Talk is good, action is better on improving European health care

There is plenty of talk at European level of improving health care, with the COVID pandemic adding its own impetus to the trend – but talk will not be enough to secure real advances for European patients. A policy framework with real actionable agendas, concrete detailed targets and timelines, and clear links among all stakeholders will be essential to integrate innovation and efficiency into Europe’s health-care provision.  

This was argued by speakers from across the health-care sector at the 9th Annual EAPM EU Presidency conference held as a video-conference in Brussels on Monday (8 March) attended by over 180 delegates.

Science and technology are every day putting new opportunities for care at the disposal of health policy, but health policy is moving more slowly in Europe – too slowly, it was suggested. As Denis Horgan, the executive director of the European Alliance for Personalised Medicine (EAPM), which organized the Presidency conference, put it: “There is an implementation gap in translating Europe’s grand plans into concrete actions. It is necessary to set up systems and investment and instruments that can deliver on the obvious potential.”

There was plenty of evidence of valuable and valiant ambitions at EU level. 

Ceri Thompson, Deputy Head of Unit DG CNECT H3 in the European Commission, responsible for eHealth, Well-being and Ageing, listed the ambitions in digital health, with the upcoming Data Governance Act, Digital Market Act, Implementing Act for the Open Data Directive, and the Data Act – each scheduled to bring new advantages to the health sector.

The European Health Data Space was scheduled to appear before the end of this year, and will be followed by a cascade of other initiatives, in cancer imaging, diagnostics and treatment, genomics, cybersecurity, and work on digital twins over the next five years.

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Ortwin Schulte, Health Attaché at the Permanent Representation of Germany to the EU, spelled out the recent progress on the EU plan for a more coordinated approach to health technology assessment – which might, he revealed, reach the stage of joint talks between Commission, Parliament and Council this month after three years of discussion among member states. He also observed how Covid had given an impulse to EU political coordination on health, which – despite some continuing national reservations about the precise division of competences – was now leading to a new level of integrated health policy.

Christine Chomienne, vice chairman of the Mission Board Cancer at the European Commission and Professor of Cellular Biology at the Université de Paris, described the joint work of the Cancer Mission as an unprecedented level of co-operation. 

Ciaran Nicholl, head of the Health in Society Unit, Joint Research Council outlined the evolution of the Knowledge Centre on Cancer, scheduled for launch in mid-2021, as an example of working across the Commission services and with stakeholders to build an aligned approach to tackling cancer.

And Daria Julkowska, co-ordinator of the European Joint Programme on Rare Diseases, reported on progress with new approaches to data coordination, working with stakeholders towards the creation of a virtual platform that can offer federated, standardised GDPR- compliant, sustainable and quality assessed data.

Stephen Hall, European Regional Director for Precision Oncology at Novartis, expressed industry's full support for the move towards developing personalised medicine with a constant move to greater selection of treatments in line with individual patients'responsiveness.

But – and it was a big but – there was also plenty of evidence of where the opportunities are not being fully taken advantage of.

Former European health commissioner Vytenis Andriukaitis pointed to a continuing lack of appreciation among national governments of the merits of working together on health – typified, he said, by the spectacle of member states cutting spending on the Europe4Health programme in the teeth of a pandemic. He spoke of a long history of member states failing to coordinate, paying only lip-service to the concept - as the still-unresolved three-year stand-off in agreeing on joint health technology assessment demonstrated.

Nicholl admitted it was a persistent challenge for many stakeholders to work together: "We know what the needs are, but the question is whether we can work together to meet them."

Julkowska recognised that co-ordination on rare disease "is difficult because of the intrinsic complexity of the issues and the wide range of stakeholders". It is, she said, important to remove barriers to innovation.

Hall pointed to the contrasting priorities of the industry and of society on the development and deployment of biomarkers, and cautioned against excessively rigid interpretation of the upcoming new EU legislation on diagnostics. "We will have to work with policy makers to adjust it to obtain more flexibility," he said.

Thompson  also recognised, on issues such as disparate national implementation of the General Data Protection Regulation, "different member states with their different health systems have their own approaches, and this is a task for them.

Chomienne said success of the Cancer Mission would depend largely on ensuring effective links with all stakeholders – "and that takes time", she said. "It is important to bring all member states on board – not just the 'usual suspects'".

And speaker after speaker identified bottlenecks and unresolved issues that still demanded a stronger sense of coordination, and more senior-level policy support.

Horgan summed it up in his conclusions to the meeting: "There is an implementation gap that must be filled", he said. "To translate the grand plans into concrete actions, support will be needed in terms of systems and investment and instruments, and a greater sense of engagement by all member states."

"Successful development and deployment of health-care innovation depends on a policy framework in which countries would find it easier to reach consistent decisions and to provide clearer funding arrangements, thus boosting access and continued development."

An editorial report will be available in the next few days. 

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