EHFF team has been in intensive discussions about our response to the Coronavirus global pandemic (partly also related to the opportunity of our scheduled AGMs, of course held on-line this year (see related news item, which allowed an extended discussion around strategy for 2020)). As the banner on our front page indicates, we’re now geared up to start producing a series of what we hope are helpful commentaries as the pandemic progresses as well as looking forward to the longer term implications for our European health systems and our societies as a whole.
What follows is a slightly abbreviated version of a thought piece just published in our Newsletter No.6: COVID-19 edition. Although curated by Lars Munter of DCHE, it does represent the views of the EHFF Board as a whole.
Picking up the pieces…
The coronavirus pandemic is a disaster of global proportions. Could it also represent a constructive opportunity?
Hindsight is easier than foresight, they say, but even before Corona, we knew that current health systems were not sustainable. They seemed to work OK, but in reality, resources were scarce, preparedness low, and strategy was on paper only. We’d spent years agreeing that health threats, e.g. climate change, possibility of pandemics, major population movements, were likely to be overwhelming through this lack of integration, data sharing, and resilience, but seemed unable to take the necessary action. And here we are.
EHFF’s position has always been that only transformational change could help tackle this problem, but many people felt it was hard to see how innovative practices could operate (or indeed be funded) in parallel with the (then) status quo. It simply got put into the ‘too difficult’ box. What is happening now offers a real opportunity to tackle that conundrum although we have also to be conscious of what we can offer to support people in the here and now, whether health ‘troops’ at the front-line or frightened and constrained citizens.
Projections assume status quo – this mustn’t happen (cf. the markets)
We are hearing almost daily, projections from expert statisticians, epidemiologists and the like, which seemingly are used to promote one or another political agenda. The familiar joke about the existence of lies, damn lies, and statistics.
A fundamental flaw in many of these studies is that they seem to assume that future systems should eventually be allowed to return to operating more or less exactly as they have done before.
The financial markets are a glaring example of why this assumption makes no sense. After several disastrous crashes in the last twenty-five or so years, the need for stronger and more effective regulation was clearly identified. Level playing fields, risk reduction, farmer-before-hunters etc, etc. We know that unfortunately that this simply didn’t happen and that the markets, and the companies within them remain very vulnerable, to the detriment of all of us.
Transformational change and disaster: history’s lesson
Uncomfortable truth as it may be, world wars or other major disasters usually have as an after-effect, major social change, usually in the direction of progress. There is already discussion among those involved, that the resistance to change that led to a much slower uptake than was needed of digital health tools is being eroded by the current crisis and change is happening willy-nilly, and unlikely to be reversed. Excellent as this is, use of better tools is in no way a solution for the overall social changes required in attitudes, understanding and practices related to health and well-being for European society as a whole.
What we can and should do:
Even while we’re coping with the immediate disaster, plan for a series of actions to ensure that during the recovery phase (and we may be talking about the period of time granted us before the second wave of infections, if the pandemic unfolds like it did in 1918), we have activities which support the necessary changes and we link up with other players on the same trajectory to get a real momentum before the vested interests that maintained the status quo can manage to turn the clock back.
We know some of the things that need to happen but how to enable them?
Take the UK: under recent Governments the proportion of GDP spent on health per head was sixth lowest in the G7. If only 1% increase was allowed, but instead of using that extra resource to prop up the system now in place, it was used almost exclusively to fund innovative practices, not ‘shiny toys’ (a re-vitalised public health function, more community based health resources, incentives to industry to behave more responsibly towards the environment e.g.), the cost benefit could be demonstrated within a reasonable period of time, sufficient to persuade policy makers and other actors to pursue change further.