7.M. Workshop: Rethinking health system resilience for Europe: Health System Functions in a time of Permacrisis
Authors:   Organised by: Centre for Health Policy and Management, Trinity College (Ireland), European Observatory on Health Systems and Policies,   Chair persons: Steve Thomas (Ireland), Ewout Van Ginneken (Germany)
Published: October 2023

Health system resilience has become a concept of growing interest among academics, policy and decision makers, practitioners and health service managers over the past decade, given the notable increase in catastrophic events, or shocks, that directly impact health systems. The focus on health system resilience intensified following the global economic crash in 2008 and more recently with the Covid-19 pandemic. Understanding health system resilience has never been more essential. Learning from past shocks is important for health system resilience, building back better rather than reverting to the status quo, thereby poising health systems for better preparedness in the future. In many European countries hardest hit by the financial crisis there were limited learnings and the health system remained in a state of “semi-crisis” when faced with the next shock, the Covid-19 pandemic. However, in contrast to the austerity years, this period was characterised by an influx of funding and resources to the health service, and in many countries this empowered agile decision-making and allowed for innovative service provision. Also in contrast to the financial shock, there was no recovery period following the pandemic, with the onset of the cost-of-living crisis following quickly. This raises the question of whether health systems are entering a state of permacrisis and, if so, what can be done to promote and support health system resilience. The objective of this session is to improved understanding and practice of health system resilience by exploring recent experiences of managing shocks across several health system functions and drawing on country experiences. This session explores and evaluates health system functions that must individually and collectively be addressed in order for health systems to become resilient and sustainable. To accomplish this, four topics will be addressed: 1) building health system resilience in and through service delivery in Europe; 2) the critical role of financing in the development of health system resilience in Europe; 3) how international health system austerity responses impacted health system and workforce resilience, and 4) rethinking health system resilience and reviewing the relationships between absorption, adaptation and transformation in shock and everyday health system resilience drawing on the Irish experience. Bringing together these presentations will allow a collective examination by the audience and presenters of the key challenges and lessons for European health systems alongside some reflection on the development of theory. Each presenter will be given a strict deadline of 10 minutes by the chair and then the audience will be invited to debate the problems identified and strategies proposed to review learnings and next steps for building better understanding and practice of health system resilience across Europe.

Key messages

• This session will improve understanding of the concept and application of health system resilience to European health systems to allow for better handling of shocks.

• Strategies for building health system resilience across financing, governance, service delivery and human resources derived from country studies will be identified, debated and evaluated.