-Many governments in Europe, either of their own volition or at the behest of the international financial institutions, have adopted stringent austerity policies in response to the financial crisis. By contrast, the USA launched a financial stimulus. The results of these experiments are now clear: the American economy is growing and those European countries adopting austerity, including the UK, Ireland, Greece, Portugal and Spain, are stagnating and struggling to repay rising debts. An initial recovery in the UK was halted once austerity measures hit. However, austerity has been not only an economic failure, but also a health failure, with increasing numbers of suicides and, where cuts in health budgets are being imposed, increasing numbers of people being unable to access care. Yet their stories remain largely untold. Here, we argue that there is an alternative to austerity, but that ideology is triumphing over evidence. Our paper was written to contribute to discussions among health policy leaders in Europe that will take place at the 15th European Health Forum at Gastein in October 2012, as its theme 'Crisis and Opportunity -Health in an Age of Austerity'.
Despite notable scientific and medical advances, broader political, socioeconomic and behavioural factors continue to undercut the response to the COVID-19 pandemic1,2. Here we convened, as part of this Delphi study, a diverse, multidisciplinary panel of 386 academic, health, non-governmental organization, government and other experts in COVID-19 response from 112 countries and territories to recommend specific actions to end this persistent global threat to public health. The panel developed a set of 41 consensus statements and 57 recommendations to governments, health systems, industry and other key stakeholders across six domains: communication; health systems; vaccination; prevention; treatment and care; and inequities. In the wake of nearly three years of fragmented global and national responses, it is instructive to note that three of the highest-ranked recommendations call for the adoption of whole-of-society and whole-of-government approaches1, while maintaining proven prevention measures using a vaccines-plus approach2 that employs a range of public health and financial support measures to complement vaccination. Other recommendations with at least 99% combined agreement advise governments and other stakeholders to improve communication, rebuild public trust and engage communities3 in the management of pandemic responses. The findings of the study, which have been further endorsed by 184 organizations globally, include points of unanimous agreement, as well as six recommendations with >5% disagreement, that provide health and social policy actions to address inadequacies in the pandemic response and help to bring this public health threat to an end.
Formally, the European Union has relatively little role in health and health care. This paper offers a guide to those responsible for developing and implementing health policy within the member states of the European Union. It first describes the legislative framework of the Union, the formal position of health and health care in European Union law, and the concept of subsidiarity. It continues by examining a series of areas in which provisions related to the 'four freedoms' of movement of goods, services, persons and capital have implications for health and health care, such as free movement of professionals, of patients, of health care providers, and of pharmaceuticals. It concludes by considering when a member state can block free movement and how health can get on to the policy agenda. R6sum6 L'Union Europienenne n'a explicitement qu'un faible role dans domazne de la sante et des services de santg. Cet article se presente comme un guide pour ceux responsables du développement et de l'implimentation des polztzques sanztazres au sezn des ftats Membres de ['Unzon Européenne. Le context legzslati f de 1'Umon d'abord d6crit aznsz que la place occupge par la santi et les services de santi dans la Loz de l'Umon Europeene et le concept de subszdzarzté. Sont ensuzt examznés plusieurs domaznes dans lesquels les provzszons lzées aux 'quatre libertés' de circulation des bzens, des services, des zndzvzdus et du capital, ont des implications (directes ou indirectes) pour la santi et les services de sante, tels que la lzberté de mouvement des professionnels de santi, des patients, des pourvoyeurs de soins, et des produzts pharmaceutiques. L'article conclue en considerant quand un £tat Membre peut bloquer la hbre czrculation et comment la sante peut apparaitre sur
The free movement of European citizens to live and work within the European Union (EU) is one of the fundamental pillars of the European single market. Recent EU legislation on the recognition of professional qualifi cations (to take effect January 2016) updates the framework within which doctors and others can migrate freely between EU member states to practise their profession. UK organisations lobbied extensively to change aspects of the original proposals, in particular those that threatened to 'water down' public protection in the interest of free movement. The legislation fi nally adopted signifi cantly increases safeguards for patients and the public. The revised law covers the rules to be applied by regulators on (for example) assuring language competence, warning 'blacklists' of practitioners subject to sanctions, 'fast track' registration based on mutual recognition of professional qualifi cations, agreed minimum education and training requirements for mutual recognition, and encouragement of continuing professional development. Drafting of detailed secondary legislation is ongoing and poses opportunities and challenges for patient safety, quality of care and transparency.
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