphasis on effective investment in the health sector and in human resources with the aim of moving away from hospital-centred systems towards integrated care systems, enhancing equitable access to high quality care and reducing inequalities, | | | | | | | | | | | | | | |
| — | further strengthen health promotion and disease prevention in an integrated manner in the spirit of the Health in All Policies approach, | | | | | | | | | | | | | | |
| — | foster health technology assessments and ensure smarter use of e-health solutions to ensure value for money and benefits for health and health systems, | | | | | | | | | | | | | | |
| — | make smarter use of EU financial programmes, including inter alia Structural Funds, which can contribute to health system innovation and to reducing health inequalities, and can trigger further economic growth; | | | | | | | | | | | | | | |

| 22. | INVITES Member States and the Commission to:
—
initiate a reflection process under the auspices of the Working Party on Public Health at Senior Level aiming to identify effective ways of investing in health, so as to pursue modern, responsive and sustainable health systems, —
in order to launch the reflection process and accomplish its objectives:
—
request the Working Party on Public Health at Senior Level to steer the reflection process, set up its roadmap and develop its modalities, —
request the Working Party on Public Health at Senior Level to hold regular dialogue with the EPC and the SPC, —
facilitate access for Member States to informal and independent advice from experts in policy areas relevant to this reflection process, —
include in this reflection process the following objectives in particular:
—
enhancing the adequate representation of health in the framework of the Europe 2020 Strategy and in the process of the European Semester, —
sharing and analysing experiences, best practices, to build up success factors for the effective use of Structural Funds for health investments, —
sharing experiences, best practices and expertise in understanding and adequately responding to society's growing and changing health needs particularly due to ageing population, and designing health sector investments effectively and efficiently, —
cooperating on measuring and monitoring the effectiveness of health investments, —
taking into account programmes, data, knowledge, evidence and expertise existing within the EU, in intergovernmental organisations, particularly the WHO and the OECD, and in the Member States, thus avoiding duplication of efforts; | — | initiate a reflection process under the auspices of the Working Party on Public Health at Senior Level aiming to identify effective ways of investing in health, so as to pursue modern, responsive and sustainable health systems, | — | in order to launch the reflection process and accomplish its objectives:
—
request the Working Party on Public Health at Senior Level to steer the reflection process, set up its roadmap and develop its modalities, —
request the Working Party on Public Health at Senior Level to hold regular dialogue with the EPC and the SPC, —
facilitate access for Member States to informal and independent advice from experts in policy areas relevant to this reflection process, | — | request the Working Party on Public Health at Senior Level to steer the reflection process, set up its roadmap and develop its modalities, | — | request the Working Party on Public Health at Senior Level to hold regular dialogue with the EPC and the SPC, | — | facilitate access for Member States to informal and independent advice from experts in policy areas relevant to this reflection process, | — | include in this reflection process the following objectives in particular:
—
enhancing the adequate representation of health in the framework of the Europe 2020 Strategy and in the process of the European Semester, —
sharing and analysing experiences, best practices, to build up success factors for the effective use of Structural Funds for health investments, —
sharing experiences, best practices and expertise in understanding and adequately responding to society's growing and changing health needs particularly due to ageing population, and designing health sector investments effectively and efficiently, —
cooperating on measuring and monitoring the effectiveness of health investments, —
taking into account programmes, data, knowledge, evidence and expertise existing within the EU, in intergovernmental organisations, particularly the WHO and the OECD, and in the Member States, thus avoiding duplication of efforts; | — | enhancing the adequate representation of health in the framework of the Europe 2020 Strategy and in the process of the European Semester, | — | sharing and analysing experiences, best practices, to build up success factors for the effective use of Structural Funds for health investments, | — | sharing experiences, best practices and expertise in understanding and adequately responding to society's growing and changing health needs particularly due to ageing population, and designing health sector investments effectively and efficiently, | — | cooperating on measuring and monitoring the effectiveness of health investments, | — | taking into account programmes, data, knowledge, evidence and expertise existing within the EU, in intergovernmental organisations, particularly the WHO and the OECD, and in the Member States, thus avoiding duplication of efforts; |
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| — | initiate a reflection process under the auspices of the Working Party on Public Health at Senior Level aiming to identify effective ways of investing in health, so as to pursue modern, responsive and sustainable health systems, | | | | | | | | | | | | | | | | | | | | | | |
| — | in order to launch the reflection process and accomplish its objectives:
—
request the Working Party on Public Health at Senior Level to steer the reflection process, set up its roadmap and develop its modalities, —
request the Working Party on Public Health at Senior Level to hold regular dialogue with the EPC and the SPC, —
facilitate access for Member States to informal and independent advice from experts in policy areas relevant to this reflection process, | — | request the Working Party on Public Health at Senior Level to steer the reflection process, set up its roadmap and develop its modalities, | — | request the Working Party on Public Health at Senior Level to hold regular dialogue with the EPC and the SPC, | — | facilitate access for Member States to informal and independent advice from experts in policy areas relevant to this reflection process, | | | | | | | | | | | | | | | | |
| — | request the Working Party on Public Health at Senior Level to steer the reflection process, set up its roadmap and develop its modalities, | | | | | | | | | | | | | | | | | | | | | | |
| — | request the Working Party on Public Health at Senior Level to hold regular dialogue with the EPC and the SPC, | | | | | | | | | | | | | | | | | | | | | | |
| — | facilitate access for Member States to informal and independent advice from experts in policy areas relevant to this reflection process, | | | | | | | | | | | | | | | | | | | | | | |
| — | include in this reflection process the following objectives in particular:
—
enhancing the adequate representation of health in the framework of the Europe 2020 Strategy and in the process of the European Semester, —
sharing and analysing experiences, best practices, to build up success factors for the effective use of Structural Funds for health investments, —
sharing experiences, best practices and expertise in understanding and adequately responding to society's growing and changing health needs particularly due to ageing population, and designing health sector investments effectively and efficiently, —
cooperating on measuring and monitoring the effectiveness of health investments, —
taking into account programmes, data, knowledge, evidence and expertise existing within the EU, in intergovernmental organisations, particularly the WHO and the OECD, and in the Member States, thus avoiding duplication of efforts; | — | enhancing the adequate representation of health in the framework of the Europe 2020 Strategy and in the process of the European Semester, | — | sharing and analysing experiences, best practices, to build up success factors for the effective use of Structural Funds for health investments, | — | sharing experiences, best practices and expertise in understanding and adequately responding to society's growing and changing health needs particularly due to ageing population, and designing health sector investments effectively and efficiently, | — | cooperating on measuring and monitoring the effectiveness of health investments, | — | taking into account programmes, data, knowledge, evidence and expertise existing within the EU, in intergovernmental organisations, particularly the WHO and the OECD, and in the Member States, thus avoiding duplication of efforts; | | | | | | | | | | | | |
| — | enhancing the adequate representation of health in the framework of the Europe 2020 Strategy and in the process of the European Semester, | | | | | | | | | | | | | | | | | | | | | | |
| — | sharing and analysing experiences, best practices, to build up success factors for the effective use of Structural Funds for health investments, | | | | | | | | | | | | | | | | | | | | | | |
| — | sharing experiences, best practices and expertise in understanding and adequately responding to society's growing and changing health needs particularly due to ageing population, and designing health sector investments effectively and efficiently, | | | | | | | | | | | | | | | | | | | | | | |
| — | cooperating on measuring and monitoring the effectiveness of health investments, | | | | | | | | | | | | | | | | | | | | | | |
| — | taking into account programmes, data, knowledge, evidence and expertise existing within the EU, in intergovernmental organisations, particularly the WHO and the OECD, and in the Member States, thus avoiding duplication of efforts; | | | | | | | | | | | | | | | | | | | | | | |

| 23. | INVITES the Commission to:
—
support Member States in initiating and implementing the reflection process, —
support the reflection process through appropriate measures, including by facilitating the access to informal and independent multisectoral expert advice to be provided on request to Member States and/or the Working Party on Public Health at Senior Level, —
promote an adequate role of the health sector in the implementation of the Europe 2020 Strategy, and support regular follow-up discussions with Member States on the state of play, —
stress the major economic role of the health sector, aiming to shift health from being regarded as just an expenditure post to being an acknowledged contributor of economic growth, —
provide effective tools and methodologies for Member States for the assessment of the performance of health systems, —
promote new ways of supporting Member States in addressing their future health investment needs, —
present regular reports to the Council to contribute to the reflection process, the first report being submitted by the end of 2012. | — | support Member States in initiating and implementing the reflection process, | — | support the reflection process through appropriate measures, including by facilitating the access to informal and independent multisectoral expert advice to be provided on request to Member States and/or the Working Party on Public Health at Senior Level, | — | promote an adequate role of the health sector in the implementation of the Europe 2020 Strategy, and support regular follow-up discussions with Member States on the state of play, | — | stress the major economic role of the health sector, aiming to shift health from being regarded as just an expenditure post to being an acknowledged contributor of economic growth, | — | provide effective tools and methodologies for Member States for the assessment of the performance of health systems, | — | promote new ways of supporting Member States in addressing their future health investment needs, | — | present regular reports to the Council to contribute to the reflection process, the first report being submitted by the end of 2012. |
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| — | support Member States in initiating and implementing the reflection process, | | | | | | | | | | | | | | |
| — | support the reflection process through appropriate measures, including by facilitating the access to informal and independent multisectoral expert advice to be provided on request to Member States and/or the Working Party on Public Health at Senior Level, | | | | | | | | | | | | | | |
| — | promote an adequate role of the health sector in the implementation of the Europe 2020 Strategy, and support regular follow-up discussions with Member States on the state of play, | | | | | | | | | | | | | | |
| — | stress the major economic role of the health sector, aiming to shift health from being regarded as just an expenditure post to being an acknowledged contributor of economic growth, | | | | | | | | | | | | | | |
| — | provide effective tools and methodologies for Member States for the assessment of the performance of health systems, | | | | | | | | | | | | | | |
| — | promote new ways of supporting Member States in addressing their future health investment needs, | | | | | | | | | | | | | | |
| — | present regular reports to the Council to contribute to the reflection process, the first report being submitted by the end of 2012. | | | | | | | | | | | | | | |

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( 1 )  OJ C 146, 22.6.2006, p. 1.

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