The Present
Health systems in Europe are built on strong pillars such as universal health coverage and access to care and especially following the onset of the pandemic, there is an increasing recognition of the value of systems integration on an international level (despite the potential barrier of subsidiarity applied to health). Current features which can sustain the ecosystem and need to be developed further include ambitions to improve the quality
of working conditions and the education of healthcare professionals and identified needs for better public health education also. Further features are technology facilitating rapid knowledge transfer from research to innovation and knowledge sharing and the gradual move from healthcare delivery which is hospital-centric to one firmly based in the community. All of this within the context of having a focus on respecting and engaging citizens.
On the negative side, presently there are major health system constraints due to the prevailing lack among policy makers of a long-term vision, symptoms of which are healthcare services at the brink
of overall system failure caused by under-resourcing, gaps in and lack of service delivery. This in turn is associated with a lack of transparent communication and increased lack of public trust. This risks alienation and polarization which again fuels a lack of solidarity, a solidarity necessary to tackle the evident gaps reinforcing undue inequality, whether material, in health or in opportunity. Despite an emerging planetary health agenda, where climate change is a threat not the least given the understanding that a healthy planet is a pre-requisite for a healthy society, health and wellbeing strategies are not prioritised politically. The inter-connectedness of societal systems is not adequately acknowledged (e.g. industrial activity leading to the loss of biodiversity or increased pollution, an economic model predicated on wealth creation rather than the needs of society as a whole and so forth). The situation is not helped by an apparent relative reluctance to embrace the use of new knowledge and technology, which hampers wider innovation.
The World We Want
A society that benefits from the pay-offs associated with a more balanced, holistic, collaborative and resilient system built on the values of a well-integrated personal and community responsibility for care, health and wellbeing. It is a system grounded in the development of, first, health literate societies aiming at promoting and maintaining health and wellbeing and secondly, better balance between health and the economy supported by new economic models with values attuned to the needs of society as a whole. Finally, increased cultural awareness of the solidarity needed to improve health and wellbeing and to reduce inequality. The system is supported by digital technology and services embracing data, authenticity, transparency, and personal control. Progress may always be hampered to some extent by sceptics who are not aligning to this future view.
Calling For Transformation
We already see an awakening to the need for change and flexibility. There is an evolving shift in agenda setting with regards to wellbeing economies and the sustainable development goals. For instance, there is a recognised need for better health and digital literacy for all, to deal with mis-and disinformation. Despite the barriers, there is a recognition of vulnerable groups and that more care and concern is needed to tackle unequal opportunities as well as the need to increase stakeholder collaboration and community ownership. Moreover, the evolution of telehealth is calling for more transparent and empowering digital solutions. Some of these issues are currently only addressed to a limited extent. The transformation we would strive for can be accelerated by
- Changing political and economic priorities and incentives towards sustainable development, health and wellbeing
- Execution of an effectively integrated health and wellbeing system
- Increasing health literacy through a new culture of education
- Promoting people-centered digital strategies and solutions
- Enhancing community action and empowerment towards sustainable health and wellbeing.
- Mobilization of social movements and cultural values to drive change