European health systems under siege

HOPE, the European Hospital and Health Care Federation asserts that many European health systems could soon be in crisis, in a report ‘The Crisis, Hospitals and Healthcare’

Pascal Gare of HOPE says, “In countries where there was already out-of-pocket or some sort of co-payment for services and drugs, It has now reached a level that we cannot go any further on cuts. The full effects will not be realized for another year or two. It is in the interest of health care professionals to make the population aware of what is happening.”

The report, which seeks to identify what impact the global economic crisis had on the health systems of European nations, states that most members states responded to the ensuing reduction in their revenues by cutting health care spending or reducing the rate of growth in health budgets. In some of Europe’s poorest nations, such as Romania, the response to slash the health budget by 25%. Other countries implemented short-term ceilings or indefinite budget freezes, or prohibited the use of monies to pay down debt within the system.

• The quick fixes that most European Union member states adopted in response to financial pressure placed on their health care systems during the global economic crisis have compromised the sustainability of their systems and the quality of the care they provide.
• Hospital closures were the order of the day in Romania during the recent economic recession. The number of employed health care professionals reduced by 25% in 2010.
• Rather than implementing measures to improve health care efficiency, most nations opted for the quick fix of slashing health care budgets, staff and services covered by national health plans, without a view to long-term sustainability or potential health consequences.
• Worsening quality and reduced access to care, particularly in poorer nations, are already being seen as a consequence of cuts in the number of health personnel.
• All the while, demand for health services continues to rise.
• Cuts were imposed in all nations.
• Cyprus, Portugal and the United Kingdom were among those that introduced hiring and salary freezes, while Luxembourg passed legislation that allows the government to cap the number of health professionals over the next five years.
• Most states also imposed strictures on replacing retiring health professionals, allowing as few as one new recruit for every 10 retired professionals. Finland strongly encouraged doctors to take a year’s leave without pay.
• Other countries, including Belgium and the Czech Republic, increased funding to train nurses to take over doctors’ duties but offered no additional monies to offset their increased workloads and responsibilities.
• *Governments also scaled back funding for hospital services. In Latvia, 67 hospitals have been shut down, while no additional monies have been provided to the nation’s 39 remaining hospitals to handle the influx of patients resulting from the closure of others.
• 40% of French hospitals faced deficits in 2010.
• 12 hospitals in Hungary were privatized, faced disruption and were then brought back under public governance.
• Hospital mortality rates are on the rise in many nations.
• The costs of care are being shifted onto the shoulders of patients, dramatically reducing access to publicly paid for care.
• Even countries such as Sweden, whose health care systems were exempted from budget cuts during the economic crisis, saw patients take blows in the form of increased out-of-pocket, direct and co-payments, or reductions in sickness benefits, drug coverage, nursing care and other forms of specialized care.
• In France, reimbursements for drugs were reduced from 35% to 25% in 2010.