The health systems of the European Union make up a central part of Europe’s social protection. They contribute to social cohesion and social justice as well as to sustainable development. Important values that should underpin all European healthcare have been agreed upon. The overarching values of universality, access to good quality care, equity, and solidarity have been widely accepted to guide the work of the different EU institutions. However, based on present cost development and structural changes in health systems, these values are being challenged.
There is considerable agreement on the values underlying almost all European health systems. They include a commitment to universal access to good quality health services, fairness, and social solidarity. This requires that individual financial contributions to health insurance systems should so far as possible be related to ability to pay and independent of sickness or utilisation. There is also increasing concern about the need to make such systems resilient to economic and other shocks, and sustainable in the medium to long term. For health services, these values are expressed in principles that include quality of care, safety, evidence based treatments, patient centredness, redress, privacy, and confidentiality.
While few would dissent from most of these principles, European health systems face major challenges in seeking to make them operational, both now and in the future. These challenges include demographic changes, most importantly the large increases in the projected size of the frail elderly population, often alongside multiple morbidities. There is also a concern about the increase in demand caused by lifestyle changes, most notably the increased prevalence of obesity and its associated chronic diseases. New technologies offer new opportunities for treatments and quality of care, but also frequently lead to increased demand for health services. More generally, there is evidence that successive generations are becoming more demanding in their expectations of their health systems, fuelled by the exchange of experiences shared across social media and the internet. At the same time, traditional sources of health system finance are constrained, limiting the extent to which increased demand can be met in traditional ways. In Gothenburg University Centre for person centred care, GPCC, we believe that future healthcare will require more direct input and responsibility from all citizens.
In order to address these challenges and provide a roadmap towards cost containment with sustained or improved health care, seven European key players have created a consortium, WE CARE, in order to submit a report to the EU-commission to describe where more research and knowledge is required. We (GPCC, Gothenburg, Sweden; Berlin University of Technology, TUB; Free University Amsterdam, VU; Imperial College, London; IBM research, Haifa; IMEC, Leuven; European Patients’ Forum, EPF, Brussels) will organise a conference in Gothenburg, Sweden April 14-15 2015 where the report will be discussed. The conference is open and free of charge and provides an opportunity for everybody to have an input on the report. More information is available at www.we-do-care.eu.
Karl Swedberg is a senior professor of medicine at the University of Gothenburg, Sweden. He is also professor of cardiology, National Heart and Lung Institute, Imperial College, London. He is a scientific adviser to the University of Gothenburg Centre for Person Centred Care (GPCC). He is a co-chair of the We care consortium.
Inger Ekmann is the centre director, GPCC, and coordinator of the We care consortium.
Competing interests: KS has read and understood the BMJ policy on declaration of interests and declares that he has no competing interests. IE has read and understood the BMJ policy on declaration of interests and declares the following interests: Director of the Gothenburg university, centre for person-centred care (GPCC), Board member of INDIKATOR, Board member of the Sahlgrenska academy, Editorial board in the European Journal of Cardiovascular Nursing, Board member of the scientific advisory board of the Swedish Society for Nursing.